There is a distinct lack of research into the concept of acute mental health crisis. Without investigating the concept of crisis itself, it is not possible to appreciate the attributes of crisis so that it can be measured. This has hampered the development of good psychometric tools for crisis. The aim of this research was to develop the first standardised, valid and reliable measure for the assessment of people presenting to Crisis Resolution and Home Treatment (CRHT) teams. This research utilised qualitative and quantitative research techniques to develop a crisis measure starting with a comprehensive investigation into the concept of acute mental health crisis to identify an item pool and clinically credible item rating scale. A prototype crisis measure was developed and piloted in two NHS CRHTs and data collected. This data was analysed to identify the key areas of crisis assessment (the subscales), a flexible rating scale and scoring system creating a measure named the Crisis Risk and Adaptive Functioning Tool (CRAFT). The CRAFT provides patient crisis profiles highlighting areas of strength, resilience, weakness and vulnerability. A thorough investigation of crisis was completed with CRHT staff and patients through interviews and focus groups. An initial 143 item pool and clinically credible item rating scale were identified and developed into a prototype pilot crisis measure. This measure utilised a flexible rating approach encapsulating both risk and protective factors believed to reflect clinical practice. The measure was piloted and the data analysed to assess the structure of the crisis measure’s item pool using the statistical techniques of Principal Component Analysis (PCA) and Rasch analysis. These analyses resulted in a 66 item measure with 8 unidimensional subscales including; 1) Crisis Recovery Indicators, 2) Adaptive Decision Making, 3) Risk of Harm to Self, 4) Mediating Factors, 5) Daily Structure, 6) Risk of Harm to Others, 7) Feelings and Affect, and 8) Basic Needs. The total variance explained by these 8 subscales was 67.6% with excellent internal reliability as indicated by a Cronbach’s alpha coefficient of 0.98 (p<0.001) and temporal reliability indicated by Spearman’s correlation of 0.971 (p<0.001, one tailed). This suggests that this measure has a strong internal structure and provides stable outcomes over time at both the subscale and global overall measurement levels. Receiver Operator Characteristic curve analysis supported the identification of cut-offs to indicate low, moderate and high levels of crisis and were shown to have good levels of sensitivity and specificity for the crude discrimination between individuals who require CRHT treatment and individuals who do not require CRHT treatment (sensitivity 0.89 and specificity 0.73) and for accurately discriminating between the basic treatment levels of low, moderate and high (sensitivity 0.80; specificity 0.69). One of the great advantages of utilising the Rasch model is that it supports the identification of key characteristics from an item pool. Application of the subscales and the overall measure to the Rasch model identified items that were most representative of underlying constructs and risk, highlighting items of essential essence for assessing crisis in the context of community treatment. These items may act as useful clinical and risk indicators for community assessment. After considering the evidence from the PCA and Rasch analysis for the underpinning construct, the measure was named the Crisis Risk and Adaptive Functioning Tool (CRAFT) to encapsulate both the risk and adaptive functioning (coping and management) aspects measured by the tool. There are a number of clinical implications resulting from the development of CRAFT for the assessment of crisis. This research clearly identifies 8 key areas for crisis assessment and the specific items that describe them. This promises to be a powerful clinical tool as it clarifies the main areas of concern and importance for crisis assessment and provides mental health professionals with a means of assessing and monitoring patients experiencing crisis. In addition to the clinical benefits offered by the CRAFT, it provides an approach to assessing and monitoring crisis to support further research in the area of acute mental health crisis. This research offers significant steps towards the development of a quality measure for crisis assessment. However, it is acknowledged that the process of measurement development is never complete. It simply evolves over time with the aim of coming closer to the valued direction.

This study investigated the effects of test length (10, 20 and 30 items), scoring schema (proportion of dichotomous ad polytomous scoring) and item analysis model (IRT and Rasch) on the ability estimates, test information levels and optimization criteria of mixed item format tests. Polytomous item responses to 30 items for 1000 examinees were simulated using the generalized partial-credit model and SAS software. Portions of the data were re-coded dichotomously over 11 structured proportions to create 33 sets of test responses including mixed item format tests. MULTILOG software was used to calculate the examinee ability estimates, standard errors, item and test information, reliability and fit indices. A comparison of IRT and Rasch item analysis procedures was made using SPSS software across ability estimates and standard errors of ability estimates using a 3 x 11 x 2 fixed factorial ANOVA. Effect sizes and power were reported for each procedure. Scheffe post hoc procedures were conducted on significant factos. Test information was analyzed and compared across the range of ability levels for all 66-design combinations. The results indicated that both test length and the proportion of items scored polytomously had a significant impact on the amount of test information produced by mixed item format tests. Generally, tests with 100% of the items scored polytomously produced the highest overall information. This seemed to be especially true for examinees with lower ability estimates. Optimality comparisons were made between IRT and Rasch procedures based on standard error rates for the ability estimates, marginal reliabilities and fit indices (-2LL). The only significant differences reported involved the standard error rates for both the IRT and Rasch procedures. This result must be viewed in light of the fact that the effect size reported was negligible. Optimality was found to be highest when longer tests and higher proportions of polytomous scoring were applied. Some indications were given that IRT procedures may produce slightly improved results in gathering available test information. Overall, significant differences were not found between the IRT and Rasch procedures when analyzing the mixed item format tests. Further research should be conducted in the areas of test difficulty, examinee test scores, and automated partial-credit scoring along with a comparison to other traditional psychometric measures and how they address challenges related to the mixed item format tests.

In second language (L2) listening assessment, various factors have the potential to impact the validity of listening test items (Brindley & Slatyer, 2002; Buck & Tatsuoka, 1998; Freedle & Kostin, 1999; Nissan, DeVincenzi, & Tang, 1996; Read, 2002; Shohamy & Inbar, 1991). One relatively unexplored area to date is who controls the aural input. In traditional standardized listening tests, an administrator controlled recording is played once or twice. In real world or classroom listening, however, listeners can sometimes request repetition or clarification. Allowing listeners to control the aural input thus has the potential to add test authenticity but requires careful design of the input and expected response as well as an appropriate computer interface. However, if candidates feel less anxious, allowing control of listening input may enhance examinees' experience and still reflect their listening proficiency. Comparing traditional and self paced (i.e., examinees having the opportunity to start, stop, and move the audio position) delivery of multiple choice comprehension items, my research inquiry is whether self paced listening can be a sufficiently reliable and valid measure of examinees' listening ability. Data were gathered from 100 prospective and current university ESL students. They were administered computer based multiple choice listening tests: 10 identical once played items, followed by 33 items in three different conditions: 1) administrator paced input with no audio player visible, 2) self paced with a short time limit, and 3) self paced with a longer time limit. Many facet Rasch (1960/1980) modeling was used to compare the difficulty and discrimination of the items across conditions. Results indicated items on average were similar difficulty overall but discriminated best in self paced conditions. Furthermore, the vast majority of examinees reported they preferred self paced listening. The quantitative results were complemented by follow up stimulated recall interviews with eight participants who took 22 additional test items using screen capture software to explore whether and when they paused and/or repeated the input. Frequency of and reasons for self pacing did not follow any particular pattern by proficiency level. Examinees tended to play more than once but not two full times through, even without limited time. Implications for listening instruction and classroom assessment, as well as standardized testing, are discussed.

Thesis advisor: Larry H. Ludlow / Preparing and supporting teachers to enact teaching practice that responds to diversity, challenges educational inequities, and promotes social justice is a pressing yet daunting and complex task. More research is needed to understand how and to what extent teacher education programs prepare and support teacher candidates to enhance the achievement of all learners while challenging systematic inequity (Cochran-Smith, Ell, Ludlow, Grudnoff, & Aitken, 2014). One piece of empirical evidence needed is a measure that captures the extent to which teachers enact teaching practice for equity. This study developed an instrument – the Teaching Equity Enactment Scenario Scale (TEES) - to measure the extent of equity-centered teaching practice by applying Rasch measurement theory (Rasch, 1960) and Guttman’s facet theory (Borg & Shye, 1995). The research question addressed whether the TEES scale can measure teachers’ self-reported enactment of practice for equity in a reliable, valid, and authentic manner. This study employed a three-phase design, comprising an extensive process of item development, a pilot study and a final full-scale administration. Fifteen scenario-style items were developed to capture the enactment levels of six interconnected principles of teaching practice for equity. Using the Rasch rating scale model the outcome was a 15-item TEES scale that reliably and validly measures increasing levels of teaching practice for equity progressing through low, moderate, and high levels of enactment. The distribution of the scenarios confirmed their hypothesized order and the instrument development principles of Rasch measurement - unidimensionality, variation and a hierarchical order of the items, as well as a uniform continuum defining the construct. The scale also provides meaningful interpretations of what a raw score means regarding one’s equity-centered teaching practice. The overall findings suggest that the novel approach of combining Rasch measurement and facet theory can be successful in developing a scenario-style scale that measures a complex construct. Moreover, the scale can provide the evidence needed in research on preparing and supporting teachers to teach with a commitment to equity and social justice.

Information systems (IS) research frequently uses survey data to measure the interplay between technological systems and human beings. Researchers have developed sophisticated procedures to build and validate multi-item scales that measure latent constructs. The vast majority of IS studies uses classical test theory (CTT), but this approach suffers from three major theoretical shortcomings: (1) it assumes a linear relationship between the latent variable and observed scores, which rarely represents the empirical reality of behavioral constructs; (2) the true score can either not be estimated directly or only by making assumptions that are difficult to be met; and (3) parameters such as reliability, discrimination, location, or factor loadings depend on the sample being used. To address these issues, we present item response theory (IRT) as a collection of viable alternatives for measuring continuous latent variables by means of categorical indicators (i.e., measurement variables). IRT offers several advantages: (1) it assumes nonlinear relationships; (2) it allows more appropriate estimation of the true score; (3) it can estimate item parameters independently of the sample being used; (4) it allows the researcher to select items that are in accordance with a desired model; and (5) it applies and generalizes concepts such as reliability and internal consistency, and thus allows researchers to derive more information about the measurement process. We use a CTT approach as well as Rasch models (a special class of IRT models) to demonstrate how a scale for measuring hedonic aspects of websites is developed under both approaches. The results illustrate how IRT can be successfully applied in IS research and provide better scale results than CTT. We conclude by explaining the most appropriate circumstances for applying IRT, as well as the limitations of IRT.

A prevalência de crianças com atrasos no desenvolvimento é estimada em torno de 16 a 18%, sendo que menos de um terço dessas crianças são identificadas por serviços básicos de saúde. Estima-se que no Brasil a taxa de identificação de crianças com problemas do desenvolvimento é ainda menor uma vez que existe uma lacuna de instrumentos validados e normatizados para crianças de idades entre zero a seis anos de idade. A identificação de atrasos e comprometimentos do desenvolvimento cognitivo de crianças é essencial já que quanto mais cedo houver encaminhamento para intervenção, maiores são os benefícios. A escala cognitiva do Inventário Dimensional de Avaliação do Desenvolvimento Infantil (IDADI) é composta por 106 itens que avaliam o desempenho em funções como formação de conceitos, simbolização, abstração, percepção, atenção, velocidade de processamento da informação, processamento visoespacial, solução de problemas e memória. O presente estudo objetivou investigar as evidências de validade relacionadas à estrutura interna da escala cognitiva do IDADI e descrever as transformações das estimativas de desenvolvimento cognitivo ao longo das faixas etárias da amostra. 1336 crianças foram avaliadas a partir das respostas das mães aos itens do inventário. Análises de Rasch indicaram consistência interna plenamente satisfatória e ótima discriminação dos participantes. Os itens forneceram uma medida compreensível do traço latente avaliado indicando validade de construto e precisão da escala. As faixas etárias tiveram diferenças significativas com grande tamanho de efeito e análises de agrupamento apontaram para diferentes padrões de associação entre desenvolvimento e idade ao longo do tempo. Deste modo, a escala cognitiva do IDADI se mostrou um instrumento válido e útil capaz de avaliar os diferentes estágios do desenvolvimento cognitivo infantil. / The prevalence of children with developmental delays is estimated to range from 16% to 18%, but less than one-third of these children are identified by their health care providers. In Brazil, underdetection of children with developmental problems is even greater due to the limited number of standardized screening and assessment tools with appropriate normative data. Early detection of delays and disabilities is essential, because the earlier the intervention, the greater the benefit. In order to address this issue, the cognitive scale of the Inventário Dimensional de Avaliação do Desenvolvimento Infantil (IDADI; Dimensional Inventory for Child Development Assessment) was developed. It consists of 106 items that assess, via mother report, cognitive development on symbolization, abstraction, perception, attention, information processing speed, visuospatial processing, problem solving and memory. A sample of 1336 Brazilian children took part on the study. Rasch analysis indicated satisfactory discrimination. Items provided a comprehensive measure of the latent trait indicating construct validity and scale reliability. Age groups had significant differences with large effect size. Cluster analyzes indicated different patterns of association between cognitive development and age over time. Thus, the results point out that the cognitive scale of IDADI can be considered a valid and useful tool, capable to assess the different stages of child cognitive development.

by Tan Ah Kiang. / Bibliography: leaves 90-96 / Thesis (M.A.Ed.) -- Chinese University of Hong Kong, 1983

Diversos estudos têm demonstrado associação entre o temperamento e os níveis de ansiedade pré-operatória em crianças. Entretanto, a natureza desta associação não é consenso. Como a maioria desses estudos utilizou o questionário EASI (emocionalidade, atividade, sociabilidade e impulsividade) como instrumento para mensurar o temperamento, o presente estudo examina em profundidade as propriedades psicométricas do mesmo utilizando a análise de Rasch, para determinar se o instrumento mede de forma adequada o temperamento de crianças. Além disso, outras análises são aplicadas para explorar novas estruturas fatoriais do instrumento original. A habilidade da nova versão do EASI para discriminar diferentes níveis de ansiedade no período préoperatório imediato em crianças também foi investigada. Trata-se de um estudo transversal, com amostra de conveniência, onde foram incluídas crianças entre dois e seis anos agendadas para procedimentos cirúrgicos eletivos ambulatoriais. Os cuidadores das crianças completaram um formulário sócio-demográfico, o questionário EASI e uma Escala Análogo-Visual (EAV) de 100mm. Também, a Escala de Ansiedade Pré-Operatória de Yale (mYPAS) foi aplicada imediatamente antes da administração da medicação préanestésica, pelo anestesista pediátrico. Uma vez que o escore médio de compreensão das questões, medido pela EAV, foi superior a 80mm, considerou-se que o nível de compreensão da versão traduzida do EASI foi adequado. O questionário foi respondido por 110 cuidadores. Os resultados da análise de Rasch evidenciaram que as quatro subescalas da estrutura original apresentam desempenho inadequado (especialmente baixo índice de classificação correta dos aspectos do temperamento). A análise de componentes principais gerou uma solução com dois fatores. O Fator 1 é composto de itens de atividade e impulsividade, e o Fator 2 é predominantemente composto por itens das sub-escalas de sociabilidade e atividade. As sub-escalas originais do EASI não se correlacionaram com os escores da mYPAS, à exceção da sociabilidade (r=-0,449; P <0,001). O Fator 1 apresentou correlação positiva (r=0,239; P =0,0034) com a mYPAS, enquanto o Fator 2 apresentou correlação negativa (r=-0,404, P <0,0001). A análise de Rasch indicou que o instrumento original teve poder de discriminação insuficiente. Dentre os dois fatores propostos, os doze itens que compõem o Fator 1 apresentam perfil estatístico adequado, com alto poder de discriminação e relevância clínica. O Fator 2 não tem poder de discriminação adequado no seu formato atual, e ainda necessita de ajustes. / Some studies have shown correlation between temperament and preoperative anxiety levels in children. However, the nature of the association is not consensual. As most of these studies have used the EASI (emotionality, activity, sociability and impulsivity) questionnaire as an instrument to assess temperament, the present study examines the psychometric properties of this questionnaire in depth using the Rasch analysis to determine whether it is suitable for measuring children’s temperament. In addition, further analyses are carried out to explore potentially new factorial structures of the original instrument. The ability to discriminate between different levels of a child’s anxiety in the immediate preoperative period was also examined. It is a cross-sectional study, with a convenience sample of children aged between 2 and 6 years, to be submitted to outpatient elective surgeries. Children’s caregivers completed a socio-demographic form, the EASI questionnaire and a 0-100mm Analogue-Visual Scale (VAS). In addition, the Yale Preoperative Anxiety Scale (mYPAS) was performed immediately prior to the administration of pre-anesthetic medication by the pediatric anesthetist. As the mean comprehension level of the EASI-questions on VAS score was above 80mm, the translation of EASI was considered adequate. The questionnaire was answered by 110 caregivers. Results from Rasch analysis showed that the four subscales have inadequate perfomance (especially low person separation indices). Principal component analysis yielded a two-factor solution. Factor 1 is composed of activity and impulsivity items, and factor 2 is predominantly composed of items from the sociability and activity subscales. The original EASI subscales did not correlate with m-YPAS scores, with exception of sociability (r=-0.449; P <0.001). Factor 1 had a positive correlation (r=0.239; P=0.0034) with m-YPAS, while factor 2 showed a negative correlation (r=-0.404, P <0.0001). Rasch analysis indicated that the original EASI instrument has insufficient separation power. The twelve items that compose Factor 1 show adequate fit statistics, high separation power, and clinical meaning. Factor 2 is not sufficiently powerful in its current state, and still requires refinements.

The concept of patient empowerment, although acknowledged by the medical community as important, is rarely understood and seldom given priority in the illness trajectory of the cancer patient. A pilot study of a Shared Care Model amongst haematological cancer patients highlighted the fact that some patients spoke of a sense of empowerment and an overall sense of greater control when more fully included in the treatment and management of their condition. The research which forms the basis of this thesis focused on the role of empowerment in the wellbeing of cancer patients. There were three objectives to be met by completing this research. Firstly, to demonstrate that empowerment is a uniquely identifiable concept and can be measured separately from other quality of life indicators. Secondly, the study sought to explore that concept that empowerment takes into account the way in which patients act upon their prognosis and optimise the outcomes of treatment. Thus it is believed that accessing tailored resources and support structures benefit cancer patients and those who are caring for them such as close family members and friends by helping the patient achieve an individual level of empowerment. Finally, the research sought to explore the concept that empowerment improves psychological outcome in patients. The benefits are increased empowerment and an active use of coping strategies amongst patients in order to regain a measure of control over their illness. The Patient Empowerment Scale was developed to measure empowerment as an individual construct. '...' The Patient Empowerment Scale (15 items) was shown to be a reliable measure of empowerment and fitted the model well. A qualitative methodological approach sought to address and explore the second and third concepts. In addition, the concept of empowerment as it relates to motivation and self-efficacy was investigated qualitatively using in-depth interviewing technique. A phenomenological methodology was used to explore the 'lived experience of cancer patients' in regard to regaining control of their illness and the management thereof. Participants were interviewed using concepts identified for the Patient Empowerment Scale such as support strategies and use of resources. A series of interviews with breast cancer patients were conducted whereby patients responded to a number of questions. The questions explored areas such as support mechanisms in relation to cancer, their relationships with health professionals and significant others and their attitude toward and use of other resources and support systems such as support groups, spirituality, complementary therapies. In addition their views on acceptance and adaptation to their altered health status were explored. Results The research confirmed that it is feasible to measure empowerment as a separate quality of life indicator. Furthermore, that empowerment is linked to motivation and self-efficacy beliefs. The research also demonstrated that there are a number of core areas which are fundamental to regaining control and increasing empowerment for patients. These core areas are linked to support mechanisms, willingness to adapt and to access resources tailored to meet their needs. Patient empowerment emerged as a key aspect of enhanced quality of life regardless of prognosis and improved psychological outlook.

An examination of the logical relationships between attitude statements suggests that attitudes can be ordered according to favourability, and can also stand in relationships of implication to one another. The traditional representation of attitudes, as points on a single dimension, is inadequate for representing both these relations but representing attitudes as intervals on a single dimension can incorporate both favourability and implication. An interval can be parameterised using its two endpoints or alternatively by its midpoint and latitude. Using this latter representation, the midpoint can be understood as the �favourability� of the attitude, while the latitude can be understood as its �generality�. It is argued that the generality of an attitude statement is akin to its latitude of acceptance, since a greater semantic range increases the likelihood of agreement. When Coombs� Theory of Unidimensional Unfolding is reformulated using the interval representation, the key question is how to measure the distance between two intervals on the dimension. There are innumerable ways to answer this question, but the present study restricts attention to eighteen possible �distance� measures. These measures are based on nine basic distances between intervals on a dimension, as well as two families of models, the Minkowski r-metric and the Generalised Hyperbolic Cosine Model (GHCM). Not all of these measures are distances in the strict sense as some of them fail to satisfy all the metric axioms. To distinguish between these eighteen �distance� measures two empirical tests, the triangle inequality test, and the aligned stimuli test, were developed and tested using two sets of attitude statements. The subject matter of the sets of statements differed but the underlying structure was the same. It is argued that this structure can be known a priori using the logical relationships between the statement�s predicates, and empirical tests confirm the underlying structure and the unidimensionality of the statements used in this study. Consequently, predictions of preference could be ascertained from each model and either confirmed or falsified by subjects� judgements. The results indicated that the triangle inequality failed in both stimulus sets. This suggests that the judgement space is not metric, contradicting a common assumption of attitude measurement. This result also falsified eleven of the eighteen �distance� measures because they predicted the satisfaction of the triangle inequality. The aligned stimuli test used stimuli that were aligned at the endpoint nearest to the ideal interval. The results indicated that subjects preferred the narrower of the two stimuli, contrary to the predictions of six of the measures. Since these six measures all passed the triangle inequality test, only one measure, the GHCM (item), satisfied both tests. However, the GHCM (item) only passes the aligned stimuli tests with additional constraints on its operational function. If it incorporates a strictly log-convex function, such as cosh, the GHCM (item) makes predictions that are satisfied in both tests. This is also evidence that the latitude of acceptance is an item rather than a subject or combined parameter.