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Ceiling Effects (ceiling + effects)
Selected AbstractsPain Management Misstatements: Ceiling Effects, Red and Yellow FlagsPAIN MEDICINE, Issue 1 2006Steven D. Passik PhD No abstract is available for this article. [source] Impairments in visual discrimination after perirhinal cortex lesions: testing ,declarative' vs. ,perceptual-mnemonic' views of perirhinal cortex functionEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 3 2003Timothy J. Bussey Abstract Two experiments tested the predictions of ,declarative' vs. ,perceptual-mnemonic' views of perirhinal cortex function. The former view predicts that perirhinal cortex lesions should impair rapidly learned, but not more slowly learned, visual discriminations, whereas the latter view predicts that impairments should be related not to speed of learning but to perceptual factors. It was found that monkeys with perirhinal cortex lesions were impaired in the acquisition and performance of slowly learned, perceptually difficult greyscale picture discriminations, but were not impaired in the acquisition of rapidly learned, perceptually easier discriminations. In addition, these same monkeys were not impaired in the acquisition or performance of difficult colour or size discriminations, indicating that the observed pattern of impairments was not due to ceiling effects or difficulty per se. These findings, taken together, are consistent with the ,perceptual-mnemonic' view that the perirhinal cortex is involved in both perception and memory, but are not consistent with the ,declarative' view that the perirhinal cortex is important exclusively for declarative memory, having little or no role in perception. Moreover, the results are consistent with the more specific proposal that the perirhinal cortex contributes to the solution of complex visual discriminations with a high degree of ,feature ambiguity', a property of visual discrimination problems that can emerge when features of an object are rewarded when part of one object, but not when part of another. These and other recent findings suggest the need for a revision of prevailing views regarding the neural organization of perception and memory. [source] Development and Validation of the Headache Needs Assessment (HANA) SurveyHEADACHE, Issue 4 2001Joyce A. Cramer BS Objective.,To develop and validate a brief survey of migraine-related quality-of-life issues. The Headache Needs Assessment (HANA) questionnaire was designed to assess two dimensions of the chronic impact of migraine (frequency and bothersomeness). Methods.,Seven issues related to living with migraine were posed as ratings of frequency and bothersomeness. Validation studies were performed in a Web-based survey, a clinical trial responsiveness population, and a retest reliability population. Headache characteristics (eg, frequency, severity, and treatment), demographic information, and the Headache Disability Inventory were used for external validation. Results.,The HANA was completed in full by 994 adults in the Web survey, with a mean total score of 77.98 ± 40.49 (range, 7 to 175). There were no floor or ceiling effects. The HANA met the standards for validity with internal consistency reliability (Cronbach , = .92, eigenvalue for the single factor = 4.8, and test-retest reliability = 0.77). External validity showed a high correlation between HANA and Headache Disability Inventory total scores (0.73, P<.0001), and high correlations with disease and treatment characteristics. Conclusions.,These data demonstrate the psychometric properties of the HANA. The brief questionnaire may be a useful screening tool to evaluate the impact of migraine on individuals. The two-dimensional approach to patient-reported quality of life allows individuals to weight the impact of both frequency and bothersomeness of chronic migraines on multiple aspects of daily life. [source] Performance on Stroop-like assessments of inhibitory control by 4- and 5-year-old childrenINFANT AND CHILD DEVELOPMENT, Issue 3 2010Dave S. Pasalich Abstract The rapid development of an aspect of executive functioning (EF), inhibitory control (IC), between the ages of 3- and 5-years, leads to an increase in a child's capacity to suppress inappropriate responding and therefore activate the necessary resources to carry-out goal-directed activity (Psychological Bulletin, 1997, 121, 65,94). To measure EF in children, tasks administered clinically to adults are adapted. The Day,Night Stroop (DNS) is a pictorial modification of the Stroop Test (Journal of Experimental Psychology, 1935, 18, 642,662), developed for pre-literate children. Although suitable as a measure of IC in 3- to 4-year-old children, ceiling effects have been reported on the DNS in slightly older preschoolers. The present study attempted to overcome this limitation by examining the suitability of two modified versions of the DNS in 4- to 5-year-old preschoolers. To investigate the executive demands made by both Stroop-like tasks, their associations with another measure of IC (stop-signal task) and a measure of working memory were examined. Counter to expectations, no significant association was found in performance between the two Stroop-like tasks; however, the modified DNS developed in this study showed significant relationships with the other executive tasks. The results are discussed in relation to the different methodologies used by these Stroop measures. Implications of this study suggest that researchers should consider more test-specific factors when assessing EF in young children. Copyright © 2010 John Wiley & Sons, Ltd. [source] Psychometric Properties of the Activities-Specific Balance Confidence Scale and the Survey of Activities and Fear of Falling in Older WomenJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2008Kristine M.C. Talley MS OBJECTIVES: To compare the psychometric properties of the Activities-specific Balance Confidence Scale (ABC) and the Survey of Activities and Fear of Falling in the Elderly (SAFE). DESIGN: Secondary analysis using baseline and 12-week data from a randomized, controlled trial on fall prevention. SETTING: Upper Midwest metropolitan area with assessments conducted in participants' homes. PARTICIPANTS: Population-based sample of 272 noninstitutionalized female Medicare beneficiaries aged 70 and older at risk of falling. MEASUREMENTS: Participants self-administered the ABC, SAFE, Geriatric Depression Scale, and Medical Outcomes Study 36-item Short Form Survey. During a home visit, a nurse practitioner administered the Berg Balance Test and Timed Up and Go, measured gait speed, and asked about falls and chronic illnesses. RESULTS: Baseline internal consistency measured using Cronbach alpha was 0.95 for the ABC and 0.82 for the SAFE. Baseline concurrent validity between the ABC and SAFE measured using a correlation coefficient was ,0.65 (P<.001). ABC and SAFE scores were significantly correlated at baseline with physical performance tests and self-reported health status. The ABC had stronger baseline correlations than the SAFE with most measures. Neither instrument demonstrated responsiveness to change at 12 weeks. CONCLUSION: The ABC and SAFE demonstrated strong internal-consistency reliability and validity when self-administered. The ABC had stronger associations with physical functioning and may be more appropriate for studies focused on improving physical function. Both instruments demonstrated ceiling effects, which may explain the lack of responsiveness to change in relatively nonfrail older women. Instruments sensitive to measuring lower levels of fear of falling are needed to capture the full range of this phenomenon in this population. [source] Nicotine Decreases Blood Alcohol Concentration in Neonatal RatsALCOHOLISM, Issue 7 2001Wei-Jung A. Chen Background : Our previous findings suggested that the intragastric coadministration of alcohol and nicotine to neonatal rats resulted in a significant decrease from the predicted peak blood alcohol concentration (BAC). We hypothesized that the coadministration of alcohol and nicotine would produce a nicotine dose,related decrease in peak BAC and a change in the BAC time curve profile. Methods: Sprague-Dawley rat pups were given alcohol and nicotine simultaneously via intragastric infusion. Two sets of nicotine doses were used in two independent studies. The low doses of nicotine were examined after the study of high doses of nicotine administration because of the possible ceiling effects from these nicotine doses on lowering BACs. Results: The results not only confirmed that the peak BAC was lowered by nicotine, but also generated new findings showing that the profile of BAC time curve was affected by these doses of nicotine. Concerns about possible ceiling effects led us to conduct another experiment to examine the effects of lower doses of nicotine on BACs. Those results showed a significant decline in BACs after cotreatment with 0.5 or 1 mg/kg nicotine and less robust changes on the BAC curve profiles. Although the nicotine dose at 0.25 mg/kg/day did not affect significantly the overall BAC profile, it did lower the peak BAC. Conclusions: Nicotine is capable of lowering the peak BAC among neonatal rat pups. Furthermore, the pattern of the BAC time curve seems to be more affected by high doses of nicotine. [source] Health-related quality of life of food allergic patients measured with generic and disease-specific questionnairesALLERGY, Issue 8 2010B. M. J. Flokstra-de Blok To cite this article: Flokstra-de Blok BMJ, van der Velde JL, Vlieg-Boerstra BJ, Oude Elberink JNG, DunnGalvin A, Hourihane JO'B, Duiverman EJ, Dubois AEJ. Health-related quality of life of food allergic patients measured with generic and disease-specific questionnaires. Allergy 2010; 65: 1031,1038. Abstract Background:, Health-related quality of life (HRQL) has never been measured with both generic and disease-specific questionnaires in the same group of food allergic patients. The aim of this study was to compare HRQL of food allergic patients as measured with generic and disease-specific questionnaires. Methods:, Generic questionnaires (CHQ-CF87 and RAND-36) and disease-specific HRQL questionnaires (FAQLQ-CF, -TF and -AF) were completed by 79 children, 74 adolescents and 72 adults with food allergy. Floor and ceiling effects, percentage of agreement and multivariate stepwise regression analysis were used to compare the generic and disease-specific measurements. Results:, The Food Allergy Quality of Life Questionnaires (FAQLQs) showed minimal floor or ceiling effects. The CHQ-CF87 and RAND-36 showed minimal floor effects, but remarkable ceiling effects (>73%) were found for the scales role functioning-emotional (RE), role functioning-behaviour (RB), role functioning-physical (RP) in children and adolescents and the scale RE (>79%) in adults. Additionally, we found low percentages of agreement between the generic and disease-specific questionnaires to identify the same food allergic patients with the best or worst HRQL. Only patients with the best disease-specific HRQL also tended to have the best generic HRQL. Finally, the explained variance in HRQL by patient characteristics was higher in the disease-specific questionnaires (30.7,62.8%) than in the generic scales (6.7,31.7%). Conclusion:, Disease-specific HRQL questionnaires may be more suitable to measure clinically important impairments in HRQL or HRQL differences over time in food allergic patients. However, generic HRQL questionnaires are indispensable for the comparison between different diseases and are thus complementary. [source] Balance assessment in patients with peripheral arthritis: applicability and reliability of some clinical assessmentsPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 4 2001Anne Marie Norén MSc PT Abstract Background and Purpose Many individuals with peripheral arthritis blame decreased balance as a reason for limiting their physical activity. It is therefore important to assess and improve their balance. The purpose of the present study was to evaluate the applicability and the reliability of some clinical balance assessment methods for people with arthritis and various degrees of disability. Method To examine the applicability and reliability of balance tests, 65, 19 and 22 patients, respectively, with peripheral arthritis participated in sub-studies investigating the applicability, inter-rater reliability and test,retest stability of the following methods: walking on a soft surface, walking backwards, walking in a figure-of-eight, the balance sub-scale of the Index of Muscle Function (IMF), the Timed Up and Go (TUG) test and the Berg balance scale. Results For patients with moderate disability walking in a figure-of-eight was found to be the most discriminative test, whereas ceiling effects were found for the Berg balance scale. Patients with severe disability were generally able to perform the TUG test and the Berg Balance Scale without ceiling effects. Inter-rater reliability was moderate to high and test,retest stability was satisfactory for all methods assessed. Conclusions Applicable and reliable assessment methods of clinical balance were identified for individuals with moderate and severe disability, whereas more discriminative tests need to be developed for those with limited disability. Copyright © 2001 Whurr Publishers Ltd. [source] Bayesian estimation of cognitive decline in patients with alzheimer's diseaseTHE CANADIAN JOURNAL OF STATISTICS, Issue 1 2002Patrick Béalisle Abstract Recently, there has been great interest in estimating the decline in cognitive ability in patients with Alzheimer's disease. Measuring decline is not straightforward, since one must consider the choice of scale to measure cognitive ability, possible floor and ceiling effects, between-patient variability, and the unobserved age of onset. The authors demonstrate how to account for the above features by modeling decline in scores on the Mini-Mental State Exam in two different data sets. To this end, they use hierarchical Bayesian models with change points, for which posterior distributions are calculated using the Gibbs sampler. They make comparisons between several such models using both prior and posterior Bayes factors, and compare the results from the models suggested by these two model selection criteria. Estimation bayésienne du déclin cognitif de patients atteints de la maladie d'Alzheimer On s'est beaucoup intéressé ces derniers temps à l'estimation du déclin des fonctions cognitives des personnes atteintes de la maladie d'Alzheimer. Il n'est pas facile de quantifier ce déclin, qui dépend de l'échelle utilisée pour mesurer les fonctions cognitives, mais aussi de la variabilité entre les individus, de 1'incertitude entourant le moment exact du début de leur maladie et d'éventuels effets plancher et plafond. Les auteurs montrent comment il est possible de tenir compte de ces différents éléments en modélisant le déclin observé dans les résultats obtenus par deux groupes de patients au mini-examen de l'état mental. Ils utilisent pour ce faire des modèles bayésiens hiérarchiques avec points de jonction, pour lesquels ils calculent les lois a posteriori au moyen de l'échantillonneur de Gibbs. Ils comparent plusieurs modèles de ce type au moyen de facteurs de Bayes a priori et a posteriori; ils comparent ensuite les résultats des modèles suggérés par ces deux critères de sélection. [source] Interviewer feedback in repeated interviews involving forced confabulationAPPLIED COGNITIVE PSYCHOLOGY, Issue 4 2007Jessica M. Hanba The effects of confirmatory interviewer feedback on eyewitness testimony following forcibly confabulated and accurate responses to repeated interview questions were investigated in two experiments. The first experiment showed that, relative to neutral feedback, confirmatory feedback provided after a forcibly confabulated response greatly increased the likelihood that participants would provide the same confabulated response when re-interviewed 2 days later, led participants to report these repeated confabulations with greater speed and fewer expressions of doubt, and increased the prevalence of false memories. Confirmatory interviewer feedback provided following accurate responses appeared to have more modest consequences for consistency and confidence, but ceiling effects provided little opportunity for observing potential effects. A second experiment showed that these effects of confirmatory feedback are of considerable practical significance, in that, regardless of their accuracy, responses that had earlier been reinforced with confirmatory feedback were much more likely to be judged by others as credible. Copyright © 2006 John Wiley & Sons, Ltd. [source] Freezing of Gait Questionnaire: validity and reliability of the Swedish versionACTA NEUROLOGICA SCANDINAVICA, Issue 5 2009M. H. Nilsson Background,,, Patient-reported assessments of freezing of gait (FOG) in Parkinson's disease (PD), such as the FOG questionnaire (FOGQ), are needed because FOG is difficult to assess objectively. However, the measurement properties of the FOGQ have been sparsely assessed. Aim,,, To assess the measurement properties of the Swedish FOGQ, and to explore relationships between FOGQ scores and other aspects of PD. Methods,,, Thirty-seven people with PD were assessed with the FOGQ, Unified PD Rating Scale (UPDRS), Hoehn and Yahr (HY), Falls-Efficacy Scale [FES(S)], timed gait tests, and the SF-36 physical functioning (PF) scale. Results,,, Mean (SD) FOGQ item scores ranged between 1.3 and 2.1 (1.2,1.5); corrected item,total correlations ranged between 0.80 and 0.94. Reliability was 0.95. Mean (SD) and median (q1,q3) FOGQ scores were 9.6 (7.4) and 10 (2,15). Floor and ceiling effects were ,5.4%. FOGQ correlated strongest with UPDRS part II (ADL), UPDRS item 14 (freezing), and HY (rS 0.65,0.66). FOGQ scores correlated with PD duration, the Timed Up and Go test, dyskinesia, motor fluctuations, FES(S), and PF scores (rS 0.40,0.62). Fallers had higher FOGQ scores than non-fallers (median 12.5 vs 5.0). Conclusion,,, Data support the measurement properties of the Swedish FOGQ by replicating and extending previous psychometric reports. [source] Research: The challenges of clinical trials in the exclusion zone: The case of the frail elderlyAUSTRALASIAN JOURNAL ON AGEING, Issue 2 2008Iman Ridda Frail older people have been systematically excluded from randomised controlled trials (RCT). We aim to recruit older, frail hospitalised patients in an RCT and evaluate the frailty index (FI) as a measure to describe the types of people included in the study. We recruited 315 hospitalised patients aged 65 years; age ranged from 60 to 102 years. Baseline assessment scores ranged as follow: Mini-Mental Status Examination from 7 to 30, Barthel index from 5 to 100 and FI from 2 to 24. Total deaths were 20 (6%). We demonstrated that it is feasible to recruit frail older people into RCTs. The FI does not show any ,floor' or ,ceiling' effects. We can measure frailty in an RCT cohort, and we believe that clinical trials should include more frail older people and that the use of an FI can facilitate such trials and generate reliable data to guide future medical practice in a rapidly ageing society. [source] | ||||||||||||||||||||||