What is the relationship between the minimally important difference and health state utility values? The case of the SF-6D

BACKGROUND: The SF-6D is a new single summary preference-based measure of health derived from the SF-36. Empirical work is required to determine what is the smallest change in SF-6D scores that can be regarded as important and meaningful for health professionals, patients and other stakeholders. OBJECTIVES: To use anchor-based methods to determine the minimally important difference (MID) for the SF-6D for various datasets. METHODS: All responders to the original SF-36 questionnaire can be assigned an SF-6D score provided the 11 items used in the SF-6D have been completed. The SF-6D can be regarded as a continuous outcome scored on a 0.29 to 1.00 scale, with 1.00 indicating "full health". Anchor-based methods examine the relationship between an health-related quality of life (HRQoL) measure and an independent measure (or anchor) to elucidate the meaning of a particular degree of change. One anchor-based approach uses an estimate of the MID, the difference in the QoL scale corresponding to a self-reported small but important change on a global scale. Patients were followed for a period of time, then asked, using question 2 of the SF-36 as our global rating scale, (which is not part of the SF-6D), if there general health is much better (5), somewhat better (4), stayed the same (3), somewhat worse (2) or much worse (1) compared to the last time they were assessed. We considered patients whose global rating score was 4 or 2 as having experienced some change equivalent to the MID. In patients who reported a worsening of health (global change of 1 or 2) the sign of the change in the SF-6D score was reversed (i.e. multiplied by minus one). The MID was then taken as the mean change on the SF-6D scale of the patients who scored (2 or 4). RESULTS: This paper describes the MID for the SF-6D from seven longitudinal studies that had previously used the SF-36. CONCLUSIONS: From the seven reviewed studies (with nine patient groups) the MID for the SF-6D ranged from 0.010 to 0.048, with a weighted mean estimate of 0.033 (95% CI: 0.029 to 0.037). The corresponding Standardised Response Means (SRMs) ranged from 0.11 to 0.48, with a mean of 0.30 and were mainly in the "small to moderate" range using Cohen's criteria, supporting the MID results. Using the half-standard deviation (of change) approach the mean effect size was 0.051 (range 0.033 to 0.066). Further empirical work is required to see whether or not this holds true for other patient groups and populations

Revealing Casual Pathways to Sustainable Water Service Delivering Using fsQCA

This study aimed to build on theory and practice regarding the combinations of conditions that influence water service sustainability when external partners are involved. The study investigates 26 well projects that have been implemented in developing countries with the assistance of Engineers Without Borders-USA (EWB-USA). Using past literature on sustainable water service delivery in developing communities, emergent coding techniques with project documents, and surveys with EWB-USA team members, this study identifies a set of project conditions to conduct fuzzy-set Qualitative Comparative Analysis (fsQCA). Findings show that the presence of a water committee cannot alone account for project sustainability. Additional conditions, such as technology and construction processes, project governance, and community engagement practices must also be considered for project sustainability. The relationship between construction quality and financial sustainability is also discussed. Overall, the findings from this research contribute to sector theory and reveal distinct pathways towards sustainable water services. These findings informed recommendations for EWB-USA well project implementation and management, and demonstrate the utility of fsQCA as a tool to navigate the complexities of water service delivery by external partners and improve understanding to increase water service sustainability

Planning for Excellence: Insights from an International Review of Regulators’ Strategic Plans

What constitutes regulatory excellence? Answering this question is an indispensable first step for any public regulatory agency that is measuring, striving towards, and, ultimately, achieving excellence. One useful way to answer this question would be to draw on the broader literature on regulatory design, enforcement, and management. But, perhaps a more authentic way would be to look at how regulators themselves define excellence. However, we actually know remarkably little about how the regulatory officials who are immersed in the task of regulation conceive of their own success. In this Article, we investigate regulators’ definitions of regulatory excellence by drawing on a unique source of data that provides an important window on regulators’ own aspirations: their strategic plans. Strategic plans have been required or voluntarily undertaken for the past decade or longer by regulators around the globe. In these plans, regulators offer mission statements, strategic goals, and measurable and achievable outcomes, all of which indicate what regulators value and are striving to become. Occasionally, they even state explicitly where they have fallen short of “best-in-class” status and how they intend to improve. To date, a voluminous literature exists examining agency practices in strategic planning, but we are aware of no study that tries to glean from the substance of a sizeable number of plans how regulators themselves construe regulatory excellence. The main task of this Article is undertaking this effort. This Article draws on twenty plans from different regulators in nine countries. We found most generally that excellent regulators describe themselves (though not necessarily using exactly these words) as institutions that are more (1) efficient, (2) educative, (3) multiplicative, (4) proportional, (5) vital, (6) just, and (7) honest. In addition to these seven shared attribute categories, our reading of the plans also revealed five other “unusual” attributes that only one or two agencies mentioned. Beyond merely cataloguing the attributes identified by agencies, this Article also discusses commonalities (and differences) between plan structures, emphases, and framings. We found that the plans differed widely in features such as the specificity of their mission statements, the extent to which they emphasized actions over outcomes (or vice versa), and the extent to which commitments were organized along organizational fiefdoms or cut across bureaucratic lines. We urge future scholarship to explore alternative methods of text mining, and to study strategic plans over time within agencies, in order to track how agencies’ notions of regulatory excellence respond to changes in the regulatory context and the larger circumstances within which agencies operate. Looking longitudinally will also shed light on how agencies handle strategic goals that are either met or that prove to be unattainable

Stable Isotope Analysis from a Burial at the Pipe Site (41AN67) in Anderson County, Texas

In this article, we present the findings of stable isotope analysis (carbon, nitrogen, and oxygen) from an analysis of human remains from a burial at the Pipe site (41AN67). The Pipe site is a late 15th-mid-16th century Caddo settlement and cemetery in the Lake Palestine area in the upper Neches River basin in East Texas that was investigated by Buddy Calvin Jones in 1968 and Southern Methodlst University in 1969

An Early Caddoan Period Cremation from the Boxed Springs Mound Site (41UR30) in Upshur County, Texas, and a Report on Previous Archaeological Investigations

The Boxed Springs Mound site (41UR30) is one of three major Early Caddoan (ca. A.D. 900- t 200) multiple mound centers in the Sabine River basin of northeastern Texas, the others including the Jamestown (41SM54) and Hudnall-Pirtle (41RK4) sites upstream and downstream, respectively, from Boxed Springs. It is situated on a large and prominent upland ridge projection that extends from a bluff on the Sabine River about 500 m north to where the landform merges with a broader stretch of uplands and Bienville alluvium. Sediments on the site are Trep loamy fine sand, a relatively fertile soil. The site is approximately 1.6 km west of the confluence of Big Sandy Creek and the Sabine River, but the old channels, sloughs, and oxbow lakes on both sides of the upland ridge and alluvial terrace suggest that previous channels of the Sabine River as well as Big Sandy Creek ran from north to south immediately adjacent to the site. When the Boxed Springs site was originally recorded by Sam Whiteside, an avocational archeologist from Tyler (see Walters and Haskins, this volume) in the early 1960s, it had four earthen mounds arranged around an open area or central plaza. The four mounds apparently included two low structural or house mounds with clay floors at the southeastern and southwestern ends of the plaza (Mounds #2 and #7 on a ca. 1962 sketch by Whiteside), one burial mound about 12 x 8 m in size and 1 m in height at the northwestern plaza edge (Mound #3), and a flat-topped mound of unknown function at the northeastern end of the plaza (Mound #6). There were borrow pits apparently visible to the east of Mound #3 and south of Mound #6, and occupation areas/midden deposits along the uplands at the southern edge of the site as well as north and northwest of Mound #3. Some years ago, while Dr. James E. Bruseth and Dr. Timothy K. Perttula were documenting a large collection of vessels and stone tools from the Boxed Springs site, they became aware of the fact that a cremation burial with associated vessels had been dug at the site. A few years later, the cremated remains from that burial were turned over to Dr. Perttula for study. In this paper, Diane E. Wilson summarizes for the first time the results of her bioarchaeological analyses of the cremated burial. With this information now available, it seemed appropriate to provide an archaeological context--as it was known--on the cremated burial, and also summarize in one place the available information on the archaeological record from the Boxed Springs site. Key to this effort was the fact that Mark Walters provided unpublished information and notes from the 1960s archaeological investigations by Sam Whiteside at the Boxed Springs site. Although it is a major Early Caddoan mound center, the archaeology of the Boxed Springs site is very poorly known. We hope that this paper on a cremated burial from the site, as well as a discussion of previous archaeological investigations at Boxed Springs, will rectify this situation to a certain extent, and also spur renewed professional archaeological interest in this very significant prehistoric Caddoan mound center

Comparison of hydrogen and methane as coolants in regeneratively cooled panels

Comparison of hydrogen and methane as coolants in regeneratively cooled panel

New Light Species and the CMB

We consider the effects of new light species on the Cosmic Microwave Background. In the massless limit, these effects can be parameterized in terms of a single number, the relativistic degrees of freedom. We perform a thorough survey of natural, minimal models containing new light species and numerically calculate the precise contribution of each of these models to this number in the framework of effective field theory. After reviewing the relevant details of early universe thermodynamics, we provide a map between the parameters of any particular theory and the predicted effective number of degrees of freedom. We then use this map to interpret the recent results from the Cosmic Microwave Background survey done by the Planck satellite. Using this data, we present new constraints on the parameter space of several models containing new light species. Future measurements of the Cosmic Microwave Background can be used with this map to further constrain the parameter space of all such models.Comment: 38 pages plus appendices and references; 10 figures and 1 table; references added, discussion of anapole moments added; supernovae cooling bounds added, discussion of models condense

Biological Characteristics and Fishery Assessment of Alaska Plaice, Pleuronectes quadrituberculatus, in the Eastern Bering Sea

Alaska plaice, Pleuronectes quadrituberculatus, is one of the major flatfishes in the eastern Bering Sea ecosystem and is most highly concentrated in the shallow continental shelf of the eastern Bering Sea. Annual commercial catches have ranged from less than 1,000 metric tons (t) in 1963 to 62,000 t in 1988. Alaska plaice is a relatively large flatfish averaging about 32 cm in length and 390 g in weight in commercial catches. They are distributed from nearshore waters to a depth of about 100 m in the eastern Bering Sea during summer, but move to deeper continental shelf waters in winter to escape sea ice and cold water temperatures. Being a long-lived species (>30 years), they have a relatively low natural mortality rate estimated at 0.20. Maturing at about age 7, Alaska plaice spawn from April through June on hard sandy substrates of the shelf region, primarily around the 100 m isobath. Prey items primarily include polychaetes and other marine worms. In comparison with other flatfish, Alaska plaice and rock sole, Pleuronectes bilineatus, have similar diets but different habitat preferences with separate areas of peak population density which may minimize interspecific competition. Yellowfin sole, Pleuronectes asper, while sharing similar habitat, differs from these two species because of the variety of prey items in its diet. Competition for food resources among the three species appears to be low. The resource has experienced light exploitation since 1963 and is currently in good condition. Based on the results of demersal trawl surveys and age-structured analyses, the exploitable biomass increased from 1971 through the mid-1980’s before decreasing to the 1997 level of 500,000 t. The recommended 1998 harvest level, Allowable Biological Catch, was calculated from the Baranov catch equation based on the FMSY harvest level and the projected 1997 biomass, resulting in a commercial harvest of 69,000 t, or about 16% of the estimated exploitable biomass