scholarly journals Intra- and inter-observer concordance of the stabilizing chains test and its relationships with measures on a force platform

2020 ◽  
pp. 1-4
Author(s):  
Orlando Conde Vázquez ◽  
Carlos Mohíno Fernández
Keyword(s):  
Test Data ◽  
Therapeutic Approach ◽  
Daily Practice ◽  
Kappa Coefficient ◽  
Force Platform ◽  
Daily Work ◽  
Weight Percentage ◽  
Literal Translation ◽  
Cohen's Kappa ◽  
Student’S T

Background: There are numerous manual tests that are part of the daily work of clinicians, in order to assist in the diagnosis to a subsequent therapeutic approach. Objectives: The stabilizing chains* test was chosen to study its intra- and inter-observer reproducibility in 24 children with 11 years old, and the possible relation with certain baropodometric variables. Methods: The test data were collected by 2 operators and the baropodometric variables by a force platform. Cohen’s Kappa coefficient and Student’s t-tests were performed. Results: The results showed a good kappa coefficient (0.497 - 0.746) in the intra-observer and poor to moderate in the inter-observer (0.083 - 0.438). There are also relationships to the weight percentage in the frontal and sagittal planes (p ≤ 0.05). Conclusion: These results give validity to use the test in daily practice. * The English denomination of the test is a literal translation of the French expression ‘chaînes stabilisatrices’.

scholarly journals Bayesian network-based methodology for selecting a cost-effective sewer asset management model

2020 ◽  
Author(s):  
Julián Guzmán-Fierro ◽  
Sharel Charry ◽  
Ivan González ◽  
Felipe Peña-Heredia ◽  
Nathalie Hernández ◽  
...  
Keyword(s):  
Asset Management ◽  
Kappa Coefficient ◽  
Wilcoxon Test ◽  
Cohen’S Kappa ◽  
Validation Data ◽  
Statistical Measures ◽  
Proactive Management ◽  
Cohen's Kappa ◽  
Cohen’S Kappa Coefficient

Abstract This paper presents a methodology based on Bayesian Networks (BN) to prioritise and select the minimal number of variables that allows predicting the structural condition of sewer assets to support the strategies in proactive management. The integration of BN models, statistical measures of agreement (Cohen's Kappa coefficient) and a statistical test (Wilcoxon test) were useful for a robust and straightforward selection of a minimum number of variables (qualitative and quantitative) that ensure a suitable prediction level of the structural conditions of sewer pipes. According to the application of the methodology to a specific case study (Bogotás sewer network, Colombia), it found that with only two variables (age and diameter) the model could achieve the same capacity of prediction (Cohen's Kappa coefficient = 0.43) as a model considering several variables. Furthermore, the methodology allows finding the calibration and validation percentage subsets that best fit (80% for calibration and 20% for validation data in the case study) in the model to increase the capacity of prediction with low variations. Furthermore, it found that a model, considering only pipes in critical and excellent conditions, increases the capacity of successful predictions (Cohen's Kappa coefficient from 0.2 to 0.43) for the proposed case study.

From painful busyness to emotional immunization: Nurses’ experiences of ethical challenges

2016 ◽  
Vol 24 (5) ◽  
pp. 556-568 ◽  
Author(s):  
Anne Storaker ◽  
Dagfinn Nåden ◽  
Berit Sæteren
Keyword(s):  
Data Storage ◽  
Ethical Issues ◽  
Daily Practice ◽  
University Hospital ◽  
Ethical Challenges ◽  
Ethical Guidelines ◽  
Science Data ◽  
Daily Work ◽  
Moral Blindness ◽  
Qualitative Interview Study

Background: The professional values presented in ethical guidelines of the Norwegian Nurses Organisation and International Council of Nurses describe nurses’ professional ethics and the obligations that pertain to good nursing practice. The foundation of all nursing shall be respect for life and the inherent dignity of the individual. Research proposes that nurses lack insight in ethical competence and that ethical issues are rarely discussed on the wards. Furthermore, research has for some time confirmed that nurses experience moral distress in their daily work and that this has become a major problem for the nursing profession. Objectives: The purpose of this article is to obtain a deeper understanding of the ethical challenges that nurses face in daily practice. The chosen research questions are “What ethical challenges do nurses experience in their daily practice?” Research design: We conducted a qualitative interview study using a hermeneutical approach to analyzing data describing nurses’ experiences. Ethical considerations: The Norwegian Social Science Data services approved the study. Furthermore, the head of the hospital gave permission to conduct the investigation. The requirement of anonymity and proper data storage in accordance with the World Medical Association Declaration of Helsinki was met. Method and results: The context for the study comprised three different clinical wards at a university hospital in Norway. Nine qualified nurses were interviewed. The results were obtained through a systematic development beginning with the discovery of busyness as a painful phenomenon that can lead to conflicts in terms of ethical values. Furthermore, the consequences compromising professional principles in nursing care emerged and ended in moral blindness and emotional immunization of the healthcare providers. Emotional immunization occurred as a new dimension involving moral blindness and immunity in relation to being emotionally touched.

scholarly journals Automatic Sleep Stage Classification Based on Two-channel EOG and One-channel EMG

2021 ◽  
Author(s):  
Yanjun LI ◽  
Xianglin Yang ◽  
Zhi Xu ◽  
Yu Zhang ◽  
Zhongping Cao
Keyword(s):  
Sleep Stage ◽  
Kappa Coefficient ◽  
Sleep Monitoring ◽  
Cohen’S Kappa ◽  
Cohen's Kappa ◽  
Stage Classification ◽  
Sleep Stage Classification ◽  
Feature Normalization ◽  
Leave One Out ◽  
Cohen’S Kappa Coefficient

Abstract The sleep monitoring with PSG severely degrades the sleep quality. In order to simplify the hygienic processing and reduce the load of sleep monitoring, an approach to automatic sleep stage classification without electroencephalogram (EEG) was explored. Totally 108 features from two-channel electrooculogram (EOG) and 6 features from one-channel electromyogram (EMG) were extracted. After feature normalization, the random forest (RF) was used to classify five stages, including wakefulness, REM sleep, N1 sleep, N2 sleep and N3 sleep. Using 114 normalized features from the combination of EOG (108 features) and EMG (6 features), the Cohen’s kappa coefficient was 0.749 and the accuracy was 80.8% by leave-one -out cross-validation (LOOCV) for 124 records from ISRUC-Sleep. As a reference for AASM standard, the Cohen’s kappa coefficient was 0.801 and the accuracy was 84.7% for the same dataset based on 438 normalized features from the combination of EEG (324 features), EOG (108 features) and EMG (6 features). In conclusion, the approach by EOG+EMG with the normalization can reduce the load of sleep monitoring, and achieves comparable performances with the "gold standard" EEG+EOG+EMG on sleep classification.

Assisting individuals ageing with learning disability: support worker perspectives

2015 ◽  
Vol 20 (4) ◽  
pp. 213-222 ◽  
Author(s):  
Stuart Wark ◽  
Rafat Hussain ◽  
Helen Edwards
Keyword(s):  
Learning Disability ◽  
Health Care Providers ◽  
Rural Areas ◽  
Daily Practice ◽  
Care Providers ◽  
Support Worker ◽  
Content Type ◽  
Daily Work ◽  
South Wales ◽  
Or Practice

Purpose – While ageing with an intellectual (learning) disability has been subject to increased research in recent years, there remains little knowledge regarding the daily practice issues that disability workers struggle most to support in this cohort. The purpose of this paper is to gain feedback directly from staff regarding the problems they experience in daily work, and to evaluate whether any changes to legislation or practice could potentially alleviate identified areas of concern. Design/methodology/approach – A Delphi project was conducted over three rounds with participants from rural areas of New South Wales (NSW). The panel was composed of support workers who assist people ageing with a learning disability. Participants were asked their perceptions of the main practice issues facing them while they provide support. Findings – The panel identified 29 issues that were considered problematic in the provision of support to people ageing with a learning disability. A thematic analysis indicated three main themes of access to services; time constraints; and funding. Research limitations/implications – The participants in this study were all disability workers employed by non-government organisations in rural NSW, and as such, many of the issues identified may be specific to this population cohort and geographic setting. Any generalisation of these results to other locations or populations must be considered within these limitations. Originality/value – Identification of the issues facing disability staff may facilitate government, health care providers and disability organisations to proactively plan to address current and future problem areas. The consequent effect of improving practices can assist individuals to receive better support and lead to a corresponding improvement in their quality of life. The current implementation of the National Disability Insurance Scheme in Australia is an ideal opportunity for cross-sectoral collaboration to change practice to facilitate better support for a highly vulnerable group of the community.

scholarly journals Patient-Specific Explanations for Predictions of Clinical Outcomes

ACI Open ◽  
2019 ◽  
Vol 03 (02) ◽  
pp. e88-e97
Author(s):  
Mohammadamin Tajgardoon ◽  
Malarkodi J. Samayamuthu ◽  
Luca Calzoni ◽  
Shyam Visweswaran
Keyword(s):  
Machine Learning ◽  
Clinical Outcomes ◽  
Characteristic Curve ◽  
Community Acquired Pneumonia ◽  
Kappa Coefficient ◽  
Patient Specific ◽  
P Value ◽  
Cohen’S Kappa ◽  
Cohen's Kappa ◽  
Cohen’S Kappa Coefficient

Abstract Background Machine learning models that are used for predicting clinical outcomes can be made more useful by augmenting predictions with simple and reliable patient-specific explanations for each prediction. Objectives This article evaluates the quality of explanations of predictions using physician reviewers. The predictions are obtained from a machine learning model that is developed to predict dire outcomes (severe complications including death) in patients with community acquired pneumonia (CAP). Methods Using a dataset of patients diagnosed with CAP, we developed a predictive model to predict dire outcomes. On a set of 40 patients, who were predicted to be either at very high risk or at very low risk of developing a dire outcome, we applied an explanation method to generate patient-specific explanations. Three physician reviewers independently evaluated each explanatory feature in the context of the patient's data and were instructed to disagree with a feature if they did not agree with the magnitude of support, the direction of support (supportive versus contradictory), or both. Results The model used for generating predictions achieved a F1 score of 0.43 and area under the receiver operating characteristic curve (AUROC) of 0.84 (95% confidence interval [CI]: 0.81–0.87). Interreviewer agreement between two reviewers was strong (Cohen's kappa coefficient = 0.87) and fair to moderate between the third reviewer and others (Cohen's kappa coefficient = 0.49 and 0.33). Agreement rates between reviewers and generated explanations—defined as the proportion of explanatory features with which majority of reviewers agreed—were 0.78 for actual explanations and 0.52 for fabricated explanations, and the difference between the two agreement rates was statistically significant (Chi-square = 19.76, p-value < 0.01). Conclusion There was good agreement among physician reviewers on patient-specific explanations that were generated to augment predictions of clinical outcomes. Such explanations can be useful in interpreting predictions of clinical outcomes.

Moral distress and professors of nursing: A cluster analysis

2020 ◽  
Vol 27 (4) ◽  
pp. 1157-1167
Author(s):  
Aline Marcelino Ramos Toescher ◽  
Edison Luiz Devos Barlem ◽  
Valéria Lerch Lunardi ◽  
Aline Neutzling Brum ◽  
Jamila Geri Tomaschewski Barlem ◽  
...  
Keyword(s):  
Higher Education ◽  
Cluster Analysis ◽  
Graduate Program ◽  
Moral Distress ◽  
Education Institution ◽  
Daily Practice ◽  
Moderate Intensity ◽  
Cross Sectional ◽  
Daily Work ◽  
Distress Scale

Background Professors of nursing sometimes experience specific situations in their daily practice that conflict with their values and ethical principles and may culminate in moral distress. Moral distress occurs when one is prevented from acting according to his or her knowledge or values, or what one considers to be ethically sound. Objectives To identify the profile of professors of nursing through grouping sociodemographic characteristics and intensity of moral distress. Method Cross-sectional and exploratory study addressing 373 nurses teaching in Brazilian federal public higher education institutions. Data were collected from June to December 2018 through email, using the Google Docs tool. A moral distress scale directed to nurse educators was used. Data were analyzed using descriptive statistics, variance analysis, and cluster analysis. Ethical considerations The Institutional Review Board at the Federal University of Rio Grande approved this study. Findings Initially, four clusters emerged for each variable predicting the profile of Brazilian professors of nursing: sex; whether the individual worked in a graduate program; age; experience in years in their respective higher education institution; and intensity of moral distress. The profile of Brazilian professors of nursing was represented by the largest cluster, 36.5% (n = 136), composed of women working in graduate programs, aged 37 years old on average, having worked in their respective institutions for approximately 5 years, and presenting a moderate intensity of moral distress. Conclusion Assigning individuals into groups facilitates seeing similarities among the predictors that compose the profile of Brazilian professors of nursing, thus recognizing those workers experiencing moral distress in their daily work routine. In addition, this study’s results are expected to encourage reflection on the planning of efficacious interventions directed to the context of education and health.

Do We Need Basic Research in Cardiac Surgery?

2016 ◽  
Vol 66 (01) ◽  
pp. 002-006 ◽  
Author(s):  
Christian Schlensak ◽  
David Schibilsky ◽  
Gloria Faerber ◽  
Torsten Doenst
Keyword(s):  
Cardiac Surgery ◽  
Clinical Practice ◽  
Basic Science ◽  
Basic Research ◽  
Daily Practice ◽  
Western Blots ◽  
Daily Work ◽  
Chain Reactions ◽  
Polymerase Chain Reactions ◽  
Cardiac Surgeons

Thinking about the daily practice of cardiac surgery, genetically altered mouse models, polymerase chain reactions, western blots, and other laboratory tools are the last that comes to mind. It is, therefore, not surprising that the pursuit of such basic science activities by practicing surgeons and those in training is often limited. However, there is an innate connection between these two seemingly different disciplines. To address and visualize this connection, we propose the following three hypotheses. First, cardiac surgery would not be at its present level of expertise without fundamental contributions of basic science. Second, without practicing cardiac surgeons performing basic research and translating their results to clinical practice next to their daily work, our ability to care for cardiac surgery patients would be poorer. Third, basic science training for those aiming to become practicing cardiac surgeons improves their ability to properly care for their patients. Finally, we will discuss some potentially even unexpected implications for our currently changing daily clinical practice.

P3362Added value of radiolabeled leukocyte scintigraphy to cardiac device-related infective endocarditis diagnostic criteria

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Holcman ◽  
B Malecka ◽  
A Zabek ◽  
W Szot ◽  
P Rubis ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Diagnostic Criteria ◽  
Predictive Value ◽  
Kappa Coefficient ◽  
Cardiac Device ◽  
Cohen's Kappa ◽  
Hmpao Spect ◽  
Leukocyte Scintigraphy ◽  
99Mtc Hmpao ◽  
Higher Sensitivity

Abstract Background Radiolabeled leukocyte scintigraphy – hybrid technique of single photon emission tomography and computed tomography with application of technetium99m-hexamethylpropyleneamine oxime-labeled autologous leukocytes (99mTc-HMPAO-SPECT/CT) is an emerging technique in patients with suspected cardiac device-related infective endocarditis (CDRIE). Purpose The aim of this prospective study was to assess 99mTc-HMPAO-SPECT/CT added value to modified Duke criteria (mDuke) in CDRIE diagnostic process. Methods During the period 2015–2018, we enrolled 103 consecutive patients with suspected CDRIE [70 males (68%), mean age: 61±18 years, mean left ventricle ejection fraction value: 44±17%)]. All patients underwent clinical, microbiologic, echocardiographic evaluation according to ESC guidelines and additionally 99mTc-HMPAO-SPECT/CT (370–740 MBq). Scans were classified as positive in the presence of abnormal tracer uptake involving cardiac and intravascular sections of device electrodes. In the analysis, we added positive 99mTc-HMPAO-SPECT/CT result as an additional major criterion to mDuke classification. Additionally, we compared the diagnostic value of the mDuke classification including 99mTc-HMPAO-SPECT/CT (mDuke-SPET/CT) with the original mDuke classification. The sensitivity and specificity of those two scales were compared with McNemar's test. Diagnostic accuracy was calculated based on final clinical CDRIE diagnosis, including microbiology, echocardiography and 6 month-long follow-up with subsequent outpatient visit. Results Overall 58% patients had pacemakers, 25% had implantable cardioverter defibrillators, 16% had resynchronization therapy and 1% had an epicardial lead. Mean time from device implantation was 3.4±3.8 years. Final CDRIE diagnosis was established in 31 (30%) patients. The most common pathogens causing CDRIE were Enterococci (39%) and Staphylococci (35%). According to the original mDuke classification 16.5% patients had definite CDRIE, 49.5% had possible and in 34% CDRIE was excluded. Overall, 34% of 99mTc-HMPAO-SPECT/CT scans were positive for CDRIE. After reclassification, according to mDuke-SPET/CT the proportion of patients with definite CDRIE increased to 34%, whereas in 37% patients CDRIE was possible and in 29% cases CDRIE was excluded. Overall, mDuke was characterized with 83% accuracy, 0.52 Cohen's kappa coefficient, 48% sensitivity, 97% specificity, 81% negative predictive value (NPV), 88% positive predictive value (PPV). Whereas mDuke-SPET/CT had 88% accuracy, 0.73 Cohen's kappa coefficient, 87% sensitivity, 89% specificity, 94% NPV, 77% PPV. Compared to mDuke, mDuke-SPET/CT had significantly higher sensitivity (p<0.001). Conclusions In patients with suspected CDRIE inclusion of positive radiolabeled leukocyte scintigraphy into modified Duke diagnostic criteria yields significantly higher sensitivity, as well as modest reduction of possible CDRIE diagnoses. Acknowledgement/Funding Grant from the Jagiellonian University Medical College (K/DSC/004383)

scholarly journals Using the 3D Ear Scanner: Seven Practical Tips to Remember if you are an Audiologist and Manage Patients with Otoscan

2020 ◽  
Vol I (1) ◽  
pp. 01-03
Author(s):  
Barbero Rodriguez A
Keyword(s):  
Daily Practice ◽  
3D Scanning ◽  
Digital Design ◽  
New Technique ◽  
Daily Work ◽  
3D Scanners ◽  
A New Technique ◽  
Short Time ◽  
Light Beams ◽  
Scanning Systems

Otoscanner 3D is a new technique used to reproduce the shape and measurements of patients’ ears in Audiology and Anaplastology, using laser light beams and 3D modeling. This new technique is increasingly used by audiologists because it has high precision and the great advantage of making a digital design of the molds personalized with the patient’s anatomy. In a very short time, it has become equipment for daily use in Audiology Clinics and Anaplastology. Our audiologists periodically review the protocols for using the 3D scanners and provide useful advice and corrections for their colleagues in their daily work with the 3D scanning systems. To know the complete evolution of our work, see the two articles previously published in industry magazines and in professional forums and which are referenced in the article.1-3 Manufacturers edit a manual with the use of the Otoscanner that the audiologist should know, but normally the advice about the difficulties we have during daily practice with 3D scanning and when working with difficult patients during the measurement is not edited. To serve as a guide, we publish here some of those aspects that include correcting the patient’s position to perform the measurement; advantages of using in combination with the Video-Otoscope; advice if you also take measures for Anaplastology; precautions to consider such as restrictions on use below adulthood; improvements in your hardware; avoid saturation of the Otocloud and Otoscan-COVID.

Sign in / Sign up

Export Citation Format

Share Document