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Aim: To translate and culturally adapt the FRAIL scale into Spanish and perform a preliminary test of diagnostic accuracy in patients admitted to intensive care units. Design: Cross‐sectional diagnostic study. Methods: Five intensive care units (ICU) in Spain were participated. Stage 1: Three native Spanish‐speaking bilingual translators familiar with the field of critical care translated the scale from English into Spanish. Stage 2: Three native English‐speaking bilingual translators familiar with critical care medicine. Stage 3: Authors of the original scale compared the English original and back‐translated versions of the scale. Stage 4: Five nurses with more than 5 years of ICU experience and five critical care physicians assessed the comprehension and relevance of each of the items of the Spanish version in 30 patients of 3 different age ranges (<50, 50–65 and >65 years). Results: The FRAIL scale was translated and adapted cross‐culturally for patients admitted to intensive care units in Spain. The process consisted of four stages: translation, back translation, comparison and pilot test. There was good correspondence between the original scale and the Spanish version in 100% of the items. The participating patients assessed the relevance (content validity) and comprehensibility (face validity) of each of the items of the first Spanish version. The relevance of some of the items scored low when the scale was used in patients younger than 65 years. Conclusions: We have cross‐culturally adapted the FRAIL scale, originally in English, to Spanish for its use in the critical care medical setting in Spanish‐speaking countries. Implications for Professionals: Physicians and nurses can apply the new scale to all patients admitted to the intensive care units. Nursing care can be adapted according to frailty, trying to reduce the side effects of admission to these units for the most fragile patients. Reporting Method: The manuscript's authors have adhered to the EQUATOR guidelines, using the COSMIN reporting guideline for studies on the measurement properties of patient‐reported outcome measures. Patient or Public Contribution: In a pilot clinical study, we applied the first version of the FRAIL‐Spain scale to intensive care unit (ICU) patients. Five nurses with more than 5 years of ICU experience and five critical care physicians assessed the relevance (content validity) and comprehensibility (face validity) of the five items of the first Spanish version. Relevance was assessed using a 4‐point Likert scale ranging from 1 (no relevance) to 4 (high relevance), and comprehensibility was assessed as poor, acceptable or good. Each health professional applied the scale to three patients (total number of patients = 30) of three different age ranges (<50, 50–65 and >65 years) and recorded the time of application of the scale to each patient. Although the frailty scales were initially created by geriatricians to be applied to the elders, there is little experience with their application in critically ill patients of any age. Therefore, more information is needed to determine the relevance of using this scale in critical care patients. In this pilot study, we considered that nurses and critical care physicians should evaluate frailty using this adapted scale in adult patients admitted to the Intensive Care Units. [ABSTRACT FROM AUTHOR]

This paper shows that, in terms of experimental design and ecological validity, the recent study by Hodgkinson et al. (1999) does not 'indicate that the framing bias is likely to be an important factor in strategic decision making.' Nor does it suggest that 'cognitive mapping provides an effective means of limiting the damage accruing from this bias.' We show that the framing bias demonstrated by Hodgkinson et al. can be removed by a simpler 'think-harder' manipulation with undergraduate respondents and, further, show that the bias is not present in the decisions of experienced respondents. We also demonstrate that, for experienced respondents, factors such as avoidance of risk and the creation of new strategies also characterize strategic decision making. Such components were not captured by Hodgkinson et al.'s experimental tasks. [ABSTRACT FROM AUTHOR]

Wright and Goodwin (2002) maintain that, in terms of experimental design and ecological validity, Hodgkinson et al. (1999) failed to demonstrate either that the framing bias is likely to be of salience in strategic decision making, or that causal cognitive mapping provides an effective means of limiting the damage accruing from this bias. In reply, we show that there is ample evidence to support both of our original claims. Moreover, using Wright and Goodwin's own data set, we demonstrate that our studies did in fact attain appropriate levels of ecological validity, and that their proposed alternative to causal cognitive mapping, a decision tree approach, is far from 'simpler.' Wright and Goodwin's approach not only fails to eliminate the framing bias--it leads to confusion. [ABSTRACT FROM AUTHOR]

Aims: To clarify the hypothesis tests associated with the full covariate modelling (FCM) approach in population pharmacokinetic analysis, investigate the potential impact of multiplicity in population pharmacokinetic analysis, and evaluate simultaneous confidence intervals (SCI) as an approach to control multiplicity. Methods: Clinical trial simulations were performed using a simple one‐compartment pharmacokinetic model. Different numbers of covariates, sample sizes, effect sizes of covariates, and correlations among covariates were explored. The false positive rate (FPR) and power were evaluated. Results: The FPR for the FCM approach dramatically increases with number of covariates. The chance of incorrectly selecting ≥1 seemingly clinically relevant covariates can be increased from 5% to a 40–70% range for 10–20 covariates. The SCI approach may provide appropriate control of the family‐wise FPR, allowing more appropriate decision making. As a result, the power detecting real effects without incorrectly identifying non‐existing effects can be greatly improved by the SCI approach compared to the approach in current practice. The performance of the SCI approach is driven by the ratio of sample size to number of covariates. The FPR can be controlled at 5% and 10% using the SCI approach when the ratio was ≥20 and 10, respectively. Conclusion: The FCM approach still lies within the framework of statistical testing, and therefore multiplicity is an issue for this approach. It is imperative to consider multiplicity reporting and adjustments in FCM modelling practice to ensure more appropriate decision making. [ABSTRACT FROM AUTHOR]

Maternal capabilities-qualities of mothers that enable them to leverage skills and resources into child health-hold potential influence over mother's adoption of child caring practices, including infant and young child feeding. We developed a survey ( n = 195) that assessed the associations of 4 dimensions of maternal capabilities (social support, psychological health, decision making, and empowerment) with mothers' infant and young child feeding practices and children's nutritional status in Uganda. Maternal responses were converted to categorical subscales and an overall index. Scale reliability coefficients were moderate to strong (α range = 0.49 to 0.80). Mothers with higher social support scores were more likely to feed children according to the minimum meal frequency (odds ratio [OR] [95% confidence interval (CI)] = 1.38 [1.10, 1.73]), dietary diversity (OR [95% CI] = 1.56 [1.15, 2.11]), iron rich foods, (OR [95% CI] = 1.47 [1.14, 1.89]), and minimally acceptable diet (OR [95% CI] = 1.55 [1.10, 2.21]) indicators. Empowerment was associated with a greater likelihood of feeding a minimally diverse and acceptable diet. The maternal capabilities index was significantly associated with feeding the minimum number of times per day (OR [95% CI] = 1.29 [1.03, 1.63]), dietary diversity (OR [95% CI] = 1.44 [1.06, 1.94]), and minimally acceptable diet (OR [95% CI] = 1.43 [1.01, 2.01]). Mothers with higher psychological satisfaction were more likely to have a stunted child (OR [95% CI] = 1.31 [1.06, 1.63]). No other associations between the capabilities scales and child growth were significant. Strengthening social support for mothers and expanding overall maternal capabilities hold potential for addressing important underlying determinants of child feeding in the Ugandan context. [ABSTRACT FROM AUTHOR]

The article presents the study that explores on the use of haematopoietic stem cell transplantation (SCT) in the treatment of Fanconi anemia (FA) patients in Canada and the U.S. The topics discussed include the attributes of FA, the factors that influenced the decision making of FA patients and family members on SCT, and the benefits and probable risks of SCT.

Background Socioeconomically deprived women are at greater risk of adverse pregnancy outcomes. Research tends to focus on access of services. Yet access may not equate with the equity of services for women from different socioeconomic backgrounds. Objectives To determine whether pregnant women's perceptions of antenatal provision differed in relation to their socioeconomic deprivation ranking (determined by the Scottish Index of Multiple Deprivation 2006). Design A longitudinal, qualitative study with comparative antenatal case studies between January 2007 and April 2009. Setting/Participants Cases were primigravida women from 'least deprived' ( n = 9) and 'most deprived' ( n = 12) geographical areas within one local authority in Scotland. Analysis Data were analysed using case study replication analysis. Results There was little difference in access to antenatal services between the 'least' and 'most' deprived groups. Perception of care differed in relation to the level of 'engagement' (defined using constructs of: language and personalization of care; power and relationships; and health literacy). Engagement was evidenced in most of the 'least deprived' cases and almost none of the 'most deprived' cases. Specifically, socioeconomically deprived women described less evidence of personal connection to their own care, effective communication and the opportunity for shared decision making. Conclusion In women from socioeconomically deprived areas, access may be a less useful indicator than engagement when assessing antenatal service quality. As engagement levels may be one method by which to predict and improve health outcomes, a more equitable antenatal service may need to be developed through the early identification of those women at risk of non-engagement. [ABSTRACT FROM AUTHOR]

Context and objective Shared decision making is especially advocated for preference-sensitive decisions. We investigated whether physicians' recommendations pull patients away from their preferred treatment option when making a preference-sensitive decision. Design, participants and methods Inpatients ( N = 102 with schizophrenia, N = 101 with multiple sclerosis) were presented with a hypothetical scenario (the choice between two drugs). They were first asked about their preferences concerning the two drugs and then they received a (fictitious) clinician's recommendation that was contrary to their preferences. Subsequently they made a final choice between the two drugs. Main outcome measures The main outcome measure was whether the patient followed the physician's advice in the hypothetical scenario. Thereby patient's (pre-recommendation) preferences served as a baseline. Results In the decision scenario, about 48% of the patients with schizophrenia and 26% of the patients with multiple sclerosis followed the advice of their physician and thus chose the treatment option that went against their initial preferences. Patients who followed their physician's advice were less satisfied with their decision than patients not following their physician's advice (schizophrenia: t = 2.61, P = 0.01; multiple sclerosis: t = 2.67, P = 0.009). Discussion and conclusions When sharing decisions with patients, physicians should be aware that their advice might influence patients' decisions away from their preferred treatment option. They should encourage their patients to identify their own preferences and help to find the treatment option most consistent with them. [ABSTRACT FROM AUTHOR]

ABSTRACT The adoption of innovations associated with environmental sustainability has been a topic of growing interest among scholars. The research presented in this paper draws on Abrahamson's theoretical framework of fads and fashions to argue that dimensions of uncertainty and degree of external versus internal influence provide significant insights into firms' decisions to adopt sustainable building innovations. We develop three hypotheses, reflecting three views of adoption influence: fad, fashion, and efficient-choice. We find that adoption of Leadership in Energy and Environmental Design (LEED) green building certification in the United States was more likely among firms similarly oriented toward end-consumers and among firms strategically positioned as environmental leaders. These results provide support for the fad and efficient-choice views of adoption, respectively. Contrary to expectations suggested by the fashion perspective, adoption was not more likely among firms located in states whose political leaders are more committed to environmental protection. Our findings offer important implications for practitioners and policy makers seeking to encourage sustainable building design. Copyright © 2011 John Wiley & Sons, Ltd and ERP Environment. [ABSTRACT FROM AUTHOR]

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This paper deals with obtaining an upper tolerance limit for a largest observation X [ABSTRACT FROM AUTHOR]

Presents a review of several studies which applied the expected utility hypothesis (EUH) to practical decision problems in agriculture. Test of EUH; Overview of an actual economic behavior tests on EUH; Details of the experimental method approach.

The crucial steps in a quantitative analysis of a decision problem are problem formulation, model building, analysis, and implementation. Given an initial model specification, the goal of analysis is to determine the values of the controllable or decision variables that optimize the objective function. Frequently the initial model is inadequate and must be reformulated. While modeling is an evolutionary process involving art and science, under certain conditions Response Surface Methodology (RSM) is an effective vehicle for constructing and parameterizing optimization models. RSM, which draws upon the areas of experimental design, modeling, inference, and optimization, utilizes different opening and ending strategies. Through simultaneous and sequential experimentation, the approximate region of the model's maximum response is found by employing the steepest ascent method. Subsequently, the exact values of the controllable variables that maximize the model's response are determined by canonical analysis. The RSM concepts are first developed within the context of a manufacturing problem. A potential application to simulation studies is then presented. [ABSTRACT FROM AUTHOR]

A decision rule for selecting a one-sided or two-sided alternative for a standard hypothesis test is developed. Using a prior distribution of the parameter to be tested, the alternative is chosen which maximizes expected power. The test of a binomial parameter is presented to illustrate the method. [ABSTRACT FROM AUTHOR]

One important aspect of experimental design is the decision whether to use a one- or two-tailed hypothesis test. Assuming that the sample size and the level of significance have been specified, the selection of an alternative hypothesis can materially affect the conclusion drawn from the experiment. In the past, this selection was made on a subjective basis or for pragmatic reasons which can bias the experiment. This paper suggests an expected value approach, maximizing the expected power of the test, to place the selection of alternative hypotheses in an objective and reliable decision framework. [ABSTRACT FROM AUTHOR]

The two-group discriminant problem has applications in many areas, for example, differentiating between good credit risks and poor ones, between promising new firms and those likely to fail, or between patients with strong prospects for recovery and those highly at risk. To expand our tools for dealing with such problems, we propose a class of nonparametric discriminant procedures based on linear programming (LP). Although these procedures have attracted considerable attention recently, only a limited number of computational studies have examined the relative merits of alternative formulations. In this paper we provide a detailed study of three contrasting formulations for the two-group problem. The experimental design provides a variety of test conditions involving both normal and nonnormal populations. Our results establish the LP model which seeks to minimize the sum of deviations beyond the two-group boundary as a promising alternative to more conventional linear discriminant techniques. [ABSTRACT FROM AUTHOR]

Despite the increased application of cluster analysis in decision sciences, few attempts have been made to derive hypothesis-testing procedures for the evaluation of clustering solutions. In fact, the present paper shows that at least one such attempt failed to specify a meaningful sampling distribution for the test procedure. An alternative index based on the concept of point-biserial correlation is proposed as a possible recovery measure. The index is subsequently used to form the basis of a valid statistical test for the existence of cluster structure. [ABSTRACT FROM AUTHOR]

In hypothesis testing, the level of significance, α, often performs a screening as well as an evaluating function. Results which are not "significant" at some preset value of α are simply not reported. Unfortunately, this value of α is usually arbitrarily set at .05 or .01 and bears no relation to the needs of potential users of the study. This paper suggests an approach to making the selection of α more responsive to these potential applications. [ABSTRACT FROM AUTHOR]

The article offers the author's insights on the significance of employing good statistical approaches in making decisions on policies in plant science. The author mentions the drawbacks of using null hypothesis significance testing (NHST), which are based on using arbitrary threshold for evaluating statistical significance. He argues that NHST's significance threshold must be established to attain the objectives of the statistical test.