Replication and validation of higher order models demonstrated that a summary score for the EORTC QLQ-C30 is robust.

Objective: To further evaluate the higher-order measurement structure of the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30) questionnaire, with the aim of generating a summary score. Study design and setting: Using pretreatment QLQ-C30 data (N=3,282), we conducted confirmatory factor analyses to test seven previously evaluated higher-order models. We compared the summary score(s) derived from the best performing higher-order model with the original QLQ-C30 scale scores, using tumor stage, performance status and change over time (N=244) as grouping variables. Results: Whereas all models showed acceptable fit, we continued in the interest of parsimony with known-groups validity and responsiveness analyses using a summary score derived from the single higher-order factor model. The validity and responsiveness of this QLQ-C30 Summary Score was equal to, and in many cases superior to the original, underlying QLQ-C30 scale scores. Conclusion: Our results provide empirical support for a measurement model for the QLQ-C30 yielding a single summary score. The availability of this Summary Score can avoid problems with potential Type I errors that arise due to multiple testing when making comparisons based on the 15 outcomes generated by this questionnaire, and may reduce sample size requirements for HRQL studies using the QLQ-C30 questionnaire when an overall summary score is a relevant primary outcome

Rationale and design: telepsychology service delivery for depressed elderly veterans

<p>Abstract</p> <p>Background</p> <p>Older adults who live in rural areas experience significant disparities in health status and access to mental health care. "Telepsychology," (also referred to as "telepsychiatry," or "telemental health") represents a potential strategy towards addressing this longstanding problem. Older adults may benefit from telepsychology due to its: (1) utility to address existing problematic access to care for rural residents; (2) capacity to reduce stigma associated with traditional mental health care; and (3) utility to overcome significant age-related problems in ambulation and transportation. Moreover, preliminary evidence indicates that telepsychiatry programs are often less expensive for patients, and reduce travel time, travel costs, and time off from work. Thus, telepsychology may provide a cost-efficient solution to access-to-care problems in rural areas.</p> <p>Methods</p> <p>We describe an ongoing four-year prospective, randomized clinical trial comparing the effectiveness of an empirically supported treatment for major depressive disorder, Behavioral Activation, delivered either via in-home videoconferencing technology ("Telepsychology") or traditional face-to-face services ("Same-Room"). Our hypothesis is that in-homeTelepsychology service delivery will be equally effective as the traditional mode (Same-Room). Two-hundred twenty-four (224) male and female elderly participants will be administered protocol-driven individual Behavioral Activation therapy for depression over an 8-week period; and subjects will be followed for 12-months to ascertain longer-term effects of the treatment on three outcomes domains: (1) clinical outcomes (symptom severity, social functioning); (2) process variables (patient satisfaction, treatment credibility, attendance, adherence, dropout); and (3) economic outcomes (cost and resource use).</p> <p>Discussion</p> <p>Results from the proposed study will provide important insight into whether telepsychology service delivery is as effective as the traditional mode of service delivery, defined in terms of clinical, process, and economic outcomes, for elderly patients with depression residing in rural areas without adequate access to mental health services.</p> <p>Trial registration</p> <p>National Institutes of Health Clinical Trials Registry (ClinicalTrials.gov identifier# NCT00324701).</p

Influence of grain boundaries on the magnetization reorientation transition in ultrathin films

A magnetic reorientation transition is studied in situ in model experimental systems of Co grown on Au(111) and Au(788). Results from magneto-optic measurements and scanning tunneling microscopy, obtained on these two different self-ordered systems, demonstrate that grain boundaries formed during the film growth strongly influence the magnetic properties of the films. The nanometer scale of the magnetization reversal at the transition makes the temperature an essential parameter to predict experimental features observed in the magnetic reorientation transition

Growth of iron on gold (788) vicinal surface: From nanodots to step flow

International audienceThe growth morphology of iron on Au(7 8 8) has been investigated from 45 K to 430 K by use of variable temperature scanning tunneling microscopy. This system displays an ordered growth regime of a nanodots array from 70 K to 300 K (room temperature, RT). According to the temperature, the dots are found to grow on two different sites: below 250 K, they form rounded isolated islands above the steps where local traps act as nucleation centers; from 250 K to 300 K, they have the shape of platelets regularly disposed along the bottom of the step edges and located on face centered cubic area of the Au(7 8 8) surface reconstruction. Above RT, as a function of temperature, we find a progressive transition of the growth morphology, from ordered platelets to a step flow growth. A surface alloy formation induced by the high step density is the driving force of this growth mode transition. (C) 2007 Elsevier B.V. All rights reserved

Atomic-scale visualization of the p − d hybridization in III-V semiconductor surfaces doped with transition metal impurities

International audienc

Discontinuous vs. continuous spin reorientation transition of magnetic films on vicinal surfaces

The Spin Reorientation Transition (SRT) of Co ultrathin films grown on two Au(111) vicinal surfaces with the same step density but different step edge microfacets has been investigated by in situ magneto-optical Kerr effect. A drastic change in the width of the SRT is reported and is explained by the difference, measured by STM, of the anisotropic surface roughness. A general model, taking into account only uniaxial first-order terms in the anisotropy, is able to explain quantitatively the transition from a continuous to a discontinuous SRT as function of the anisotropic surface roughness. This model is generally applicable to magnetic ultrathin films grown on vicinal surfaces