Development of the PsAQoL: a quality of life instrument specific to psoriatic arthritis

Background: Patient reported outcome measures used in studies of psoriatic arthritis (PsA) have been found to be inadequate for determining the impact of the disease from the patient’s perspective. Objective: To produce the PsAQoL, a PsA-specific quality of life (QoL) instrument, employing the needs based model of QoL that would be relevant and acceptable to respondents, valid, and reliable. Methods: Content was derived from qualitative interviews conducted with patients with PsA. Face and content validity were assessed by field test interviews with a new sample of patients with PsA. A postal survey was conducted to improve the scaling properties of the new measure. Finally, a test-retest postal survey was used to identify the final measure and to test its scaling properties, reliability, internal consistency, and validity. Results: Analysis of the qualitative interview transcripts identified a 51 item questionnaire. Field test interviews confirmed the acceptability and relevance of the measure. Analysis of data from the first postal survey (n = 94) reduced the questionnaire to 35 items. Rasch analysis of data from the test-retest survey (n = 286) identified a 20 item version of the PsAQoL with good item fit. This version had excellent internal consistency (a = 0.91), test-retest reliability (0.89), and validity. Conclusions: The PsAQoL is a valuable tool for assessing the impact of interventions for PsA in clinical studies and trials. It is well accepted by patients, taking about three minutes to complete, is easy to administer, and has excellent scaling and psychometric properties

Interpreting scores on multiple sclerosis-specific patient reported outcome measures (the PRIMUS and U-FIS)

BACKGROUND: The PRIMUS is a Multiple Sclerosis (MS)-specific suite of outcome measures including assessments of QoL (PRIMUS QoL, scored 0-22) and activity limitations (PRIMUS Activities, scored 0-30). The U-FIS is a measure of fatigue impact (scored 0-66). These measures have been fully validated previously using an MS sample with mixed diagnoses. The aim of the present study was to validate the measures further in a specifically Relapse Remitting MS (RRMS) sample and to provide preliminary evidence of the responder definitions (RD; also known as minimal important difference) for these instruments. METHODS: Data were derived from a multi-country efficacy trial of MS patients with assessments at baseline and 12 months. Baseline data were used to assess the internal reliability and validity of the measures. Both anchor-based and distribution-based approaches were employed for estimating RD. Anchor-based estimates were based on published RD values for the EQ-5D and were assessed for those improving and deteriorating separately. Distribution-based estimates were based on standard error of measurement (SEM), change score equivalent to 0.30, and change score equivalent to 0.50, effect sizes (ES). RESULTS: The sample included 911 RRMS patients (67.3% female, age mean (SD) 36.2 (8.4) years, duration of MS mean (SD) 4.8 (5.2) years). Results showed that the PRIMUS and U-FIS had good internal consistency. Appropriate correlations were observed with comparator instruments and both measures were able to distinguish between participants based on Expanded Disability Status Scale scores and time since diagnosis. The anchor-based and distribution-based RD estimates were: PRIMUS Activities range = 1.2-2.3, PRIMUS QoL range = 1.0-2.2, and U-FIS range = 2.4-7.0. CONCLUSIONS: The results show that the PRIMUS and U-FIS are valid instruments for use with RRMS patients. The analyses provide preliminary information on how to interpret scores on the scales. These data will be useful for assessing treatment efficacy and for powering clinical studies. TRIAL REFERENCE NUMBER: ClinicalTrials.gov Identifier NCT00340834

Development of the ASQoL: a quality of life instrument specific to ankylosing spondylitis

Background: Although disease-specific health status measures are available for ankylosing spondylitis (AS), no instrument exists for assessing quality of life (QoL) in the condition. Objective: To produce an AS-specific QoL measure that would be relevant and acceptable to respondents, valid, and reliable. Methods: The ASQoL employs the needs-based model of QoL and was developed in parallel in the UK and the Netherlands (NL). Content was derived from interviews with patients in each country. Face and content validity were assessed through patient field test interviews (UK and NL). A postal survey in the UK produced a more efficient version of the ASQoL, which was tested for scaling properties, reliability, internal consistency, and validity in a further postal survey in each country. Results: A 41 item questionnaire was derived from interview transcripts. Field testing interviews confirmed acceptability. Rasch analysis of data from the first survey (n=121) produced a 26 item questionnaire. Rasch analysis of data from the second survey (UK: n=164; NL: n=154) showed some item misfit, but showed that items formed a hierarchical order and were stable over time. Problematic items were removed giving an 18 item scale. Both language versions had excellent internal consistency (α=0.89–0.91), test-retest reliability (r(s)=0.92 UK and r(s)=0.91 NL), and validity. Conclusions: The ASQoL provides a valuable tool for assessing the impact of interventions for AS and for evaluating models of service delivery. It is well accepted by patients, taking about four minutes to complete, and has excellent scaling and psychometric properties

Matemaattisen identiteetin tyypit ja niiden rakentuminen : Tapaustutkimus tansanialaisen luokan oppilaista

Students’ mathematical identity, referring to students’ context-based narratives about their mathematical self-perceptions, has recently received researchers’ increased attention in mathematics education because, as a construct, it offers a broader socially engaging perspective for analysing the role of these perceptions and socio-cultural factors that shape them. While previous studies have mostly examined students in ‘Western’ schools who do not vary greatly in their mathematical and socio-economic backgrounds compared to students in Tanzanian schools, this study focused on a Tanzanian mathematics classroom whose students varied greatly in these backgrounds. The study applied socio-cultural and socio-psychological perspectives to examine the features and development of these students’ mathematical identity. An ethnographic approach was used to collect and analyse data on the students’ mathematical identity and conditions affecting its development at home, in school, and in the classroom. Students’ narratives provided insights into context-specific features of mathematical identity and patterns of identity development. Also, observations of the school and mathematics classroom, review of official documents, and open-ended questionnaires generated data for contextualising students’ identity narratives.Data analysis resulted in multiple mathematical identities. While positive identities of Innate ability, Persistent effort, and Image-maintenance characterised students’ engagement in mathematical activities, the negative mathematical identity of Oppositional identity was accompanied by the students’ tendency to refrain from these activities. The study further showed that each type of mathematical identity had a distinct pattern of mathematical experiences. Overall, positive mathematical identities were associated with more supportive previous mathematical experiences compared to the negative identity. Contextual factors such as teachers and parents positively or negatively shaped these experiences. The study suggests that teaching strategies that enable students to exercise their agency may not be enough to promote students’ mathematical identities. It is also important to understand how students have experienced mathematics and how they perceive their future relationship with mathematics, and support them accordingly. ________________________________________ Keywords: mathematical identity, positive mathematical identity, negative mathematical identity, mathematical experiencing, contextual factorsTämä tutkimus käsittelee oppilaiden matemaattista identiteettiä, jolla tarkoitetaan oppilaiden kertomuksellisia havaintoja itsestä suhteessa matematiikkaan. Matemaattista identiteettiä käsitellään tutkimuksessa sosiokulttuurisista ja sosiaalipsykologisista näkökulmista käsin. Käsitettä käytetään työssä analyyttisenä välineenä, jonka avulla oppilaiden havaintoja itsestä matematiikan oppijana sekä näiden merkitystä matematiikan oppimisessa tarkastellaan suhteessa sosiokulttuurisiin tekijöihin. Toisin kuin aiemmat matemaattisen identiteetin tutkimukset tämä tutkimus kohdistui tansanialaisen luokan oppilaisiin, joiden matemaattiset ja sosio-ekonomiset taustat vaihtelivat suuresti. Tutkimuksessa tarkasteltiin matemaattisen identiteetin tyyppejä sekä niiden kehittymistä kodin, koulun ja luokan konteksteissa käyttäen sosiokulttuurisia ja sosiaalipsykologisia näkökulmia. Tutkimusaineiston hankinnassa ja analysoinnissa käytettiin tulkinnallista etnografista lähestymistapaa. Oppilaiden narratiivien lisäksi tutkimusaineisto pohjautui koulun ja luokan havainnointiin, virallisiin dokumentteihin sekä opettajien haastatteluihin ja kyselyihin. Tutkimustuloksina saatiin useita erilaisia matemaattisia identiteettejä. Kyvykkyyden, Sinnikkään työskentelyn ja Minäkuvan säilyttämisen positiiviset identiteetit kuvastivat oppilaiden sitoutumista matematiikan oppimiseen, kun taas negatiivinen matematiikan identiteetti, Vastustava identiteetti, yhdistyi pyrkimykseen päästä eroon matematiikasta. Tutkimus osoitti, että jokaisella identiteettityypillä oli toisista poikkeava matematiikan kokemustausta. Positiiviset identiteetit yhdistyivät negatiivista identiteettiä useammin aikaisempiin kannustaviin matematiikan kokemuksiin. Opettajat ja vanhemmat osana oppimiskontekstia vaikuttivat näihin kokemuksiin joko positiivisesti tai negatiivisesti. Tämän tutkimuksen tulokset näyttävät, että opetustavat jotka tukevat omaehtoista oppimista eivät välttämättä riitä edistämään matemaattisen identiteetin rakentumista. Matematiikan opiskelun ja matemaattisen identiteetin rakentumisen tukemiseksi on ymmärrettävä myös oppilaiden aiempia matematiikan kokemuksia sekä heidän käsityksiä tarpeista opiskella matematiikkaa jatkossa. ________________________________________ Avainsanat: matemaattinen identiteetti, positiivinen matemaattinen identiteetti, negatiivinen matemaattinen identiteetti, matematiikan kokeminen, kontekstitekijä

Slumming it? Township tour reviews ‘gloss over poverty’

Is it time to rethink “slum tourism”? Researchers at the University of Bath believe the answer is a resounding yes. They claim that foreign visitors are glossing over the hardships of those living in poor areas with well-meaning attempts to portray their inhabitants in a positive ligh

Liberal market economies, business, and political finance: Britain under New Labour

The extent and nature of business financing of parties is an important feature of political finance. Britain’s transparent and permissive regulatory system provides an excellent opportunity to study business financing of parties. Business donations have been very important to the Conservative party over the last decade, and of only marginal importance to Labour. Unlike other Conservative contributors, business donors are more likely to contribute when the party is popular. In contrast to the previous period of Conservative government, the biggest British businesses tended to abstain from political finance under New Labour. However, their bias towards the Conservatives is affected by the party’s popularity and the closeness of an election. Britain shares the political importance of business financing of parties and its mixture of ideological and pragmatic motivations with other liberal market economies. However, in Britain the bias towards the right is much stronger and the role of big business more marginal

Stress corrosion cracking in Al-Zn-Mg-Cu aluminum alloys in saline environments

Copyright 2013 ASM International. This paper was published in Metallurgical and Materials Transactions A, 44A(3), 1230 - 1253, and is made available as an electronic reprint with the permission of ASM International. One print or electronic copy may be made for personal use only. Systematic or multiple reproduction, distribution to multiple locations via electronic or other means, duplications of any material in this paper for a fee or for commercial purposes, or modification of the content of this paper are prohibited.Stress corrosion cracking of Al-Zn-Mg-Cu (AA7xxx) aluminum alloys exposed to saline environments at temperatures ranging from 293 K to 353 K (20 °C to 80 °C) has been reviewed with particular attention to the influences of alloy composition and temper, and bulk and local environmental conditions. Stress corrosion crack (SCC) growth rates at room temperature for peak- and over-aged tempers in saline environments are minimized for Al-Zn-Mg-Cu alloys containing less than ~8 wt pct Zn when Zn/Mg ratios are ranging from 2 to 3, excess magnesium levels are less than 1 wt pct, and copper content is either less than ~0.2 wt pct or ranging from 1.3 to 2 wt pct. A minimum chloride ion concentration of ~0.01 M is required for crack growth rates to exceed those in distilled water, which insures that the local solution pH in crack-tip regions can be maintained at less than 4. Crack growth rates in saline solution without other additions gradually increase with bulk chloride ion concentrations up to around 0.6 M NaCl, whereas in solutions with sufficiently low dichromate (or chromate), inhibitor additions are insensitive to the bulk chloride concentration and are typically at least double those observed without the additions. DCB specimens, fatigue pre-cracked in air before immersion in a saline environment, show an initial period with no detectible crack growth, followed by crack growth at the distilled water rate, and then transition to a higher crack growth rate typical of region 2 crack growth in the saline environment. Time spent in each stage depends on the type of pre-crack (“pop-in” vs fatigue), applied stress intensity factor, alloy chemistry, bulk environment, and, if applied, the external polarization. Apparent activation energies (E a) for SCC growth in Al-Zn-Mg-Cu alloys exposed to 0.6 M NaCl over the temperatures ranging from 293 K to 353 K (20 °C to 80 °C) for under-, peak-, and over-aged low-copper-containing alloys (~0.8 wt pct), they are typically ranging from 20 to 40 kJ/mol for under- and peak-aged alloys, and based on limited data, around 85 kJ/mol for over-aged tempers. This means that crack propagation in saline environments is most likely to occur by a hydrogen-related process for low-copper-containing Al-Zn-Mg-Cu alloys in under-, peak- and over-aged tempers, and for high-copper alloys in under- and peak-aged tempers. For over-aged high-copper-containing alloys, cracking is most probably under anodic dissolution control. Future stress corrosion studies should focus on understanding the factors that control crack initiation, and insuring that the next generation of higher performance Al-Zn-Mg-Cu alloys has similar longer crack initiation times and crack propagation rates to those of the incumbent alloys in an over-aged condition where crack rates are less than 1 mm/month at a high stress intensity factor