Measurement Challenges in Shared Decision Making: Putting the ‘Patient’ in Patient‐Reported Measures

Measuring clinicians\u27 shared decision-making (SDM) performance is a key requirement given the intensity of policy interest in many developed countries - yet it remains one of the most difficult methodological challenges, which is a concern for many stakeholders. In this Viewpoint Article, we investigate the development of existing patient-reported measures (PRMs) of SDM identified in a recent review. We find that patients were involved in the development of only four of the 13 measures. This lack of patient involvement in PRM development is associated with two major threats to content validity, common to all 13 PRMs of SDM: (i) an assumption of patient awareness of \u27decision points\u27 and (ii) an assumption that there is only one decision point in each healthcare consultation. We provide detailed examples of these threats and their impact on accurate assessment of SDM processes and outcomes, which may hamper efforts to introduce incentives for SDM implementation. We propose cognitive interviewing as a recommended method of involving patients in the design of PRMs in the field of SDM and provide a practical example of this approach

Measurement Challenges in Shared Decision Making: Putting the ‘Patient’ in Patient‐Reported Measures

Measuring clinicians\u27 shared decision-making (SDM) performance is a key requirement given the intensity of policy interest in many developed countries - yet it remains one of the most difficult methodological challenges, which is a concern for many stakeholders. In this Viewpoint Article, we investigate the development of existing patient-reported measures (PRMs) of SDM identified in a recent review. We find that patients were involved in the development of only four of the 13 measures. This lack of patient involvement in PRM development is associated with two major threats to content validity, common to all 13 PRMs of SDM: (i) an assumption of patient awareness of \u27decision points\u27 and (ii) an assumption that there is only one decision point in each healthcare consultation. We provide detailed examples of these threats and their impact on accurate assessment of SDM processes and outcomes, which may hamper efforts to introduce incentives for SDM implementation. We propose cognitive interviewing as a recommended method of involving patients in the design of PRMs in the field of SDM and provide a practical example of this approach

A new genus and species of stygobiontic dytiscid beetle, Comaldessus stygius (Coleoptera: Dytiscidae: Bidessini) from Comal Springs, Texas

A new genus and species of stygobiontic bidessine dytiscid beetle, Comaldessus stygius, from Comal Springs, Texas, is described and compared with the proposed sister epigean genus Uuarus and the only other known stygobiontic bidessine water beetles, Trogloguignotus concii Sanfilippo from Venezuela and Uvarus chappuisi (Peschet) from Africa. Distinctive characters of the adult are illustrated with pen and ink drawings and scanning electron micrographs. The new taxon is the second stygobiontic bidessine genus with rudimentary eyes known from the Western Hemisphere and the first known from North America

A new genus and species of stygobiontic dytiscid beetle, \u3ci\u3eComaldessus stygius \u3c/i\u3e (Coleoptera: Dytiscidae: Bidessini) from Comal Springs, Texas

A new genus and species of stygobiontic bidessine dytiscid beetle, Comaldessus stygius, from Comal Springs, Texas, is described and compared with the proposed sister epigean genus Uuarus and the only other known stygobiontic bidessine water beetles, Trogloguignotus concii Sanfilippo from Venezuela and Uvarus chappuisi (Peschet) from Africa. Distinctive characters of the adult are illustrated with pen and ink drawings and scanning electron micrographs. The new taxon is the second stygobiontic bidessine genus with rudimentary eyes known from the Western Hemisphere and the first known from North America

A new genus and species of stygobiontic dytiscid beetle, \u3ci\u3eComaldessus stygius \u3c/i\u3e (Coleoptera: Dytiscidae: Bidessini) from Comal Springs, Texas

A new genus and species of stygobiontic bidessine dytiscid beetle, Comaldessus stygius, from Comal Springs, Texas, is described and compared with the proposed sister epigean genus Uuarus and the only other known stygobiontic bidessine water beetles, Trogloguignotus concii Sanfilippo from Venezuela and Uvarus chappuisi (Peschet) from Africa. Distinctive characters of the adult are illustrated with pen and ink drawings and scanning electron micrographs. The new taxon is the second stygobiontic bidessine genus with rudimentary eyes known from the Western Hemisphere and the first known from North America

Stratigraphy and structure of the Horton Group, Lochaber-Mulgrave area, northern mainland Nova Scotia

The Lochaber-Mulgrave area of northern mainland Nova Scotia is underlain by rocks of the Late Devonian - Early Carboniferous Horton Group, in faulted contact with older Devonian and Silurian rocks to the south and west, and younger Carboniferous rocks to the north and east. The Horton Group is divided into (from oldest to youngest) the Clam Harbour River, Tracadie Road, Caledonia Mills, and Steep Creek formations, with a total thickness of at least 4000 m. These units were deposited in a variety of braided fluvial and shallow to deep lacustrine environments, and show lithological and stratigraphic similarities to the Horton Group elsewhere in Nova Scotia. Sparse palaeonto-logical data from macrofossils and spores indicate an age range from Famennian to late Tournaisian. Compared to elsewhere in Nova Scotia, the Horton Group in the Lochaber-Mulgrave area is more deformed and metamorphosed, especially in the southern part of the area near the Roman Valley Fault. The time of regional deformation and meta-morphism is constrained to ca. 340– 335 Ma by whole-rock 40Ar/39Ar dating of slate in the Clam Harbour River and Tracadie Road formations. Regional deformation and metamorphism may have resulted from burial by older rocks of the Guysborough block, thrust over the Horton Group in the Lochaber-Mulgrave area from the south as a result of transpression at a restraining bend along the Chedabucto-Roman Valley fault system during juxtaposition of the Avalon and Meguma terranes. RÉSUMÉ Le secteur de Lochaber-Mulgrave dans le nord de l'intérieur de la Nouvelle-Écosse repose sur des roches du groupe du Dévonien tardif au Carbonifère précoce de Horton, en contact faillé avec des roches du Dévonien et du Silurien au sud et à l'ouest, et avec des roches carbonifères au nord et à l'est. Le groupe de Horton se subdivise en (de la plus ancienne à la plus récente) formations de Clam Harbour River, de Tracadie Road, de Caledonia Mills et de Steep Creek, d'une épaisseur totale d'au moins 4 000 mètres. Ces unités se sont déposées au sein de divers environnements lacustres allant de peu profonds à profonds et d'environnements fluviaux anastomosés; elles présentent des similarités lithologiques et stratigraphiques avec le groupe de Horton ailleurs en Nouvelle-Écosse. Des données paléontologiques éparses tirées de macrofossiles et de spores révèlent une fourchette d'âges du Famennien au Tournaisien tardif. Comparativement aux autres régions de la Nouvelle-Écosse, le groupe de Horton dans le secteur de Lochaber-Mulgrave est plus déformé et métamorphisé, en particulier dans la partie méridionale du secteur, près de la faille de la vallée Roman. Le moment de la déformation et du métamorphisme régionaux se trouve restreint à environ 340-335 Ma par la datation 40Ar/39Ar de roche totale de l'ardoise dans les formations de Clam Harbour River et de Tracadie Road. La déformation et le métamorphisme régionaux pourraient avoir découlé de l'enfouissement de roches plus anciennes du bloc de Guysborough, qui chevauche le groupe de Horton dans le secteur de Lochaber-Mulgrave à partir du sud, par suite d'une transpression dans une inflexion de retenue le long du système de failles de Chedabucto-vallée Roman pendant la juxtaposition des terranes d'Avalon et de Megum

Design and implementation of an integrated surface texture information system for design, manufacture and measurement

The optimised design and reliable measurement of surface texture are essential to guarantee the functional performance of a geometric product. Current support tools are however often limited in functionality, integrity and efficiency. In this paper, an integrated surface texture information system for design, manufacture and measurement, called “CatSurf”, has been designed and developed, which aims to facilitate rapid and flexible manufacturing requirements. A category theory based knowledge acquisition and knowledge representation mechanism has been devised to retrieve and organize knowledge from various Geometrical Product Specifications (GPS) documents in surface texture. Two modules (for profile and areal surface texture) each with five components are developed in the CatSurf. It also focuses on integrating the surface texture information into a Computer-aided Technology (CAx) framework. Two test cases demonstrate design process of specifications for the profile and areal surface texture in AutoCAD and SolidWorks environments respectively

Delamination Detection of Reinforced Concrete Decks Using Modal Identification

This study addressed delamination detection of concrete slabs by analyzing global dynamic responses of structures. Both numerical and experimental studies are presented. In the numerical examples, delaminations with different sizes and locations were introduced into a concrete slab; the effects of presence, sizes, and locations of delaminations on the modal frequencies and mode shapes of the concrete slab under various support conditions were studied. In the experimental study, four concrete deck specimens with different delamination sizes were constructed, and experimental tests were conducted. Traditional peak-picking, frequency domain decomposition, and stochastic subspace identification methods were applied to the modal identification from dynamic response measurements. The modal parameters identified by these three methods correlated well. The changes in modal frequencies, damping ratios, and mode shapes that were extracted from the dynamic measurements were investigated and correlated to the actual delaminations and can indicate presence and severity of delamination. Finite element (FE) models of reinforced concrete decks with different delamination sizes and locations were established. The modal parameters computed from the FE models were compared to those obtained from the laboratory specimens, and the FE models were validated. The delamination detection approach was proved to be effective for concrete decks on beams