The Wellesley News (02-20-1930)

https://repository.wellesley.edu/news/1846/thumbnail.jp

Shared decision making and the practice of community translation in presenting a pre-final Afrikaans for the Western Cape Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire: a proposal for improved translation and cross-cultural adaptation

Background Translation and cross cultural adaptation of patient reported outcome measures (PROMs) involves a step referred to as harmonisation, following forward and backward translation of the measure. This article proposes the introduction of methods not previously included in the process of harmonisation. The aim of the study was to introduce shared decision making (SDM) and the practice of community translation (CT) during the harmonisation of the Afrikaans for the Western Cape version of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, a PROM that measures symptoms and activity and participation in persons with upper limb conditions. Methods A broader approach to harmonisation is proposed by incorporating CT and SDM in addition to existing methods toward harmonisation. Participants (n = 8) involved in the harmonisation meeting included the principal investigator, a linguistic expert, occupational therapists with knowledge of the target population, context and the DASH questionnaire and members of the target population with and without upper limb conditions. A partnership was formed with the participants (a principle of SDM) and the principles of non-parallel CT and the CT approach were applied during harmonisation. Employing CT principles ensures that the norm for the translation is set by the population the translation is intended for. Results Forward and backward translation of the DASH questionnaire presented a version of the measure in the target language for consideration during harmonisation. There were however a significant number of conceptually problematic items on the version presented at the meeting. Only seven items (7 of 30) remained unchanged. Conclusion SDM and CT was used during the harmonisation of the Afrikaans for the Western Cape DASH questionnaire. Both these practices could have relevance in the translation and cross-cultural adaptation of PROMs where the translation is intended for persons from low socio-economic backgrounds and low levels of education

Systemic risk and macroeconomic fat tails

We propose a mechanism for shock amplification that potentially can account for fat tails in the distribution of the growth rate of national output. We argue that extreme macroeconomic events, such as the Great Depression and the Great Recession, were preceded by significant turmoil in the banking system. We have developed a model of bank network formation and presented numerical simulations that show that, for the benchmark case, aggregate credit follows a random walk. When we introduce fire sales the model does not only produce larger variations in the growth of aggregate credit but also shows that there is an asymmetry between booms and busts that is also consistent with empirical evidence

Angiosarcoma of the Descending Aorta, Diagnostic Difficulties

: Introduction: Primary angiosarcomas of the aorta are rare and because of their non-specific presentation, the initial diagnosis is often very difficult. Report: A 66 year old woman, initially suffering from night sweats and general malaise, is presented. A computerized tomography (CT) scan was performed which showed a filling defect of the descending aorta. This defect later caused embolic occlusion of the celiac vessels. The patient underwent surgical resection of the filling defect of the descending aorta and an embolectomy of the celiac vessels. The defect was histopathologically diagnosed as an angiosarcoma. The clinical presentation, diagnostic pitfalls, histopathological diagnosis, and the therapeutic management are discussed. Discussion: In this case report, the importance of carefully diagnosing an angiosarcoma is highlighted as the consequences could be rapid metastasization or embolization. Keywords: Angiosarcoma, Descending aorta, Malignancy, Primary aortic tumo

Compact high order complete flux schemes

In this paper we outline the complete flux scheme for an advection-diffusion-reaction model problem. The scheme is based on the integral representation of the flux, which we derive from a local boundary value problem for the entire equation, including the source term. Consequently, the flux consists of a homogeneous part, corresponding to the advection-diffusion operator, and an inhomogeneous part, taking into account the effect of the source term. We apply (weighted) Gauss quadrature rules to derive the standard complete flux scheme, as well as a compact high order variant. We demonstrate the performance of both schemes