If brief and easy to use self report screening tools are available to identify frail elderly, this may avoid costs and unnecessary assessment of healthy people. This study investigates the predictive validity of three self-report instruments for identifying community-dwelling frail elderly.
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The Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV) is a risk assessment instrument for adolescents that estimates the risk of multiple adverse outcomes. Prior research into its predictive validity is limited to a handful of studies conducted with the START:AV pilot version and often by the instrument’s developers. The present study examines the START:AV’s field validity in a secure youth care sample in the Netherlands. Using a prospective design, we investigated whether the total scores, lifetime history, and the final risk judgments of 106 START:AVs predicted inpatient incidents during a 4-month follow-up. Final risk judgments and lifetime history predicted multiple adverse outcomes, including physical aggression, institutional violations, substance use, self-injury, and victimization. The predictive validity of the total scores was significant only for physical aggression and institutional violations. Hence, the short-term predictive validity of the START:AV for inpatient incidents in a residential youth care setting was partially demonstrated and the START:AV final risk judgments can be used to guide treatment planning and decision-making regarding furlough or discharge in this setting.
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Most violence risk assessment tools have been validated predominantly in males. In this multicenter study, the Historical, Clinical, Risk Management–20 (HCR-20), Historical, Clinical, Risk Management–20 Version 3 (HCR-20V3), Female Additional Manual (FAM), Short-Term Assessment of Risk and Treatability (START), Structured Assessment of Protective Factors for violence risk (SAPROF), and Psychopathy Checklist–Revised (PCL-R) were coded on file information of 78 female forensic psychiatric patients discharged between 1993 and 2012 with a mean follow-up period of 11.8 years from one of four Dutch forensic psychiatric hospitals. Notable was the high rate of mortality (17.9%) and readmission to psychiatric settings (11.5%) after discharge. Official reconviction data could be retrieved from the Ministry of Justice and Security for 71 women. Twenty-four women (33.8%) were reconvicted after discharge, including 13 for violent offenses (18.3%). Overall, predictive validity was moderate for all types of recidivism, but low for violence. The START Vulnerability scores, HCR-20V3, and FAM showed the highest predictive accuracy for all recidivism. With respect to violent recidivism, only the START Vulnerability scores and the Clinical scale of the HCR-20V3 demonstrated significant predictive accuracy.
MULTIFILE
This study intends to investigate the validity of a self-efficacy measure which is developed for predictive and diagnostic purposes concerning student teachers in competence-based education. CFA results delivered converging evidence for the multidimensionality of the student teacher self-efficacy construct and the bi-factor model as underlying structure, reflecting a teacher competence framework. Factor loadings of the bifactor model evidenced the theoretical assumption that incipient student teachers enter the programme with a global undifferentiated sense of teacher self-efficacy, having teaching experiences a further differentiation takes place to a partly differentiated sense of teacher efficacy. Logistic regression analysis revealed that the measure succeeds in predicting students' first-year outcomes and delivered evidence for the diagnostic value of the scale.
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We investigated the predictive value of a new kindergarten assessment of handwriting readiness on handwriting performance in first grade as evaluated by the Systematic Screening for Handwriting Difficulties (Dutch abbreviation: SOS). The kindergarten assessment consisted of the Writing Readiness Inventory Tool In Context (WRITIC), the Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery™VMI) and the Nine-Hole Peg Test (9-HPT). The WRITIC evaluates in kindergarten children (aged 5-6 years) prewriting skills, the Beery™VMI and 9-HPT evaluate visual motor integration and fine-motor coordination, all elements important for handwriting readiness. In kindergarten, 109 children (55 boys; mean age 70 months, SD 4.8 months) were tested with the WRITIC, Beery™VMI and 9-HPT and one year later in first grade (mean age 85 months, SD 4.5 months) with the SOS. A multivariable linear mixed model was used to identify variables that independently predict outcomes in first grade (SOS): baseline scores on WRITIC-TP, Beery™VMI, 9-HPT, 'sustained attention,' 'gender,' 'age' and 'intervention' in the intermediate period. The results showed that WRITIC-TP, Beery™VMI, and 9-HPT, 'sustained attention,' 'gender' and 'intervention' had all predictive value on the handwriting outcome. Thereby WRITIC-TP was the main predictor for outcome of SOS-Quality, and Beery™VMI and 9-HPT were the main predictors of SOS-Speed. This kindergarten assessment of WRITIC-TP, Beery™VMI, and 9-HPT contributes to the detection of children at risk for developing handwriting problems.
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The full potential of predictive maintenance has not yet been utilised. Current solutions focus on individual steps of the predictive maintenance cycle and only work for very specific settings. The overarching challenge of predictive maintenance is to leverage these individual building blocks to obtain a framework that supports optimal maintenance and asset management. The PrimaVera project has identified four obstacles to tackle in order to utilise predictive maintenance at its full potential: lack of orchestration and automation of the predictive maintenance workflow, inaccurate or incomplete data and the role of human and organisational factors in data-driven decision support tools. Furthermore, an intuitive generic applicable predictive maintenance process model is presented in this paper to provide a structured way of deploying predictive maintenance solutions https://doi.org/10.3390/app10238348 LinkedIn: https://www.linkedin.com/in/john-bolte-0856134/
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Background & aims: Individual energy requirements of overweight and obese adults can often not be measured by indirect calorimetry, mainly due to the time-consuming procedure and the high costs. To analyze which resting energy expenditure (REE) predictive equation is the best alternative for indirect calorimetry in Belgian normal weight to morbid obese women.Methods: Predictive equations were included when based on weight, height, gender, age, fat free mass and fat mass. REE was measured with indirect calorimetry. Accuracy of equations was evaluated by the percentage of subjects predicted within 10% of REE measured, the root mean squared prediction error (RMSE) and the mean percentage difference (bias) between predicted and measured REE.Results: Twenty-seven predictive equations (of which 9 based on FFM) were included. Validation was based on 536 F (18–71 year). Most accurate and precise for the Belgian women were the Huang, Siervo, Muller (FFM), Harris–Benedict (HB), and the Mifflin equation with 71%, 71%, 70%, 69%, and 68% accurate predictions, respectively; bias −1.7, −0.5, +1.1, +2.2, and −1.8%, RMSE 168, 170, 163, 167, and 173 kcal/d. The equations of HB and Mifflin are most widely used in clinical practice and both provide accurate predictions across a wide range of BMI groups. In an already overweight group the underpredicting Mifflin equation might be preferred. Above BMI 45 kg/m2, the Siervo equation performed best, while the FAO/WHO/UNU or Schofield equation should not be used in this extremely obese group.Conclusions: In Belgian women, the original Harris–Benedict or the Mifflin equation is a reliable tool to predict REE across a wide variety of body weight (BMI 18.5–50). Estimations for the BMI range between 30 and 40 kg/m2, however, should be improved.
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Background: Due to differences in the definition of frailty, many different screening instruments have been developed. However, the predictive validity of these instruments among community-dwelling older people remains uncertain. Objective: To investigate whether combined (i.e. sequential or parallel) use of available frailty instruments improves the predictive power of dependency in (instrumental) activities of daily living ((I)ADL), mortality and hospitalization. Design, setting and participants: A prospective cohort study with two-year followup was conducted among pre-frail and frail community-dwelling older people in the Netherlands. Measurements: Four combinations of two highly specific frailty instruments (Frailty Phenotype, Frailty Index) and two highly sensitive instruments (Tilburg Frailty Indicator, Groningen Frailty Indicator) were investigated. We calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for all single instruments as well as for the four combinations, sequential and parallel. Results: 2,420 individuals participated (mean age 76.3 ± 6.6 years, 60.5% female) in our study. Sequential use increased the levels of specificity, as expected, whereas the PPV hardly increased. Parallel use increased the levels of sensitivity, although the NPV hardly increased. Conclusions: Applying two frailty instruments sequential or parallel might not be a solution for achieving better predictions of frailty in community-dwelling older people. Our results show that the combination of different screening instruments does not improve predictive validity. However, as this is one of the first studies to investigate the combined use of screening instruments, we recommend further exploration of other combinations of instruments among other study populations.
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Objective: The Tilburg Frailty Indicator (TFI) is a self-report user-friendly questionnaire for assessing multidimensional frailty among community-dwelling older people. The main aim of this study is to re-evaluate the validity of the TFI, both cross-sectionally and longitudinally, focusing on the predictive value of the total TFI and its physical, psychological, and social domains for adverse outcomes disability, indicators of healthcare utilization, and falls. Methods: The validity of the TFI was determined in a sample of 180 Dutch communitydwelling older people aged 70 years and older. The participants completed questionnaires including the TFI, the Groningen Activity Restriction Scale (GARS) for assessing disability, and questions with regard to health care utilization and falls in 2016 and again one year later. Results: The physical and psychological domains of the TFI were significantly correlated as expected with adverse outcomes disability, many indicators of healthcare utilization, and falls. Regression analyses showed that physical frailty was mostly responsible for the effect of frailty on the adverse outcomes. The cross-sectional and longitudinal predictive validity of total frailty with respect to disability and receiving personal care was excellent, evidenced by Areas Under the Curves (AUCs) >0.8. In most cases, using the cut-off point 5 for total frailty ensured the best values for sensitivity and specificity. Conclusion: The present study provided new, additional evidence for the validity of the TFI for assessing frailty in Dutch community-dwelling older people aiming to prevent or delay adverse outcomes, including disability.
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Rationale: Predictive equations for resting energy expenditure (REE) are used in the treatment of overweight and obesity, but the validity of these equations in overweight older adults is unknown. This study evaluates which predictive REE equation is the best alternative to indirect calorimetry in overweight older adults with and without diabetes. Methods: In total 273 adults aged ≥55 years with a BMI of ≥25 kg/m2 were included. REE (by indirect calorimetry), body weight, body height, age, gender, and fat-free and fat mass (from air-displacement plethysmography) were measured. The measured REE was used as a reference and compared with 28 existing REE equations. The accuracy of the equations was evaluated by the percentage accurate predictions (within 10% of REE measured), the root mean squared error (RMSE), and the mean percentage difference (bias) between predicted and measured REE. Subgroup analyses were performed for type 2 diabetics (T2D) and non-T2D. Results: Mean age was 64 ± (SD 6) years, 42% had T2D (n = 116), and mean BMI was 32.8 ± (SD 4.5) with range 25–54 kg/m2. The adjusted Harris & Benedict (1984) provided the highest percentage accurate predictions in all adults (70%) and in T2D (74%), and second best in non-T2D (67%). RMSE was 184, 175 and 191 kcal/day, and bias −1.2%, −1.5% and −1.0% for all adults, T2D and non-T2D, respectively. Conclusion: For Dutch overweight older adults with and without diabetes the adjusted Harris–Benedict (1984) predictive equation for REE seems to be the best alternative to indirect calorimetry.
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