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Anderson, Gera. "Investigation of the multidimensional well-being assessment (MWA) in a sample of African Americans." Thesis, Pepperdine University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10254742.
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ABSTRACT Existing models and measures of well-being tend to be based on an individualistic, western worldview. In addition, when cross-cultural comparisons are made, diverse cultural groups within the same national border are typically not examined. The Multidimensional Well-Being Assessment (MWA) was developed because of the absence of a culturally relevant measure to assess the well-being of those whose worldview is more consistent with collectivism. Although much attention has been given to detrimental forces in the lives of African Americans, less consideration has been given to assessing well-being in this population. In this study, a nonrandom sample was used to examine the validity of the MWA. In addition, several demographic variables were considered to explore the relationship of the dimensions of well-being contained on the MWA. A total of the 169 persons who identified as African-American or as a Black person with African ancestry participated in the study. The MWA showed strong reliability on nearly all dimensional subscales, as well as a pattern of expected significant positive and negative correlations with multiple validation measures. Significant correlations between demographic variables (i.e., age, education, income, and gender) and several dimensions on the MWA were also found. This study has implications for future research and the MWA shows promising results with regard to its psychometric properties. It is a potentially useful instrument to utilize in research that seeks to deepen understanding of life satisfaction and wellness in diverse populations, with particular attention to unique findings within the African American population.
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Reinhardt, Julia. "Multidimensional assessment of heterogeneity of human CD4+CD25+ T cells in health and Type 1 Diabetes." Doctoral thesis, Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2018. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-234017.
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Background Regulatory T cells (Treg) are a subpopulation of CD4+ T cells that play an important role in the peripheral tolerance mechanisms of the immune system. Their suppressive function on autoreactive T cells can prevent autoimmunity. In type 1 diabetes (T1D), Treg have been inconsistently reported to be impaired in their capability to suppress autoreactive T cells (Tan, et al., 2014; Zhang, et al., 2012). Treg can be thymus derived (tTreg) or generated from naïve CD4+ CD25- T cells in the periphery (pTreg), which exhibit similar suppressive qualities as tTreg. They have also been reported to be actively induced (iTreg) under tolerogenic conditions (Kleijwegt, et al., 2010; Yuan and Malek, 2012). Although several Treg subpopulations have been described, the archetypical Treg express the major markers CD4, CD25 and FOXP3, while CD127 is heavily downregulated. However, activated conventional T cells (Tconv) show a similar phenotype, at least transiently (Miyara, et al., 2009). Since Treg and Tconv have opposing functions and therapeutic indications, it is important to obtain markers that confidently identify bona fide Treg. Scientific aim The aim of my thesis is to define the heterogeneity of human T cells with a specific emphasis to identify bona fide Treg. I examined heterogeneity of this population in healthy controls and T1D patients, as my model disease, and examined how T cells that are exposed to antigen can be defined as Treg or Tconv. Material and Methods For marker phenotyping I used samples from new onset T1D patients (age 7-11 years), autoantibody positive (Aab+) patients and age-matched healthy controls, which were tested by flow cytometry with an array of Treg-associated markers. Separately, freshly isolated CD4+CD25+CD127lo Treg and CD+CD25- Tconv were used for transcriptomic analysis, which was done by RNAseq on isolated whole RNA. For functional analysis of antigen specific gene expression patterns I developed a multi-dye proliferation assay. Treg (CD4+CD25+CD127lo) and Tconv (CD4+CD25-CD127+/lo) were sorted from isolated peripheral blood mononuclear cells (PBMC). I recombined the sorted and proliferation dye stained subsets with CD4- cells to simulate whole PBMC assays and stimulated them with tetanus-, influenza- or auto-antigens (GAD65, proinsulin). Cells were incubated for 5 days and responding proliferating cells as well as non-responding cells were single cell sorted and analyzed by multiplex qPCR. In investigating therapeutic approaches to expand or generate Treg, I examined in vitro approaches for de novo induction of Tregs with tolerogenic dendritic cells (tDCs). The tDCs were differentiated from monocytes either in the presence of 1α,25-OH(2)Vitamin D3 and/or Dexamethasone and matured with lipopolysaccharide. In a multistep assay, naïve T cells were incubated with DCs for two rounds and functional suppression assays were performed. The resultant T cells were analyzed at the DNA, protein, and functional level. Results Substantial phenotypic heterogeneity of peripheral blood CD4+ T cells was observed and documented for three major populations: resting Tconv (CD25-CD127+/lo), activated Tconv (CD25+CD127+) and Treg (CD25+CD127lo) in healthy controls. Despite this, I observed no differences between the Treg subpopulations from new onset T1D patients, Aab+ patients and healthy controls. In addition, there were no differences in the Treg transcriptome of T1D patients and healthy controls by RNAseq. I was, however, able to identify a small set of differentially expressed genes was discovered in Tconv suggesting a role of neutrophils in the onset of T1D. Heterogeneity of antigen-responsive Tconv and Treg was identified by gene expression profiling. I was able to define Treg specific as well as activation specific profiles, and found different expression profiles if T cells are foreign antigen or autoantigen activated and if the responding cells are Treg or Tconv. Genes that define the specific profiles include FOXP3, CD127, several cytokines, transcription factors and activation markers. The manipulation of naïve CD4+CD25- T cells by tDCs led to an unstable CD25+CD127loFOXP3+ phenotype of the generated cells. However, none of the subsequently performed functional assays could confirm that the resultant cells were iTreg or exhausted activated Tconv. In particular, methylation status of the Treg-specific demethylated region (TSDR) was inconsistent with stable Treg, suggesting that so-called tolerogenic protocols may not lead to a long-lived Treg phenotype. Conclusion CD4+CD25+ T cells are heterogeneous. I defined marker combinations that will help distinguish Treg from ex vivo and in vitro activated Tconv cells. With these tools, I was able to show that healthy controls and patients with type 1 diabetes cannot be distinguished by Treg phenotype. Comprehensive single cell analysis of antigen activated T cells provided the most promising avenue for identifying antigen-specific Treg and opens new possibilities to analyze immune therapeutic approaches, particularly when Treg expansion is the therapeutic objective. The findings will be used for monitoring children participating in antigen-based prevention studies in children at risk for T1DHintergrund Regulatorische T Zellen (Treg) sind eine Subpopulation der CD4+ T Zellen, welche eine wichtige Rolle in den peripheren Toleranzmechanismen des Immunsystems spielen. Ihre suppressive Funktion auf autoreaktive T Zellen kann Autoimmunität verhindern. Verschiedene Studien berichteten widersprüchlich, dass Treg in Typ 1 Diabetes (T1D) in ihrer Fähigkeit beeinträchtigt sind autoreaktive T Zellen zu supprimieren (Tan et al., 2014; Zhang et al., 2012). Treg können im Thymus differenzieren (tTreg) oder aus peripheren naïven CD4+CD25- T Zellen generiert werden (pTreg), welche ähnliche suppressive Eigenschaften wie tTreg besitzen. Es wurde außerdem berichtet, dass Treg aktiv unter tolerisierenden Konditionen induziert werden können (iTreg) (Kleijwegt et al., 2010; Yuan and Malek, 2012). Obwohl verschiedene Treg Subpopulationen beschrieben wurden, exprimieren die archetypischen humanen Treg die Hauptmarker CD4, CD25 und FOXP3 exprimieren, während CD127 herunterreguliert ist. Jedoch zeigen auch aktivierte konventionelle T Zellen (Tconv) diesen Phänotyp (Miyara et al., 2009). Da Treg und Tconv gegensätzliche Funktionen und therapeutische Indikationen aufweisen, ist es wichtig Marker zu erhalten, die sicher bona fide Treg identifizieren. Fragestellung Das Ziel meiner Arbeit ist es, die Heterogenität von humanen T Zellen zu definieren mit einen spezifischen Fokus bona fide Treg zu identifizieren. Dafür untersuchte ich die Heterogenität dieser Zellpopulation in gesunden Individuen und T1D Patienten, als Krankheitsmodell, und wie T Zellen als Treg oder Tconv definiert werden können wenn sie einem Antigen ausgesetzt sind. Material und Methoden Für das Phänotypisieren habe ich Proben von Patienten mit beginnendem T1D (Alter 7-11 Jahre), Autoantikörper positiven Patienten (Aab+) und gesunden Individuen mittels Durchflusszytometrie auf eine Reihe von Treg-assoziierten Markern getestet. Des Weiteren wurden frisch isolierte CD4+CD25+CD127lo Treg und CD+CD25- Tconv für die Transkriptomanalyse (RNAseq) genutzt, welche mit der Gesamt-RNA durchgeführt wurden. Für die funktionelle Analyse von Antigen-spezifischen Genexpressionsmustern habe ich ein Multifarbenproliferationstest entwickelt. Treg (CD4+CD25+CD127lo) und Tconv (CD4+CD25-CD127+/lo) wurden aus isolierten mononukleären Zellen des peripheren Blutes (PBMC) sortiert. Ich habe die sortierten und gefärbten Zellen mit CD4- Zellen zusammengefügt, um einen Gesamt-PBMC-Test zu simulieren und habe die Zellen mit Tetanus-, Influenza- oder Auto-antigen (GAD65, Proinsulin) stimuliert. Die Zellen wurden für 5 Tage inkubiert und die Antigen-reagierenden und -proliferierenden Zellen sowie die nicht-reagierenden Zellen Einzelzell sortiert und mittels Multiplex qPCR analysiert. Um therapeutische Ansätze zum Expandieren oder Generieren von Treg zu untersuchen, habe ich in vitro Ansätze für die de novo Induktion von Treg durch die Nutzung von tolerisierenden dendritischen Zellen (tDCs) untersucht. Die tDCs wurden von Monozyten in Anwesenheit von 1α,25-OH(2)Vitamin D3 und/oder Dexamethason differenziert und mit Lipoploysaccharid maturiert. Naïve T Zellen wurden in einem Mehrschrittverfahren mit DCs inkubiert. Die resultierenden T Zellen wurden auf DNA, Protein und funktioneller Ebene analysiert. Ergebnisse Substantielle phänotypische Heterogenität von peripheren Blut CD4+ T Zellen wurde in drei Hauptpopulationen in gesunden Individuen beobachtet und dokumentiert: ruhende Tconv (CD25-CD127+/lo), aktivierte Tconv (CD25+CD127+) und Treg (CD25+CD127lo). Weiterführend ergab der phänotypische Vergleich von Patienten mit beginnender T1D, Aab+ Patienten und gesunden Individuen keine Unterschiede in den Treg Subpopulationen. Außerdem zeigten sich keine Unterschiede in den durch RNAseq gemessenen Treg Transkriptomen von T1D Patienten und gesunden Individuen. Jedoch wurde ein kleine Gruppe von differentiell exprimierten Genen in Tconv entdeckt, welche eine mögliche Rolle von Neutrophilen in T1D andeuten. Heterogenität von Antigen-spezifischen Tconv und Treg Antworten wurde durch Genexpressionsanalysen identifiziert. Ich konnte Treg- sowie Aktivierungs-spezifische Muster definieren und verschiedene Expressionsprofile finden, wenn T Zellen durch Fremd- oder Autoantigen aktiviert wurden und ob sie die reagierenden Zellen Treg oder Tconv sind. Folgende Gene waren hauptsächlich in die Profilbildung involviert: FOXP3, CD127, mehrere Zytokine, Transkriptionsfaktoren und Aktivierungsmarker. Die Manipulation von naïven CD4+CD25- T Zellen durch tDCs führte zu einem instabilen CD25+CD127loFOXP3+ Phänotyp der generierten Zellen. Jedoch konnte keiner der weiterführenden funktionellen Analysen unterscheiden, ob die resultierenden Zellen iTreg oder aktivierte erschöpfte T Zellen waren. Insbesondere war der Methylierungsstatus der Treg-spezifisch demethylierten Region (TSDR) nicht konsistent mit einen stabilen Treg Phänotyp, was darauf hinweist, dass sogenannte tolerisiernde Protokolle nicht zu einem langlebigen Treg Phänotyp führen. Schlussfolgerungen CD4+CD25+ T Zellen sind heterogen. Ich habe Markerkombinationen definiert die helfen werden Treg von ex vivo und in vitro aktivierten Tconv Zellen zu unterscheiden. Mit diesen Mitteln war ich in der Lage zu zeigen, dass gesunde Individuen und Patienten mit Typ 1 Diabetes nicht anhand ihres Treg Phänotyps unterschieden werden können. Umfassende Einzelzell-Analysen von Antigen aktivierten T Zellen lieferten den vielversprechendsten Ansatz für die Identifizierung von Antigen-spezifischen Treg und eröffnen neue Möglichkeiten um immuntherapeutische Ansätze zu analysieren, insbesondere wenn Treg Expansion das therapeutische Ziel ist. Diese Erkenntnisse werden zukünftig für das Monitoring von Kindern, mit einem hohen T1D Risiko, genutzt die an Antigen-basierten Präventionsstudien teilnehmen
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Sevo, Goran, and sevo1984@yubc net. "A multidimensional assessment of health and functional status in older Aboriginal Australians from Katherine and Lajamanu, Northern Territory." The Australian National University. Faculty of Arts, 2003. http://thesis.anu.edu.au./public/adt-ANU20051021.144853.
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Human health is multidimensional: apart from physical, mental, and social aspects, it also
incorporates subjective perceptions of health, and functional status (FS). Given that elderly
persons have very distinctive health and social needs, multidimensional assessment (MA)
of health proves particularly useful in this age group.¶
Aboriginal populations suffer poor health, and there are relatively few studies addressing
the health problems of older Aboriginal Australians, mainly because of their distinctive
demographic structure, and the low proportion of their elderly. Also, there is no prior
information available on MA of health in this Australian population group.¶
This thesis offers a MA of health in older Aboriginal persons from two, urban and
rural/isolated, locations in the NT, Katherine and Lajamanu (the NT survey).¶
This thesis specifically addresses the following questions:
- what is the physical health, FS, subjective perception of health, and social
functioning amongst the NT survey participants?
- what are the possible similarities and differences in various dimensions of health
between the two major survey locations, what age and gender patterns are
observed, and what are the reasons for these patterns, similarities and
differences?
- how do various dimensions of health relate to each other, and why?
- how do current findings relate to broader Aboriginal and non-Aboriginal
populations, and why?
- what can MA add to a better understanding of various aspects of morbidity and
health care use?
- what are its possible implications for health planning?¶
Findings from this work indicate poor physical health amongst participants in almost all
investigated aspects, comparable to information available from other Aboriginal
populations. These are accompanied by low levels of ability for physical functioning. Despite this, subjective perception of health is rather optimistic amongst participants, and
levels of social functioning high. Use of health services is mainly related to available health
infrastructure. Important health differences exist between Katherine and Lajamanu, and
they became particularly visible when all dimensions of health are considered together.¶
The Main conclusions from the current work are that 1) poor physical health is not
necessarily accompanied by similar level of deterioration in other dimensions of health:
even though participants from the isolated community of Lajamanu experience most
chronic diseases, their ability for physical functioning is better, self-perceived health (SPH)
more optimistic and levels of social functioning highest 2) institutionalised participants from
Katherine suffer by far the worst health of all sample segments in this study; at least some
of the poor health outcomes are potentially avoidable, and could be improved by more
appropriate residential choices for Aboriginal elderly 3) better health infrastructure does
not necessarily bring better health in all its dimensions, suggesting that other factors
(primarily socio-economic and cultural) should be addressed in conjunction with this in
solving complex health problems of Aboriginal Australians, and 4) it provides strong
support that MA can become a useful tool in comprehensive health assessment of older
Aboriginals.
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Sevo, Goran. "A multidimensional assessment of health and functional status in older Aboriginal Australians from Katherine and Lajamanu, Northern Territory /." View thesis entry in Australian Digital Theses Program, 2003. http://thesis.anu.edu.au/public/adt-ANU20051021.144853/index.html.
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Garay, Martinez Roberto. "Caracterización térmica dinámica de la transferencia de calor multidimensional en edificios. Dynamic performance assessment of multidimensional heat transfer in buildings." Doctoral thesis, Universitat de Lleida, 2017. http://hdl.handle.net/10803/460756.
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Aquesta tesi presenta un nou mètode per integrar l'anàlisi tèrmic en trobades arquitectòniques. Aquest mètode està enfocat al seu ús en processos de monitorització i anàlisi tèrmica d'edificis, per a la millor valoració tècnica d'alternatives de rehabilitació per a l'actualització dels nivells d'aïllament tèrmic als edificis. La tesi presenta avanços en la formulació tèrmica dinàmica de fenòmens multidimensionals i de mètodes d'anàlisi tèrmics experimentals. Es deriva una formulació generalitzada de la transmissió de calor dinàmic a partir de normativa tècnica existent en el camp de la transmissió de calor multidimensional. Es desenvolupa un procediment experimental per a l'avaluació de la transmissió de calor en trobades entre sistemes constructius. Aquest procediment fa servir models numèrics calibrats i permet el càlcul tèrmic dinàmic del camp tèrmic multidimensional en aquestes unions.
En aquesta tesi es consideren els mètodes d'anàlisi tèrmica experimental i càlculs diferencials per a l'anàlisi del comportament tèrmic de sistemes d'aïllament tèrmic exterior.Esta tesis investiga en nuevos métodos de análisis térmico dinámico multidimensional en las envolventes arquitectónicas. Se presenta métodos de análisis térmico con aproximaciones diversas. En concreto se presentan aproximaciones variadas con métodos estacionarios o transitorios; numéricos o experimentales; y uni- o multi-dimensionales. Se presenta una formulación generalizada de la transmisión de calor en la edificación que se desarrolla en casos de estudio numéricos y experimentales. Adicionalmente, esta formulación se integra en una metodología detallada para el análisis de la transmisión de calor mediante la calibración de modelos numéricos en base a datos experimentales. Esta metodología permite su posterior uso para el análisis diferencial de medidas de mejora de la envolvente térmica de los edificios. Se presenta un caso experimental de análisis térmico diferencial de un sistema de aislamiento térmico exterior.
This thesis proposes new assessment methods related to dynamic multi-dimensional heat transfer processes in buildings. Various assessment procedures are presented with different approaches, comprising steady-state or transient; numerical or experimental; one- or multi-dimensional cases. A generalized formulation is proposed for the definition of heat transfer in buildings, which is developed into numerical and experimental case studies. This same formulation is integrated into a detailed procedure for the calibration of numerical models to meet experimental data. The use of these methods for detailed thermal assessment procedures within building envelope retrofitting processes is discussed. A case study on the differential thermal analysis of an external thermal insulation system is presented where the additional thermal resistance of the system is calculated by experimental means.
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Corbett, Gina M. "The Corbett Pain Scale : a multidimensional pain scale for adult intensive care patients /." VCU Scholars Compass, 2006. http://hdl.handle.net/10156/1432.
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Joshi, Hrishikesh Bhaskar. "Assessment of health-related quality of life (HRQoL) in patients with ureteric stents by development and validation of a multidimensional questionnaire." Thesis, University of Bristol, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.399931.
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Prouskas, Constantinos Panagiotis. "Investigating aspects of health among older Greeks : the development and utilisation of an Hellenic version of a multidimensional and functional assessment questionnaire." Thesis, King's College London (University of London), 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.343959.
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Maldonado, Auccahuallpa Marie. "Validación del MD-HAQ (Multidimensional health assessment questionnaire) en un grupo de pacientes con artritis reumatoide del Hospital Nacional Dos de Mayo." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2005. https://hdl.handle.net/20.500.12672/1905.
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Siendo la artritis reumatoide una enfermedad inflamatoria sistémica, con gran impacto en la vida del paciente al producir deformación y destrucción articular; lo que ocasiona reducción de la capacidad funcional, limitación de sus tareas de la vida diaria, baja productividad y retiro ocupacional prematuro; es importante mantener un nivel de funcionalidad lo más adecuado posible desde el inicio de la enfermedad.
La discapacidad puede y debe ser medida a través de cuestionarios como el MD-HAQ (Multidimensional Health Assessment Questionnaire) que es un instrumento de evaluación integral de la salud del paciente con AR y es factible de usar en nuestro medio; pues reúne los atributos básicos para ser considerado un instrumento válido: por otro lado da información al clínico de una manera práctica.
Sabiendo que el compromiso funcional inicial es un factor de mal pronóstico en artritis reumatoide, se realiza este trabajo de investigación para evaluar el instrumento que evalúe la discapacidad producida por la enfermedad.Tesis de segunda especialidad
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Reinhardt, Julia [Verfasser], Ezio [Akademischer Betreuer] Bonifacio, Ezio [Gutachter] Bonifacio, and Michael [Gutachter] Bachmann. "Multidimensional assessment of heterogeneity of human CD4+CD25+ T cells in health and Type 1 Diabetes / Julia Reinhardt ; Gutachter: Ezio Bonifacio, Michael Bachmann ; Betreuer: Ezio Bonifacio." Dresden : Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2018. http://d-nb.info/1156169496/34.
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Carl, Johannes [Verfasser], Klaus [Akademischer Betreuer] Pfeifer, and Klaus [Gutachter] Pfeifer. "Physical Activity-Related Health Competence: From the Development of a Multidimensional Assessment Instrument to Population-Specific Model Results / Johannes Carl ; Gutachter: Klaus Pfeifer ; Betreuer: Klaus Pfeifer." Erlangen : Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 2021. http://d-nb.info/1236402820/34.
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Ferreira, Fernanda Pretti Chalet. "Adaptação transcultural da versão brasileira do interRAI-Home Care: avaliação multidimensional em assistência domiciliar." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/5/5169/tde-31082015-164115/.
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O acelerado processo de envelhecimento populacional é desafiador para a elaboração de estratégias de atenção à saúde nos diferentes níveis de complexidade. Em concordância com a integralidade do cuidado em assistência domiciliar, o interRAI-Home Care é um exemplo de avaliação multidimensional utilizado em vários países na gerência de casos, gestão em saúde pública e cooperação internacional na busca de melhores soluções para gestão de saúde. As características culturais e do funcionamento dos serviços de assistência domiciliar podem influenciar o processo de adaptação transcultural e uso desses instrumentos. Os objetivos desse estudo foram realizar a adaptação transcultural do interRAI-Home Care para a população brasileira e verificar a validade de conteúdo e face da versão em português brasileiro em um serviço de assistência domiciliar. Foram seguidas as etapas do processo de adaptação transcultural com tradução do instrumento, retro tradução para a língua de origem, avaliação de equivalência das versões do instrumento por uma comissão de especialistas e pré-teste com aplicação da versão pré-final em uma amostra selecionada por conveniência de 30 indivíduos (n=30), matriculados e atendidos no Núcleo de Assistência Domiciliar Interdisciplinar do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Os resultados mostram que os procedimentos para a adaptação transcultural foram realizados com ajustes necessários para garantir a equivalência de conteúdo das versões original, traduzida e retro traduzida após revisão e consenso da comissão de especialistas. Na fase pré-teste, verificou-se compreensão de todos os itens da versão pré-final por parte dos entrevistados e concordância entre os avaliadores >= 85% para cada item do instrumento, obtendo-se a versão final do interRAI-Home Care, traduzido e adaptado para o português, interRAI-Assistência Domiciliar. Conclui-se que a adaptação transcultural de um instrumento de avaliação multidimensional em assistência domiciliar foi realizada com verificação da validade de conteúdo e face dos itens do instrumento e elaboração da versão brasileira do interRAI-Home Care, em português brasileiro, interRAI-Assistência Domiciliar. Em etapas futuras, sugere-se a avaliação das propriedades psicométricas do interRAI-Assistência Domiciliar para viabilizar o seu uso e aplicabilidade prática em nosso meioThe accelerated population aging process is challenging for health care strategies development at different levels of complexity. In agreement with the integrality of care in home care, the interRAI-Home Care is an example of multidimensional assessment used in different countries in case and public health management and international cooperation for better solutions to health management. The culture and functioning of home care services can influence the process of cross-cultural adaptation and use of these instruments. This study aims to perform the cross-cultural adaptation of interRAI-Home Care for the Brazilian population and verify the content and face validity of the Brazilian Portuguese version in a home care service. Cross-cultural adaptation process stages were followed with translation, back translation, assessment of equivalence by an expert committee and pretesting with the pre-final version in a sample selected by convenience of 30 subjects (n = 30) registered and attended by the Núcleo de Assistência Domiciliar Interdisciplinar do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. The results shows that the procedures for cross-cultural adaptation were carried out with adjustments to ensure the equivalence of content of the original, translated and back translated versions after the committee experts review and consensus. Pretesting resulted in understanding of all items in the pre-final version by the interviewees and agreement between observers >= 85% for each item of the instrument thus obtaining the final version of interRAI-Home Care, translated and adapted to Brazilian Portuguese, interRAI-Assistência Domiciliar. In conclusion, the cross-cultural adaptation of a home care multidimensional assessment instrument was performed with statement of content and face validity of the instrument items and development of brazilian interRAI-Home Care version, in Brazilian Portuguese, interRAI-Assistência Domiciliar. In future steps, we suggest the evaluation of the psychometric properties of the interRAI-Assistência Domiciliar to enable its use and practical applicability in home care in Brazil
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Argenta, Carla. "Modelo multidimensional de cuidado ao idoso associado aos sistemas de linguagens padronizadas de enfermagem NANDA-I, NIC E NOC." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2018. http://hdl.handle.net/10183/186134.
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O cuidado integral ao idoso pode ser garantido mediante a utilização do Processo de Enfermagem (PE), aliado a um referencial teórico como, por exemplo, o Modelo Multidimensional de Envelhecimento bem Sucedido (MMES), que possui uma proposta de avaliação do idoso. Há, contudo, uma lacuna para a sua utilização, uma vez que não há estudos que comprovem a sua eficácia na prática clínica da Enfermagem associado à aplicação de sistemas de classificação da disciplina como a NANDA-I, NIC e NOC. O objetivo deste estudo é construir um modelo multidimensional de cuidado ao idoso associado aos Sistemas de Linguagens Padronizadas de Enfermagem NANDA-I, NIC e NOC, aplicável à consulta de enfermagem. O estudo foi conduzido em duas etapas metodológicas distintas. A primeira compreendeu um estudo de validação de conteúdo enquanto a segunda uma pesquisa de resultados, que contemplou um estudo quase experimental. As amostras foram constituídas de 15 especialistas em Enfermagem Gerontológica e 28 idosos em primeira consulta na Cidade do Idoso, local do estudo, com idade igual ou superior a 60 anos, que apresentaram o diagnóstico de enfermagem Risco de Síndrome do Idoso Frágil (RSIF) ou Síndrome do Idoso Frágil (SIF), no período de maio a outubro de 2017. Após a validação do conteúdo do modelo multidimensional, com a opinião dos especialistas, efetuou-se a sua aplicação aos idosos em quatro consultas de enfermagem para cada um. Durante as consultas estabeleceram-se os diagnósticos, mensuraram-se os resultados e implementaram-se as intervenções de enfermagem, conforme o modelo e a avaliação clínica. Os especialistas validaram informações da anamnese e exame físico referentes às características definidoras, fatores relacionados e de risco dos dois diagnósticos e às dimensões fisiológica, psicológica e social, conforme propõe o MMES. A validação também confirmou que dos 13 diferentes resultados de enfermagem validados, 10 foram comuns em ambos os diagnósticos. Os resultados validados para os dois diagnósticos avaliaram Equilíbrio (0202), Cognição (0900), Estado nutricional (1004), Autocontrole da doença crônica (3102), Conhecimento: controle da dor (1843), Participação em programa de exercício físico (1633), Conhecimento: controle da doença crônica (1847), Conhecimento: prevenção de quedas (1828), Conhecimento: controle do peso (1841) e Estado de conforto (2008). Apenas dois dos 13 resultados foram validados para o diagnóstico SIF, sendo eles: Nível de fadiga (0007) e Autocuidado: atividades da vida diária (0300), e um resultado, Conhecimento: medicamento (1808), foi validado apenas para o diagnóstico RSIF. As intervenções de enfermagem da NIC, validadas para os dois diagnósticos de enfermagem, foram praticamente iguais. Das oito diferentes intervenções validadas apenas a Assistência ao Autocuidado (1800) foi validada exclusivamente para o diagnóstico SIF e as outras sete foram validadas para os dois diagnósticos. As intervenções destacam a importância da Promoção do exercício (0200), Aconselhamento nutricional (5246), Controle de medicamentos (2380), Estimulação cognitiva (4720), Melhora na socialização (5100), Prevenção contra quedas (6490) e Ensino sobre o processo da doença (5602). A segunda etapa mostrou que dos 28 idosos a maioria era do sexo feminino (17 - 60,7%), com idade média de 65,6 ± 6,3 anos e, desses, 23 idosos foram diagnosticados com RSIF e cinco com SIF. Dos resultados de enfermagem utilizados para avaliar idosos com RSIF e SIF percebeu-se melhora significativa na média dos escores dos seus indicadores: Participação em programa de exercício físico; Autocontrole da doença crônica; 7 Conhecimento: controle da doença crônica; Conhecimento: controle do peso; Conhecimento: prevenção de quedas e Estado de conforto. Os resultados Estado nutricional e Conhecimento: controle da dor tiveram melhora significativa nos escores dos indicadores somente para idosos com RSIF, assim como a avaliação do Autocuidado: atividades da vida diária para idosos com SIF. As intervenções que apresentaram efetividade estatisticamente significativa na utilização de suas atividades em idosos, com ambos os diagnósticos, foram: Ensino: processo da doença e Promoção do exercício, enquanto a intervenção Prevenção contra quedas foi encontrada somente em idosos com RSIF. Conclui-se que as sete intervenções de enfermagem validadas pelos especialistas foram implementadas aos idosos com diagnóstico de enfermagem RSIF e foram consideradas efetivas, tendo como base a avaliação de nove resultados que apontaram melhora significativa na comparação entre as médias da primeira e quarta consultas. Dentre as oito intervenções de enfermagem implementadas aos idosos com diagnóstico de enfermagem SIF, sete foram consideradas efetivas, tendo como base a avaliação de 11 resultados que apontaram melhora significativa na comparação entre as médias da primeira e quarta consultas. Dessa forma, conclui-se ainda, que o modelo multidimensional de cuidado ao idoso associado aos SLP contribui para a prática assistencial do enfermeiro na consulta de enfermagem, com vistas ao envelhecimento bem sucedido. Dentre as importantes implicações e contribuições dos resultados desta pesquisa está a possibilidade de apoiar a ligação entre resultados e intervenções validados com os diagnósticos de enfermagem RSIF e SIF, facilitando a avaliação de enfermagem e os cuidados de enfermagem aos idosos na prática clínica. Além disso, recomenda-se a construção de definições operacionais para os indicadores dos resultados de enfermagem. Uma limitação do estudo foi o fato de realizarmos a pesquisa com especialistas do mesmo país.Comprehensive care for the elderly can be guaranteed through the use of the Nursing Process (PE), together with a theoretical framework such as the Multidimensional Model of Successful Aging (MMSA), which has a proposal for the evaluation of the elderly. There is, however, a gap to its use, since there are no studies that prove its effectiveness in the clinical practice of Nursing associated with the application of discipline classification systems such as NANDA-I, NIC and NOC. The objective of this study is to build an elderly care multidimensional model associated with the standardized NANDA-I, NIC and NOC Nursing language systems, applicable to the nursing consultation. The study was conducted in two different methodological steps. The first comprised a content validation study while the second a results research, which included a quasi-experimental study. The samples consisted of 15 specialists in Gerontology Nursing and 28 elderly people in a first consultation in the City of the Elderly, place of study, with age equal to or greater than 60 years, of both sexes, who presented the diagnosis of Nursing Risk of Syndrome of the Elderly (RSIF) or Fragile Elderly Syndrome (SIF), from May to October 2017. After the validation of the multidimensional model content, with the opinion of the specialists, it was applied to the elderly in four every elderly person. During the consultations the diagnoses were established, the results were measured and the Nursing interventions were implemented, according to the multidimensional model and the clinical evaluation. The specialists validated information about the anamnesis and the physical examination referring to the defining characteristics, related and risk factors of the two diagnoses and the physiological, psychological and social dimensions, as proposed by the MMSA. Validation also confirmed that of the 13 different validated Nursing outcomes, 10 were common in both diagnoses. The results validated for the two diagnoses evaluated: Equilibrium (0202), Cognition (0900), Nutritional status (1004), Self-control of chronic disease (3102), Knowledge: pain control (1843), Knowledge: control of chronic disease (1847), Knowledge: prevention of falls (1828), Knowledge: weight control (1841) and Comfort state (2008). Only two of the 13 results were validated for SIF diagnosis, being: Fatigue level (0007) and Self-care: activities of daily living (0300), and a result, Knowledge: medicine (1808), was validated only for the diagnosis RSIF. The Nursing interventions of the NIC, validated for the two Nursing diagnoses, were practically the same. Of the eight different validated interventions, only Self-care Assistance (1800) was validated exclusively for SIF diagnosis and the other seven were validated for both diagnoses. The interventions emphasize the importance of Promoting Exercise (0200), Nutrition Counseling (5246), Medication Control (2380), Cognitive Stimulation (4720), Improving Socialization (5100), Fall Prevention (6490) and Teaching the Process of the disease (5602). The second stage showed that of the 28 elderly, the majority were female (17-60.7%), with a mean age of 65.6 ± 6.3 years, and of these, 23 elderly were diagnosed with RSIF and five with SIF. Nursing results used to evaluate the elderly with RSIF and SIF showed a significant improvement in the mean of the scores of their indicators: Knowledge: control of chronic disease; Self-control of chronic disease; Knowledge: prevention of falls; Weight control; State of comfort and Participation in physical exercise program. The results Knowledge: pain control and nutritional status had significant improvement in the scores of indicators only for the elderly with RSIF, as well as the self-care evaluation: daily life activities for elderly with 9 SIF. The interventions that presented a statistically significant reduction in the use of their activities in the elderly, with both diagnoses, were Teaching: disease process and Exercise promotion, while the intervention Prevention of falls was found only in the elderly with RSIF. It is concluded that the seven nursing interventions validated by the specialists were implemented to the elderly with a diagnosis of RSIF Nursing and were considered effective, based on the evaluation of nine results that indicated a significant improvement in the comparison between the means of the first and fourth visits. Among the eight Nursing interventions implemented to the elderly with SIF Nursing diagnosis, seven were considered effective, based on the evaluation of 11 results that indicated a significant improvement in the comparison between the means of the first and fourth visits. Thus, it can be concluded that the multidimensional model of elderly care associated with standardized Nursing language systems contributes to the nurses practice in the nursing consultation, with a view to successful aging. Among the important implications and contributions of the results of this research is the possibility of supporting the link between results and validated interventions with the RSIF and SIF, facilitating nursing assessment and nursing care for the elderly in clinical practice. In addition, it is recommended to construct operational definitions for indicators of nursing outcomes. One limitation of the study was the fact that we conducted the research with specialists from the same country.
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Wintermann, Gloria-Beatrice, Jenny Rosendahl, Kerstin Weidner, Bernhard Strauß, Andreas Hinz, and Katja Petrowski. "Fatigue in chronically critically ill patients following intensive care - reliability and validity of the multidimensional fatigue inventory (MFI-20)." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2018. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-235556.
Full textAbstract:
Background
Fatigue often occurs as long-term complication in chronically critically ill (CCI) patients after prolonged intensive care treatment. The Multidimensional Fatigue Inventory (MFI-20) has been established as valid instrument to measure fatigue in a wide range of medical illnesses. Regarding the measurement of fatigue in CCI patients, the psychometric properties of the MFI-20 have not been investigated so far. Thus, the present study examines reliability and validity of the MFI-20 in CCI patients.
Methods
A convenience sample of n = 195 patients with Critical Illness Polyneuropathy (CIP) or Myopathy (CIM) were recruited via personal contact within four weeks (t1) following the transfer from acute care ICU to post-acute ICU at a large rehabilitation hospital. N = 113 (median age 61.1 yrs., 72.6% men) patients were again contacted via telephone three (t2) and six (t3) months following the transfer to post-acute ICU. The MFI-20, the Euro-Quality of Life (EQ-5D-3 L) and the Structured Clinical Interview for the Diagnostic and Statistical Manual of mental disorders DSM-IV (SCID-I) were applied within this prospective cohort study.
Results
The internal consistency Cronbach’s α was adequate for the MFI-total and all but the subscale Reduced Motivation (RM) (range: .50–.91). Item-to-total correlations (range: .22–.80) indicated item redundancy for the subscale RM. Confirmatory Factor analyses (CFAs) revealed poor model fit for the original 5-factor model of the MFI-20 (t2/t3, Confirmatory Fit Index, CFI = .783/ .834; Tucker-Lewis Index, TLI = .751/ .809; Root Mean Square Error of Approximation, RMSEA = .112/ .103). Among the alternative models (1-, 2-, 3-factor models), the data best fit to a 3-factor solution summarizing the highly correlated factors General −/ Physical Fatigue/ Reduced Activity (GF/ PF/ RA) (t2/ t3, CFI = .878/ .896, TLI = .846/ .869, RMSEA = .089/ .085, 90% Confidence Interval .073–.104/ .066–.104). The MFI-total score significantly correlated with the health-related quality of life (range: −.65-(−).66) and the diagnosis of major depression (range: .27–.37).
Conclusions
In the present sample of CCI patients, a reliable and valid factor structure of the MFI-20 could not be ascertained. Especially the subscale RM should be revised. Since the factors GF, PF and RA cannot be separated from each other and the unclear factorial structure in the present sample of CCI patients, the MFI-20 is not recommended for use in this context.
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Rimec, Daniel. "Multidimensional Assessment For a Case Studied Zero Energy Building : Climate positive buildings with and without a connection to the district heating network." Thesis, Mälardalens högskola, Akademin för ekonomi, samhälle och teknik, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-54650.
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The purpose of this report is to get an overview of the CO2 reduction possibilities when adopting different renewable energy source, when the case studied building sustains a district heating network connection and when not, and how the renewable energy source flexibilities (Solar and Wind) differ depending on region. The method regards a ETC house that falls into the climate positive category and assesses the reduction when comparing CO2 emissions form the energy demand. The result for the flexibilities is then compared to the BBR demand. The result shows a difference of around 10% in production for the flexibilities when comparing the northern and middle region with the southern. And a decrease between 19-36% gCO2. Comparing a scenario with and without a connection to the district heating network showed that when the ground source heat pump offsets the energy demand, CO2, and cost reductions (6 and 4% respectively) can be seen. With an average installation cost, the payback period for the ground source heat pump can be estimated to be around 4 year. In conclusion the thesis project shows that the climate is a ruling factor when assessing energy questions for the residential sector. It also shows the difference in CO2 and cost that comes with it can be reduced and help mitigated the sectors effects on the environment. This in turn shows that the overall reduction of CO2 for the case studied building follows the demands and goals set by the European commission and gives motivation to expand the construction as cost is also reduced.
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Taylor, Pennissi Locker Patrick. "Multidimensional Assessment of Pain Related Disability." Thesis, University of North Texas, 1995. https://digital.library.unt.edu/ark:/67531/metadc278421/.
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A factor analysis was performed on eleven variables derived from scores on the McGill Pain Questionnaire, Oswestry Activity Rating Scale, graphic rating scales designed to assess the average pain intensity, frequency of leg pain, back pain, numbness and tingling in legs, and weakness in legs, as well as bothersomeness of back pain, leg pain, numbness and tingling in legs and weakness of legs. A composite Pain Index was created on the basis of three factors: leg pain, back pain, and overall pain complaints. Extraclassificatory variables, such as negative affect including depression and anxiety, cognitions regarding health status and expectation of recovery, bodily awareness/somatization and demographic variables such as smoking or non-smoking, compensation status, litigation status, use of narcotic and non-narcotic medication, use of alcohol, and time off of work were analyzed in combination and independently in relationship to the Pain Index.
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Mair, Patrick, Ingwer Borg, and Thomas Rusch. "Goodness-of-Fit Assessment in Multidimensional Scaling and Unfolding." Taylor & Francis Group, 2016. http://epub.wu.ac.at/5354/1/mairetal2016.pdf.
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Judging goodness of fit in multidimensional scaling requires a comprehensive set of diagnostic tools instead of relying on stress rules of thumb. This article elaborates on corresponding strategies and gives practical guidelines for researchers to obtain a clear picture of the goodness of fit of a solution. Special emphasis will be placed on the use of permutation tests. The second part of the article focuses on goodness-of-fit assessment of an important variant of multidimensional scaling called unfolding, which can be applied to a broad range of psychological data settings. Two real-life data sets are presented in order to walk the reader through the entire set of diagnostic measures, tests, and plots. R code is provided as supplementary information that makes the whole goodness-of-fit assessment workflow, as presented in this article, fully reproducible.
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Morgeson, Paul Taylor. "Deconstructing Webern's Op 25, Drei Lieder: a Multidimensional Assessment." Thesis, University of North Texas, 2013. https://digital.library.unt.edu/ark:/67531/metadc283780/.
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Webern scholarship has not comprehensively examined op. 25, drei lieder. If the selection of text for op. 25 is viewed as one work in three movements they create a ternary form (A-B-A1). To show how this form is developed in the music the author creates a new analytical system based on Schoenberg's Grundgestalt which is defined by three basic ideas: symmetry, liquidation, and variation. The relationship between the voice and accompaniment and Webern's deliberate manipulation of the text is used to reveal the use of a program which is then tied to the numerical symbolism of 2 and 3.
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Rosmus, Christina. "Multidimensional pain response in Chinese infants." Thesis, McGill University, 1995. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=22799.
Full textAbstract:
This study was designed to compare the behavioral pain responses of 2-month-old Canadian-born Chinese babies receiving a routine immunization to those of Caucasian infants in similar situations. Two groups of 26 infants were obtained through convenience from a pediatric clinic held by a Chinese pediatrician at the Chinese Hospital and a suburban pediatric practice of a large Canadian city. Facial expression using the Neonatal Facial Coding System (Grunau & Craig, 1987) and cry using the Fast Fourier Transform were measured during 30 seconds following the insertion of the needle. Acculturation in Chinese mothers, infant temperament, circadian rhythm, were assessed. Multivariate analysis of variance revealed significant differences in pain response between these two groups with the Chinese babies showing greater response. No significant effect of temperament, circadian rhythm, and gender was identified. This supports the presence of differences in pain response in relation to culture/race by at least 2 months of age.
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Moshfegh, Nicole. "The multidimensional wellbeing assessment| Preliminary validation in an Iranian sample." Thesis, Pepperdine University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3629335.
Full textAbstract:
Although nations with a dominant worldview of individualism are a minority in the world as a whole, most psychological models are generated based on research conducted in these countries. Existing models and measures of well-being tend to have an individualistic, Western cultural bias, making it difficult to assess the well-being of those whose dominant worldview is more consistent with collectivism. Due to the absence of an existing cross-culturally relevant measure of well-being, the Multidimensional Well-Being Assessment (MWA) was developed. As attention to Middle Eastern populations has not typically received much consideration in psychological literature, this study aimed to inform researchers and clinicians of critical issues relevant to the well-being of those with ancestry and identity in Iran in addition to examining the validity of the MWA in an Iranian sample. This study used a non-random sampling method for data collection and utilized a cross-sectional correlational design to examine both the validity of the MWA and the relationship of dimensions of well-being to several demographic variables. A total of 62 participants were included in this study. The MWA showed good to excellent reliability on most MWA contexts and dimensions, in addition to showing significant positive correlations with two additional measures of well-being and significant negative correlations with a measure of distress and dysfunction. Significant correlations between several demographic variables (including age, length of time in the United States, and relationship status) and several dimensions on the MWA were also found. This study has implications for future research within the fields of culture and well-being with particular attention to unique findings within the Iranian population.
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Jones, Patricia Ann Blodgett. "Assessment of dimensionality in dichotomously-scored data using multidimensional scaling." Diss., The University of Arizona, 1987. http://hdl.handle.net/10150/184267.
Full textAbstract:
The effectiveness of multidimensional scaling (MDS) techniques in recovering the underlying dimensionality of dichotomously-scored data was examined for unidimensional and multidimensional data. Thirty-three data sets of varying numbers of dimensions with differing patterns of item discrimination were generated using a multidimensional latent trait model in a Monte Carlo simulation study. Margin-sensitive measures (agreement, phi, and kappa) and margin-free measures (Φ/ Φ(max), Yule's Q, and the tetrachoric correlation) were used as measures of similarity and the resulting matrices were scaled in one through five dimensions. Values of the stress coefficient, S₁, S₁ by dimensionality plots, and plot configurations were examined to determine the dimensionality of the item set. Principal components analyses (PCAs) of phi and tetrachoric matrices were carried out as a basis for comparison. In addition, MDS and PCA were used to examine a data set comprised of items obtained from the routing tests of the Head Start Measures Battery. Two effects of item discrimination on MDS results were especially noteworthy. First, factors tended to be located equally distant from each other in the MDS space. Items were located closest to the factor for which the primary factor loading occurred. Second, as item discrimination decreased, items tended to be more widely dispersed from their appropriate locations in space. Extra dimensions in the MDS representational space were required for margin-sensitive coefficients to accommodate difficulty effects. Margin-free coefficients generally eliminated difficulty-related dimensions, although occasional problems were noted with the tetrachoric correlation. Analysis of the HSMB revealed that the data were primarily unidimensional, although specific effects due to each subtest were clearly present in the analysis. MDS was found to be a useful technique and its use in conjunction with PCA or factor analysis is recommended.
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Broughton, Ross Harold. "Distance from the protype : a multidimensional scaling approach to personality assessment." Thesis, University of British Columbia, 1986. http://hdl.handle.net/2429/26777.
Full textAbstract:
An MDS (MultiDimenaional Scaling) model of personality assessment is presented as an alternative method of personality assessment designed to incorporate recently discovered cognitive principles relating to how people mentally organize categories (Roach, 1978), including personality trait categories
(Broughton, 1984). The MDS model is shown to generalize from a tool for evaluating the self concept and the semantics of interpersonal categories (Partridge, 1984) to one that taps the full gamut of personality assessment in the interpersonal domain as defined by Wiggins (1979). In this paradigm, subjects rated the similarity of their own personality to prototypical characters described in short stories, or vignettes.
In asking subjects to compare themselves to hypothetical people who display prototypical behaviors (based on the act-frequency prototype analyses of Buss & Craik, 1980), one is able to standardize the measure against which similarity ratings are made. Thus "prototypical dominance" (in this case
operationalized as an excellent example of what it means in behavioral terms to be dominant) is the same for each subject, as is prototypical extraversion, aggression, and so on. Unlike traditional self-report measures, the respondent is not required to provide his or her own (possibly idiosyncratic) trait definition.
Study 1 involved the development and use of the vignette materials in a paper and pencil administration. In this study 25 undergraduate subjects rated the 28 nonredundant pairs of eight vignette characters for similarity. The usefulness of the vignettes as personality testing stimuli was gauged
according to structural criteria, namely the circular ordering (circumplexity) to emerge from the MDS analysis of the eight vignette stimuli. Although the results were judged
satisfactory, steps were taken in Study 2 to improve the interpersonal meaning of two of the prototype stories, in an attempt to improve the solution.
In Study 3, a microcomputer administration involving 158 participants, subjects compared the eight stimuli for similarity as in Study 1 but also compared themselves (each subject's usual and ideal self) to the eight vignette characters. Derived MDS distances from the prototypical characters were compared with conventional self-report scale scores from four widely used personality inventories (the Personality Research Form, PRF; Adjective Check List, ACL; California Psychological Inventory, CPI; and the Interpersonal Adjective Scales, IAS). Correlational analyses revealed low to moderate congruence between the MDS technique and these traditional personality measures.
Three multiple regression analyses were performed to test how well subjects' MDS distance scores could predict standard trait measures. Results from the first analysis indicated that MDS measures were better at predicting IAS self-esteem than the four traditional Inventories. The second analysis showed that MDS distance scores better predicted IAS dominance than the remaining three inventories. The purpose of the third
regression analysis was to test the comparative predictive validity of the MDS scores with a different self-report method PRF dominance. The MDS measures placed last in this category, but were not far behind the others.Arts, Faculty of
Psychology, Department of
Graduate
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Esparza, Oscar Armando. "Development of a multidimensional fatalism measure." To access this resource online via ProQuest Dissertations and Theses @ UTEP, 2008. http://0-proquest.umi.com.lib.utep.edu/login?COPT=REJTPTU0YmImSU5UPTAmVkVSPTI=&clientId=2515.
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Li, Wang-on, and 李允安. "The assessment of learning outcome: knowledgestructure." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2003. http://hub.hku.hk/bib/B31227582.
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Leiter-McBeth, Justin Rashawn Leiter. "Heartbeat Perception and its Association with The Multidimensional Assessment of Interoceptive Awareness." Kent State University Honors College / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=ksuhonors1462969942.
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Abdel, Malik Philip. "Multidimensional epidemiological transformations : addressing location-privacy in public health practice." Thesis, University of Plymouth, 2011. http://hdl.handle.net/10026.1/901.
Full textAbstract:
The ability to control one’s own personally identifiable information is a worthwhile human right that is becoming increasingly vulnerable. However just as significant, if not more so, is the right to health. With increasing globalisation and threats of natural disasters and acts of terrorism, this right is also becoming increasingly vulnerable. Public health practice – which is charged with the protection, promotion and mitigation of the health of society and its individuals – has been at odds with the right to privacy. This is particularly significant when location privacy is under consideration. Spatial information is an important aspect of public health, yet the increasing availability of spatial imagery and location-sensitive applications and technologies has brought location-privacy to the forefront, threatening to negatively impact the practice of public health by inhibiting or severely limiting data-sharing. This study begins by reviewing the current relevant legislation as it pertains to public health and investigates the public health community’s perceptions on location privacy barriers to the practice. Bureaucracy and legislation are identified by survey participants as the two greatest privacy-related barriers to public health. In response to this clash, a number of solutions and workarounds are proposed in the literature to compensate for location privacy. However, as their weaknesses are outlined, a novel approach - the multidimensional point transform - that works synergistically on multiple dimensions, including location, to anonymise data is developed and demonstrated. Finally, a framework for guiding decisions on data-sharing and identifying requirements is proposed and a sample implementation is demonstrated through a fictitious scenario. For each aspect of the study, a tool prototype and/or design for implementation is proposed and explained, and the need for further development of these is highlighted. In summary, this study provides a multi-disciplinary and multidimensional solution to the clash between privacy and data-sharing in public health practice.
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Rechel, Maggie E. "Pregnancy Intentions and Maternal Health Behaviors Reexamined: A Multidimensional Analysis." The Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=osu1243535056.
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Rechel, Maggie Elizabeth. "Pregnancy intentions and maternal health behaviors reexamined a multidimensional analysis /." Columbus, Ohio : Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1243535056.
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Bjertness, Espen. "A multidimensional study of dental health in urban Norwegian adults." Oslo : Dept. of Operative Dentistry, Dental Faculty, University of Oslo, 1990. http://catalog.hathitrust.org/api/volumes/oclc/22775459.html.
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Taylor, Lou Ella Viola. "The Multidimensional Characteristics of Persistent Pain in Adults with Sickle Cell Disease." Thesis, University of California, San Francisco, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3587906.
Full textAbstract:
Sickle cell disease (SCD) is a major healthcare and societal problem that affects millions of people worldwide. Sickle cell pain is the hallmark feature of SCD and includes manageable and unmanageable persistent pain that affects every aspect of an individual's life. Most of the research on pain in SCD has focused on children with acute vaso-occlusive episodes. Consequently, significant gaps exist in our knowledge of the occurrence and characteristics of manageable and unmanageable persistent pain in adults with SCD.
The specific aims of this study in a sample of adults with SCD were to: 1) determine the occurrence of persistent SCD pain and compare those with manageable and unmanageable persistent SCD pain on demographic and clinical characteristics, as well as, pain-related measures; 2) compare those with manageable and unmanageable persistent SCD pain on coping strategies; and 3) determine which factors influence quality of life (QOL) in these patients.
One hundred and three patients who were ≥18 years with SCD completed questionnaires on demographic, clinical, and pain characteristics, as well as, the Pain Catastrophizing Scale (PCS), the Duke Religious Index (DRI), and the Medical Outcomes Study Short-Form (SF-36). Patients were divided into those with manageable (average pain intensity ≤5) and unmanageable pain (average pain intensity >5) based on established cutpoints. Final analyses were done on 94 patients.
Seventy percent of patients had manageable pain and 30% had unmanageable pain. Patients with unmanageable pain reported higher ratings for all of the items on the Pain Quality Assessment Scale (PQAS); were more likely to be taking only a short-acting opioid; reported less relief from analgesic medications, and reported significantly lower SF-36 scores. Significant negative correlations were found between pain catastrophizing and religiosity/spirituality, and physical and mental health. Several variables were found to have an influence on QOL. These findings suggest that persistent pain in adults with SCD is a significant problem. More research needs to evaluate how adults with SCD cope with persistent pain and its impact on their QOL.
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Snow, Tyler A. "Establishing the Viability of the Multidimensional Quality Metrics Framework." BYU ScholarsArchive, 2015. https://scholarsarchive.byu.edu/etd/5593.
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The Multidimensional Quality Metrics (MQM) framework is a new system for creating customized translation quality assessment and evaluation metrics designed to fit specific translation needs. In this study I test the viability of MQM to determine whether the framework in its current state is ready for implementation as a quality assessment framework in the translation industry. Other contributions from this study include: (1) online software for designing and using metrics based on the MQM framework; (2) a survey of the typical, real-world quality assessment and evaluation practices of language service providers in the translation industry; and (3) a measurement scale for determining the viability of translation quality assessment and evaluation frameworks such as MQM. The study demonstrates that the MQM framework is a viable solution when it comes to the validity and practicality of creating translation quality metrics for the translation industry. It is not clear whether those metrics can be used reliably without extensive training of qualified assessors on the use of MQM metrics.
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Wilson, Stephen M., Dana K. Eriksson, Sarah M. Schneck, and Jillian M. Lucanie. "A quick aphasia battery for efficient, reliable, and multidimensional assessment of language function." PUBLIC LIBRARY SCIENCE, 2018. http://hdl.handle.net/10150/627164.
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This paper describes a quick aphasia battery (QAB) that aims to provide a reliable and multidimensional assessment of language function in about a quarter of an hour, bridging the gap between comprehensive batteries that are time-consuming to administer, and rapid screening instruments that provide limited detail regarding individual profiles of deficits. The QAB is made up of eight subtests, each comprising sets of items that probe different language domains, vary in difficulty, and are scored with a graded system to maximize the informativeness of each item. From the eight subtests, eight summary measures are derived, which constitute a multidimensional profile of language function, quantifying strengths and weaknesses across core language domains. The QAB was administered to 28 individuals with acute stroke and aphasia, 25 individuals with acute stroke but no aphasia, 16 individuals with chronic post-stroke aphasia, and 14 healthy controls. The patients with chronic post-stroke aphasia were tested 3 times each and scored independently by 2 raters to establish test-retest and inter-rater reliability. The Western Aphasia Battery (WAB) was also administered to these patients to assess concurrent validity. We found that all QAB summary measures were sensitive to aphasic deficits in the two groups with aphasia. All measures showed good or excellent test-retest reliability (overall summary measure: intraclass correlation coefficient (ICC) = 0.98), and excellent inter-rater reliability (overall summary measure: ICC = 0.99). Sensitivity and specificity for diagnosis of aphasia (relative to clinical impression) were 0.91 and 0.95 respectively. All QAB measures were highly correlated with corresponding WAB measures where available. Individual patients showed distinct profiles of spared and impaired function across different language domains. In sum, the QAB efficiently and reliably characterized individual profiles of language deficits.
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DeWolfe, Nadine Alison. "Early identification of Attention Deficit Hyperactivity Disorder, a multidimensional assessment protocol for preschoolers." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape15/PQDD_0014/NQ36577.pdf.
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Walts, Nancy S. "Multidimensional assessment of cognitively impaired adults age 65 years of age and older." Virtual Press, 1988. http://liblink.bsu.edu/uhtbin/catkey/535895.
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The purpose of the study was to validate the use of the Geriatric Functional Rating Scale (GFRS) in assessing cognitively impaired individuals 65 years of age and older to determine the need for institutionalization. The population of interest consisted of individuals 65 years of age and older exhibiting cognitive impairment and residing in Delaware County, Indiana. A nonrandomized two-group experimental design was utilized for the study. Eighty subjects were selected from two subpopulations consisting of 40 institutionalized and 40 noninstitutionalized elderly.Two geriatric assessment tools were used for the study, the Mental Status Questionnaire (MSQ) and the Geriatric Functional Rating Scale (GFRS). The hypothesis for the study stated that the mean GFRS score of the noninstitutionalized subjects, the control group, would be significantly greater than the mean score of the institutionalized subjects, the experimental group.The MSQ scores as well as the means and standard deviations for the seven subscales of the GFRS were reported for the two groups. A one-tailed t-test was used to test the hypothesis. A decision with regard to the hypothesis was made at the .05 level.Findings of the study included the following:1. The subjects ranged in age from 65 to 92 years, were 90 percent female, and predominantly Protestant, 88 percent.2. The MSQ scores for the combined groups ranged from minimal cognitive impairment, 71 percent, to severe cognitive impairment, four percent.3. The total mean score on the GFRS for the institutionalized group was 6.8 indicating a need for institutionalization.4. The total score on the GFRS of the noninstitutionalized was over 10 times higher at 70.7.5. The noninstitutionalized group scored significantly higher in the GFRS (p<.00) than the institutionalized counterparts.In conclusion, the research supports the use of the Geriatric Functional Rating Scale in assessing the need for institutionalization in cognitively impaired individuals, 65 years of age and older in Delaware County, Indiana.Department of Educational Administration and Supervision
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Mariana, Valerie Ruth. "The Multidimensional Quality Metric (MQM) Framework: A New Framework for Translation Quality Assessment." BYU ScholarsArchive, 2014. https://scholarsarchive.byu.edu/etd/4312.
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This document is a supplement to the article entitled “The Multidimensional Quality Metric (MQM) Framework: A New Framework for Translation Quality Assessment”, which has been acepted for publication in the upcoming January volume of JoSTrans, the Journal of Specialized Translation. The article is a coauthored project between Dr. Alan K. Melby, Dr. Troy Cox and myself. In this document you will find a preface describing the process of writing the article, an annotated bibliography of sources consulted in my research, a summary of what I learned, and a conclusion that considers the future avenues opened up by this research. Our article examines a new method for assessing the quality of a translation known as the Multidimensional Quality Metric, MQM. In our experiment we set the MQM framework to mirror, as closely as possible, the American Translators Association's (ATA) translator certification exam. To do this we mapped the ATA error categories to corresponding MQM error categories. We acquired a set of 29 student translations and had a group of student raters use the MQM framework to rate these translations. We measured the practicality of the MQM framework by comparing the time required for ratings to the average time required to rate translations in the industry. In addition, we had 2 ATA certified translators rate the anchor translation (a translation that was scored by every rater in order to have a point of comparison). The certified translators' ratings were used to verify that the scores given by the student raters were valid. Reliability was also measured, which found that the student raters were not interchangeable, but that the measurement estimate of reliability was adequate. The article's goal was to determine the extent to which the Multidimensional Quality Metric framework for translation evaluation is viable (practical, reliable and valid) when designed to mirror the ATA certification exam. Overall, the results of the experiment showed that MQM could be a viable way to rate translation quality when operationalized based on the ATA's translator certification exam. This is an important discovery in the field of translation quality, because it shows that MQM could be a viable tool for future researchers. Our experiment suggests that researchers ought to take advantage of the MQM framework because, not only is it free, but any studies completed using the MQM framework would have a common base, making these studies more easily comparable.
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Ramelet, Anne-Sylvie. "The development of a multidimensional pain assessment scale for critically ill preverbal children." Thesis, Curtin University, 2006. http://hdl.handle.net/20.500.11937/1524.
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Adequate pain assessment is a pre-requisite for appropriate pain management. If pain remains untreated in critically ill young children, it can have dramatic short- and long-term consequences on their health and development. Apart from humanitarian reasons, the assessment of pain has been recognised in some parts of the world as the fifth vital sign and thus should be part of standard practice of pain management. The evaluation of pain in preverbal children is, nevertheless, challenging for health professionals, as they cannot rely on self-report when making their assessment. Observational pain instruments have been developed to facilitate this task, but none of these existing instruments are appropriate for the postoperative critically ill young child. The aim of this research was to provide a clinically valid pain instrument for health professionals to use in practice for the evaluation of the pain and the effectiveness of pain treatment in critically ill young children. This thesis presents research that was conducted in three phases to (a) describe pain, (b) develop, and (c) test the pain instrument. Conceptualisation of pain and psychometric theory informed the conceptual framework for this study. An observational design was used in Phase One of the study to define pain behaviour in critically ill infants. Correlational design was used in Phase Two and Three to determine the association between the newly developed pain scale and other pain assessment instruments. Phase One of the study was conducted in the paediatric intensive care units of two tertiary referral hospitals. Eight hundred and three recorded segments were generated from recordings of five critically ill infants, aged between 0 and 9 months, who had undergone major surgery.Results indicated significant physiological and behavioural changes in response to postoperative pain and when postoperative pain was exacerbated by painful procedures. Using the pain indicators observed in Phase One, in Phase Two the Multidimensional Assessment Pain Scale (MAPS) was developed and tested for reliability and validity in 43 postoperative preverbal children from the same settings. Internal consistency and interrater reliability were moderate and good, respectively. Concurrent and convergent validity was good. In Phase Three, the MAPS' response to analgesics and clinical utility was demonstrated in a convenience sample of 19 postoperative critically ill children aged between 0 and 3 1 months of age at a tertiary referral hospital in Western Australia. Development of a pain instrument is a complex and lengthy process. This study presents the preliminary psychometric properties that support the validity and clinical utility of the Multidimensional Assessment Pain Scale. The MAPS is a promising tool for assessing postoperative pain in critically ill young children, and its clinical validity will be strengthened with further testing and evaluation.
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Ramelet, Anne-Sylvie. "The development of a multidimensional pain assessment scale for critically ill preverbal children." Curtin University of Technology, School of Nursing and Midwifery, 2006. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=17177.
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Adequate pain assessment is a pre-requisite for appropriate pain management. If pain remains untreated in critically ill young children, it can have dramatic short- and long-term consequences on their health and development. Apart from humanitarian reasons, the assessment of pain has been recognised in some parts of the world as the fifth vital sign and thus should be part of standard practice of pain management. The evaluation of pain in preverbal children is, nevertheless, challenging for health professionals, as they cannot rely on self-report when making their assessment. Observational pain instruments have been developed to facilitate this task, but none of these existing instruments are appropriate for the postoperative critically ill young child. The aim of this research was to provide a clinically valid pain instrument for health professionals to use in practice for the evaluation of the pain and the effectiveness of pain treatment in critically ill young children. This thesis presents research that was conducted in three phases to (a) describe pain, (b) develop, and (c) test the pain instrument. Conceptualisation of pain and psychometric theory informed the conceptual framework for this study. An observational design was used in Phase One of the study to define pain behaviour in critically ill infants. Correlational design was used in Phase Two and Three to determine the association between the newly developed pain scale and other pain assessment instruments. Phase One of the study was conducted in the paediatric intensive care units of two tertiary referral hospitals. Eight hundred and three recorded segments were generated from recordings of five critically ill infants, aged between 0 and 9 months, who had undergone major surgery.Results indicated significant physiological and behavioural changes in response to postoperative pain and when postoperative pain was exacerbated by painful procedures. Using the pain indicators observed in Phase One, in Phase Two the Multidimensional Assessment Pain Scale (MAPS) was developed and tested for reliability and validity in 43 postoperative preverbal children from the same settings. Internal consistency and interrater reliability were moderate and good, respectively. Concurrent and convergent validity was good. In Phase Three, the MAPS' response to analgesics and clinical utility was demonstrated in a convenience sample of 19 postoperative critically ill children aged between 0 and 3 1 months of age at a tertiary referral hospital in Western Australia. Development of a pain instrument is a complex and lengthy process. This study presents the preliminary psychometric properties that support the validity and clinical utility of the Multidimensional Assessment Pain Scale. The MAPS is a promising tool for assessing postoperative pain in critically ill young children, and its clinical validity will be strengthened with further testing and evaluation.
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Shortt, Niamh Maura Kelly. "Defining regions for locality health care planning : a multidimensional geographic approach." Thesis, University of Ulster, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.232848.
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Castle, Courtney. "Measuring Multidimensional Science Learning: Item Design, Scoring, and Psychometric Considerations." Thesis, Boston College, 2018. http://hdl.handle.net/2345/bc-ir:107904.
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Thesis advisor: Henry BraunThe Next Generation Science Standards propose a multidimensional model of science learning, comprised of Core Disciplinary Ideas, Science and Engineering Practices, and Crosscutting Concepts (NGSS Lead States, 2013). Accordingly, there is a need for student assessment aligned with the new standards. Creating assessments that validly and reliably measure multidimensional science ability is a challenge for the measurement community (Pellegrino, et al., 2014). Multidimensional assessment tasks may need to go beyond typical item designs of standalone multiple-choice and short-answer items. Furthermore, scoring and modeling of student performance should account for the multidimensionality of the construct. This research contributes to knowledge about best practices for multidimensional science assessment by exploring three areas of interest: 1) item design, 2) scoring rubrics, and 3) measurement models. This study investigated multidimensional scaffolding and response format by comparing alternative item designs on an elementary assessment of matter. Item variations had a different number of item prompts and/or response formats. Observations about student cognition and performance were collected during cognitive interviews and a pilot test. Items were scored using a holistic rubric and a multidimensional rubric, and interrater agreement was examined. Assessment data was scaled with multidimensional scores and holistic scores, using unidimensional and multidimensional Rasch models, and model-data fit was compared. Results showed that scaffolding is associated with more thorough responses, especially among low ability students. Students tended to utilize different cognitive processes to respond to selected-response items and constructed-response items, and were more likely to respond to selected-response arguments. Interrater agreement was highest when the structure of the item aligned with the structure of the scoring rubric. Holistic scores provided similar reliability and precision as multidimensional scores, but item and person fit was poorer. Multidimensional subscales had lower reliability, less precise student estimates than the unidimensional model, and interdimensional correlations were high. However, the multidimensional rubric and model provide nuanced information about student performance and better fit to the response data. Recommendations about optimal combinations of scaffolding, rubric, and measurement models are made for teachers, policymakers, and researchers
Thesis (PhD) — Boston College, 2018
Submitted to: Boston College. Lynch School of Education
Discipline: Educational Research, Measurement and Evaluation
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Guevarra, Crystle. "Fontana Community Health Assessment." Thesis, Western University of Health Sciences, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10112508.
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Obesity often arises from poor diet and lack of exercise. Food deserts, in particular, cause people to develop poor eating habits because of the limited healthy food options and availability to cheap fast food chains. People affected by food deserts are usually found in communities of color and low-income areas. The purpose of the study was to identify whether Fontana residents are willing to adopt healthier lifestyles based on the perceptions about their own health and the health of the community. Mixed method research was utilized for the study. The participants in the study included adult residents of both sexes and all ethnic backgrounds from the City of Fontana. Those participants ranged in ages from 18 and above. The data results proved some significance between Fontana residents' will to adopt healthier lifestyles and their perceptions on personal and community health. The bivariate correlation tests indicated a statistical significance between the tested variables despite their small correlations and large unshared variances. The ANOVA tests aided with proving the validity of the proposed hypotheses. Based on the data findings, the null hypothesis was rejected and alternative hypothesis was accepted. For future research on getting residents to be more proactive about their health and that of the community, shorter and simpler surveys were advised.
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Danner, Travis W. "A Formulation of Multidimensional Growth Models for the Assessment and Forecast of Technology Attributes." Diss., Georgia Institute of Technology, 2006. http://hdl.handle.net/1853/11546.
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A Formulation of Multidimensional Growth Models for the Assessment and Forecast of Technology Attributes
Travis W. Danner
229 Pages
Directed by Dr. Dimitri Mavris
This research proposes the formulation of multidimensional growth models as an approach to simulating the advancement of multi-objective technologies towards their upper limits. These multidimensional growth models are formulated by noticing and exploiting the correlation between technology growth models and technology frontiers. Both are frontiers in actuality. The technology growth curve is a frontier between capability levels of a single attribute and time, while a technology frontier is a frontier between the capability levels of two or more attributes. Multidimensional growth models are formulated by exploiting the mathematical significance of this correlation. The result is a model that can capture both the interaction between multiple system attributes and their expected rates of improvement over time. The fundamental nature of technology development is maintained and interdependent growth curves are generated for each system metric with minimal data requirements. Being founded on the basic nature of technology advancement, relative to physical limits, the availability for further improvement can be determined for a single metric relative to other system measures of merit. A byproduct of this modeling approach is a single n-dimensional technology frontier linking all n system attributes with time. This provides an environment capable of forecasting future system capability in the form of advancing technology frontiers.
In addition to formulating the multidimensional growth model, this research provides a systematic procedure for applying it to specific technology architectures. Researchers and decision-makers are able to investigate the potential for additional improvement within that technology architecture and estimate the expected cost of each incremental improvement relative to the cost of past improvements. In this manner, multidimensional growth models provide the necessary information to set reasonable program goals for the further development of a particular technological approach or to establish the need for new technological approaches in light of the constraining limits of conventional approaches.
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Khan, Eijaz Ahmed. "Sustainable growth of informal social microenterprises (ISMs) in a developing country: a multidimensional assessment." Thesis, Curtin University, 2014. http://hdl.handle.net/20.500.11937/1650.
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This study investigates the factors affecting the sustainable growth of informal social microenterprises (ISMs) in the context of a developing country. A mixed method approach was used. At first, a comprehensive model was developed through a literature review and field study analysis. Next, the data of the survey was analysed through Partial Least Square approach. Results indicate that various resources and capabilities affect the ISMs growth. This study proposes several future directions and policy implications.
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Siquenique, Sofia. "Avaliação Multidimensional da Pessoa Idosa: análise crítica da literatura e proposta de protocolo: domínios e Instrumentos de Avaliação." Master's thesis, Instituto Politécnico de Setúbal. Escola Superior de Saúde, 2015. http://hdl.handle.net/10400.26/11119.
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Dissertação de Mestrado em Fisioterapia em Condições Músculo-EsqueléticasObjetivo: definir os domínios que constituem uma avaliação multidimensional da pessoa idosa, bem como os instrumentos de avaliação mais adequados para a análise de cada um desses domínios de acordo com os critérios estabelecidos e tendo em conta a evidência científica atual. Enquadramento: tendo em conta as alterações inerentes ao envelhecimento, é esperado que a população idosa apresente necessidades complexas, havendo tendência para uma perda funcional e consequentemente da qualidade de vida visto existir uma relação estreita entre todas as vertentes biopsicossociais da pessoa. Assim, a evidência científica tem vindo a comprovar a necessidade e importância de uma avaliação multidimensional da pessoa idosa, no sentido de se compreender de uma forma global todas as necessidades dos utentes, identificando perturbações funcionais, físicas, mentais e sociofamiliares e contribuindo assim para intervenções mais adequadas e personalizadas, com consequente melhoria na resolução dos problemas identificados e prevenção de comorbilidades. Métodos: Este estudo iniciou-se com uma pesquisa na literatura científica atual com o objetivo de encontrar os domínios considerados de maior relevância numa avaliação multidimensional da pessoa idosa, bem como os instrumentos existentes para análise de cada um dos campos. Posteriormente foi realizada uma consulta de peritos através do método Delphi, onde foram incluídos 5 profissionais de saúde experts em geriatria e quatro idosos com diferentes níveis de literacia, com a finalidade de recolher as suas opiniões acerca dos domínios e instrumentos de avaliação previamente selecionados de acordo com a evidência e critérios pré-definidos. De acordo com os resultados obtidos no painel, foram então estabelecidos os domínios e instrumentos de avaliação inerentes a uma avaliação multidimensional da pessoa idosa. Resultados: numa primeira ronda quatro membros do painel responderam aos questionários, sendo que todos eles foram consensuais em relação à importância dos domínios em causa. Por sua vez, dos quatro membros que participaram nesta ronda, somente dois se manifestaram na seção relativa aos instrumentos de avaliação, estando ambos de acordo quanto à adequabilidade dos instrumentos selecionados. Contudo, ao contrário dos restantes instrumentos, no caso do domínio Dor, o consenso encontrado foi de discordância quanto à Escala Numérica da Dor enquanto ferramenta de avaliação da intensidade deste sintoma. Por sua vez, as opiniões destes membros do painel em relação à melhor alternativa a este instrumento não foram congruentes, tendo sido necessário recorrer a uma segunda ronda. Nesta fase, dois membros do painel responderam ao questionário, tendo sido possível concluir que o melhor instrumento de avaliação da intensidade da Dor é a Escala Qualitativa. Conclusão: de acordo com o painel Delphi, dos domínios e instrumentos selecionados primeiramente tendo em conta a pesquisa na literatura atual, somente a Escala Numérica da Dor não foi considerada adequada. Neste sentido, foram estabelecidos como domínios essenciais numa avaliação multidimensional da pessoa idosa, os seguintes: autoperceção de saúde; morbilidade; dor; funcionalidade; história de quedas; equilíbrio, marcha, força muscular e risco de quedas; estado cognitivo; humor/condições emocionais; aspetos sociofamiliares; estado nutricional e atividade física. Por sua vez, concluiu-se que os instrumentos mais adequados são: SF-36, MAB, Escala Qualitativa da Dor, MDG, Escala de Barthel, Índice de Lawton-Brody, Teste TUG, Escala de Equilibrio de Berg, Escala CEA, Teste “30´s chair stand”, MMSE, EDG-15, Escala de Apgar Familiar, ESSS, MNA (versão reduzida), Questionário IPAQ e Acelerómetro.
Objective: To identify the areas which are a multidimensional assessment of the elderly, as well as assessment tools best suited to the analysis of each of these areas according to established criteria, taking into account the current scientific evidence. Framework: given the inherent to aging changes, it is expected that the elderly population has higher and more complex needs with a tendency to a loss of function and hence quality of life since there is a close relationship between all biopsychosocial aspects of the person. Thus, the scientific evidence has come to prove the need and importance of a multidimensional assessment of the elderly, in order to understand in a comprehensive manner all the needs of users, identifying functional impairment, physical, mental, social and family and contributing to interventions most appropriate and customized, with consequent improvement in the resolution of identified problems and prevention of comorbidities. Methods: This study began with a survey on the current scientific literature in order to find the areas considered most relevant in a multidimensional assessment of the elderly, as well as existing tools for analyzing each of the fields. It was later held an expert consultation through the Delphi method, which included 5 professional health experts in geriatrics and four elderly people with different levels of literacy, in order to collect their opinions regarding the areas and assessment tools previously selected according with evidence and pre-defined criteria. According to the results of the panel it was then established domains and evaluation tools inherent in a multidimensional assessment of the elderly. Results: in the first round only four panel members answered the questionnaire, and all agreed on the importance of the areas concerned. In turn, between the four members who participated in this round, only two demonstrated in the section relative to the assessment instruments, agreeding both on the suitability of the selected instruments. However, unlike other instruments, in the case of pain domain, the consensus was of disagreement as to the Numerical Pain Scale as evaluation tool of the intensity of this symptom. In turn, the opinions of these panel members regarding the best alternative to this instrument were not congruent, being necessary to resort to a second round. At this stage, only two panel members responded to the questionnaire, it was possible to conclude that the best instrument to evaluate the intensity of pain is the Qualitative Scale. Conclusion: According to the Delphi panel, the areas and instruments selected primarily in view of the research in the literature, only the Numerical Pain Scale was not considered appropriate. It was established as key areas in a multidimensional assessment of the elderly: health auto-perception; morbidity; pain; functionality; history of falls; balance, gait, muscle strength and risk of falls; cognitive state; mood / emotional conditions; social-familial aspects; nutritional status and physical activity. In turn, it was concluded that the most appropriate instruments are: SF-36, MAB, Verbal Pain Scale, MDG, Barthel Index, Lawton-Brody Index, TUG Test, Berg Balance Scale, CEA Scale, "30's chair stand" test, MMSE, GDS-15, Family Apgar Score, ESSS, MNA (reduced version), IPAQ and Accelerometer.
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Grefe, Linderbaum Beth. "FEEDBACK ORIENTATION: THE DEVELOPMENT AND VALIDATION OF A MULTIDIMENSIONAL MEASURE." University of Akron / OhioLINK, 2006. http://rave.ohiolink.edu/etdc/view?acc_num=akron1152204402.
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Broaddus, Michelle. "Multidimensional implicit and explicit condom attitudes: Structure and implications for health messages." Connect to online resource, 2008. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3315812.
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Dangel, Trever. "Associations between Multidimensional Spirituality and Mental Health: Positive Psychological Traits as Mediators." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etd/3436.
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Research in the areas of religion and spirituality and positive psychology have experienced considerable growth within the past two decades. Such growth has led to a plethora of research identifying important constructs in both areas and key relationships among them. The current literature is, however, limited by unclear distinctions between the constructs of religion and spirituality, and a general lack of research into their associations with positive psychological traits and mental health status. As such, the present study aimed to investigate a new model of spirituality, the RiTE model, which is a three-part model designed to capture the multifaceted nature of the spiritual experience. The RiTE model was investigated in its relationship with mental health status in the context of a parallel mediation model, with self-forgiveness, gratitude, and mindfulness serving as parallel mediators. Results suggested that ritualistic and existential spirituality displayed direct associations with mental health status (positive and negative, respectively), while theistic spirituality displayed indirect associations. Indirect associations between theistic spirituality and mental health status were primarily a function of higher levels of gratitude, while existential spirituality was associated with higher levels of all three mediator variables. Clinicians may benefit from utilizing this knowledge when conceptualizing an individual’s spiritual worldview and utilizing spirituality when attempting to enhance client resilience via positive psychological approaches. Future studies should provide further insight into these treatment applications in addition to further clarifying the nuanced mechanisms of the spirituality-mental health association.
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Zetterberg, Lena. "Multidimensional Aspects of Dystonia : Description and Physiotherapy Management." Doctoral thesis, Uppsala universitet, Institutionen för neurovetenskap, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-9417.
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Aims: The overall aim of this research was to increase the knowledge about dystonia by identifying factors that influence self-reported quality of life and health in this disorder and to determine what factors predict disability. A further aim was to develop an objective outcome measure for quantifying the movement dysfunction in cervical dystonia (CD) and evaluate effects of physiotherapy. Methods: A descriptive correlative design was adopted for study I (n=351), with a questionnaire covering physical activity, satisfaction with treatment, physiotherapy or not, and quality of life and health measured with the Craniocervical Dystonia Questionnaire (CDQ-24) and the Cervical Dystonia Impact Profile, respectively. In study II a CD group (n=6) was compared with a control group (n=6). Head movements were measured with a motion capture system, and a Movement Energy Index (MEI) was calculated. In study III an experimental single-case design (n=6) was used, with continuous assessments during pre-treatment, intervention and follow-up. Quality of life, measured with CDQ-24, was the primary outcome measure. A prospective correlative design was applied in study IV (n=179), where data from questionnaires were collected on inclusion and 2 months later. Independent variables were: duration of dystonia, severity of dystonia, pain intensity, catastrophizing, self-efficacy, fatigue, kinesiophobia, depression, anxiety and physical activity; and the dependent variables were the Neck Disability Index and the Functional Disability Questionnaire. Results: Study I indicated that physical activity and satisfaction with treatment were associated with quality of life and health in dystonia. In study II the groups differed significantly concerning MEI in all movement directions. Mean MEI was significantly higher in patients than in controls. Positive treatment outcomes were reported by all patients in study III, mainly with reduced pain and reduced CD severity during the treatment period. Five of the six patients reported increased quality of life at the 6-month follow-up. Perceived self-efficacy, fatigue, pain intensity and anxiety contributed significantly to disability prediction in study IV. Conclusion: These investigations have increased the knowledge of dystonia from a multidimensional perspective and the results could be valuable in developing new treatment strategies.
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Deville, Craig W. "An Investigation of Content- and Construct-Related Evidence of Self-Assessment Items Using Multidimensional Scaling." The Ohio State University, 1994. http://rave.ohiolink.edu/etdc/view?acc_num=osu1389191999.
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Deville, Craig W. "An investigation of content- and construct-related evidence of self-assessment items using multidimensional scaling /." The Ohio State University, 1993. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487848891513513.
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Lett, Robin M. "A multidimensional investigation of the relationships among spiritual maturity, spiritual experience, and health-promoting behaviors." Virtual Press, 2002. http://liblink.bsu.edu/uhtbin/catkey/1233202.
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The purpose of this study was to investigate the influence of spiritual experiences, spiritually maturity, and the interaction of spiritual experience and maturity above the additive effects of separate effects, on the engagement in health-promoting behaviors (personal development, sense of purpose, self-awareness and satisfaction; health responsibility; participation in regular exercise and meal patterns; close relationships; and stress management). This study was important because there is a deficit in the literature investigating the effects of spiritual experience and maturity on wellness behaviors.The study's sample consisted of 241 volunteers from various religious and nonreligious groups in a medium sized Midwestern town. Participants completed a battery of questionnaires, including the Health-Promoting Lifestyle Profile, Index of Core Spiritual Experiences, the Spiritual Maturity subscale of the Spiritual Experience Index- Revised, and a demographic questionnaire. The combination of spiritual experience and spiritual maturity, with demographic variables held constant, was significant and accounted for 22% of the variance in health-promoting behaviors. Results showed that spiritual experience is a significant predictor of health-promoting behaviors. Spiritual maturity and the interaction between spiritual experience and spiritual maturity were not significantly related to health-promoting behaviors.Department of Counseling Psychology and Guidance Services