Background: Visual Analog Scale (VAS) and Numeric Rating Scale (NRS) are commonly used for measuring pain intensity. Although several studies have investigated agreement between VAS and NRS, there is a lack of knowledge about agreement in persistent neck pain and whether neck disability affects the agreement. Objective: Evaluate agreement between the two pain rating scales VAS and NRS for patients with persistent neck pain, and evaluate if the agreement is affected by neck disability, measured with Neck Disability Index. Methods: A cohort study with 43 participants with neck pain > 3 months. Neck pain now and average neck pain last week was measured on VAS and NRS, and were recorded two times. Correlation between VAS and NRS was analyzed with Spearmans r and agreement was calculated with Bland Altman. Between group differences in patients with high (>15) compared to low (<15) NDI regarding agreement in VAS/NRS, were analyzed with Mann-Whitney U-test. Results: There was a significant positive correlation between VAS and NRS (r=0,927–r=0,909, p>0,01) and neck disability did not affect the agreement. The largest mean difference was 0,5 with variation between -2 to 2 in 95% of the patients. Conclusion: The same measurement (VAS or NRS) should be used for repeated measuring in neck pain. It is important to be aware of the differences between VAS and NRS, especially when research results will be implemented in primary care.

Indiana University-Purdue University Indianapolis (IUPUI) / Vitamin D deficiency has been linked to chronic pain and increased opioid use. Realworld data such as electronic medical records and administrative claim data contain large amounts of clinical data and present an opportunity to study the relationship of serum 25- hydroxyvitamin D [25(OH)D] with pain intensity and opioid use. The first study assessed the association between serum 25(OH)D) levels and pain intensity. Compared to patients with normal 25(OH)D levels, those who had insufficient or deficient levels were more likely to experience moderate or severe pain, with multivariable-adjusted odds ratios (95% confidence intervals) of 1.19 (1.05-1.36) and 1.51 (1.28-1.79), respectively. Similar findings were obtained using propensity scores in the matched analyses. In the second study, we investigated the association between serum 25(OH.)D levels and opioid use among opioid-naïve patients. We revealed that those who had insufficient or deficient levels of 25(OH)D were more likely to receive an opioid prescription, with multivariableadjusted odds ratios of 1.10 (1.02-1.17) and 1.18 (1.09-1.28), respectively, compared to patients with normal 25(OH)D levels. Vitamin D deficiency was also associated with a longer duration of opioid use. In the third study, we performed machine learning to identify patient characteristics associated with persistent moderate-to-severe pain (PMSP), explicitly investigating if low serum 25(OH)D levels were a risk factor for heightened pain intensity among obese patients. Low levels of 25(OH)D were consistently identified as a key predictor from a large number of candidate variables in the machine learning models. We detected a significant positive association between serum 25(OH)D levels and PMSP in the logistic regression analysis. Compared to patients with normal levels of 25(OH)D, those who had insufficient or deficient levels of 25(OH)D were more likely to report PMSP, with multivariable-adjusted OR (95% CIs) of 1.15 (1.10-1.21) and 1.28 (1.21-1.35) respectively. We replicated the findings in the first study in a different cohort that showed that low serum 25(OH)D levels might play a role in pain perception. This research contributes to an improved understanding of the role of vitamin D on pain, and opioid use. Individuals who experience pain and need opioid therapy may benefit from optimizing their serum 25(OH)D levels.

The notion of learner autonomy is one of the major theoretical constructs studied in L2 learning. Drawing on Deci and Ryan's (1985) Self-Determination Theory (SDT), I sought to investigate and describe L2 learner autonomy and how an educational intervention influences it. The SDT conceptualizing human motivation for learning as existing on a continuum from extrinsic to intrinsic motivation provides ways of measuring learner autonomy and a rationale for educational interventions for developing it. First, Japanese adult EFL learners' characteristics were described in terms of learner autonomy-related psychological constructs (motivation, affect, and strategy use) according to levels of learner autonomy based on SDT. Second, the adapted VSS yielded significant effects on the participants' vocabulary learning and L2 learning anxiety (for the high and low autonomous motivation groups) and social strategy use (for the low autonomous motivation group). Third, the implementation of the adapted VSS into the adult L2 English classes was considered in terms of the development of linguistic and autonomous forms of learning quoting from the participants' quantitative and qualitative responses for this approach. / CITE/Language Arts

The O*NET was built to replace the Dictionary of Occupational Titles (DOT) and form a highly accessible, on-line (through the World Wide Web), common language occupational information center (Dye & Silver, 1999). This study tested the relevance of the self-rating choice and unconventional BARS format to be used by the O*NET system for occupational ratings. In addition, a new rating scale format named NBADS, was tested for improved ratings. Fifty three Incumbent raters in two occupations (Graduate teaching assistants and Secretaries) and 87 laypeople raters who have never worked in these occupations, rated 21 item-pairs (Importance and Level type questions) picked randomly from the 52 items on the original O*NET Ability questionnaire. Participants rated each of the 21 item-pairs three times, with the Level question being presented in the O*NET BARS, a Likert GRS and the NBADS formats; The importance type question was always rated using a 1-5 Likert scale. Hypothesis 1a was supported, showing a significant leniency bias across formats for self-ratings. Hypothesis 1b was mostly supported, failing to show significant leniency, elevation error or interrater agreement improvement over laypeople ratings; only the overall-error measure showed a significant improvement for incumbent raters. Hypothesis 2 was not supported, failing to show that the GRS format had any improvement on leniency, accuracy or interrater agreement over the O*NET BARS format. Hypothesis 3a was supported, showing significant leniency reduction, accuracy error reduction and higher interrater agreement using the NBADS format over the GRS format. In a similar sense, hypothesis 3b was partially supported, showing reduction in leniency effect and higher agreement using the NBADS format over the O*NET BARS format. Finally, hypothesis 4 was mostly supported, showing hardly any significant differences in the ratings of the Importance type question across the three format sessions, strengthening the idea that no other interfering variables have caused the format sessions' differences. Implications of the results are discussed. / Master of Science

Jakten på orörd snö är en central del i offpistskidåkning. För att hjälpa allmänheten att ta säkra beslut i lavinterräng skriver lavinexperter varje år en lavinprognos. Lavinprognoser är en form av riskkommunikation vars syfte är att göra vinterturister och andra människor medvetna om vilka risker dem eventuellt kan utsättas för på berget. Den här rapportens syfte är att undersöka vinterturisternas förståelse för “the danger rating scale” och lavinprognoser. Samt för att se hur den påverkar deras risktagande och beslutsfattande i lavinterräng. För att besvara dessa forskningsfrågor har ett kvalitativt metodval använts i form av 8 semi-strukturerade intervjuer. Resultatet visar att “the danger rating scale” och lavinprognoser har ett stort inflytande på vinterturisternas risktagande och beslutsfattande i lavinterräng. Men att det finns en tveksamhet i tolkandet av skalan. / The hunt for untouched snow is a central part of off-piste skiing. To help the public make safe decisions in avalanche terrain, avalanche experts write an avalanche forecast every year. Avalanche forecasts are a form of risk communication whose purpose is to make winter tourists' and other people aware of the risks they may be exposed to on the mountain. The purpose of this report is to investigate winter tourists' understanding of "the danger rating scale" and avalanche forecasts. As well as to see how it affects their risk-taking and decision-making in avalanche terrain. To answer these research questions, a qualitative choice of method has been used in the form of 8 semi-structured interviews. The results show that "the danger rating scale" and avalanche forecasts have a great influence on winter tourists' risk-taking and decision-making in avalanche terrain. But that there is a doubt in the interpretation of the scale. / <p>2023-06-16</p>

It is critical for researchers to be confident of the quality of survey data. Problems with data quality often relate to measurement method design, through choices made by researchers in their creation of standardised measurement instruments. This is known to affect the way respondents interpret and respond to these instruments, and can result in substantial measurement error. Current methods for removing measurement error are post-hoc and have been shown to be problematic. This research proposes that innovations can be made through the creation of measurement methods that take respondents' individual cognitions into consideration, to reduce measurement error in survey data. Specifically, the aim of the study was to develop and test a measurement instrument capable of having respondents individualise their own rating-scales. A mixed methodology was employed. The qualitative phase provided insights that led to the development of the Individualised Rating-Scale Procedure (IRSP). This electronic measurement method was then tested in a large multi-group experimental study, where its measurement properties were compared to those of Likert-Type Rating-Scales (LTRSs). The survey included pre-validated psychometric constructs which provided a baseline for comparing the methods, as well as to explore whether certain individual characteristics are linked to respondent choices. Structural equation modelling was used to analyse the survey data. Whilst no strong associations were found between individual characteristics and respondent choices, the results demonstrated that the IRSP is reliable and valid. This study has produced a dynamic measurement instrument that accommodates individual-level differences, not addressed by typical fixed rating-scales.

This study documented the psychometric development of the Adaptive Leadership Competency Profile (ALCP). The ALCP was derived from a qualitative database from the National Science Foundation project (NSF 9422368) and the academic body of literature. Test items were operationalized, and subject matter experts validated 11 macro-leadership competencies and 65 items. Rasch rating scale measurement models were applied to answer the following questions: (a) How well do the respective items of the ALCP fit the Rasch rating scale measurement model for the 11 scales of the ACLP? (b) How well do the person's abilities fit the Rasch rating scale measurement model, using the 11 scales of the ALCP? (c) What are the item separation and reliability coefficients for the 11 ALCP scales? (d) What are the person separation and reliability coefficients for the 11 ALCP scales? This study also sought to discern whether the ALCP could predict leader effectiveness as measured by the likelihood ratio index and frequency of correct predictions indices. The WINSTEPS and LIMDEP programs were used to obtain Rasch calibrations and probit estimates, respectively. The ALCP profiles the frequency and intensity of leadership behavior. Composite measures were calculated and used to predict leadership effectiveness. Results from this study validated 10 competencies and 55 items.

Introduction: Exploring the brain for optimal locations for deep brain stimulation (DBS) therapy is a challenging task, which can be facilitated by analysis of DBS efficacy in a large number of patients with Parkinson’s disease (PD). The Unified Parkinson's Disease Rating Scale (UPDRS) scores indicate the DBS efficacy of the corresponding stimulation location in a particular patient. The spatial distribution of these clinical scores can be used to construct a functional model which closely models the expected efficacy of stimulation in the region. Designs and Methods: In this study, different interpolation techniques were investigated that can appropriately model the DBS efficacy for Parkinson’s disease patients. These techniques are linear triangulation based interpolation, ‘roving window’ interpolation and ‘Monopolar inverse weighted distance’ (MIDW) interpolation. The MIDW interpolation technique is developed on the basis of electric field geometry of the monopolar DBS stimulation electrodes, based on the DBS model of monopolar cathodic stimulation of brain tissues. Each of these models was evaluated for their predictability, interpolation accuracy, as well as other benefits and limitations. The bootstrapping based optimization method was proposed to minimize the observational and patient variability in the collected database. A simulation study was performed to validate that the statistically optimized interpolated models were capable to produce reliable efficacy contour plots and reduced false effect due to outliers. Some additional visualization and analysis tools including a graphic user interface (GUI) were also developed for better understanding of the scenario. Results: The interpolation performance of the MIDW interpolation, the linear triangulation method and Roving window method was evaluated as interpolation error as 0.0903, 0.1219 and0.3006 respectively. Degree of prediction for the above methods was found to be 0.0822, 0.2986 and 0.0367 respectively. The simulation study demonstrate that the mean improvement in outlier handling and increased reliability after bootstrapping based optimization (performed on Linear triangulation interpolation method) is 6.192% and 12.8775% respectively. The different interpolation techniques used to model monopolar and bipolar stimulation data is found to be useful to study the corresponding efficacy distribution. A user friendly GUI (PDRP_GUI) and other utility tools are developed. Conclusion: Our investigation demonstrated that the MIDW and linear triangulation methods provided better degree of prediction, whereas the MIDW interpolation with appropriate configuration provided better interpolation accuracy. The simulation study suggests that the bootstrapping-based optimization can be used as an efficient tool to reduce outlier effects and increase interpolated reliability of the functional model of DBS efficacy. Additionally, the differential interpolation techniques used for monopolar and bipolar stimulation modeling facilitate study of overall DBS efficacy using the entire dataset.

Purpose: The aim of this research was to determine whether there is a difference in the presence of minimal cerebellar signs, hypermobility and dyspraxia in the group of patients with idiopathic scoliosis (IS) and a control group of individuals without IS. Methods: 11 patients have been selected for this research with IS and 11 individuals without IS as a control group. The International Cooperative Ataxia Rating Scale (ICARS) was used for examination of cerebellar signs. Hypermobility was evaluated with ten tests according to Janda. The presence of pendulum reflexes was determined by examination of patellar and triceps reflex, while dyspraxia was analyzed by means of the Czechoslovak test. Results: Patients with IS scored significantly worse in ICARS than the control group (p < 0,05). IS patients presented with significantly more pronounced hypermobility in head rotation (p = 0,0384) and forward bending (p = 0,0409) tests comparing to the control group. No significant difference between the two groups was identified in pendulum reflexes and the Czechoslovak dyspraxia test. Conclusion: The study confirms significantly more positive signs of ataxia and asynergy in a group of patients with IS comparing to control group. Hypermobility was significantly more pronounced in head rotation and forward...

Introdução - A disfunção sexual é uma queixa comum, porém, ainda pouco valorizada no âmbito da saúde pública, acometendo indistintamente homens e mulheres e com potenciais reflexos negativos na sua qualidade de vida e bem-estar. Objetivo - Avaliar a prevalência de disfunções sexuais e seus possíveis fatores associados entre mulheres de meia-idade residentes na Região Norte do Brasil. Métodos - Estudo transversal e prospectivo, envolvendo 1.415 mulheres entre 35 e 65 anos atendidas no Ambulatório de Ginecologia do Hospital das Clínicas do município de Rio Branco - Acre - Brasil. Para avaliar a sintomatologia menopausal e a sua função sexual, foram aplicados a Escala de Classificação da Menopausa e o Índice da Função Sexual Feminina. Na análise dos dados, usou-se o pacote estatístico Stata 10, aceitando-se um nível de significância de 5 por cento . Na análise de proporções, usou-se o teste não paramétrico do Qui-Quadrado de Pearson. No estudo dos fatores associados às disfunções sexuais, recorreu-se à análise multivariada através de regressão logística múltipla. Resultados - A média etária das mulheres estudadas foi de 47,7 (+8,5) anos. A sua maioria era de baixa escolaridade (6,4+4,6) anos completos de estudo. A menarca, em média, foi aos 13,4 (+1,6) anos. A maioria referiu gestações anteriores (4,6+2,8). Cerca de 35,9 por cento eram pós-menopáusicas, tendo a menopausa ocorrido ao redor dos 48,3 (+4,9) anos. A autopercepção de saúde foi considerada pelas entrevistadas ruim/muito ruim em 54,6 por cento . A irritabilidade foi a queixa mais frequente (78,3 por cento ), seguida pelos problemas osteoarticulares (74,8 por cento ) e ansiedade (72,7 por cento ). A prevalência de disfunção sexual foi de 62,3 por cento . Ajustados os possíveis fatores de confusão, mostraram-se associados a disfunção sexual: baixa escolaridade (OR:1,70; [IC 95 por cento :1,31-2,19]; p<0,001); sedentarismo (OR:1,73; [IC 95 por cento :1,23-2,42]; p=0,001); autopercepção de saúde ruim/muito ruim (OR:1,99; [IC 95 por cento :1,55-2,57]; p<0,001); estado de ânimo depressivo (OR:1,16; [IC 95 por cento :1,05-1,27]; p=0,002); problemas sexuais (OR:2,50; [IC 95 por cento :1,96-3,20]; p<0,001); ressecamento vaginal (OR:1,49; [IC 95 por cento :1,33-1,66]; p<0,001) e a fase de pós-menopausa (OR:1,82; [IC 95 por cento :1,39-2,38]; p<0,001). Conclusão - Entre a população de mulheres da Região Norte Brasileira estudada, a prevalência de disfunção sexual encontrada foi elevada e a análise dos possíveis fatores associados a sua ocorrência revelaram a influência das condições socioeconômicas, estilo de vida, além da sintomatologia e do estado menopausal, desvelando uma multidimensionalidade de aspectos biológicos e não biológicos envolvidos na sua gênese. / Introduction - Sexual dysfunction is a common complaint, under-recognized by public health services, that affects both men and women equally and has potentially negative impacts on the quality of life and general well-being of sufferers. Objective - To assess the prevalence of sexual dysfunctions, and their possible associated factors, among middle-aged women from the Northern region of Brazil. Methods - A cross-sectional, prospective study was carried out involving 1,415 women aged 35-65 years attended at the Gynecology Outpatient unit of the Clinicas Hospital of Rio Branco city - Acre state - Brazil. Menopausal symptomatology and female sexual function were assessed by applying the Menopause Rating Scale and Female Sexual Index. The Stata 10 statistics package was used for all data analysis, adopting a level of statistical significance of 5 per cent . Pearsons Chi-squared nonparametric association test was used for proportions analysis. Multivariate analysis using multiple logistic regression was employed to study the factors associated with sexual dysfunctions. Results - Mean age of the women studied was 47.7 (+8.5) years. The majority had a low educational level averaging (6.4+4.6) full years of schooling. Mean age at menarche was 13.4 (+1.6) years. The majority reported previous gestations (4.6+2.8). Approximately 35.9 per cent were post-menopausal with menopause occurring at around 48.3 (+4.9) years. Self-perceived health among respondents was rated as poor/very poor by 54.6 per cent . Irritability was the most frequent complaint (78.3 per cent ), followed by osteoarticular problems (74.8 per cent ), and anxiety (72.7 per cent ). The prevalence of sexual dysfunction was 62.3 per cent . After adjusting for potential confounding factors, the following were found to be associated with sexual dysfunction: low educational level (OR:1.70; [95 per cent CI:1.31-2.19]; p<0.001); sedentarism (OR:1.73; [95 per cent CI:1.23-2.42]; p=0.001); poor/very poor self-perceived health (OR:1.99; [95 per cent CI:1.55-2.57]; p<0,001); depressive mood (OR:1.16; [95 per cent CI:1.05-1.27]; p=0.002); sexual problems (OR:2.50; [95 per cent CI:1.96-3.20]; p<0.001); vaginal dryness (OR:1.49; [95 per cent CI:1.33-1.66]; p<0.001) and the post-menopausal stage (OR:1.82; [95 per cent CI:1.39-2.38]; p<0.001). Conclusion - A high prevalence of sexual dysfunction was found among women from Brazils Northern region, where socioeconomic conditions, lifestyle, as well as menopausal symptoms and status, influenced its occurrence, revealing a multidimensionality of biological and non-biological aspects involved in its genesis.