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Selected AbstractsPsychometric properties of the Pediatric Motor Activity Log used for children with cerebral palsyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 3 2009MARGARET WALLEN MA BAPPSC(OT) The Pediatric Motor Activity Log (PMAL) is a parent-report measure of the use, by children with hemiplegic cerebral palsy (CP), of their affected upper limb in everyday activities. The aim of this study was to examine the psychometric properties of both scales of the PMAL (,How Often' and ,How Well' scales) using Rasch measurement modelling. Sixty-one parents of children with hemiplegic CP completed the PMAL and 31 completed it again 3 weeks later. The mean age of children was 4 years 6 months (SD 1y 9mo); 35 males, 26 females. Children were at Gross Motor Function Classification System (GMFCS) levels I (83%) and II (17%), and Manual Ability Classification System levels I (35%), II (52%), and III (14%). The original scales were found to have disordered rating scale structure. Further Rasch modelling with collapsed rating scale structures resulted in both scales conforming to the expectations of the Rasch model, yielding strong evidence for construct validity and reliability. One item from the How Often scale failed to conform to Rasch expectations and was deleted in subsequent analyses. Test,retest reliability of both scales was high (the intraclass correlation coefficient for the How Often scale was 0.94, and for the How Well scale 0.93). The revised scales possess good psychometric properties, specifically a logical item hierarchy, evidence of unidimensionality, adequate rating scale structure, and good test,retest reliability. We conclude that the revised PMAL has the capacity to yield valid and reliable scores except for children at the extremes of upper limb ability. [source] The talking touchscreen: A new approach to outcomes assessment in low literacyPSYCHO-ONCOLOGY, Issue 2 2004Elizabeth A. Hahn Purpose. Cancer patients who are deficient in literacy skills are particularly vulnerable to experiencing different outcomes due to disparities in care or barriers to care. Outcomes measurement in low literacy patients may provide new insight into problems previously undetected due to the challenges of completing paper-and-pencil forms. Description of study. A multimedia program was developed to provide a quality of life assessment platform that would be acceptable to patients with varying literacy skills and computer experience. One item at a time is presented on the computer touchscreen, accompanied by a recorded reading of the question. Various colors, fonts and graphic images are used to enhance visibility, and a small picture icon appears near each text element allowing patients to replay the sound as many times as they wish. Evaluation questions are presented to assess patient burden and preferences. Results. An ethnically diverse group of 126 cancer patients with a range of literacy skills and computer experience reported that the ,talking touchscreen' (TT) was easy to use, and commented on the usefulness of the multimedia approach. Clinical implications. The TT is a practical, user-friendly data acquisition method that provides greater opportunities to measure self-reported outcomes in patients with a range of literacy skills. Copyright © 2003 John Wiley & Sons, Ltd. [source] The association of physical activity and depression in Type 2 diabetesDIABETIC MEDICINE, Issue 10 2008Z. Lysy Abstract Aims Physical inactivity and depressed mood are both associated with a higher likelihood of diabetes-related complications; the association between physical activity and depressed mood in Type 2 diabetes has not been reviewed previously. We have reviewed (i) the strength of this association and (ii) the impact of depression-specific management and physical activity interventions on mood and activity levels in overweight adults with Type 2 diabetes. Methods Studies published between January 1996 and September 2007 were identified (Ovid - medline, Psych- Info and embase) using pertinent search terms (keyword/title). Results Of the 12 studies included (10 cross-sectional, two trials), most employed a standardized questionnaire for depressed mood but only one item for physical activity. In adults with Type 2 diabetes, the inactive are 1.72 to 1.75 times more likely to be depressed than the more active; the depressed are 1.22 to 1.9 times more likely to be physically inactive than the non-depressed. Two randomized trials demonstrated that a depression management programme improved mood, but only one demonstrated increased physical activity. Conclusions Studies to date suggest an association between depressed mood and physical inactivity in adults with Type 2 diabetes, although objective measures of physical activity have not been employed. Depression-specific management may improve mood and possibly activity. A trial comparing the impact of depression-specific management compared with exercise intervention on depressed mood and activity in Type 2 diabetes is justified. [source] Examining item bias in the anxiety subscale of the Hospital Anxiety and Depression Scale in patients with chronic obstructive pulmonary diseaseINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 2 2008Wai-Kwong Tang Abstract The Hospital Anxiety and Depression Scale (HADS) is a widely used screening instrument for depression and anxiety in medically compromised patients. The purpose of this study was to examine the differential item functioning (DIF) of the anxiety subscale of the HADA (HADS-A). A research assistant administered the HADS-A to 166 Chinese patients with chronic obstructive pulmonary disease (COPD) who were consecutively admitted to a rehabilitation hospital. Although the HADS-A was overall uni-dimensional, there were one mute item and two items with borderline misfit. Only one item had a DIF for arterial oxygen saturation. No item had DIF for other indicators of the severity of COPD. In conclusion, this study found that for one item the HADS-A has significant item bias for the severity of disease in patients with COPD. Copyright © 2008 John Wiley & Sons, Ltd. [source] Genetic polymorphism of sulfotransferase 1A1, cigarette smoking, hazardous chemical exposure and urothelial cancer risk in a Taiwanese populationINTERNATIONAL JOURNAL OF UROLOGY, Issue 12 2008Yuan-Hung Wang Objectives: To investigate the association between genetic polymorphism of sulfotransferase1A1 (SULT1A1), cigarette smoking, hazardous chemical exposure and urothelial cancer risk in a Taiwanese population. Methods: In a hospital-based case,control study, a total of 300 urothelial cancer (UC) cases and 300 cancer-free controls frequency-matched by age and gender were recruited from September 1998 to December 2005. The SULT1A1 arginine213histidine (Arg213His) polymorphism was genotyped using a polymerase chain reaction,restriction fragment length polymorphism method. Results: We found that the significantly increased UC risks of ever smokers and heavy smokers (,28 pack-years) were 2.1 (95% confidence interval [CI] = 1.4,3.3) and 2.2 (95% CI = 1.3,3.6), respectively. An increased UC risk of 1.8 (95% CI = 0.8,3.8) was observed among individuals with more than one item of hazardous chemical exposure, but it was not statistically significant. Compared with study subjects carrying the SULT1A1 Arg/Arg genotype, those with SULT1A1 Arg/His or His/His genotypes have a significantly decreased UC risk (Odds ratio [OR] = 0.5, 95% CI = 0.3,0.8). Heavy smokers carrying the SULT1A1 Arg/Arg genotype have a significantly increased UC risk (OR = 5.2, 95% CI = 2.3,11.6). Individuals who had been exposed to more than one item of hazardous chemicals and who carried the SULT1A1 Arg/Arg genotype have a significantly increased UC risk (OR = 3.7, 95% CI = 1.4,9.7). The highest significant increased UC risk (OR = 16.1, 95% CI = 2.9,87.2) was observed among ever smokers with hazardous chemical exposure and the SULT1A1 Arg/Arg genotype. Conclusions: SULT1A1 Arg213His polymorphism is associated with the development of UC, especially among cigarette smokers exposed to hazardous chemicals. [source] Improving the quality of reporting acupuncture interventions: describing the collaboration between STRICTA, CONSORT and the Chinese Cochrane CentreJOURNAL OF EVIDENCE BASED MEDICINE, Issue 1 2009Hugh MacPherson Background First published in 2001, STRICTA (STandards for Reporting Interventions in Controlled Trials of Acupuncture) was designed to expand on the reporting of one item within the CONSORT (Consolidated Standards of Reporting Trials) Statement checklist, the item relating to the intervention. Two recent reviews had found that STRICTA was highly regarded in the field and that there was a need for minor revisions. Objective To revise STRICTA within the CONSORT family of reporting guidelines. Design A collaborative effort involving the STRICTA Group, the CONSORT Group and the Chinese Cochrane Centre was agreed. A consultation process with 47 international experts provided detailed feedback on an initial draft of a revised checklist. These data, along with the two review studies, comprised the documentation for a consensus meeting in Freiburg, Germany in October 2008. A total of 21 participants attended the meeting, bringing their expertise as research methodologists, reporting guideline developers, acupuncturists, physicians and journal editors. Results At the workshop, a revised draft checklist was agreed. There was general consensus that STRICTA should continue to function as a stand-alone guideline as well as an extension to CONSORT. It was agreed that STRICTA should be sufficiently broad to cover all type of clinical studies, from case reports through uncontrolled studies to randomised controlled trials. It was also decided that explanations and examples, as with other CONSORT reporting guidelines, would provide a useful way of supporting the uptake to the new recommendations when published. Discussion The checklist will be subjected to further revision processes in order to further its impact and support wider dissemination. Journals that regularly publish acupuncture trials will be encouraged to adopt the revised STRICTA, include it in their guidelines for authors, and promote the adoption of its recommendations for clinical studies of acupuncture. [source] Association of dietary habits with symptoms of temporomandibular disorders in Bangladeshi adolescentsJOURNAL OF ORAL REHABILITATION, Issue 8 2004R. Akhter summary, The prevalences of signs and symptoms of temporomandibular disorder (TMD) in Bangladeshi adolescents and their associations with intake of various hard food items were investigated. A group of 1200 randomly selected high school students aged 12,17 years from three communities (rural, semi-urban and urban) completed a questionnaire on dietary habits and presence of TMD symptoms and were examined clinically. In bivariate analysis, no significant relationship was observed between TMD symptoms and eating of hard foods. However, in logistic regression analysis, clicking showed a significant correlation with consumption of hard vegetable and fruits more than three times per week (P < 0·05). A statistically significant correlation was also observed between consumption of all hard food items (at least one item in each of the four categories of hard food) more than 12 times per week and pain in the temporomandibular joint (TMJ) (P < 0·05). A positive association was found between pain in the TMJ and older age (15,17 years) (P < 0·001). The prevalence of pain in the TMJ was significantly higher in males (P < 0·01). Prevalences of clicking and pain in the TMJ were significantly higher in subjects living in a rural area than in subjects living in an urban area (P < 0·01 and P < 0·01, respectively). Subjects having one or more decayed, missing and filled teeth (DMFT) showed significantly higher prevalences of clicking (P < 0·01) and restricted mouth opening (P < 0·01). The results suggest that prevalence of TMD symptoms are related to prolonged consumption of hard food items. [source] Self-rated health as predictor of medicine use in adolescence,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 2 2008Bjørn E. Holstein Mag Scient Soc Abstract Purpose To examine the association between self-rated health (SRH) and medicine use for four common complaints: headache, stomach-ache, difficulties in getting to sleep and nervousness, in a nationally representative sample of adolescents. Methods The study population comprised of all students in the fifth, seventh and ninth grade (mean ages 11.6, 13.6 and 15.6 years) in a random sample of schools in Denmark 2002, participation rate 90.6%, n,=,4.824. The students reported health problems, medicine use, social and psychosocial conditions in an anonymous and standardized questionnaire. The outcome measure was self-reported medicine use during the past month and the determinant was SRH measured by one item. Results There was an association between poor/fair SRH and medicine use for headache and stomach-ache. The associations remained statistically significant even after adjustment for frequency of the complaint for which the medicine was used: OR (95%CI) for medicine use for headache was 1.54 (1.10,2.14) among boys with poor/fair SRH and 1.50 (1.12,2.03) among girls with poor/fair SRH. A similar association was found between poor SRH and medicine use for stomach-ache for both boys (OR,=,3.41 (2.09,5.55)) and girls (OR,=,1.90 (1.36,2.67). Further, there was an association between poor/fair SRH and medicine use for difficulties in getting to sleep among girls, OR,=,2.66 (1.26,5.63) but not among boys. There was no association between SRH and medicine use for nervousness. Conclusion Poor/fair SRH is associated with medicine use for aches among Danish adolescents. Copyright © 2007 John Wiley & Sons, Ltd. [source] Translating questionnaire items for a multi-lingual worker population: The iterative process of translation and cognitive interviews with English-, Spanish-, and Chinese-speaking workers,,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 2 2010Kaori Fujishiro PhD Abstract Background The increasing ethnic diversity of the US workforce has created a need for research tools that can be used with multi-lingual worker populations. Developing multi-language questionnaire items is a complex process; however, very little has been documented in the literature. Methods Commonly used English items from the Job Content Questionnaire and Quality of Work Life Questionnaire were translated by two interdisciplinary bilingual teams and cognitively tested in interviews with English-, Spanish-, and Chinese-speaking workers. Results Common problems across languages mainly concerned response format. Language-specific problems required more conceptual than literal translations. Some items were better understood by non-English speakers than by English speakers. De-centering (i.e., modifying the English original to correspond with translation) produced better understanding for one item. Conclusions Translating questionnaire items and achieving equivalence across languages require various kinds of expertise. Backward translation itself is not sufficient. More research efforts should be concentrated on qualitative approaches to developing useful research tools. Am. J. Ind. Med. 53:194,203 2010. Published 2009 Wiley-Liss, Inc. [source] Associated and predictive factors of sleep disturbance in advanced cancer patientsPSYCHO-ONCOLOGY, Issue 10 2007Tatsuo Akechi Abstract Little attention has been paid to sleep disturbance experienced by advanced cancer patients. The purpose of the present study was to investigate longitudinal change in sleep disturbance and to identify factors that associated with and predicted sleep disturbance among 209 consecutive terminally ill cancer patients. Patients were assessed twice for sleep disturbance by one item of the structured clinical interview for assessing depression, once at the time of their registration with a palliative care unit (PCU) (baseline) and again at the time of their PCU admission (follow-up), and possible associated medical and psychosocial factors were evaluated. The proportions of patients with obvious sleep disturbance at baseline and follow-up were 15.3 and 25.9%, respectively. Sixty-seven percent of the subjects showed some sleep status changes, including both aggravation and improvement, between baseline and follow-up. Being younger, having diarrhea and living alone were significantly associated with sleep disturbance at baseline, and the increase of psychological distress was the only significant predictive factor for sleep disturbance at follow-up. These findings suggest that psychological distress is a possible key cause of sleep disturbance and management of psychological distress may be one promising strategy for prevention of sleep disturbance among advanced cancer patients. Copyright © 2006 John Wiley & Sons, Ltd. [source] | ||||||||||