Statistics for Risk Assessment of Chemical Carcinogens∗

Risk assessment is a scientific process of evaluation of potential health risks of chemical exposures to humans from available information. It involves analysis of the relationship between exposure and health related outcomes to derive an allowable exposure level. Because of lack of human exposure data, the major source of information for studying potential health effects of chemicals on humans is generally obtained from animal dose response experiments. Animal data are often evaluated in two aspects via statistical analysis: qualitative testing and quantitative estimation. The qualitative testing is to determine if the chemical causes an adverse health effect, i.e., if there is a statistically significant difference between treated and control animals. Quantitative estimation involves fitting a dose-response model to derive an allowable exposure level for humans. This paper reviews statistical principles and procedures for qualitative and quantitative approaches to human risk assessment.     

The Rheology of Liquids: A Comparison of Clinicians’ Subjective Impressions and Objective Measurement

Texture-modified diets are commonly prescribed for patients with dysphagia; it is therefore important to demonstrate that clinicians form accurate impressions of the rheological (flow) properties of the items that they recommend for their clients. We explored the correlation between objective rheological measurement and clinicians subjective impressions of liquid consistency, rated on the bases of product labeling and sampling. Ten liquids, ranging from thin through nectar-thick and honey-thick to spoon-thick consistencies, were selected for study. Rheological analysis was conducted using a Carri-Med CSL Controlled Stress Rheometer. Fifty speech-language pathologists ranked the liquids in order of perceived viscosity, based on their interpretation of the product packaging and label. Product nomenclature proved insufficient to accurately represent the consistency class to which each liquid belonged. A second group of 16 speech-language pathologists rated the perceived relative viscosity and density of nectar-thick and honey-thick juice items in blinded two-point discrimination tests of stirring-resistance, oral manipulation, and vessel weight. Physical sampling of these two products enabled clinicians to reliably perceive relative viscosity and density differences between the nectar- and honey-thick items.     

EAT-10中文版在急性期脑卒中后吞咽障碍评估中的信度效度评价

目的：探讨进食评估问卷调查工具-10(eating assessment tool-10,EAT-10)中文版在急性期脑卒中后吞咽障碍评估中的信度和效度。方法：选择急性期脑卒中后住院患者180例,采用EAT-10中文版量表进行筛查评估,并用吞咽障碍的诊断金标准--视频透视吞咽功能检查(videofluoroscopic swallow study,VFSS)为效标进行检验。结果：180名入选患者中有130名问卷合格并顺利行VFS检查,EAT-10中文版总量表Cronbach’s α=0.845,各条目与总分均存在相关,相关系数最低的为条目2(r=0.271),相关系数最高的为条目3(r=0.772),重测信度均为0.7以上,重测信度符合要求。经调查员一致性信度检验,条目2有一位调查员的结果是恒定值,量表其余9个条目的一致相关系数均>0.7,各亚项和总分均值间一致性较高。分别对EAT-10分界值3,2,1进行效度检验,发现分界值1为最理想分界值,灵敏度及阴性预测值最高,判断吞咽障碍的灵敏度为77.9%,特异度为66.1%,阳性预测值71.6%,阴性预测值73.2%,阳性似然比2.30,阴性似然比0.33。结论：EAT-10中文版仅适用于已有饮水和进食经历的患者,EAT-10中文版对评估急性期脑卒中患者有良好的信度和效度,当分界值为1,EAT-10总分≥1时灵敏度和阴性预测值最佳,能够较好地预测急性期脑卒中患者吞咽障碍、吞咽能力受损、渗透和误吸。     

医务人员对卫生技术评估的认知分析

为了解医务人员对卫生技术评估的认知,采用现场问卷调查与访谈相结合的方法,对山西省三级综合类医院的医务人员进行调查,从卫生技术评估知晓度、接受培训的意愿、支持意愿、知识获取渠道、期待的职能等方面对结果进行分析,在此基础上指出存在的问题并提出发展建议。     

Psychometric properties of the Recovery Assessment Scale in a sample with substance use disorder

Background: Conceptualisations of recovery from substance use disorder (SUD) and mental illness overlap significantly, and the rate of comorbidity of these problems is high. This study investigated the psychometric properties of the Recovery Assessment Scale (RAS), a measure originally developed for individuals with mental illness. Method: A sample of 1094 people with SUD attending residential treatment services provided by the Australian Salvation Army completed the RAS and other outcome measures at admission. Results: Confirmatory factor analysis (CFA) indicated a poor fit of the data to the five factor solution previously identified in mental illness samples. Exploratory factor analysis, however, produced three of the five factors included in the CFA, and two factors which arranged constructs in a slightly different manner from previous factor analytic studies in samples with mental illness. Correlations of these factors with other symptom distress and recovery measures indicated satisfactory convergent and divergent validity. Conclusions: The study provides modest support for the use of the RAS in groups with SUD.     

Risks of Lung Cancer due to Radon Exposure among the Regions of Korea

Radon is likely the second most common cause of lung cancer after smoking. We estimated the lung cancer risk due to radon using common risk models. Based on national radon survey data, we estimated the population-attributable fraction (PAF) and the number of lung cancer deaths attributable to radon. The exposure-age duration (EAD) and exposure-age concentration (EAC) models were used. The regional average indoor radon concentration was 37.5 95 Bq/m³. The PAF for lung cancer was 8.3% (European Pooling Study model), 13.5% in males and 20.4% in females by EAD model, and 19.5% in males and 28.2% in females by EAC model. Due to differences in smoking by gender, the PAF of radon-induced lung cancer deaths was higher in females. In the Republic of Korea, the risk of radon is not widely recognized. Thus, information about radon health risks is important and efforts are needed to decrease the associated health problems.

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Assessment programs to enhance learning

Background: Assessment is an essential part of the educational system. Usually, assessment is used to measure students’ knowledge, but it can also be used to drive students’ learning and behaviors. Assessment programs should be constructed in a well-balanced way allowing not only measuring students’ knowledge but also changing students’ behavior.

Objectives: In this paper, we will discuss different strategies that can be used to change students’ behaviors which may improve their learning.

Main findings: Assessment as well as the learning material should be congruent with the objectives. Based on the literature, we summarize findings that would address key points to allow assessment for learning instead of learning.

Conclusions: When constructing an assessment program, choices have to be made that depend on aspects like logistics, financial, organizational, managerial, educational culture, and cooperation of individual and key faculty members. It is important to realize that whatever decisions you make, students will always adapt their behavior to the way you construct your assessment program.