Ratings scales

Owing to the lack of well-defined, broadly established and valid biological markers in psychiatric diseases, the clinical assessment of patients is routinely based on different rating scales. When selecting a scale for use in the investigation of the effect of a drug on a particular disorder, some potential sources of error should be kept in mind  

Despite these limitations, rating scales today are the preferred clinical recording instrument in most areas of psychopharmacology. In order to cancel out the disadvantages, they are often combined with brief case histories or occasionally with symptom lists, which can be prepared individually for each patient. 

These are instruments developed to identify specific psychiatric disorders. Most of these scales are based on a structured or semi-structured interview lasting some 60 90 min. Structured interviews contain a mix of open-ended and closed questions. Open-ended questions are essential for the validity of a diagnostic procedure closed questions support the reliability and the standardization of diagnostic tools. The primary goal for the use of diagnostic scales is to reduce the variance within samples caused by diagnostic differences, i.e. to create homogeneous patient populations included in clinical trials. 

The most commonly used semi-structured diagnostic scale is the Structured Clinical Interview for DSM-IV Axis I Disorders (SCI I) First et al., 1997). A clinical version of the SCID (SCID-CV) is designed for use in clinical settings and covers the most commonly seen diagnoses according to DSM-IV. The research version of the SCID includes ratings for different subtypes, severity and course specifiers of mental disorders. The SCLD-CV contains six modules (A) Mood Episodes (B) Psychotic Symptoms (C) Psychotic Disorders (D) Mood Disorders (E) Substance Use Disorders fF) Anxiety and Other Disorders. 

The Mini-International Neuropsychiatric Interview (MINI) is a short structured diagnostic interview for DSM-IV and ICD-10 psychiatric disorders. With an administration time of approximately 15 min, it was designed to meet the need for a short but accurate structured psychiatric interview for multicenter clinical trials and epidemiology studies, and to be used as a first step in outcome tracking in non-research clinical settings (Sheehan et al.y 1998). 

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Specific scales may be used to rate the perception of intensity of (/) the malodor, and (2) the malodor along with an odorous material designed to modify the malodor. Rating scales may consist of numerical assignments to words, eg, from 0 = no odor to 10 = very strong odor. These same type of scales maybe used to describe both the hedonic acceptabiUty of the net result, ie, from 0 = very unpleasant to 10 = extremely pleasant, and the degree of modification, ie, from 0 = does not modify to 10 = complete elimination or cover-up. 

Sc e-up on rate Scale-up on cake discharge Scale-up on actual area... 

An octane rating scale was devised for fuels to quantify their knock resistance. Further research led to cataloguing the antiknock qualities of the myriad individual hydrocarbon species found in gasoline. 

Most plants have boilers producing steam for space heating many need steam for other purposes as well. Boiler water requirements for boilers have changed radically over recent years. The old Lancashire and Economic boilers had large heating surfaces and low heat transfer rates scale deposits would do no more harm than reduce their thermal efficiency. 

Figure 9.17. Reduction of NO by propene on Pt/p -AI203.7,25 Effect of catalyst potential on the rate of N2 production, (a) linear rate scale, (b) logarithmic scale. T=375°C, p ,0 =1.27 kPa ppropene =1-47 kPa (A) and 0.60 kPa (O). Reprinted from ref. 7 with permission from the Institute for Ionics.

From the observed drop in yield, one can calculate the rate of Reaction 10 relative to hydride transfer with cyclobutane (on the rate scale used in Table I) as 1.55 for the ethyl ion and 0.83 for the propyl ion. 

Ortells MO, Lunt GG Evolutionary history of the ligand-gated ion-channel superfamily of receptors. Trends Neurosci 18 121—127, 1995 Overall JE, Gorham DR The Brief Psychiatric Rating Scale. Psychol Rep 10 799—812,1962 Payne JP The criminal use of chloroform. Anaesthesia 53 685—690, 1998... 

Use Scalable Heat Transfer. The feed flow rate scales as S and a cold feed stream removes heat from the reaction in direct proportion to the flow rate. If the energy needed to heat the feed from to Tout can absorb the reaction exotherm, the heat balance for the reactor can be scaled indefinitely. Cooling costs may be an issue, but there are large-volume industrial processes that have Tin —40°C and Tout 200°C. Obviously, cold feed to a PFR will not work since the reaction will not start at low temperatures. Injection of cold reactants at intermediate points along the reactor is a possibility. In the limiting case of many injections, this will degrade reactor performance toward that of a CSTR. See Section 3.3 on transpired-wall reactors. 

Figure 4. Effect of Inlet flow rates on Isotherms, flow streamlines and relative deposition rates of GaAs (a) 70 cc/sec (standard conditions) (b) 140 cc/sec (c) 210 cc/sec. The absolute growth rates scale as 1 (a) 2.6 (b) 3.1 (c).

Basically, there are four major types of measures that are used in taste intensity measurements (a) threshold measures or estimates of the physical level at which the sensation of sweetness begins, (b) equal-sweetness matches between a sugar and other sweeteners, (c) category or rating scales, and (d) ratio scales. Each method has found its adherents and uses, and each possesses specific advantages and defects that indicate its use for one application, but contraindicate its use for another. These methods and their applications have been critically analyzed and reviewed, " " and it is, therefore, superfluous to deal with the topic here. 

Conners, C.K. A teacher rating scale for use in drug studies with children. Am J Psychiatry 126 152-156, 1969. 

Using the PCP rating scale for stereotyped behavior and ataxia as described by Sturgeon et al. (1979), the central effects of PCP analogs, dexoxadrol, and its levo-isomer, levoxadrol, were determined. As shown in figure 1, all drugs except the (-) isomers produced dose-dependent stereotyped behavior. In contrast,... 

Sturgeon, R.D. Fessler, R.G. and Meltzer, H.Y. Behavioral rating scales for assessing phencyclidine-induced locomotor activity, stereotyped behavior and ataxia in rats. J. 

Locomotion, stereotypy, and ataxia were rated via behavioral observations for all compounds, using behavioral rating scales devised specifically for PCP (Sturgeon et al. 1979). Behaviors were rated by observing each animal for 1 or 2 minutes at the midpoint of each 30-minute dosing interval during collection of the EEG. 

The pro- and anticonvulsant effects of the phencyclinoids were studied by assessing their ability to increase or decrease the intensity of electrically-induced convulsions. A 32 mA, 0.2-second stimulus was delivered via corneal electrodes with a constant-current electroshock apparatus. The shock parameters were chosen to produce a convulsion intensity of "3" on a five-point rating scale as follows 0 = stunned only, 1 = facial and vibrissae tremor, 2 = clonic forepaw treading, 3 = tonic forelimb extension, 4 = tonic forelimb and hindlimb extension, and 5 = death. Thus, both increases and decreases in the convulsion intensity subsequent to drug administration could be observed. 

FIGURE 4. Dose-response-curves for the effects of phencyclinoids on (A) locomotion (B) stereotypy and (C) ataxia. Overt behaviors were scored using the behavioral rating scales of Sturgeon et al. (1979). 

This section focuses on steady and unsteady hydrodynamic modes that emerge as the rotational speed of the inner cylinder (expressed by Ta) and pressure-driven axial flow rate (scaled by Re) are varied, while the outer cylinder is kept fixed. These modes constitute primary, secondary and higher order bifurcations, which break the symmetry of the base helical Couette-Poiseuille (CP) flow and represent drastic changes in flow structure. Figure 4.4.2 presents a map of observed hydrodynamic modes in the (Ta, Re) space, and marks the domain where all of the hydrodynamic modes that interest us appear. We will return to this figure shortly. 

Assess intensity by utilizing a visual analog or numeric rating scale (0-10 with 10 being the worst possible pain)... 

Patients at greatest risk for mortality from acute pancreatitis are those who have multi-organ failure (e.g., hypotension, respiratory failure, or renal failure), pancreatic necrosis, obesity, volume depletion, greater than 70 years of age, and an elevated APACHE II score.3,4 The Acute Physiology, Age, and Chronic Health Evaluation (APACHE) II score is a rating scale of disease severity in critically ill patients. 

TABLE 26-2. Clinical Rating Scales Used in MS23... 

The most useful diagnostic tool is the clinical history, including both presenting symptoms and associated risk factors. The Unified Parkinson s Disease Rating Scale (UPDRS) is used to define the degree of disability. 

UPDRS Unified Parkinson s Disease Rating Scale... 

Pain, particularly acute pain, may be accompanied by physiologic signs and symptoms, and there are no reliable objective markers for pain. Many tools have been designed for assessing the severity of pain including rating scales and multidimensional pain assessment tools. 

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