Developing and testing a satisfaction survey for nursing home residents: the Ohio Experience

Input from consumers has become an important part of quality improvement in long-term care and for consumer decision-making. This paper documents the development of the Ohio Nursing Home Resident Satisfaction Survey (ONHRSS) through a partnership of state government, research, and industry experts. The instrument was tested and refined through two waves of data--a pretest phase and later with statewide data. Exploratory and confirmatory analyses with statewide data identified eight primary factors along with an underlying, secondary Global Satisfaction factor. Reliability of the domains ranged from .69 to .95. Recommendations for further refinement and testing of the instrument are discussed along with policy and practice implications.     

Validity of work-related assessments

Insufficient evidence of the validity of work-related assessments is frequently reported as a major concern in occupational rehabilitation. Despite this concern, and the continuing development of new and old assessments, no comprehensive evaluation of the evidence has been conducted. OBJECTIVES: The purpose of this study was to first determine the extent and quality of available evidence for the validity of work-related assessments, and then where sufficient evidence was available, determine the level of validity. STUDY DESIGN: This study examined available literature and sources in order to review the extent to which validity has been established for 28 work-related assessments. RESULTS: The levels of evidence and validity are presented for each assessment. Most work-related assessments have limited evidence of validity. Of those that had adequate evidence, validity ranged from poor to good. There was no instrument that demonstrated moderate to good validity in all areas. Very few work-related assessments were able to demonstrate adequate validity in more than one area, or with more than one study, even when contributory evidence was included. CONCLUSION: With this study clinicians will be able to examine their options with regard to the validity of the assessments they choose to use.     

A review of research on techniques for lifting low-lying objects: 1. Criteria for evaluation

Advice and training on techniques for lifting is frequently provided. The choice of which technique to use should be based on the evidence available on a number of criteria. Important criteria include: psychophysical, physiological, biomechanical, psychological, performance and clinical. However few professionals have the time to read all the original research required to understand the limitations of the available criteria. The purpose of this paper was to present an accessible synthesis of the criteria used to choose a specific technique. Each criterion is described and its validity discussed to provide the reader with a better understanding of the criteria, and thus the evidence available.     

Reading Desire: Commentary on Papers by Danielle Knafo,Victoria Pitts-Taylor,and Nikki Sullivan

All 3 papers on body modification share a particular approach to their topic as they are substantially located in discourse analysis and a deconstructive approach to their material, and all are concerned with binaries. All 3 papers also grapple with the matter of interiority. Having explored how these issues play themselves out in the particularity of the practices of tattooing and cosmetic surgery and in the work of Orlan, the author invites further dialogue between Foucauldian analyses and psychoanalytic ones with special reference to the notions of desire and unreason.     

Reliability of work-related assessments

Insufficient evidence of the reliability of work-related assessments is a major concern in this area of practice. Despite this concern there has been ongoing development of new assessments, while existing assessments have been revised, modified and updated and others are no longer used or available. OBJECTIVES: The purpose of this study was to determine the extent and quality of evidence for the reliability of work-related assessments. STUDY DESIGN: This study examined available literature and sources in order to review the extent which reliability has been established for 28 work-related assessments. RESULTS: The levels of evidence and reliability are presented for each assessment. This indicates that a number of commercially available work-related assessments have insufficient evidence of reliability. For the limited number of work-related assessments with an adequate level of evidence on which to judge their reliability, most demonstrate a moderate to good level. Few assessments, however, have demonstrated levels of reliability sufficient for clinical (and legal) purposes. CONCLUSION: With this study clinicians will be able to examine their options with regard to the reliability of the assessments they choose to use. Interpretation of changes in test results can be considered in the light of the evidence for the reliability of the instrument used.     

The effect of individually adjusted workstations on upper quadrant posture and muscle activity in school children

Evidence suggests there is increasing use of computers by children and poor workstation designs for children. This laboratory study investigated the effect of adjusting computer display height and desk height on upper quadrant posture and muscle activity. Thirty three children aged 4-17 years worked on a desktop computer at a standard school workstation and at a workstation adjusted to the individual, typically consisting of a lower display and desk height. The adjustments resulted in increased head tilt, neck flexion, gaze angle, cervical erector spinae activity and a trend for lower right upper trapezius activity. The recent evidence that suggests more head and neck flexion is not necessarily worse is discussed and normative values for children's head tilt and neck flexion presented. The role of forearm support in decreasing trapezius activity is also discussed.     

Using hidden Markov models with raw,triaxial wrist accelerometry data to determine sleep stages

Accelerometry is a low‐cost and noninvasive method that has been used to discriminate sleep from wake, however, its utility to detect sleep stages is unclear. We detail the development and comparison of methods which utilise raw, triaxial accelerometry data to classify varying stages of sleep, ranging from sleep/wake detection to discriminating rapid eye movement sleep, stage one sleep, stage two sleep, deep sleep and wake. First‐ and second‐order hidden Markov models (HMMs) with time‐homogeneous and time‐varying transition probability matrices, along with continuous acceleration observations in the form of a Gaussian‐observation HMM and K‐means classified acceleration in a discrete‐observation HMM were explored. In addition, generalised linear mixed models (GLMMs) with binary and multinomial responses and logit link functions were considered as was whether incorporating adjoining acceleration information into the models improved prediction. Model predictions were compared to the reference‐standard in sleep detection (polysomnography) and outcome accuracies were calculated. Consistently, HMMs yielded greater sleep stage detection than GLMMs but there was little difference between first‐ and second‐order HMMs. Varying degrees of difference were observed when comparing Gaussian‐observation HMMs to discrete‐observation HMMs, and time‐varying HMMs yielded greater discrimination than time‐homogeneous HMMs, as did models which considered adjoining acceleration information. These results suggest that wrist‐worn accelerometry data may be able to detect sleep stages but that further investigation is required to optimise classification accuracy.