Test-retest reliability of a questionnaire to assess physical environmental factors pertaining to physical activity

BACKGROUND: Despite the documented benefits of physical activity, many adults do not obtain the recommended amounts. Barriers to physical activity occur at multiple levels, including at the individual, interpersonal, and environmental levels. Only until more recently has there been a concerted focus on how the physical environment might affect physical activity behavior. With this new area of study, self-report measures should be psychometrically tested before use in research studies. Therefore the objective of this study was to document the test-retest reliability of a questionnaire designed to assess physical environmental factors that might be associated with physical activity in a diverse adult population. METHODS: Test and retest surveys were conducted over the telephone with 106 African American and White women and men living in either Forsyth County, North Carolina or Jackson, Mississippi. Reliability of self-reported environmental factors across four domains (e.g., access to facilities and destinations, functionality and safety, aesthetics, natural environment) was determined using intraclass correlation coefficients (ICC) overall and separately by gender and race. RESULTS: Generally items displayed moderate and sometimes substantial reliability (ICC between 0.4 to 0.8), with a few differences by gender or race, across each of the domains. CONCLUSION: This study provides some psychometric evidence for the use of many of these questions in studies examining the effect of self-reported physical environmental measures on physical activity behaviors, among African American and White women and men

The Credit Union Difference

The credit union difference is in part reflected in its social impact. This report enables credit unions to identify, measure and report on their social impact with members and in society at large

Research ethics in practice: Lessons from studies exploring intimate partner violence in different contexts

Studies researching interpersonal violence (IPV) are associated with a range of ethical challenges. In this paper, lessons are drawn from three case studies exploring the experiences of different groups of survivors and perpetrators of IPV in diverse contexts: refugees in the Thailand-Burma border area; partner-violent adult men and female survivors in Ireland; and, school children in five European countries. The ethical – and associated methodological - challenges faced, and the ways in which they were overcome, are presented. Drawing on the case studies presented, the paper concludes that three key areas require special attention when conducting research in this field: accessing and recruiting participants, researcher skills and experience, and appropriate use of data

The Decomposition of YBa₂Cu₃O₇₋δ Doped into Ba₂YRuO₆

One of the persistent criticisms of claims for observation of superconductivity in Ba2YRu1−uCuuO6 (O6) is that the diamagnetism is actually due to the decomposition of the material into YBa2Cu3O7−delta and other phases. We report a series of experiments in which YBa2Cu3O7−delta is doped into Ba2YRuO6 and carried through a series of sintering steps which were followed by magnetization, neutron diffraction, and scanning electron microscopy/microprobe measurements. It was found that the dopant YBa2Cu3O7−delta decomposed and failed to reform with cooling. It is concluded that the O6 phase is the stable high-temperature phase. The Cu released from the Y123 decomposition doped the host Ba2YRuO6, in partial substitution for Ru. This doping resulted in a small diamagnetic response with an onset temperature of ~84 K

Associations of adult physical activity with perceived safety and police-recorded crime: the Multi-ethnic Study of Atherosclerosis

Abstract Background Due to the inconsistent findings of prior studies, we explored the association of perceived safety and police-recorded crime measures with physical activity. Methods The study included 818 Chicago participants of the Multiethnic Study of Atherosclerosis 45 to 84 years of age. Questionnaire-assessed physical activity included a) transport walking; b) leisure walking; and c) non-walking leisure activities. Perceived safety was assessed through an interviewer-administered questionnaire. Police-recorded crime was assessed through 2-year counts of selected crimes (total and outdoor incivilities, criminal offenses, homicides) per 1000 population. Associations were examined using generalized estimating equation logistic regression models. Results Perceiving a safer neighborhood was positively associated with transport walking and perceiving lower violence was associated with leisure walking. Those in the lowest tertile of total or outdoor incivilities were more likely to report transport walking. Models with both perceived safety and police-recorded measures of crime as independent variables had superior fit for both transport walking and leisure walking outcomes. Neither perceived safety nor police-recorded measures of crime were associated with non-walking leisure activity. Conclusions Perceived and police-recorded measures had independent associations with walking and both should be considered in assessing the impact of neighborhood crime on physical activity.http://deepblue.lib.umich.edu/bitstream/2027.42/112746/1/12966_2012_Article_681.pd

Cardiovascular Disease Risk of Abdominal Obesity vs. Metabolic Abnormalities

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/93656/1/oby.2010.168.pd

Adaptive design of a clinical decision support tool: What the impact on utilization rates means for future CDS research

© The Author(s) 2019. OBJECTIVE: We employed an agile, user-centered approach to the design of a clinical decision support tool in our prior integrated clinical prediction rule study, which achieved high adoption rates. To understand if applying this user-centered process to adapt clinical decision support tools is effective in improving the use of clinical prediction rules, we examined utilization rates of a clinical decision support tool adapted from the original integrated clinical prediction rule study tool to determine if applying this user-centered process to design yields enhanced utilization rates similar to the integrated clinical prediction rule study. MATERIALS & METHODS: We conducted pre-deployment usability testing and semi-structured group interviews at 6 months post-deployment with 75 providers at 14 intervention clinics across the two sites to collect user feedback. Qualitative data analysis is bifurcated into immediate and delayed stages; we reported on immediate-stage findings from real-time field notes used to generate a set of rapid, pragmatic recommendations for iterative refinement. Monthly utilization rates were calculated and examined over 12 months. RESULTS: We hypothesized a well-validated, user-centered clinical decision support tool would lead to relatively high adoption rates. Then 6 months post-deployment, integrated clinical prediction rule study tool utilization rates were substantially lower than anticipated based on the original integrated clinical prediction rule study trial (68%) at 17% (Health System A) and 5% (Health System B). User feedback at 6 months resulted in recommendations for tool refinement, which were incorporated when possible into tool design; however, utilization rates at 12 months post-deployment remained low at 14% and 4% respectively. DISCUSSION: Although valuable, findings demonstrate the limitations of a user-centered approach given the complexity of clinical decision support. CONCLUSION: Strategies for addressing persistent external factors impacting clinical decision support adoption should be considered in addition to the user-centered design and implementation of clinical decision support

Live usability testing of two complex clinical decision support tools: Observational study

© 2019 Journal of Medical Internet Research. All rights reserved. Background: Potential of the electronic health records (EHR) and clinical decision support (CDS) systems to improve the practice of medicine has been tempered by poor design and the resulting burden they place on providers. CDS is rarely tested in the real clinical environment. As a result, many tools are hard to use, placing strain on providers and resulting in low adoption rates. The existing CDS usability literature relies primarily on expert opinion and provider feedback via survey. This is the first study to evaluate CDS usability and the provider-computer-patient interaction with complex CDS in the real clinical environment. Objective: This study aimed to further understand the barriers and facilitators of meaningful CDS usage within a real clinical context. Methods: This qualitative observational study was conducted with 3 primary care providers during 6 patient care sessions. In patients with the chief complaint of sore throat, a CDS tool built with the Centor Score was used to stratify the risk of group A Streptococcus pharyngitis. In patients with a chief complaint of cough or upper respiratory tract infection, a CDS tool built with the Heckerling Rule was used to stratify the risk of pneumonia. During usability testing, all human-computer interactions, including audio and continuous screen capture, were recorded using the Camtasia software. Participants\u27 comments and interactions with the tool during clinical sessions and participant comments during a postsession brief interview were placed into coding categories and analyzed for generalizable themes. Results: In the 6 encounters observed, primary care providers toggled between addressing either the computer or the patient during the visit. Minimal time was spent listening to the patient without engaging the EHR. Participants mostly used the CDS tool with the patient, asking questions to populate the calculator and discussing the results of the risk assessment; they reported the ability to do this as the major benefit of the tool. All providers were interrupted during their use of the CDS tool by the need to refer to other sections of the chart. In half of the visits, patients\u27 clinical symptoms challenged the applicability of the tool to calculate the risk of bacterial infection. Primary care providers rarely used the incorporated incentives for CDS usage, including progress notes and patient instructions. Conclusions: Live usability testing of these CDS tools generated insights about their role in the patient-provider interaction. CDS may contribute to the interaction by being simultaneously viewed by the provider and patient. CDS can improve usability and lessen the strain it places on providers by being short, flexible, and customizable to unique provider workflow. A useful component of CDS is being as widely applicable as possible and ensuring that its functions represent the fastest way to perform a particular task

PREDICATION AND EXTENSIONALIZATION

In his 2000 book Logical Properties Colin McGinn argues that predicates denote properties rather than sets or individuals. I support the thesis, but show that it is vulnerable to a type-incongruity objection, if properties are (modelled as) functions, unless a device for extensionalizing properties is added. Alternatively, properties may be construed as primitive intensional entities, as in George Bealer. However, I object to Bealer’s construal of predication as a primitive operation inputting two primitive entities and outputting a third primitive entity. Instead I recommend we follow Pavel Tichý in construing both predication and extensionalization as instances of the primitive operation of functional application.PhilosophyTechnology, Policy and Managemen