Medical and psychosocial experiences of family caregivers with children fed enterally at home.

PubMed

Enrione, Evelyn B; Thomlison, Barbara; Rubin, Aviva

2005-01-01

Pediatric home enteral nutrition (HEN) studies that evaluate the psychosocial aspects of caregiving are limited. Overlooking the psychosocial needs of the caregiver may result in negative outcomes such as lack of adherence to the HEN regimen. This study determined whether caregivers report psychosocial situations more frequent and difficult to manage than medical situations. A questionnaire, which identified 10 psychosocial and 10 medical issues related to pediatric HEN, was mailed to 150 caregivers (37 responded), who rated the statements for frequency and difficulty. Each statement was ranked from most frequent/difficult to least frequent/difficult by mean cross-product score (frequency x difficulty). To indicate overall burden, a medical total composite score (MTCS) and a psychosocial total composite score (PTCS) were calculated by summing the cross-products of the respective problems. Paired t tests compared MTCS to PTCS and also the psychosocial frequency means and difficulty means to the same for the medical problems. Of the top 10 problems, 7 were psychosocial, whereas 3 were medical. Caregivers reported incidences of psychosocial problems more frequently (p < .003) than medical problems, and they had more difficulty (p < .001) with the psychosocial situations than with the medical ones. The PTCS was significantly higher (p < .001) than the MTCS. The psychosocial situations were perceived as causing a greater burden and greater difficulty in coping with everyday life. Health professionals need to understand and address the psychosocial difficulties of the caregiver in order to provide support for the caregiver and promote positive growth and development of the child.

Child behavioural problems and body size among 2-6 year old children predisposed to overweight. results from the "healthy start" study.

PubMed

Olsen, Nanna J; Pedersen, Jeanett; Händel, Mina N; Stougaard, Maria; Mortensen, Erik L; Heitmann, Berit L

2013-01-01

Psychological adversities among young children may be associated with childhood overweight and obesity. We examined if an increased level of child behavioural problems was associated with body size among a selected group of 2-6 year old children, who were all predisposed to develop overweight. Cross-sectional analyses were conducted using baseline data from the "Healthy Start" intervention study. A total of 3058 children were invited to participate, and data from 583 children who were all predisposed for obesity was analyzed. The Danish version of the Strengths and Difficulties Questionnaire (SDQ) was used to assess child stress by the SDQ Total Difficulties (SDQ-TD) score and the Prosocial Behavior (PSB) score. Height and weight were measured, and BMI z-scores were calculated. A direct, but non-significant linear trend was found between SDQ-TD score and BMI z-score (β = 0.021, p = 0.11). Having an SDQ-TD score above the 90(th) percentile was associated with BMI z-score (β = 0.36, p = 0.05). PSB score was not associated with BMI z-score. Analyses were adjusted for parental socioeconomic status, parental BMI, family structure, dietary factors, physical activity, and family stress level. The results suggested a threshold effect between SDQ-TD score and BMI z-score, where BMI z-score was associated with childhood behavioural problems only for those with the highest scores of SDQ-TD. No significant association between PSB score and BMI z-score was found.

Older age, higher perceived disability and depressive symptoms predict the amount and severity of work-related difficulties in persons with multiple sclerosis.

PubMed

Raggi, Alberto; Giovannetti, Ambra Mara; Schiavolin, Silvia; Brambilla, Laura; Brenna, Greta; Confalonieri, Paolo Agostino; Cortese, Francesca; Frangiamore, Rita; Leonardi, Matilde; Mantegazza, Renato Emilio; Moscatelli, Marco; Ponzio, Michela; Torri Clerici, Valentina; Zaratin, Paola; De Torres, Laura

2018-04-16

This cross-sectional study aims to identify the predictors of work-related difficulties in a sample of employed persons with multiple sclerosis as addressed with the Multiple Sclerosis Questionnaire for Job Difficulties. Hierarchical linear regression analysis was conducted to identify predictors of work difficulties: predictors included demographic variables (age, formal education), disease duration and severity, perceived disability and psychological variables (cognitive dysfunction, depression and anxiety). The targets were the questionnaire's overall score and its six subscales. A total of 177 participants (108 females, aged 21-63) were recruited. Age, perceived disability and depression were direct and significant predictors of the questionnaire total score, and the final model explained 43.7% of its variation. The models built on the questionnaire's subscales show that perceived disability and depression were direct and significant predictors of most of its subscales. Our results show that, among patients with multiple sclerosis, those who were older, with higher perceived disability and higher depression symptoms have more and more severe work-related difficulties. The Multiple Sclerosis Questionnaire for Job Difficulties can be fruitfully exploited to plan tailored actions to limit the likelihood of near-future job loss in persons of working age with multiple sclerosis. Implications for rehabilitation Difficulties with work are common among people with multiple sclerosis and are usually addressed in terms of unemployment or job loss. The Multiple Sclerosis Questionnaire for Job Difficulties is a disease-specific questionnaire developed to address the amount and severity of work-related difficulties. We found that work-related difficulties were associated to older age, higher perceived disability and depressive symptoms. Mental health issues and perceived disability should be consistently included in future research targeting work-related difficulties.

Team-based learning on a third-year pediatric clerkship improves NBME subject exam blood disorder scores.

PubMed

Saudek, Kris; Treat, Robert

2015-01-01

Purpose At our institution, speculation amongst medical students and faculty exists as to whether team-based learning (TBL) can improve scores on high-stakes examinations over traditional didactic lectures. Faculty with experience using TBL developed and piloted a required TBL blood disorders (BD) module for third-year medical students on their pediatric clerkship. The purpose of this study is to analyze the BD scores from the NBME subject exams before and after the introduction of the module. Methods We analyzed institutional and national item difficulties for BD items from the NBME pediatrics content area item analysis reports from 2011 to 2014 before (pre) and after (post) the pilot (October 2012). Total scores of 590 NBME subject examination students from examinee performance profiles were analyzed pre/post. t-Tests and Cohen's d effect sizes were used to analyze item difficulties for institutional versus national scores and pre/post comparisons of item difficulties and total scores. Results BD scores for our institution were 0.65 (±0.19) compared to 0.62 (±0.15) nationally (P=0.346; Cohen's d=0.15). The average of post-consecutive BD scores for our students was 0.70(±0.21) compared to examinees nationally [0.64 (±0.15)] with a significant mean difference (P=0.031; Cohen's d=0.43). The difference in our institutions pre [0.65 (±0.19)] and post [0.70 (±0.21)] BD scores trended higher (P=0.391; Cohen's d=0.27). Institutional BD scores were higher than national BD scores for both pre and post, with an effect size that tripled from pre to post scores. Institutional BD scores increased after the use of the TBL module, while overall exam scores remained steadily above national norms. Conclusions Institutional BD scores were higher than national BD scores for both pre and post, with an effect size that tripled from pre to post scores. Institutional BD scores increased after the use of the TBL module, while overall exam scores remained steadily above national norms.

The transmission of trauma in refugee families: associations between intra-family trauma communication style, children's attachment security and psychosocial adjustment.

PubMed

Dalgaard, Nina Thorup; Todd, Brenda Kathryn; Daniel, Sarah I F; Montgomery, Edith

2016-01-01

This study explores the transmission of trauma in 30 Middle Eastern refugee families in Denmark, where one or both parents were referred for treatment of PTSD symptoms and had non-traumatized children aged 4-9 years. The aim of the study was to explore potential risk and protective factors by examining the association between intra-family communication style regarding the parents' traumatic experiences from the past, children's psychosocial adjustment and attachment security. A negative impact of parental trauma on children might be indicated, as children's Total Difficulties Scores on the Strengths and Difficulties Questionnaire (SDQ) were significantly higher than the Danish norms. A negative association between children's attachment security as measured by the Attachment and Traumatization Story Task and higher scores on the SDQ Total Difficulties Scale approached significance, suggesting that the transmission of trauma may be associated with disruptions in children's attachment representations. Furthermore a significant association between parental trauma communication and children's attachment style was found.

Judging in Rhythmic Gymnastics at Different Levels of Performance.

PubMed

Leandro, Catarina; Ávila-Carvalho, Lurdes; Sierra-Palmeiro, Elena; Bobo-Arce, Marta

2017-12-01

This study aimed to analyse the quality of difficulty judging in rhythmic gymnastics, at different levels of performance. The sample consisted of 1152 difficulty scores concerning 288 individual routines, performed in the World Championships in 2013. The data were analysed using the mean absolute judge deviation from the final difficulty score, a Cronbach's alpha coefficient and intra-class correlations, for consistency and reliability assessment. For validity assessment, mean deviations of judges' difficulty scores, the Kendall's coefficient of concordance W and ANOVA eta-squared values were calculated. Overall, the results in terms of consistency (Cronbach's alpha mostly above 0.90) and reliability (intra-class correlations for single and average measures above 0.70 and 0.90, respectively) were satisfactory, in the first and third parts of the ranking on all apparatus. The medium level gymnasts, those in the second part of the ranking, had inferior reliability indices and highest score dispersion. In this part, the minimum of corrected item-total correlation of individual judges was 0.55, with most values well below, and the matrix for between-judge correlations identified remarkable inferior correlations. These findings suggest that the quality of difficulty judging in rhythmic gymnastics may be compromised at certain levels of performance. In future, special attention should be paid to the judging analysis of the medium level gymnasts, as well as the Code of Points applicability at this level.

Judging in Rhythmic Gymnastics at Different Levels of Performance

PubMed Central

Ávila-Carvalho, Lurdes; Sierra-Palmeiro, Elena; Bobo-Arce, Marta

2017-01-01

Abstract This study aimed to analyse the quality of difficulty judging in rhythmic gymnastics, at different levels of performance. The sample consisted of 1152 difficulty scores concerning 288 individual routines, performed in the World Championships in 2013. The data were analysed using the mean absolute judge deviation from the final difficulty score, a Cronbach’s alpha coefficient and intra-class correlations, for consistency and reliability assessment. For validity assessment, mean deviations of judges’ difficulty scores, the Kendall’s coefficient of concordance W and ANOVA eta-squared values were calculated. Overall, the results in terms of consistency (Cronbach’s alpha mostly above 0.90) and reliability (intra-class correlations for single and average measures above 0.70 and 0.90, respectively) were satisfactory, in the first and third parts of the ranking on all apparatus. The medium level gymnasts, those in the second part of the ranking, had inferior reliability indices and highest score dispersion. In this part, the minimum of corrected item-total correlation of individual judges was 0.55, with most values well below, and the matrix for between-judge correlations identified remarkable inferior correlations. These findings suggest that the quality of difficulty judging in rhythmic gymnastics may be compromised at certain levels of performance. In future, special attention should be paid to the judging analysis of the medium level gymnasts, as well as the Code of Points applicability at this level. PMID:29339996

Demographic and clinical factors related to ostomy complications and quality of life in veterans with an ostomy.

PubMed

Pittman, Joyce; Rawl, Susan M; Schmidt, C Max; Grant, Marcia; Ko, Clifford Y; Wendel, Christopher; Krouse, Robert S

2008-01-01

The purpose of this study is to describe demographic, clinical, and quality-of-life variables related to ostomy complications (skin irritation, leakage, and difficulty adjusting to an ostomy) in a veteran population in the United States. The original study employed a descriptive crosssectional study using a mixed method design. This secondary analysis used the quantitative data collected. Two hundred thirty-nine veterans with intestinal ostomies from 3 Veteran's Administration hospitals participated in the study. Instruments used for this investigation included the City of Hope Quality of Life: Ostomy Instrument. Demographic and medical history data were collected from the survey, the Veteran's Administration health information system, and the Tumor Registry database. A self-administered survey questionnaire (mCOH-QOL-Ostomy) was mailed to each participant. The severity of skin irritation, problems with leakage, and difficulty adjusting were significantly related to demographic, clinical, and quality-of-life domains. Univariate analyses showed that age, income, employment, preoperative care (stoma site marking and education), having a partner, ostomy type, reason for ostomy, time since surgery, total quality-of-life scores and scores on all 4 domains of quality of life were related to the severity of these ostomy complications. Age was inversely related to severity of all 3 ostomy complications (skin irritation, leakage, and difficulty adjusting). Having an ileostomy, rather than a colostomy, was associated with higher severity of skin irritation. Having had the stoma site marked preoperatively was associated with less difficulty adjusting to an ostomy, and having had preoperative ostomy education was associated with less severe problems with skin irritation and leakage. Severity of each ostomy complication predicted total quality-of-life scores. Difficulty adjusting to the ostomy was related to all 4 quality-of-life domains (physical, psychological, social, and spiritual). This study found important relationships between demographic and clinical factors and ostomy complications. Skin problems, leakage, and difficulty adjusting predicted total quality of life scores and domains. Establishing relationships among ostomy complications and demographic, clinical factors, and quality of life can enhance identification of patients at risk for the development of complications and is an important first step in identifying the development of effective interventions to reduce the negative impact of complications for people with ostomies. Further study of predictors and outcomes of ostomy complications is needed to improve care.

Factor Structure and Initial Validation of a Multidimensional Measure of Difficulties in the Regulation of Positive Emotions: The DERS-Positive

PubMed Central

Weiss, Nicole H.; Gratz, Kim L.; Lavender, Jason M.

2015-01-01

Emotion regulation difficulties are a transdiagnostic construct relevant to numerous clinical difficulties. Although the Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004) is a multidimensional measure of maladaptive ways of responding to emotions, it focuses on difficulties with the regulation of negative emotions and does not assess emotion dysregulation in the form of problematic responding to positive emotions. The aim of this study was to develop and validate a measure of clinically-relevant difficulties in the regulation of positive emotions (DERS-Positive). Findings revealed a 3-factor structure and supported the internal consistency and construct validity of the total and subscale scores. PMID:25576185

Factor Structure and Initial Validation of a Multidimensional Measure of Difficulties in the Regulation of Positive Emotions: The DERS-Positive.

PubMed

Weiss, Nicole H; Gratz, Kim L; Lavender, Jason M

2015-05-01

Emotion regulation difficulties are a transdiagnostic construct relevant to numerous clinical difficulties. Although the Difficulties in Emotion Regulation Scale (DERS) is a multidimensional measure of maladaptive ways of responding to emotions, it focuses on difficulties with the regulation of negative emotions and does not assess emotion dysregulation in the form of problematic responding to positive emotions. The aim of this study was to develop and validate a measure of clinically relevant difficulties in the regulation of positive emotions (DERS-Positive). Findings revealed a three-factor structure and supported the internal consistency and construct validity of the total and subscale scores. © The Author(s) 2015.

[Pilot study to resolve problems of visual acuity assessment in grading vision of the physically handicapped--visual acuity and difficulties in daily life of age-related macular degeneration-].

PubMed

Yuzawa, Mitsuko; Ishibashi, Tatsuro; Honda, Yoshihito; Kubota, Nobue

2010-09-01

To resolve the problems of visual acuity assessment in grading the vision of the physically handicapped as proposed by the Subcommittee for Promoting the Realization of a Cohesive Society with the Visually Disabled, Science Council of Japan, a method suitable for assessing visual disturbances, and the relationship between the degree of visual disturbances and the degree of difficulty in activities of daily life are clarified. 151 persons with age-related macular degeneration were studied. Examination methods for measuring visual acuity and reading performance were studied, and interviews using the daily living task dependent on vision (DLTV) questionnaire were performed. The correlations between total DLTV score and each examination method were analyzed. The median total DLTV score for each grade of visual acuity of the better eye was calculated. Spearman's correlation coefficient between distance corrected visual acuity of the better eye and total DLTV score was 0.76. Median DLTV scores for visual acuities (better eye) of 0.2, 0.3, 0.4, 0.5 were 65, 73.5, 62, 79 respectively. Visual acuity can be assessed by measuring distant corrected visual acuity of the better eye and setting the upper limit of visual disturbance at either 0.3 or 0.4.

The key incident monitoring and management system - history and role in quality improvement.

PubMed

Badrick, Tony; Gay, Stephanie; Mackay, Mark; Sikaris, Ken

2018-01-26

The determination of reliable, practical Quality Indicators (QIs) from presentation of the patient with a pathology request form through to the clinician receiving the report (the Total Testing Process or TTP) is a key step in identifying areas where improvement is necessary in laboratories. The Australasian QIs programme Key Incident Monitoring and Management System (KIMMS) began in 2008. It records incidents (process defects) and episodes (occasions at which incidents may occur) to calculate incident rates. KIMMS also uses the Failure Mode Effects Analysis (FMEA) to assign quantified risk to each incident type. The system defines risk as incident frequency multiplied by both a harm rating (on a 1-10 scale) and detection difficulty score (also a 1-10 scale). Between 2008 and 2016, laboratories participating rose from 22 to 69. Episodes rose from 13.2 to 43.4 million; incidents rose from 114,082 to 756,432. We attribute the rise in incident rate from 0.86% to 1.75% to increased monitoring. Haemolysis shows the highest incidence (22.6% of total incidents) and the highest risk (26.68% of total risk). "Sample is suspected to be from the wrong patient" has the second lowest frequency, but receives the highest harm rating (10/10) and detection difficulty score (10/10), so it is calculated to be the 8th highest risk (2.92%). Similarly, retracted (incorrect) reports QI has the 10th highest frequency (3.9%) but the harm/difficulty calculation confers the second highest risk (11.17%). TTP incident rates are generally low (less than 2% of observed episodes), however, incident risks, their frequencies multiplied by both ratings of harm and discovery difficulty scores, concentrate improvement attention and resources on the monitored incident types most important to manage.

Quality of life and related factors of nursing home residents in Singapore.

PubMed

Wang, Pei; Yap, Philip; Koh, Gerald; Chong, Jia An; Davies, Lucy Jennifer; Dalakoti, Mayank; Fong, Ngan Phoon; Tiong, Wei Wei; Luo, Nan

2016-07-28

Litter is known about the well-being of nursing home (NH) residents in Singapore. This study aimed to identify predictors of self-reported quality of life (QOL) of NH residents in Singapore. In face-to-face interviews, trained medical students assessed each consenting resident recruited from 6 local NHs using a modified Minnesota QOL questionnaire, and rating scales and questions assessing independence, cognitive function, depression, and communication. Predictors of residents' QOL in five aspects (comfort, dignity, food enjoyment, autonomy, and security) were identified using the censored least absolute deviations (CLAD) models. A total of 375 residents completed the interviews. A higher score on comfort was negatively associated with major depression while a higher score on dignity was positively associated with no difficulty in communication with staff. Higher scores in food enjoyment were negatively associated with major depression and poorer cognitive function. Higher scores in autonomy were negatively associated with major depression, greater dependence, and difficulty in communication with staff. A higher score on security were negatively associated with major depression. It appears that depression and difficulty in communication with staff are the two main modifiable risk factors of poor quality of life of local NH residents.

Pick-N Multiple Choice-Exams: A Comparison of Scoring Algorithms

ERIC Educational Resources Information Center

Bauer, Daniel; Holzer, Matthias; Kopp, Veronika; Fischer, Martin R.

2011-01-01

To compare different scoring algorithms for Pick-N multiple correct answer multiple-choice (MC) exams regarding test reliability, student performance, total item discrimination and item difficulty. Data from six 3rd year medical students' end of term exams in internal medicine from 2005 to 2008 at Munich University were analysed (1,255 students,…

Distribution of autistic traits and their association with sociodemographic characteristics in Japanese workers.

PubMed

Suzuki, Tomoko; Miyaki, Koichi; Eguchi, Hisashi; Tsutsumi, Akizumi

2017-09-01

This study aimed to confirm whether autistic traits are normally distributed across a population and to describe their association with the sociodemographic characteristics of Japanese workers. The participants were 2075 workers aged 23-65 years from various parts of Japan. Autistic traits were measured using an abridged Japanese version of the Autism-Spectrum Quotient (AQ-Short). The AQ-Short comprises five subcomponents assessing a fascination for numbers and patterns (numbers/patterns), difficulties with imagination, a preference for routine, difficulties with social skills, and difficulties with switching attention. The five subcomponents of the autistic phenotype as well as the overall autistic phenotype itself were continuously distributed across the sample population of Japanese workers. Men had significantly higher AQ-Short scores than women. AQ-Short scores were not associated with age. Except for the numbers/patterns scores, workers of a lower socioeconomic status had significantly higher AQ-Short scores than their respective counterparts. For the numbers/patterns trait, workers of a higher socioeconomic status scored higher. Workers with low general physical activity had or tended to have higher scores for total and all subcomponent traits, except for the numbers/patterns trait. Generally, the autistic phenotype was more prevalent in workers of a low socioeconomic status, while a particular trait was prevalent among workers of a high socioeconomic status.

Media use and psychosocial adjustment in children and adolescents.

PubMed

Limtrakul, Nicha; Louthrenoo, Orawan; Narkpongphun, Atsawin; Boonchooduang, Nonglak; Chonchaiya, Weerasak

2018-03-01

Currently, television and new forms of media are readily available to children and adolescents in their daily lives. Excessive use of media can lead to negative physical and psychosocial health effects. This study aimed to describe children's media use, including media multitasking, as well as the associations between media use and their psychosocial adjustment. This study recruited 339 participants aged 10-15 years from an international school. The children and their care givers were asked to complete the Strengths and Difficulties Questionnaire independently to evaluate the psychosocial problems of the children. The mean age of the study participants was 12.4 ± 1.5 years, who were recruited from grades 5 to 9. Multitasking media use was reported in 59.3% of participants. The average total media exposure time was 7.0 h/day. The behavioural problem scores from self-reports were greater with increased media use time. After adjusting for confounding variables, the school report and sleep problems were among the factors associated with the total behavioural problem scores from the multiple linear regression analysis (P = 0.001 and <0.001, respectively), whereas age and average total media exposure time were significantly associated with the prosocial behaviour scores reported by the children (P = 0.004 and 0.02, respectively). Multitasking media use was not significantly associated with the total difficulties scores or the prosocial behaviour scores in this study. Increased media use time was significantly associated with decreased prosocial behaviour scores in children in this study. This can provide important information to parents regarding media use in children. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Epidemiological survey of mental health in adolescent school children of Gujarat, India.

PubMed

Nair, Sandhya; Ganjiwale, Jaishree; Kharod, Nikhil; Varma, Jagdish; Nimbalkar, Somashekhar Marutirao

2017-01-01

Mental health problems in adolescents are inadequately researched in low-resource settings. We aimed in this study to assess the prevalence of mental health problems and correlates in school children aged 13-17 years and compare differences between urban and rural schools in Anand District, Gujarat. A cross-sectional study was conducted in five Gujarati medium higher secondary schools in Anand, Gujarat. Six hundred and ninety-three students with equal distribution of boys and girls belonging to 9th to 12th grades were included in the study. Strengths and Difficulties Questionnaire (SDQ) was used to assess the mental health status of the students, and total difficulties scoring was used to categorise participants into normal (0-15) and high (borderline (16-19) and abnormal (20-40)). Socio-demographic data and Teenage Screening Questionnaire-Trivandrum (TSQ) were used to assess associated medical and psychosocial factors. Clearance was obtained from the institutional ethics committee before conducting the study. 15% participants had a high SDQ score. Girls had more emotional problems, while the rest of the mental health problems were more prevalent in boys. Rural children were found to have more mental health issues. Having an eye problem, scoring <50% in last annual examinations, failure in examinations, difficulties in studying at home and difficulties in relationships were associated with high SDQ score. Keeping physically fit and having friends were associated with normal SDQ score. Logistic regression model revealed that age, receiving punishment in form of more homework and difficulty discussing friends with parents increased odds of high SDQ score, while having friends and after-school entertainment like watching movies decreased odds of high SDQ score. At least one in eight adolescents in this study was at risk of mental health problems. SDQ self-report questionnaire and TSQ survey may be used as a screening modality to identify at-risk students.

Association Between Internet Use and Sleep Problems in Adolescents.

PubMed

Ekinci, Özalp; Çelik, Tanju; Savaş, Nazan; Toros, Fevziye

2014-06-01

Sleep problems are commonly encountered in adolescents. It has been shown that electronic media have a negative influence on the sleep quality and daytime functioning in adolescents. This study aims to investigate the association between internet use and sleep problems in adolescents. A total of 1212 adolescents were recruited to the study. Self-report study questionnaire included two main parts: Young's Internet Addiction Scale (IAS) and a semi-structured inquiry on sleep habits/problems. Of the study sample, 16% (n=198) reported their sleep quality as bad or very bad. One-fourth of the sample reported using internet everyday and 27% of them reported spending more than one hour when online. The mean IAS total score was 35.56±13.87. Adolescents with a higher IAS score reported getting to bed later in the night, needing more time to fall asleep and having an increased number of awakenings in the night than the adolescents with lower IAS score (p=.001). They were also found to have higher frequencies of several sleep problems including difficulty in initiating and sustaining sleep, difficulty in waking up and feelings of sleepiness in day. In addition, sleep quality of them was worse when compared to the adolescents with a lower IAS score (p=.001). Problematic sleep habits and sleep problems were found to be more frequent in adolescents with a higher IAS total score. Health care providers must be aware of the possible negative impact of excessive and uncontrolled internet use on adolescents' sleep habits.

An evaluation of clinical treatment of convergence insufficiency for children with reading difficulties.

PubMed

Dusek, Wolfgang A; Pierscionek, Barbara K; McClelland, Julie F

2011-08-11

The present study investigates two different treatment options for convergence insufficiency CI for a group of children with reading difficulties referred by educational institutes to a specialist eye clinic in Vienna. One hundred and thirty four subjects (aged 7-14 years) with reading difficulties were referred from an educational institute in Vienna, Austria for visual assessment. Each child was given either 8Δ base-in reading spectacles (n=51) or computerised home vision therapy (HTS) (n=51). Thirty two participants refused all treatment offered (clinical control group). A full visual assessment including reading speed and accuracy were conducted pre- and post-treatment. Factorial analyses demonstrated statistically significant changes between results obtained for visits 1 and 2 for total reading time, reading error score, amplitude of accommodation and binocular accommodative facility (within subjects effects) (p<0.05). Significant differences were also demonstrated between treatment groups for total reading time, reading error score and binocular accommodative facility (between subjects effects) (p<0.05). Reading difficulties with no apparent intellectual or psychological foundation may be due to a binocular vision anomaly such as convergence insufficiency. Both the HTS and prismatic correction are highly effective treatment options for convergence insufficiency. Prismatic correction can be considered an effective alternative to HTS.

Predictive value of callous-unemotional traits in a large community sample.

PubMed

Moran, Paul; Rowe, Richard; Flach, Clare; Briskman, Jacqueline; Ford, Tamsin; Maughan, Barbara; Scott, Stephen; Goodman, Robert

2009-11-01

Callous-unemotional (CU) traits in children and adolescents are increasingly recognized as a distinctive dimension of prognostic importance in clinical samples. Nevertheless, comparatively little is known about the longitudinal effects of these personality traits on the mental health of young people from the general population. Using a large representative sample of children and adolescents living in Great Britain, we set out to examine the effects of CU traits on a range of mental health outcomes measured 3 years after the initial assessment. Parents were interviewed to determine the presence of CU traits in a representative sample of 7,636 children and adolescents. The parents also completed the Strengths and Difficulties Questionnaire, a broad measure of childhood psychopathology. Three years later, parents repeated the Strengths and Difficulties Questionnaire. At 3-year follow-up, CU traits were associated with conduct, hyperactivity, emotional, and total symptom scores. After adjusting for the effects of all covariates, including baseline symptom score, CU traits remained robustly associated with the overall levels of conduct problems and emotional problems and with total psychiatric difficulties at 3-year follow-up. Callous-unemotional traits are independently associated with future psychiatric difficulties in children and adolescents. An assessment of CU traits adds small but significant improvements to the prediction of future psychopathology.

Mental health problems of Iranian female adolescents and its association with pubertal development: a nationwide study.

PubMed

Rabbani, Ali; Mahmoudi-Gharaei, Javad; Mohammadi, Mohammad Reza; Motlagh, Mohammad Esmaeil; Mohammad, Kazem; Ardalan, Gelayol; Maftoon, Farzaneh; Shahryari, Safiyeh; Khodaei, Shahnaz; Sotoudeh, Aria; Ziaaldini, Hassan; Kamali, Kobra; Motaghian, Molouk

2012-01-01

Mental health problems including emotional and behavioral problems during puberty may be under influence of different risk factors including cultures, living in urban or rural areas and ethnic factors which may vary between different countries. The main aim of this study is to investigate the profile of emotional and behavioral problems and the role of factors such as age, stage of puberty, ethnicity, rurality and living in urban area, as risk factors in Iranian girls. As a part of a large national study we evaluated the emotional and behavioral problems in different stages of puberty in a community sample of Iranian adolescent girls from public schools that were selected by clustered random sampling method. In all subjects, demographic characteristics, and pubertal stages were measured. Emotional and behavioral problems were evaluated using Strength and Difficulties Questionnaire (SDQ). The associations of age, pubertal development indices, socioeconomic and demographic factors with the behavioral problems were assessed. A total number of 4576 students enrolled the study and responded to the questions. The mean age of participants was 13.83 ± 2.19 years. The mean total score of difficulties in participants was 14.34 ± 5.81. According to these results 813 (17.8%) adolescents had total problem scores higher than Goodman's cutoff points and the most frequent problem domain was conduct problems (20.5%). According to the results the most related variable with the total difficulty score of SDQ were ethnicity, residency in urban areas and development of menstrual cycle respectively. The results of this study showed that the most correlated factors with mental health problems in Iranian girls during puberty are ethnicity, urbanity and development of menstrual cycle.

Difficulties with Emotion Regulation and Psychopathology Interact to Predict Early Smoking Cessation Lapse.

PubMed

Farris, Samantha G; Zvolensky, Michael J; Schmidt, Norman B

2016-06-01

There is little knowledge about how emotion regulation difficulties interplay with psychopathology in terms of smoking cessation. Participants ( n = 250; 53.2 % female, M age = 39.5, SD = 13.85) were community-recruited daily smokers (≥8 cigarettes per day) who self-reported motivation to quit smoking; 38.8 % of the sample met criteria for a current (past 12-month) psychological disorder. Emotion regulation deficits were assessed pre-quit using the Difficulties with Emotion Regulation Scale (DERS; Gratz and Roemer in J Psychopathol Behav Assess 26(1):41-54, 2004) and smoking behavior in the 28 days post-quit was assessed using the Timeline Follow-Back (TLFB; Sobell and Sobell in Measuring alcohol consumption: psychosocial and biochemical methods. Humana Press, Totowa, 1992). A Cox proportional-hazard regression analysis was used to model the effects of past-year psychopathology, DERS (total score), and their interaction, in terms of time to lapse post-quit day. After adjusting for the effects of gender, age, pre-quit level of nicotine dependence, and treatment condition, the model revealed a non-significant effect of past-year psychopathology ( OR = 1.14, CI 95 % = 0.82-1.61) and difficulties with emotion regulation ( OR = 1.01, CI 95 % = 1.00-1.01) on likelihood of lapse rate. However, the interactive effect of psychopathology status and difficulties with emotion regulation was significant ( OR = 0.98, CI 95 % = 0.97-0.99). Specifically, there was a significant conditional effect of psychopathology status on lapse rate likelihood at low, but not high, levels of emotion regulation difficulties. Plots of the cumulative survival functions indicated that for smokers without a past-year psychological disorder, those with lower DERS scores relative to elevated DERS scores had significantly lower likelihood of early smoking lapse, whereas for smokers with past-year psychopathology, DERS scores did not differentially impact lapse rate likelihood. Smokers with emotion regulation difficulties may have challenges quitting, and not having such difficulties, especially without psychopathology, decreases the potential likelihood of early lapse.

Routine behavioral and mental health screening in young children with type 1 diabetes mellitus.

PubMed

Zenlea, Ian Spencer; Mednick, Lauren; Rein, Jennifer; Quinn, Maryanne; Wolfsdorf, Joseph; Rhodes, Erinn T

2014-08-01

The American Diabetes Association and International Society for Pediatric and Adolescent Diabetes recommend that providers of diabetes care receive training in the recognition of psychosocial problems related to diabetes. To report the results of routine behavioral/mental health screening for children with type 1 diabetes mellitus (T1D) seen in a multidisciplinary pediatric diabetes program. This was a cross-sectional study of children with T1D ages 4-11 years, who underwent behavioral/mental health screening as part of their diabetes care. Screening utilized the Strengths and Difficulties Questionnaire (SDQ) Parent Proxy Version, and scores were reviewed by a social worker. SDQ scale and total difficulties scores were compared by gender, visit type, age, T1D duration, and HbA1c. Scores were also compared to age-appropriate normative data for children in United States of America (US). SDQ Parent Proxy Version total difficulties and scale scores did not differ by patient or visit characteristics. Compared with normative data for US children, a greater proportion of children with T1D ages 4-7 and 8-10 years had borderline/abnormal scores on the emotional symptoms scale (p = 0.01 and p = 0.03, respectively), suggesting risk for psychological disorders, such as anxiety and depression. Our findings suggest that children less than 11 years old with T1D may have greater emotional symptoms as compared to their age-matched healthy peers. Pediatric diabetes care providers, with access to mental health services, should consider incorporating routine behavioral/mental health screening for children less than 12 years old in their practice. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Borderline personality disorder features, emotion dysregulation and non-suicidal self-injury: Preliminary findings in a sample of community-dwelling Italian adolescents.

PubMed

Somma, Antonella; Sharp, Carla; Borroni, Serena; Fossati, Andrea

2017-02-01

In order to assess the relationships among borderline personality disorder features, non-suicidal self-injury (NSSI) and emotion dysregulation, 122 community-dwelling Italian adolescents were administered by the Italian translations of the Borderline Personality Features Scale for Children-11, the Deliberate Self-Harm Inventory and the Difficulties in Emotion Regulation Scale (DERS). Regression models showed that both Deliberate Self-Harm Inventory (DSHI) and DERS scores significantly predicted Borderline Personality Features Scale for Children-11 total score; moreover, the DSHI total score significantly predicted the DERS total score. Our findings suggest that borderline personality features in adolescence are moderately, albeit significantly related to NSSI, and that emotion dysregulation does not completely account for the association between borderline personality features and NSSI, although it seems to explain a non-trivial proportion of this relationship. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Bisphenol A, phthalates and lead and learning and behavioral problems in Canadian children 6-11 years of age: CHMS 2007-2009.

PubMed

Arbuckle, Tye E; Davis, Karelyn; Boylan, Khrista; Fisher, Mandy; Fu, Jingshan

2016-05-01

Childhood developmental disorders and related problems such as learning disabilities and attention deficit hyperactivity disorder (ADHD) account for a growing burden on the family, education and health care systems. Exposure to environmental chemicals such as bisphenol A (BPA) and phthalates may play a role in the development of child behavioral problems. Using cross-sectional data from Cycle 1 of the Canadian Health Measures Survey (CHMS), we examined the potential association between urinary concentrations of BPA and various phthalate metabolites and child learning and behavioral problems, considering important covariates such as gender, blood lead and environmental tobacco smoke (ETS). The Strengths and Difficulties Questionnaire (SDQ) outcomes of interest were emotional symptoms, hyperactivity/inattention, and a total difficulties score with borderline and abnormal scores grouped together and compared with children with normal scores. Other outcomes studied included any reported learning disability, a subset of learning disabilities reported as ADD/ADHD (attention deficit disorder) and use of psychotropic medications in the past month. Among children ages 6-11 years, the prevalences of any learning disability, ADD, and ADHD were 8.7%, 1.5% and 2.8%, respectively. Estimated prevalences for SDQ hyperactivity/inattention, emotional symptoms and total difficulties scores were 16.9%, 15.0%, and 13.0%, respectively. Child's urinary BPA was associated with taking psychotropic medications (OR 1.59; 95% CI 1.05-2.40). Urinary MBzP concentration was significantly associated with emotional symptoms in girls (OR 1.38 95% CI 1.09-1.75) but not in boys (OR 1.05 95% CI 0.82-1.36).) Blood lead was significantly associated with several of the outcomes examined, with a significant interaction observed between prenatal smoking and blood lead for the total difficulties score (OR=10.57; 95% CI 2.81-39.69 vs. OR=1.98; 95% CI 1.41-2.79 if mother did not smoke during pregnancy). Although limited by the cross-sectional nature of the study which precludes examining causation, the results suggest that although some indicators of child behavior were significantly associated with their urinary BPA and phthalate concentrations, the major chemical associated with adverse behavioral indicators was lead. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

[Evaluating work-personality insufficiency of schizophrenic patients; an assessment of employability in psychiatric rehabilitation].

PubMed

Nozu, M

1995-01-01

Work-Personality means a person's motivation, values and attitude toward labor, general abilities which make his/her work performance efficient, which can be grasped through observation of behavior patterns in working situations. Problems connected with Work-Personality may cause schizophrenics some vocational difficulties. The author made out a "Work-Personality Insufficiency (WPI) Rating Scale" with 15 items, in order to estimate the employability of schizophrenics, and examined its inter-rater reliability by means of ANOVA-ICC and the results were sufficient enough. Then, WPI was applied to 71 schizophrenic outpatients of Tokyo Metropolitan Chubu Comprehensive Mental Health Center (Occupational Training Unit). Also positive and negative symptoms were estimated at admission, and some indicies of historical data were collected. These data were examined statistically as shown below. (1) Construct validity was verified through factor analysis of scores at admission. (2) By comparison of admission scores between two groups of employed and unemployed at discharge, the average score of employed was significantly low (p < 0.01), and the correlation between the discharge state and the total WPI score was significantly high (r = 0.472, p < 0.01), which proved predict validity. (3) The total score of negative symptoms correlated to WPI scores. Also the total score of positive symptoms correlated to some components of WPI scores. (4) By comparison of WPI scores between at admission and at discharge, reduction of disability was seen mainly in interpersonal area, which meant the improvement of patients' adaptability to work situation. Work performance in the narrow sense, however, seemed to make little development, which meant the limited effect of prevocational training with limited time. (5) Indicies of historical data had no relations to outcome and WPI, which showed the difficulty of predicting vocational prognosis from these variables directly. From above, the author concluded that WPI could be utilized to the vocational issues of prolonged schizophrenic patients, and discussed the predictors of vocational prognosis.

Difficulties in emotion regulation and risky driving among Lithuanian drivers.

PubMed

Šeibokaitė, Laura; Endriulaitienė, Auksė; Sullman, Mark J M; Markšaitytė, Rasa; Žardeckaitė-Matulaitienė, Kristina

2017-10-03

Risky driving is a common cause of traffic accidents and injuries. However, there is no clear evidence of how difficulties in emotion regulation contribute to risky driving behavior, particularly in small post-Soviet countries. The present study aimed to investigate the relationship between difficulties in emotion regulation and self-reported risky driving behavior in a sample of Lithuanian drivers. A total of 246 nonprofessional Lithuanian drivers participated in a cross-sectional survey. Difficulties in emotion regulation were assessed using the Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer 2004), and risky driving behavior was assessed using the Manchester Driver Behaviour Questionnaire (DBQ; Lajunen et al. 2004). Males scored higher than females in aggressive violations and ordinary violations. Females scored higher for the nonacceptance of emotional responses, whereas males had more difficulties with emotional awareness than females. More difficulties in emotion regulation were positively correlated with driving errors, lapses, aggressive violations, and ordinary violations for both males and females. Structural equation modeling showed that difficulties in emotion regulation explained aggressive and ordinary violations more clearly than lapses and errors. When controlling for interactions among the distinct regulation difficulties, difficulties with impulse control and difficulties engaging in goal-directed behavior predicted risky driving. Furthermore, nonacceptance of emotional responses and limited access to emotion regulation strategies were related to less violations and more driving errors. Emotion regulation difficulties were associated with the self-reported risky driving behaviors of Lithuanian drivers. This provides useful hints for improving driver training programs in order to prevent traffic injuries.

The stroke impairment assessment set: its internal consistency and predictive validity.

PubMed

Tsuji, T; Liu, M; Sonoda, S; Domen, K; Chino, N

2000-07-01

To study the scale quality and predictive validity of the Stroke Impairment Assessment Set (SIAS) developed for stroke outcome research. Rasch analysis of the SIAS; stepwise multiple regression analysis to predict discharge functional independence measure (FIM) raw scores from demographic data, the SIAS scores, and the admission FIM scores; cross-validation of the prediction rule. Tertiary rehabilitation center in Japan. One hundred ninety stroke inpatients for the study of the scale quality and the predictive validity; a second sample of 116 stroke inpatients for the cross-validation study. Mean square fit statistics to study the degree of fit to the unidimensional model; logits to express item difficulties; discharge FIM scores for the study of predictive validity. The degree of misfit was acceptable except for the shoulder range of motion (ROM), pain, visuospatial function, and speech items; and the SIAS items could be arranged on a common unidimensional scale. The difficulty patterns were identical at admission and at discharge except for the deep tendon reflexes, ROM, and pain items. They were also similar for the right- and left-sided brain lesion groups except for the speech and visuospatial items. For the prediction of the discharge FIM scores, the independent variables selected were age, the SIAS total scores, and the admission FIM scores; and the adjusted R2 was .64 (p < .0001). Stability of the predictive equation was confirmed in the cross-validation sample (R2 = .68, p < .001). The unidimensionality of the SIAS was confirmed, and the SIAS total scores proved useful for stroke outcome prediction.

[An Investigation of the Role Responsibilities of Clinical Research Nurses in Conducting Clinical Trials].

PubMed

Kao, Chi-Yin; Huang, Guey-Shiun; Dai, Yu-Tzu; Pai, Ya-Ying; Hu, Wen-Yu

2015-06-01

Clinical research nurses (CRNs) play an important role in improving the quality of clinical trials. In Taiwan, the increasing number of clinical trials has increased the number of practicing CRNs. Understanding the role responsibilities of CRNs is necessary to promote professionalism in this nursing category. This study investigates the role responsibilities of CRNs in conducting clinical trials / research. A questionnaire survey was conducted in a medical center in Taipei City, Taiwan. Eighty CRNs that were registered to facilitate and conduct clinical trials at this research site completed the survey. "Subject protection" was the CRN role responsibility most recognized by participants, followed by "research coordination and management", "subject clinical care", and "advanced professional nursing". Higher recognition scores were associated with higher importance scores and lower difficulty scores. Participants with trial training had significantly higher difficulty scores for "subject clinical care" and "research coordination and management" than their peers without this training (p < .05). Participants who had participated in a long-term trial-training course earned higher importance scores for "CRN four-subthemes role responsibilities" (p <.05) and lower difficulty scores for "subject protection", "research coordination and management" (p <.005) than their short-term course peers. "Recognition of overall responsibilities" and "receiving trial training" were the significant predictors of difficulty in performing CRN role responsibilities, explaining 21.9% of the total variance. To further promote CRN as a professional career in Taiwan, the findings of this study recommend identifying the core competences of CRNs and adding CRN-related study materials into the advanced nursing curriculum. Long-term and systematic educational training may help CRNs understand the importance of their role responsibilities, better recognize their professional role, and reflect these responsibilities in clinical practice.

Speech, language, and reading skills in 10-year-old children with palatal clefts: The impact of additional conditions.

PubMed

Feragen, Kristin Billaud; Aukner, Ragnhild; Særvold, Tone K; Hide, Øydis

2017-03-01

This study examined speech (hypernasality and intelligibility), language, and reading skills in children with a cleft palate, specifically investigating additional conditions to the cleft, in order to differentiate challenges related to a cleft only, and challenges associated with an additional condition. Cross-sectional data collected during routine assessments of speech and language in a centralised treatment setting. Children born with cleft with palatal involvement from four birth cohorts (n=184), aged 10. Speech: SVANTE-N; Language: Language 6-16; Reading: Word Chain Test and Reading Comprehension Test. Descriptive analyses revealed that 123 of the children had a cleft only (66.8%), while 61 children (33.2%) had a cleft that was associated with an additional condition (syndrome, developmental difficulty, attentional difficulties). Due to close associations with the outcome variables, children with specific language impairments and dyslexia were excluded from the sample (n=14). In the total cleft sample, 33.1% had mild to severe hypernasality, and 27.9% had mild to severe intelligibility deviances. Most children with intelligibility and hypernasality scores within the normal range had a cleft without any other condition. A high number of children with developmental difficulties (63.2%) or AD/HD (45.5%) had problems with intelligibility. Hypernasality scores were also associated with developmental difficulties (58.8%), whereas most children with AD/HD had normal hypernasality scores (83.3%). As could be expected, results demonstrated that children with a cleft and an additional condition had language and reading scores below average. Children with a cleft only had language and reading scores within the normal range. Among the children with scores below average, 33.3-44.7% had no other conditions explaining difficulties with language and reading. The findings highlight the need for routine assessments of language and reading skills, in addition to assessments of speech, in children with a cleft, in order to identify potential problems as early as possible. Study designs need to take additional difficulties into account, so that potential problems with language and reading are not ascribed the cleft diagnosis, and can be followed by appropriate treatment and interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

Emotion dysregulation and amygdala dopamine D2-type receptor availability in methamphetamine users.

PubMed

Okita, Kyoji; Ghahremani, Dara G; Payer, Doris E; Robertson, Chelsea L; Dean, Andy C; Mandelkern, Mark A; London, Edythe D

2016-04-01

Individuals who use methamphetamine chronically exhibit emotional and dopaminergic neurochemical deficits. Although the amygdala has an important role in emotion processing and receives dopaminergic innervation, little is known about how dopamine transmission in this region contributes to emotion regulation. This investigation aimed to evaluate emotion regulation in subjects who met DSM-IV criteria for methamphetamine dependence, and to test for a relationship between self-reports of difficulty in emotion regulation and D2-type dopamine receptor availability in the amygdala. Ninety-four methamphetamine-using and 102 healthy-control subjects completed the Difficulties in Emotion Regulation Scale (DERS); 33 of those who used methamphetamine completed the Addiction Severity Index (ASI). A subset of 27 methamphetamine-group and 20 control-group subjects completed positron emission tomography with [(18)F]fallypride to assay amygdala D2-type dopamine receptor availability, measured as binding potential (BPND). The methamphetamine group scored higher than the control group on the DERS total score (p<0.001), with DERS total score positively correlated with the Drug Composite Score on the ASI (p=0.02) in the methamphetamine group. The DERS total score was positively correlated with amygdala BPND in both groups and the combined group of participants (combined: r=0.331, p=0.02), and the groups did not differ in this relationship. These findings highlight problems with emotion regulation linked to methamphetamine use, possibly contributing to personal and interpersonal behavioral problems. They also suggest that D2-type dopamine receptors in the amygdala contribute to emotion regulation in both healthy and methamphetamine-using subjects. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Emotion Dysregulation and Amygdala Dopamine D2-type Receptor Availability in Methamphetamine Users

PubMed Central

Okita, Kyoji; Ghahremani, Dara G.; Payer, Doris E.; Robertson, Chelsea L.; Dean, Andy C.; Mandelkern, Mark A.; London, Edythe D.

2016-01-01

Background Individuals who use methamphetamine chronically exhibit emotional and dopaminergic neurochemical deficits. Although the amygdala has an important role in emotion processing and receives dopaminergic innervation, little is known about how dopamine transmission in this region contributes to emotion regulation. This investigation aimed to evaluate emotion regulation in subjects who met DSM-IV criteria for methamphetamine dependence, and to test for a relationship between self-reports of difficulty in emotion regulation and D2-type dopamine receptor availability in the amygdala. Method Ninety-four methamphetamine-using and 102 healthy-control subjects completed the Difficulties in Emotion Regulation Scale (DERS); 33 of those who used methamphetamine completed the Addiction Severity Index (ASI). A subset of 27 methamphetamine-group and 20 control-group subjects completed positron emission tomography with [18F]fallypride to assay amygdala D2-type dopamine receptor availability, measured as binding potential (BPND). Results The methamphetamine group scored higher than the control group on the DERS total score (p < 0.001), with DERS total score positively correlated with the Drug Composite Score on the ASI (p = 0.02) in the methamphetamine group. The DERS total score was positively correlated with amygdala BPND in both groups and the combined group of participants (combined: r = 0.331, p = 0.02), and the groups did not differ in this relationship. Conclusion These findings highlight problems with emotion regulation linked to methamphetamine use, possibly contributing to personal and interpersonal behavioral problems. They also suggest that D2-type dopamine receptors in the amygdala contribute to emotion regulation in both healthy and methamphetamine-using subjects. PMID:26880595

Autism characteristics and behavioural disturbances in ~ 500 children with Down's syndrome in England and Wales.

PubMed

Warner, Georgina; Moss, Joanna; Smith, Patrick; Howlin, Patricia

2014-08-01

Recent research shows that a significant minority of children with Down's syndrome (DS) also meet diagnostic criteria for an autism spectrum disorder (ASD). The present study investigated what proportion of children aged 6-15 years with a confirmed diagnosis of DS in England and Wales display autistic-type behaviours, and explored the characteristics of this group of children. The Social Communication Questionnaire (SCQ) was used to screen for autism characteristics and the Strengths and Difficulties Questionnaire (SDQ) to explore behavioural difficulties. The proportion of children who met the cut-off score for ASD on the SCQ (total score ≥ 15) was 37.7% (95% CI: 33.4-42.0%); for autism (total score ≥ 22) the proportion was 16.5% (95% CI: 13.2-19.8%). Children who met the cut-off for ASD were significantly more likely to be reported as having emotional symptoms, conduct problems and hyperactivity on the SDQ than children who scored well below cut-off (total score < 10). However, the profile of their autism characteristics on the SCQ was atypical compared with individuals with idiopathic ASD. The pervasiveness of ASD in children with DS in England and Wales is substantially higher than in the general population. These children also experience significantly greater behavioural problems than children with DS only. Early detection of autism characteristics is important for appropriate intervention. However, the unusual profile of autism characteristics in this group may affect the recognition of the disorder and hinder the implementation of appropriate interventions. © 2014 International Society for Autism Research, Wiley Periodicals, Inc.

Late neurologic and cognitive sequelae of inflicted traumatic brain injury in infancy.

PubMed

Barlow, Karen M; Thomson, Elaine; Johnson, David; Minns, Robert A

2005-08-01

There is limited information regarding the long-term outcome of inflicted traumatic brain injury (TBI), including shaken infant syndrome. The purpose of this study was to describe the long-term neurologic, behavioral, and cognitive sequelae seen in this population. A cross-sectional and prospective longitudinal study was conducted of 25 children with inflicted TBI in Scotland between 1980 and 1999. After consent was obtained, neurologic and cognitive examinations were performed on all participants and sequentially in the prospective cohort. Two global outcome measures were used: Glasgow Outcome Score (GOS) and Seshia's outcome score. Cognitive outcome was assessed using the Bayley Scales of Infant Development, British Ability Scales, and the Vineland Adaptive Behavior Scales. The mean length of follow-up was 59 months. A total of 68% of survivors were abnormal on follow-up, 36% had severe difficulties and were totally dependant, 16% had moderate difficulties, and 16% had mild difficulties on follow-up. A wide range of neurologic sequelae were seen, including motor deficits (60%), visual deficits (48%), epilepsy (20%), speech and language abnormalities (64%), and behavioral problems (52%). There was a wide range of cognitive abilities: the mean psychomotor index, 69.9 (SD: +/-25.73); and mean mental development index, 74.53 (SD: +/-28.55). Adaptive functioning showed a wide range of difficulties across all domains: communication domain (mean: 76.1; SD: +/-25.4), Daily living skills domain (mean: 76.9; SD: +/-24.3), and socialization domain (mean: 79.1; SD: +/-23.1). Outcome was found to correlate with the Pediatric Trauma Score and the Glasgow Coma Score but did not correlate with age at injury or mechanism of injury. Inflicted TBI has a very poor prognosis and correlates with severity of injury. Extended follow-up is necessary so as not to underestimate problems such as specific learning difficulties and attentional and memory problems that may become apparent only once the child is in school. Behavioral problems are present in 52% and begin to manifest clinically between the second and third years of life, although the consequences of frontal lobe injury may be underestimated unless follow-up is extended into adolescence and early adulthood.

Ambiguities and conflicting results: the limitations of the kappa statistic in establishing the interrater reliability of the Irish nursing minimum data set for mental health: a discussion paper.

PubMed

Morris, Roisin; MacNeela, Padraig; Scott, Anne; Treacy, Pearl; Hyde, Abbey; O'Brien, Julian; Lehwaldt, Daniella; Byrne, Anne; Drennan, Jonathan

2008-04-01

In a study to establish the interrater reliability of the Irish Nursing Minimum Data Set (I-NMDS) for mental health difficulties relating to the choice of reliability test statistic were encountered. The objective of this paper is to highlight the difficulties associated with testing interrater reliability for an ordinal scale using a relatively homogenous sample and the recommended kw statistic. One pair of mental health nurses completed the I-NMDS for mental health for a total of 30 clients attending a mental health day centre over a two-week period. Data was analysed using the kw and percentage agreement statistics. A total of 34 of the 38 I-NMDS for mental health variables with lower than acceptable levels of kw reliability scores achieved acceptable levels of reliability according to their percentage agreement scores. The study findings implied that, due to the homogeneity of the sample, low variability within the data resulted in the 'base rate problem' associated with the use of kw statistic. Conclusions point to the interpretation of kw in tandem with percentage agreement scores. Suggestions that kw scores were low due to chance agreement and that one should strive to use a study sample with known variability are queried.

The effect of preinjury sleep difficulties on neurocognitive impairment and symptoms after sport-related concussion.

PubMed

Sufrinko, Alicia; Pearce, Kelly; Elbin, R J; Covassin, Tracey; Johnson, Eric; Collins, Michael; Kontos, Anthony P

2015-04-01

Researchers have reported that sleep duration is positively related to baseline neurocognitive performance. However, researchers have yet to examine the effect of preinjury sleep difficulties on postconcussion impairments. To compare neurocognitive impairment and symptoms of athletes with preinjury sleep difficulties to those without after a sport-related concussion (SRC). Cohort study; Level of evidence, 3. The sample included 348 adolescent and adult athletes (age, mean ± SD, 17.43 ± 2.34 years) with a diagnosed SRC. The sample was divided into 2 groups: (1) 34 (10%) participants with preinjury sleep difficulties (sleeping less as well as having trouble falling asleep; SLEEP SX) and (2) 231 (66%) participants without preinjury sleep difficulties (CONTROL). The remaining 84 (24%) participants with minimal sleep difficulties (1 symptom) were excluded. Participants completed the Immediate Postconcussion Assessment and Cognitive Test (ImPACT) and Postconcussion Symptom Scale (PCSS) at baseline and 3 postinjury intervals (2, 5-7, and 10-14 days after injury). A series of repeated-measures analyses of covariance with Bonferroni correction, controlling for baseline non-sleep-related symptoms, were conducted to compare postinjury neurocognitive performance between groups. Follow-up exploratory t tests examined between-group differences at each time interval. A series of analyses of variance were used to examine total PCSS score, sleep-related, and non-sleep-related symptoms across time intervals between groups. Groups differed significantly in PCSS scores across postinjury intervals for reaction time (P < .001), with the preinjury SLEEP SX group performing worse than controls at 5-7 days (mean ± SD, 0.70 ± 0.32 [SLEEP SX], 0.60 ± 0.14 [CONTROL]) and 10-14 days (0.61 ± 0.17 [SLEEP SX]; 0.57 ± 0.10 [CONTROL]) after injury. Groups also differed significantly on verbal memory performance (P = .04), with the SLEEP SX (68.21 ± 18.64) group performing worse than the CONTROL group (76.76 ± 14.50) 2 days after injury. The SLEEP SX group reported higher total symptom (P = .02) and sleep-related symptom (P = .02) scores across postinjury time intervals. Preinjury sleep difficulties may exacerbate neurocognitive impairment and symptoms after concussion. The findings may help clinicians identify athletes who are at risk for worse impairments after a concussion due to preinjury sleep difficulties. © 2015 The Author(s).

[Relationships between the emotional and cognitive components of alexythymia and PTSD in victims of domestic violence].

PubMed

Dabkowska, Małgorzata

2007-01-01

Alexythymia has been reported in various psychiatric disorders, also in post-traumatic stress disorder (PTSD). The 20-item Toronto Alexythymia Scale (TAS-20) measures three inter-correlated dimensions ofalexythymia: 1. difficulties in identifying feelings, 2. difficulties in describing feelings, 3. externally oriented thinking. The aim of the study was to assess the correlation between factors of TAS-20 and intensification of PTSD symptoms. Presence and a degree of alexythymia were estimated using three factorial 20-point self-assessment Toronto Alexythymia Scale. Diagnosis and a degree of intensification of PTSD was based on C.G. Watson's et al. PTSD-I. The study group consisted of 30 women who have experienced domestic violence. Women were residents of hostels for victims of domestic violence or residents of the Lonely Mother House. There was a significant correlation between factor 2 (difficulties describing feelings) scores of TAS-20 and intensification of PTSD (correlation is significant at the 0.05 level, Spearman's correlation coefficient 0.383, p = 0.037). There was no significant relationship between the scores of PTSD-I and the scores of sub-factors 1 and 3. The results emphasize, in addition to the TAS-20 total score, the three sub-factors providing information about whether cognitive and/or affective aspects of alexythymia are associated with posttraumatic stress disorder. The most significant factor determining occurrence of PTSD symptoms in the study group of women who have experienced domestic violence was a difficulty in verbalising emotions.

Quality of life in breast cancer sufferers.

PubMed

Shouman, Ahmed Essmat; Abou El Ezz, Nahla Fawzy; Gado, Nivine; Ibrahim Goda, Amal Mahmoud

2016-08-08

Purpose - The purpose of this paper is to measure health-related quality of life (QOL) among patients with early stage cancer breast under curative treatment at department of oncology and nuclear medicine at Ain Shams University Hospitals. Identify factors affecting QOL among these patients. Design/methodology/approach - A cross-sectional study measured QOL among early stage female breast cancer (BC) patients and determined the main factors affecting their QOL. Three interviewer administered questionnaires were used. Findings - The physical domain mostly affected in BC patients and the functional domain least. Socio-demographic factors that significantly affected BC patients QOL scores were patient age, education, having children and family income. Specific patient characteristics include caregiver presence - a factor that affected different QOL scores. Age at diagnosis, affection in the side of the predominant hand, post-operative chemotherapy and difficulty in obtaining the medication were the disease-related factors that affected QOL scores. Originality/value - The final model predicting QOL for early stage female BC patients included age, education and difficulty in obtaining the medication as determinants for total QOL score. Carer presence was the specific patient characteristic that affected different QOL scores.

What Can We Learn about Auditory Processing from Adult Hearing Questionnaires?

PubMed

Bamiou, Doris-Eva; Iliadou, Vasiliki Vivian; Zanchetta, Sthella; Spyridakou, Chrysa

2015-01-01

Questionnaires addressing auditory disability may identify and quantify specific symptoms in adult patients with listening difficulties. (1) To assess validity of the Speech, Spatial, and Qualities of Hearing Scale (SSQ), the (Modified) Amsterdam Inventory for Auditory Disability (mAIAD), and the Hyperacusis Questionnaire (HYP) in adult patients experiencing listening difficulties in the presence of a normal audiogram. (2) To examine which individual questionnaire items give the worse scores in clinical participants with an auditory processing disorder (APD). A prospective correlational analysis study. Clinical participants (N = 58) referred for assessment because of listening difficulties in the presence of normal audiometric thresholds to audiology/ear, nose, and throat or audiovestibular medicine clinics. Normal control participants (N = 30). The mAIAD, HYP, and the SSQ were administered to a clinical population of nonneurological adults who were referred for auditory processing (AP) assessment because of hearing complaints, in the presence of normal audiogram and cochlear function, and to a sample of age-matched normal-hearing controls, before the AP testing. Clinical participants with abnormal results in at least one ear and in at least two tests of AP (and at least one of these tests to be nonspeech) were classified as clinical APD (N = 39), and the remaining (16 of whom had a single test abnormality) as clinical non-APD (N = 19). The SSQ correlated strongly with the mAIAD and the HYP, and correlation was similar within the clinical group and the normal controls. All questionnaire total scores and subscores (except sound distinction of mAIAD) were significantly worse in the clinical APD versus the normal group, while questionnaire total scores and most subscores indicated greater listening difficulties for the clinical non-APD versus the normal subgroups. Overall, the clinical non-APD group tended to give better scores than the APD in all questionnaires administered. Correlation was strong for the worse-ear gaps-in-noise threshold with the SSQ, mAIAD, and HYP; strong to moderate for the speech in babble and left-ear dichotic digit test scores (at p < 0.01); and weak to moderate for the remaining AP tests except the frequency pattern test that did not correlate. The worse-scored items in all three questionnaires concerned speech-in-noise questions. This is similar to worse-scored items by hearing-impaired participants as reported in the literature. Worse-scored items of the clinical group also included quality aspects of listening questions from the SSQ, which most likely pertain to cognitive aspects of listening, such as ability to ignore other sounds and listening effort. Hearing questionnaires may help assess symptoms of adults with APD. The listening difficulties and needs of adults with APD to some extent overlap with those of hearing-impaired listeners, but there are significant differences. The correlation of the gaps-in-noise and duration pattern (but not frequency pattern) tests with the questionnaire scores indicates that temporal processing deficits may play an important role in clinical presentation. American Academy of Audiology.

Normative Data of the Self-Report Version of the German Strengths and Difficulties Questionnaire in an Epidemiological Setting.

PubMed

Becker, Andreas; Wang, Biyao; Kunze, Barbara; Otto, Christiane; Schlack, Robert; Hölling, Heike; Ravens-Sieberer, Ulrike; Klasen, Fionna; Rogge, Jana; Isensee, Corinna; Rothenberger, Aribert; Bella Study Group, The

2018-05-30

This study served to establish German norms for the Strengths and Difficulties Questionnaire self-report (SDQ-S) by using data from a representative epidemiological sample from the German National Health Interview and Examination Survey for Children and Adolescents (KiGGS study). Although the German version of the SDQ has been widely used and normative data for the parent version (SDQ-P) exist, no German norms for the self-report version have been reported, so that practitioners had to rely on the available British norms. In addition, we investigated whether sex- and age-specific norms are necessary. At the baseline of the KiGGS study, SDQ-S ratings were collected from n = 6,726 children and adolescents between 11 and 17 years (n = 3,440 boys und n = 3,286 girls). We assessed the internal consistency and age/sex effects of the SDQ-S. Confirmatory factor analysis was conducted to assess the factor structure of the SDQ-S. Banding scores were developed to differentiate children and adolescents with levels of difficulties and categorized them as "normal," "borderline," and "abnormal." General as well as age- and sex-specific bandings were created for both total score and subscales of SDQ-S. In addition, the German norms of the SDQ-S were compared with those of the UK, Norway, and Thailand. The five-factor solution of the SDQ-S (including Emotional symptoms, Conduct problems, Hyperactivity/Inattention, Peer problems, and Prosocial behavior) provided a satisfactory fit to the data. Moderate internal consistencies (Cronbach's α) were observed for the scales Emotional symptoms, Hyperactivity/Inattention, and Total difficulties score, whereas insufficient internal consistency was found for the scales Peer problems and Conduct problems. However, using McDonald's ω as a more appropriate measure of homogeneity, internal consistencies were found to be satisfactory for all subscales and for Total difficulties. Normative banding scores were established conservatively to avoid producing too many false positives in the category "abnormal." In line with previous research, girls showed more emotional problems but fewer Peer problems than boys. German normative bandings of SDQ-S were similar to the original British bandings and those of other countries. This study of the German SDQ-S in a large representative epidemiological sample presents evidence of partly moderate to good psychometric properties. It also supports the usefulness of SDQ-S as an effective and efficient instrument for child and adolescent mental health problems in Germany. German normative banding scores of SDQ-S established in this study were comparable with the original British norms as well as with those of other countries, so that SDQ-S can be recommended as a psychopathological broadband-screening tool.

Difficulties with Emotion Regulation and Psychopathology Interact to Predict Early Smoking Cessation Lapse

PubMed Central

Zvolensky, Michael J.; Schmidt, Norman B.

2015-01-01

There is little knowledge about how emotion regulation difficulties interplay with psychopathology in terms of smoking cessation. Participants (n = 250; 53.2 % female, Mage = 39.5, SD = 13.85) were community-recruited daily smokers (≥8 cigarettes per day) who self-reported motivation to quit smoking; 38.8 % of the sample met criteria for a current (past 12-month) psychological disorder. Emotion regulation deficits were assessed pre-quit using the Difficulties with Emotion Regulation Scale (DERS; Gratz and Roemer in J Psychopathol Behav Assess 26(1):41–54, 2004) and smoking behavior in the 28 days post-quit was assessed using the Timeline Follow-Back (TLFB; Sobell and Sobell in Measuring alcohol consumption: psychosocial and biochemical methods. Humana Press, Totowa, 1992). A Cox proportional-hazard regression analysis was used to model the effects of past-year psychopathology, DERS (total score), and their interaction, in terms of time to lapse post-quit day. After adjusting for the effects of gender, age, pre-quit level of nicotine dependence, and treatment condition, the model revealed a non-significant effect of past-year psychopathology (OR = 1.14, CI95 % = 0.82–1.61) and difficulties with emotion regulation (OR = 1.01, CI95 % = 1.00–1.01) on likelihood of lapse rate. However, the interactive effect of psychopathology status and difficulties with emotion regulation was significant (OR = 0.98, CI95 % = 0.97–0.99). Specifically, there was a significant conditional effect of psychopathology status on lapse rate likelihood at low, but not high, levels of emotion regulation difficulties. Plots of the cumulative survival functions indicated that for smokers without a past-year psychological disorder, those with lower DERS scores relative to elevated DERS scores had significantly lower likelihood of early smoking lapse, whereas for smokers with past-year psychopathology, DERS scores did not differentially impact lapse rate likelihood. Smokers with emotion regulation difficulties may have challenges quitting, and not having such difficulties, especially without psychopathology, decreases the potential likelihood of early lapse. PMID:27239081

Language and social/emotional problems identified at a universal developmental assessment at 30 months

PubMed Central

2013-01-01

Background Preschool language and neurodevelopmental problems often persist and impede learning. The aims of the current study are to assess the uptake of a new universal 30 month health visitor contact and to quantify the prevalence of language delay and social/emotional difficulties. Methods All families of 30 month old children in four Glasgow localities were offered a visit from their health visitor. Structured data were collected relating to language, social and emotional development using three instruments; The Strengths and Difficulties Questionnaire (SDQ), the abbreviated Sure Start Language Measure and a two-item language screen. Results From an eligible population of 543 children, there was a 90% return rate of contact forms from the health visitors, and assessments were completed on 78% of eligible children. Visit completion rates did not differ significantly by socio-economic status. 3-8% of children were reported to have language delay depending on the method of assessment. 8.8% of children scored in the “abnormal” range of SDQ total difficulties scores and 31.1% had an abnormality in at least one subscale. There was substantial overlap between language delay and abnormal scores on the SDQ. Conclusions Universal assessment of neurodevelopmental function at 30 months identified a significant proportion of children, including those previously considered at low risk, with both language and social/emotional difficulties. Further work is required to assess the precise nature of these difficulties and to assess the potential impact on services. PMID:24330767

Symptoms of anxiety and depression in school-aged children with active epilepsy: A population-based study.

PubMed

Reilly, Colin; Atkinson, Patricia; Chin, Richard F; Das, Krishna B; Gillberg, Christopher; Aylett, Sarah E; Burch, Victoria; Scott, Rod C; Neville, Brian G R

2015-11-01

Children (5-15 years) with active epilepsy were screened using the parent-report (n=69) and self-report (n=48) versions of the Spence Children's Anxiety Scale (SCAS) and the self-report version of the Children's Depression Inventory (CDI) (n=48) in a population-based sample. A total of 32.2% of children (self-report) and 15.2% of children (parent-report) scored ≥1 SD above the mean on the SCAS total score. The subscales where most difficulty were reported on parent-report were Physical Injury and Separation Anxiety. There was less variation on self-report. On the CDI, 20.9% of young people scored ≥1 SD above the mean. Children reported significantly more symptoms of anxiety on the SCAS total score and three of the subscales (p<.05). There was a significant effect on the SCAS total score of respondents by seizure type interaction, suggesting higher scores on SCAS for children with generalized seizures on self- but not parent-report. Higher CDI scores were significantly associated with generalized seizures (p>.05). Symptoms of anxiety were more common based on self-report compared with parent-report. Children with generalized seizures reported more symptoms of depression and anxiety. Copyright © 2015 Elsevier Inc. All rights reserved.

Antisocial and psychopathic personalities in a sample of addicted subjects: differences in psychological resources, symptoms, alexithymia and impulsivity.

PubMed

Gori, Alessio; Craparo, Giuseppe; Sareri, Giuseppe Iraci; Caretti, Vincenzo; Giannini, Marco; Meringolo, Patrizia

2014-10-01

Psychopathy and antisocial personality disorder (ASPD) are two constructs not interchangeable. Compared to the ASPD, psychopathy is characterized by lack of anxiety, low withdrawal, and high levels of attention seeking. The sample of this study included 76 subjects with a substance use disorder. Subjects were aged between 18 and 59 years old (M=32.87, SD=9.36). With respect to level of education 3 subjects are elementary school graduates, 49 have a middle school diploma, 21 own a high school diploma, and 3 participants have a bachelor's degree. We administered the following measures: a) Psychopathic Personality Inventory-Revised (PPI-R); b) Psychological Treatment Inventory (PTI); c) 20-Item-Toronto Alexithymia Scale (TAS-20); d) Barratt Impulsiveness Scale (BIS). Most of the significant correlations between the Psychopathic Index (PPI-R total score), and the measures administered are listed below: PPI-R total score and Deviance (r=.482, p<.001), PPI-R total score and Hypomania (r=.369, p < .001), PPI-R total score and Unresolved attachment (r=.293, p<.001), PPI-R total score and Manipulativeness (r=.550, p<.001), PPI-R total score and the TAS-20 total score (r=.230; p<.001), PPI-R total score and Difficulty in Identifying Feelings (DIF) factor (r=.250, p<.001), PPI-R total score and Attentional Impulsiveness (r=.409, p<.001); PPI-R total score and Motor Impulsiveness (r=.526, p<.001). Results of MANOVAs between the two groups also revealed significant differences on several variables analyzed. Our study showed that addicted subjects with psychopathic tendencies are more likely to experience negative emotions and have a peculiar cognitive style with respect to antisocial addicts. These results partially confirm those ones of previous studies underlining that psychopathic population is generally characterized for a major need for stimulation, poor behavioral controls, lack of realistic long-term goals, impulsivity, irresponsibility. Copyright © 2014 Elsevier Inc. All rights reserved.

Technical analysis of the Slosson Written Expression Test.

PubMed

Erford, Bradley T; Hofler, Donald B

2004-06-01

The Slosson Written Expression Test was designed to assess students ages 8-17 years at risk for difficulties in written expression. Scores from three independent samples were used to evaluate the test's reliability and validity for measuring students' written expression. Test-retest reliability of the SWET subscales ranged from .80 to .94 (n = 151), and .95 for the Written Expression Total Standard Scores. The median alternate-form reliability for students' Written Expression Total Standard Scores was .81 across the three forms. Scores on the Slosson test yielded concurrent validity coefficients (n = 143) of .60 with scores from the Woodcock-Johnson: Tests of Achievement-Third Edition Broad Written Language Domain and .49 with scores on the Test of Written Language-Third Edition Spontaneous Writing Quotient. Exploratory factor analytic procedures suggested the Slosson test is comprised of two dimensions, Writing Mechanics and Writing Maturity (47.1% and 20.1% variance accounted for, respectively). In general, the Slosson Written Expression Test presents with sufficient technical characteristics to be considered a useful written expression screening test.

Spatial abilities, Earth science conceptual understanding, and psychological gender of university non-science majors

NASA Astrophysics Data System (ADS)

Black, Alice A. (Jill)

Research has shown the presence of many Earth science misconceptions and conceptual difficulties that may impede concept understanding, and has also identified a number of categories of spatial ability. Although spatial ability has been linked to high performance in science, some researchers believe it has been overlooked in traditional education. Evidence exists that spatial ability can be improved. This correlational study investigated the relationship among Earth science conceptual understanding, three types of spatial ability, and psychological gender, a self-classification that reflects socially-accepted personality and gender traits. A test of Earth science concept understanding, the Earth Science Concepts (ESC) test, was developed and field tested from 2001 to 2003 in 15 sections of university classes. Criterion validity was .60, significant at the .01 level. Spearman/Brown reliability was .74 and Kuder/Richardson reliability was .63. The Purdue Visualization of Rotations (PVOR) (mental rotation), the Group Embedded Figures Test (GEFT) (spatial perception), the Differential Aptitude Test: Space Relations (DAT) (spatial visualization), and the Bem Inventory (BI) (psychological gender) were administered to 97 non-major university students enrolled in undergraduate science classes. Spearman correlations revealed moderately significant correlations at the .01 level between ESC scores and each of the three spatial ability test scores. Stepwise regression analysis indicated that PVOR scores were the best predictor of ESC scores, and showed that spatial ability scores accounted for 27% of the total variation in ESC scores. Spatial test scores were moderately or weakly correlated with each other. No significant correlations were found among BI scores and other test scores. Scantron difficulty analysis of ESC items produced difficulty ratings ranging from 33.04 to 96.43, indicating the percentage of students who answered incorrectly. Mean score on the ESC was 34%, indicating that the non-majors tested exhibited many Earth science misconceptions and conceptual difficulties. A number of significant results were found when independent t-tests and correlations were conducted among test scores and demographic variables. The number of previous university Earth science courses was significantly related to ESC scores. Preservice elementary/middle majors differed significantly in several ways from other non-majors, and several earlier results were not supported. Results of this study indicate that an important opportunity may exist to improve Earth science conceptual understanding by focusing on spatial ability, a cognitive ability that has heretofore not been directly addressed in schools.

Relationship between alexithymia and coping strategies in patients with somatoform disorder

PubMed Central

Tominaga, Toshiyuki; Choi, Hyungin; Nagoshi, Yasuhide; Wada, Yoshihisa; Fukui, Kenji

2014-01-01

Purpose A multidimensional intervention integrating alexithymia, negative affect, and type of coping strategy is needed for the effective treatment of somatoform disorder; however, few studies have applied this approach to the three different dimensions of alexithymia in patients with somatoform disorder. The purpose of this study was to determine the relationship between type of coping strategy and three different dimensions of alexithymia expressed in patients. Patients and methods A total of 196 patients with somatoform disorder completed the 20-item Toronto Alexithymia Scale, the Zung Self-Rating Depression Scale, the Spielberger State–Trait Anxiety Inventory, the Somatosensory Amplification Scale, and the Lazarus Stress Coping Inventory. The relationships between alexithymia (Toronto Alexithymia Scale – 20 score and subscales), demographic variables, and psychological inventory scores were analyzed using Pearson’s correlation coefficients and stepwise multiple regression analysis. Results The mean Toronto Alexithymia Scale – 20 total score (56.1±10.57) was positively correlated with the number of physical symptoms as well as with psychopathology scores (Self-Rating Depression Scale, State–Trait Anxiety Inventory trait, state, and Somatosensory Amplification Scale), but negatively correlated with planful problem solving, confrontive coping, seeking social support, and positive reappraisal coping scores. With respect to coping strategy, multiple regression analyses revealed that “difficulty in identifying feelings” was positively associated with an escape–avoidance strategy, “difficulty in describing feelings” was negatively associated with a seeking social support strategy, and “externally oriented thinking” was negatively associated with a confrontive coping strategy. Conclusion Alexithymia was strongly associated with the number of somatic symptoms and negative affect. Patients with high “difficulty in describing feelings” tend to rely less on seeking social support, and patients with high “externally oriented thinking” tend to rely less on confrontive coping strategies. The coping skills intervention implemented should differ across individuals and should be based on the alexithymia dimension of each patient. PMID:24403835

Per-Oral Endoscopic Myotomy (POEM) After Previous Laparoscopic Heller Myotomy Is Feasible and Safe in a Porcine Model.

PubMed

Miles, Luke F; Frelich, Matthew J; Gould, Jon C; Dua, Kulwinder S; Jensen, Eric S; Kastenmeier, Andrew S

2015-10-01

We sought to evaluate the feasibility, safety, and difficulty of performing the per-oral endoscopic myotomy (POEM) procedure in the setting of a prior Heller myotomy using a survival porcine model. Four pigs underwent laparoscopic Heller myotomy with Dor partial anterior fundoplication followed by the POEM performed 4 weeks later. Two additional pigs served as controls, undergoing only the POEM. All procedures were completed without complications. The revisional POEM was not significantly more difficult than POEM controls based on procedure time, POEM procedure components, or procedure difficulty scores. Revisional POEM had a longer mean operative time when compared with Heller myotomy (126.0 vs. 83.8 min; P<0.01) but had a lower total difficulty score (28.6 vs. 52.1; P≪0.01). A POEM after previous Heller myotomy is safe and feasible in the porcine model and has potential as an option for patients suffering from recurrent or persistent symptoms after failed surgical myotomy.

Academic Performance in Primary School Children With Common Emotional and Behavioral Problems.

PubMed

Mundy, Lisa K; Canterford, Louise; Tucker, Dawn; Bayer, Jordana; Romaniuk, Helena; Sawyer, Susan; Lietz, Petra; Redmond, Gerry; Proimos, Jenny; Allen, Nicholas; Patton, George

2017-08-01

Many emotional and behavioral problems first emerge in primary school and are the forerunners of mental health problems occurring in adolescence. However, the extent that these problems may be associated with academic failure has been explored less. We aimed to quantify the association between emotional and behavioral problems with academic performance. A stratified random sample of 8- to 9-year-olds (N = 1239) were recruited from schools in Australia. Data linkage was performed with a national assessment of academic performance to assess reading and numeracy. Parent report assessed emotional and behavioral problems with students dichotomized into "borderline/abnormal" and "normal" categories. One in 5 grade 3 students fell in the "borderline/abnormal" category. Boys with total difficulties (β = -47.8, 95% CI: -62.8 to -32.8), conduct problems, and peer problems scored lower on reading. Numeracy scores were lower in boys with total difficulties (β = -37.7, 95% CI: -53.9 to -21.5) and emotional symptoms. Children with hyperactivity/inattention scored lower in numeracy. Girls with peer problems scored lower in numeracy. Boys with emotional and behavioral problems in mid-primary school were 12 months behind their peers. Children with emotional and behavioral problems are at high risk for academic failure, and this risk is evident in mid-primary school. © 2017, American School Health Association.

Disordered eating attitudes, alexithymia and suicide probability among Turkish high school girls.

PubMed

Alpaslan, Ahmet Hamdi; Soylu, Nusret; Avci, Kadriye; Coşkun, Kerem Şenol; Kocak, Uğur; Taş, Hanife Uzel

2015-03-30

We aimed to examine association between disordered eating attitudes (DEAs), alexithymia and suicide probability among adolescent females and to explore potential link between alexithymia and suicide probability in subjects with DEAs. 381 female students completed Eating Attitude Test (EAT-26), Toronto Alexithymia Scale (TAS-20) and Suicide Probability Scale (SPS). It was found that 13.2% (n=52) of the subjects have DEAs. Results indicated that total TAS-20 score and scores of Difficulty in Identifying Feelings (DIF) and Difficulty in Describing Feelings (DDF) subscales were significantly higher in DEAs group than in those non DEAs group (p<0.05). Additionally, total SPS score (p<0.001), Hopelessness (p=0.001), Suicide Ideation (p<0.001) and Hostility (p=0.003) subscales scores of SPS were significantly higher in the alexithymic DEAs than the non-alexithymic DEAs group. In order to control potential effect of depression, SPS subscales were used as covariate factors in ANCOVA. Negative Self-Evaluation subscale yielded a statistically significant difference between groups, other subscales did not. Results point out these; DEAs are relatively frequent phenomenon among female students in Turkey and presence of alexithymia was associated with an increased suicide probability in adolescents with DEAs. The results should be evaluated taking into account that depressive symptomatology was not assessed using a depression scale. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Behavioural problems in children who weigh 1000 g or less at birth in four countries.

PubMed

Hille, E T; den Ouden, A L; Saigal, S; Wolke, D; Lambert, M; Whitaker, A; Pinto-Martin, J A; Hoult, L; Meyer, R; Feldman, J F; Verloove-Vanhorick, S P; Paneth, N

2001-05-26

The increased survival chances of extremely low-birthweight (ELBW) infants (weighing <1000 g at birth) has led to concern about their behavioural outcome in childhood. In reports from several countries with different assessments at various ages, investigators have noted a higher frequency of behavioural problems in such infants, but cross-cultural comparisons are lacking. Our aim was to compare behavioural problems in ELBW children of similar ages from four countries. We prospectively studied 408 ELBW children aged 8-10 years, whose parents completed the child behaviour checklist. The children came from the Netherlands, Germany, Canada, and USA. The checklist provides a total problem score consisting of eight narrow-band scales. Of these, two (aggressive and delinquent behaviour) give a broad-band externalising score, three (anxious, somatic, and withdrawn behaviour) give a broad-band internalising score, and three (social, thought, and attention problems) indicate difficulties fitting neither broad-band dimension. For each cohort we analysed scores in ELBW children and those in normal- birthweight controls (two cohorts) or national normative controls (two cohorts). Across countries, we assessed deviations of the ELBW children from normative or control groups. ELBW children had higher total problem scores than normative or control children, but this increase was only significant in European countries. Narrow-band scores were raised only for the social, thought, and attention difficulty scales, which were 0.5-1.2 SD higher in ELBW children than in others. Except for the increase in internalising scores recorded for one cohort, ELBW children did not differ from normative or control children on internalising or externalising scales. Despite cultural differences, types of behavioural problems seen in ELBW children were very similar in the four countries. This finding suggests that biological mechanisms contribute to behavioural problems of ELBW children.

Behavioural problems in school age children with cerebral palsy.

PubMed

Brossard-Racine, Marie; Hall, Nick; Majnemer, Annette; Shevell, Michael I; Law, Mary; Poulin, Chantal; Rosenbaum, Peter

2012-01-01

Although behavioural problems are frequent in children with Cerebral Palsy (CP), the exact nature of these difficulties and their relationship with intrinsic or extrinsic factors are just beginning to be explored. To describe and characterize behavioural problems in children with CP and to determine the nature of any relationships with child and family characteristics. In this cross-sectional study, children with CP between 6 and 12 years of age were recruited. Children were assessed using the Leiter Intelligence Test, the Gross Motor Function Measure, the Strengths and Difficulties Questionnaire (SDQ), the Vineland Adaptive Behavior Scales and questionnaires on demographic factors. Parents' level of stress was measured with the Parenting Stress Index. Seventy-six parents completed the SDQ. Using the Total Difficulties Scores, 39.4% of the sample scored in the borderline to clinically abnormal range. Peer problems were the most common (55.3%). High parental stress was consistently associated with behavioural difficulties across all domains of the SDQ. Not surprisingly, better socialization skills and a lower parental stress were correlated with more positive behaviours. Behavioural difficulties are common in children with CP and appear not to be associated with socio-demographic variables and physical and cognitive characteristics. These difficulties are an important correlate of parental distress. This study emphasizes the need to recognize and address behavioural difficulties that may arise so as to optimize the health and well-being of children with CP and their families. Copyright © 2011 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Emotion dysregulation and schizotypy.

PubMed

Henry, Julie D; Green, Melissa J; Restuccia, Corinne; de Lucia, Amber; Rendell, Peter G; McDonald, Skye; Grisham, Jessica R

2009-04-30

In schizophrenia, blunted affect has been argued to reflect difficulties with the amplification of emotion expressive behavior. The aim of the present study was to assess whether ostensibly healthy individuals vulnerable to schizophrenia present with similar difficulties. In the first component of the study, 843 non-clinical participants completed the Schizotypal Personality Questionnaire, of which 27 scoring in the upper 15% (high schizotypy group) and 27 scoring in the lower 15% (low schizotypy group) were asked to watch amusing film clips, whilst engaging in different emotion regulatory strategies, and specifically, amplify the expression of an experienced emotion ('amplification') or suppress the expression of an experienced emotion ('suppression'). The results indicate that highly schizotypal participants present with specific difficulties with the amplification (but not suppression) of emotion expressive behavior. These difficulties are significantly correlated with total negative schizotypy, particularly blunted affect. In the second component of the study, an individual differences approach was used to assess the interrelationship between self-reported use of suppression and schizotypy in an independent sample of 204 community volunteers. The results suggest that, although blunted affect is associated with increased use of suppression, it cannot be regarded as the primary mechanism underpinning this disturbance. Implications for understanding blunted affect in schizophrenia and related disorders are discussed.

Concurrence of the strengths and difficulties questionnaire and developmental behaviour checklist among children with an intellectual disability.

PubMed

Rice, L J; Emerson, E; Gray, K M; Howlin, P; Tonge, B J; Warner, G L; Einfeld, S L

2018-02-01

The Strengths and Difficulties Questionnaire (SDQ) is widely used to measure emotional and behavioural problems in typically developing young people, although there is some evidence that it may also be suitable for children with intellectual disability (ID). The Developmental Behaviour Checklist - Parent version (DBC-P) is a measure of emotional and behavioural problems that was specifically designed for children and adolescents with an ID. The DBC-P cut-off has high agreement with clinical diagnosis. The aim of this study was to estimate the relationship between DBC-P and SDQ scores in a sample of children with ID. Parents of 83 young people with ID aged 4-17 years completed the parent versions of the SDQ and the DBC-P. We evaluated the concurrent validity of the SDQ and DBC-P total scores, and the agreement between the DBC-P cut-off and the SDQ cut-offs for 'borderline' and 'abnormal' behaviour. The SDQ total difficulties score correlated well with the DBC-P total behaviour problem score. Agreement between the SDQ borderline cut-off and the DBC-P cut-off for abnormality was high (83%), but was lower for the SDQ abnormal cut-off (75%). Positive agreement between the DBC-P and the SDQ borderline cut-off was also high, with the SDQ borderline cut-off identifying 86% of those who met the DBC-P criterion. Negative agreement was weaker, with the SDQ borderline cut-off identifying only 79% of the participants who did not meet the DBC-P cut-off. The SDQ borderline cut-off has some validity as a measure of overall levels of behavioural and emotional problems in young people with ID, and may be useful in epidemiological studies that include participants with and without ID. However, where it is important to focus on behavioural profiles in children with ID, a specialised ID instrument with established psychometric properties, such as the DBC-P, may provide more reliable and valid information. © 2017 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Patient-reported sleep difficulty and cognitive function during the first year of dialysis.

PubMed

Kutner, Nancy G; Zhang, Rebecca; Huang, Yijian; Bliwise, Donald L

2008-01-01

Research in the general population indicates that sleep fragmentation is detrimental for cognitive function, but little attention has been given to this issue in dialysis patients. We hypothesized that patients with self-reported persistent sleep difficulty would have an increased risk of scoring lower on a cognitive function measure at follow-up compared to their score at baseline. Sleep difficulty and cognitive function were reported by a large national patient cohort near the start of dialysis and at a 9- to 12-month follow-up. Logistic regression was used to investigate the risk of scoring lower on a cognitive function measure at follow-up as a function of self-reported sleep difficulty, controlling for patients' sociodemographic, clinical and treatment characteristics, including depressed mood. At follow-up, cognitive function scores were lower among 35.8% of the cohort. Patients with self-reported persistent sleep difficulty had the lowest average cognitive function score. Men with reported persistent sleep difficulty, regardless of presence of depressed mood, had a significantly increased risk of a lower cognitive function score at follow-up. Women with reported persistent sleep difficulty as well as depressed mood had significantly increased risk of a lower cognitive function score. The potential impact of sleep difficulty and depressed mood on the cognitive function of dialysis patients emphasizes the importance of evaluating and treating these risks and highlights the value of continued research to improve our understanding and management of these issues.

Green and Blue Spaces and Behavioral Development in Barcelona Schoolchildren: The BREATHE Project

PubMed Central

Amoly, Elmira; Forns, Joan; López-Vicente, Mónica; Basagaña, Xavier; Julvez, Jordi; Alvarez-Pedrerol, Mar; Nieuwenhuijsen, Mark J.; Sunyer, Jordi

2014-01-01

Background: Green spaces have been associated with improved mental health in children; however, available epidemiological evidence on their impact on child behavioral development is scarce. Objectives: We investigated the impact of contact with green spaces and blue spaces (beaches) on indicators of behavioral development and symptoms of attention deficit/hyperactivity disorder (ADHD) in schoolchildren. Methods: This study was based on a sample of 2,111 schoolchildren (7–10 years of age) from 36 schools in Barcelona in 2012. We obtained data on time spent in green spaces and beaches and Strengths and Difficulties Questionnaires (SDQ) from parents, and ADHD/DSM-IV questionnaires from teachers. Surrounding greenness was abstracted as the average Normalized Difference Vegetation Index (NDVI) in buffers of 100 m, 250 m, and 500 m around each home address. Proximity to green spaces was defined as living within 300 m of a major green space (≥ 0.05 km2). We applied quasi-Poisson mixed-effects models (with school random effect) to separately estimate associations between indicators of contact with green spaces and SDQ and ADHD total and subscale scores. Results: We generally estimated beneficial associations between behavioral indicators and longer time spent in green spaces and beaches, and with residential surrounding greenness. Specifically, we found statistically significant inverse associations between green space playing time and SDQ total difficulties, emotional symptoms, and peer relationship problems; between residential surrounding greenness and SDQ total difficulties and hyperactivity/inattention and ADHD/DSM-IV total and inattention scores; and between annual beach attendance and SDQ total difficulties, peer relationship problems, and prosocial behavior. For proximity to major green spaces, the results were not conclusive. Conclusion: Our findings support beneficial impacts of contact with green and blue spaces on behavioral development in schoolchildren. Citation: Amoly E, Dadvand P, Forns J, López-Vicente M, Basagaña X, Julvez J, Alvarez-Pedrerol M, Nieuwenhuijsen MJ, Sunyer J. 2014. Green and blue spaces and behavioral development in Barcelona schoolchildren: the BREATHE Project. Environ Health Perspect 122:1351–1358; http://dx.doi.org/10.1289/ehp.1408215 PMID:25204008

[Can teenage obesity affect mental health?].

PubMed

Assunção, Maria Cecília Formoso; Muniz, Ludmila Correa; Schäfer, Antônio Augusto; Meller, Fernanda de Oliveira; Carús, Juliana Pires; Quadros, Lenice de Castro Muniz de; Domingues, Lídice Rodrigues; da Silva, Vera Lúcia Schmidt; Gonçalves, Helen; Hallal, Pedro Curi; Menezes, Ana Maria Baptista

2013-09-01

This study evaluated the association between obesity and emotional and behavioral difficulties in adolescents. We studied 4,325 individuals 11 to 15 years of age who were members of the 1993 birth cohort in Pelotas, Rio Grande do Sul State, Brazil. Information on body mass index (BMI), maternal assessment of the adolescents' emotional and behavioral health (Strengths and Difficulties Questionnaire - SDQ), and sociodemographic and behavioral characteristics were used. Gender-stratified analyses were conducted with simple and multivariate linear regression. In the adjusted analysis, obesity only correlated with total SDQ scores in boys. Among the latter, teenage obesity was associated with higher scores on the subscale of relational problems with peers. Given current knowledge on the future implications of obesity and mental health and in dealing with adolescents, studies on gender differences in adolescence may contribute to understanding such associations.

Anxiety and depression in chronic hemodialysis: some somatopsychic determinants.

PubMed

Jadoulle, V; Hoyois, P; Jadoul, M

2005-02-01

Depression and anxiety are so common in hemodialysis (HD) patients that we found it useful to study the respective contributions of the subjective somatic sensations and of the objective medical comorbidity to psychological distress. We also hypothesized that denial has a protective effect against anxiety and depression, and that alexithymia is, on the contrary, a risk factor. In a cross-sectional design, we investigated relationships between psychological distress and somatic complaints, Charlson comorbidity index, denial and alexithymia, in a group of 54 patients on incenter HD. They filled psychometric self-rated questionnaires in (State Anxiety Inventory, Hospital Anxiety and Depression Scale, 13-item Short Beck Depression Inventory, Kidney Disease Quality of Life Short Form, 20-item Toronto Alexithymia Scale). A principal component analysis allowed us to focus on HADS-total score, which was confirmed to be representative of anxio-depression. Then, correlational analyses and a stepwise regression analysis were performed. HADS-total score is inversely associated with the use of denial as a psychological defence mechanism (p < 0.001), and positively correlated with difficulties in identifying emotions (p < 0.001), with difficulties in expressing feelings (p < 0.05), and with the intensity of subjective somatic complaints (p < 0.001). On the contrary, it is not related to the somatic comorbidity. In the stepwise regression, the somatic complaints, the denial and the difficulties in recognizing emotions emerge as the three main variables related to the HADS-total score (p < 0.001). Subjective physical complaints are here associated with psychological distress in chronic HD patients, while objective organic comorbidity does not seem to influence their mood and anxiety status. Denial is an efficient coping style against negative emotions, but it can diminish compliance. So, the subjective perception of the disease seems to have an important impact on the anxiety and mood levels, which can also be influenced by the emotional regulation abilities.

Does the Animal Fun program improve social-emotional and behavioural outcomes in children aged 4-6 years?

PubMed

Piek, Jan P; Kane, Robert; Rigoli, Daniela; McLaren, Sue; Roberts, Clare M; Rooney, Rosanna; Jensen, Lynn; Dender, Alma; Packer, Tanya; Straker, Leon

2015-10-01

Animal Fun was designed to enhance motor and social development in young children. Its efficacy in improving motor skills was presented previously using a randomised controlled trial and a multivariate nested cohort design. Based on the Environmental Stress Hypothesis, it was argued that the program would also result in positive mental health outcomes, investigated in the current study. Pre-intervention scores were recorded for 511 children aged 4.83-6.17 years (M=5.42, SD=.30). Intervention and control groups were compared 6 months following intervention, and again in their first school year. Changes in teacher-rated prosocial behaviour and total difficulties were assessed using the Strengths and Difficulties Questionnaire, and data analysed using Generalised Linear Mixed Models. There was a significant improvement in prosocial behaviour of children in the intervention group six months after initial testing, which remained at 18-month follow-up. Total difficulties decreased at 6 months for the intervention group, with no change at 18 months. This effect was present only for the hyperactivity/inattention subscale. The only significant change for the control group was an increase in hyperactivity/inattention scores from pre-intervention to 18-month follow-up. The Animal Fun program appears to be effective in improving social and behavioural outcomes. Copyright © 2015 Elsevier B.V. All rights reserved.

Emotional development in children with tics: a longitudinal population-based study.

PubMed

Hoekstra, P J; Lundervold, A J; Lie, S A; Gillberg, C; Plessen, Kerstin J

2013-03-01

Children with tics often experience accompanying problems that may have more impact on their well being and quality of life than the tics themselves. The present study investigates characteristics and the course of associated problems. In a population-based follow-up study, we investigated the developmental trajectory of children with and without tics when they were 7-9 years old. Parents and teachers completed the strengths and difficulties questionnaire (SDQ) when the children were 7-9 years (wave 1) and 4 years later (wave 2). Using strict criteria, we identified 38 children with tics in the cohort of 4,025 children (0.94% of the total cohort) with a preponderance of boys (78.9%). 22 children (57.9%) in the group with tics had only motor tics, and 16 (42.1%) had both motor and vocal tics. Children with tics had significantly higher parent- and teacher-rated SDQ total difficulty scores and subscale scores in both waves. Children with tics experienced an increase in emotional problems and in peer problems between the first and the second wave. This study in a general population indicates that the presence of tics is associated with a range of internalizing and externalizing difficulties, as well as problems in peer relationships. Moreover, our study indicates that emotional and peer problems tend to increase over time in the group of children with tics.

The Relationship between Neighbourhood Green Space and Child Mental Wellbeing Depends upon Whom You Ask: Multilevel Evidence from 3083 Children Aged 12-13 Years.

PubMed

Feng, Xiaoqi; Astell-Burt, Thomas

2017-02-27

Recent reviews of the rapidly growing scientific literature on neighbourhood green space and health show strong evidence for protective and restorative effects on mental wellbeing. However, multiple informants are common when reporting mental wellbeing in studies of children. Do different informants lead to different results? This study utilised nationally representative data on Goodman's 25-item Strengths and Difficulties Questionnaire reported by 3083 children (aged 12-13 years old), and their parents and teachers. Multilevel models were used to investigate whether similar associations between child mental wellbeing (as measured using the total difficulties score and the internalising and externalising subscales) and neighbourhood green space quantity and quality are obtained regardless of the informant. After adjustment for confounders, higher green space quantity and quality were associated with consistently more favourable child mental wellbeing on all three measures, regardless of the informant. However, associations with green space quantity were statistically significant ( p < 0.05) only for the parent-reported total difficulties score and the internalising subscale. Significant associations with green space quality were consistently observed for both parent- and child-reported outcomes. Teacher-reported outcomes were not significantly associated with green space exposure. Future studies of green space and child health should acknowledge when different informants of outcomes could lead to different conclusions.

The Relationship between Neighbourhood Green Space and Child Mental Wellbeing Depends upon Whom You Ask: Multilevel Evidence from 3083 Children Aged 12–13 Years

PubMed Central

Feng, Xiaoqi; Astell-Burt, Thomas

2017-01-01

Recent reviews of the rapidly growing scientific literature on neighbourhood green space and health show strong evidence for protective and restorative effects on mental wellbeing. However, multiple informants are common when reporting mental wellbeing in studies of children. Do different informants lead to different results? This study utilised nationally representative data on Goodman’s 25-item Strengths and Difficulties Questionnaire reported by 3083 children (aged 12–13 years old), and their parents and teachers. Multilevel models were used to investigate whether similar associations between child mental wellbeing (as measured using the total difficulties score and the internalising and externalising subscales) and neighbourhood green space quantity and quality are obtained regardless of the informant. After adjustment for confounders, higher green space quantity and quality were associated with consistently more favourable child mental wellbeing on all three measures, regardless of the informant. However, associations with green space quantity were statistically significant (p < 0.05) only for the parent-reported total difficulties score and the internalising subscale. Significant associations with green space quality were consistently observed for both parent- and child-reported outcomes. Teacher-reported outcomes were not significantly associated with green space exposure. Future studies of green space and child health should acknowledge when different informants of outcomes could lead to different conclusions. PMID:28264461

Symptoms of Emotional, Behavioral, and Social Difficulties in the Danish Population of Children and Adolescents with Type 1 Diabetes – Results of a National Survey

PubMed Central

Kristensen, Lene J.; Birkebaek, Niels H.; Mose, Anne H.; Hohwü, Lena; Thastum, Mikael

2014-01-01

Objective To assess the prevalence of psychological difficulties in Danish children and adolescents with type 1 diabetes using both child/adolescent and caregiver reports, and to investigate associations between these symptoms and metabolic control, adherence, and quality of life. Research Design and Method: A total of 786 children and adolescents (8–17 years) recruited through the Danish Registry of Childhood Diabetes completed subscales of the Beck's Youth Inventories (BYI-Y), while 910 caregivers completed the Strength and Difficulties Questionnaire (SDQ). The participants also completed questionnaires assessing adherence and quality of life. BYI-Y and SDQ responses were compared with results from normative samples. Results Children with diabetes generally reported a lower level of symptoms of depression and anxiety, while older adolescents in most cases were comparable to the normative samples. However, the numbers of patients with elevated scores were similar to normative groups, especially regarding the proportion of participants with ‘Extremely elevated’ scores. Caregivers of children and adolescents with diabetes generally reported the prevalence of elevated scores on the SDQ to exceed the prevalence observed in the norm sample – particularly with regard to older boys. Both BYI-Y and SDQ responses were significantly correlated with HbA1c, adherence, and quality of life. Conclusions This study finds Danish children and adolescents with diabetes to report lower or comparable levels of emotional difficulties compared to norms, while caregiver reports are less positive. The results therefore support the value of a multi-informant approach to the assessment of symptoms of psychological difficulty in girls and boys with diabetes. PMID:24842772

Community integration after burn injuries.

PubMed

Esselman, P C; Ptacek, J T; Kowalske, K; Cromes, G F; deLateur, B J; Engrav, L H

2001-01-01

Evaluation of community integration is a meaningful outcome criterion after major burn injury. The Community Integration Questionnaire (CIQ) was administered to 463 individuals with major burn injuries. The CIQ results in Total, Home Integration, Social Integration, and Productivity scores. The purposes of this study were to determine change in CIQ scores over time and what burn injury and demographic factors predict CIQ scores. The CIQ scores did not change significantly from 6 to 12 to 24 months postburn injury. Home integration scores were best predicted by sex and living situation; Social Integration scores by marital status; and Productivity scores by functional outcome, burn severity, age, and preburn work factors. The data demonstrate that individuals with burn injuries have significant difficulties with community integration due to burn and nonburn related factors. CIQ scores did not improve over time but improvement may have occurred before the initial 6-month postburn injury follow-up in this study.

Prosocial Behaviors during School Activities among Child Survivors after the 2011 Earthquake and Tsunami in Japan: A Retrospective Observational Study

PubMed Central

Usami, Masahide; Iwadare, Yoshitaka; Watanabe, Kyota; Kodaira, Masaki; Ushijima, Hirokage; Tanaka, Tetsuya; Harada, Maiko; Tanaka, Hiromi; Sasaki, Yoshinori; Okamoto, Seiko; Sekine, Keisuke; Saito, Kazuhiko

2014-01-01

Background The 2011 Japan massive tsunami traumatized many children. The aim of this study was to assess changes in strengths and difficulties experienced in home and school by among surviving children after the 2011 tsunami, in comparison with published normal Japanese data. Methods In November 2012 (20 months after the disaster) and September 2013 (30 months after the disaster), the Strengths and Difficulties Questionnaire (SDQ), a questionnaire on children's strengths and difficulties in home and school activities, were distributed to 12,193 and 11,819 children, respectively. An effective response of children 20 months and 30 month after the disaster was obtained in 10,597 children (86.9%), and 10,812 children (91.4%), respectively. The SDQ scores evaluated by parents and teachers were compared with published normal Japanese SDQ scores. Results The SDQ scores (emotional problems, conduct problems, hyperactivity/inattention, peer relationship problems, and total difficulty score) evaluated by parents of children in the 4th to 9th grade who were evaluated after 30 and 20 months were significantly high compared with the published normal data of children without traumatic experiences (all P<0.001). The SDQ scores (prosocial behavior) evaluated by teachers of children in the 4th to 9th grade who were evaluated after 30 and 20 months were significantly low compared with the published normal data of children without traumatic experiences (all P<0.001). Conclusions This study showed that the experience of the disaster affected those children with prosocial behaviors towards teachers and friends at school. However, no significant changes (in their prosocial attitude) had been seen at home, where they continued to keep their respect and caring feelings for parents. These results indicate that for accurate diagnosis, clinicians should not only evaluate these children's daily activities at home but also try to objectively assess their daily activities at school. PMID:25415450

Primary teachers' subject matter knowledge: decimals

NASA Astrophysics Data System (ADS)

Ubuz, Behiye; Yayan, Betül

2010-09-01

The main objective of this study was to investigate primary teachers' subject matter knowledge in the domain of decimals and more elaborately to investigate their performance and difficulties in reading scale, ordering numbers, finding the nearest decimal and doing operations, such as addition and subtraction. The difficulties in these particular areas are analysed and suggestions are made regarding their causes. Further, factors that influence this knowledge were explored. The sample of the study was 63 primary teachers. A decimal concepts test including 18 tasks was administered and the total scores for the 63 primary teachers ranged from 3 to 18 with a mean and median of 12. Fifty per cent of the teachers were above the mean score. The detailed investigation of the responses revealed that the primary teachers faced similar difficulties that students and pre-service teachers faced. Discrepancy on teachers' knowledge revealed important differences based on educational level attained, but not the number of years of teaching experience and experience in teaching decimals. Some suggestions have been made regarding the implications for pre- and in-service teacher training.

Psychometric Properties of Difficulties of Working with Patients with Personality Disorders and Attitudes Towards Patients with Personality Disorders Scales.

PubMed

Eren, Nurhan

2014-12-01

In this study, we aimed to develop two reliable and valid assessment instruments for investigating the level of difficulties mental health workers experience while working with patients with personality disorders and the attitudes they develop tt the patients. The research was carried out based on the general screening model. The study sample consisted of 332 mental health workers in several mental health clinics of Turkey, with a certain amount of experience in working with personality disorders, who were selected with a random assignment method. In order to collect data, the Personal Information Questionnaire, Difficulty of Working with Personality Disorders Scale (PD-DWS), and Attitudes Towards Patients with Personality Disorders Scale (PD-APS), which are being examined for reliability and validity, were applied. To determine construct validity, the Adjective Check List, Maslach Burnout Inventory, and State and Trait Anxiety Inventory were used. Explanatory factor analysis was used for investigating the structural validity, and Cronbach alpha, Spearman-Brown, Guttman Split-Half reliability analyses were utilized to examine the reliability. Also, item reliability and validity computations were carried out by investigating the corrected item-total correlations and discriminative indexes of the items in the scales. For the PD-DWS KMO test, the value was .946; also, a significant difference was found for the Bartlett sphericity test (p<.001). The computed test-retest coefficient reliability was .702; the Cronbach alpha value of the total test score was .952. For PD-APS KMO, the value was .925; a significant difference was found in Bartlett sphericity test (p<.001); the computed reliability coefficient based on continuity was .806; and the Cronbach alpha value of the total test score was .913. Analyses on both scales were based on total scores. It was found that PD-DWS and PD-APS have good psychometric properties, measuring the structure that is being investigated, are compatible with other scales, have high levels of internal reliability between their items, and are consistent across time. Therefore, it was concluded that both scales are valid and reliable instruments.

From dV-Trainer to Real Robotic Console: The Limitations of Robotic Skill Training.

PubMed

Yang, Kun; Zhen, Hang; Hubert, Nicolas; Perez, Manuela; Wang, Xing Huan; Hubert, Jacques

To investigate operators' performance quality, mental stress, and ergonomic habits through a training curriculum on robotic simulators. Forty volunteers without robotic surgery experience were recruited to practice 2 exercises on a dV-Trainer (dVT) for 14 hours. The simulator software (M-score a ) provided an automatic evaluation of the overall score for the surgeons' performance. Each participant provided a subjective difficulty score (validity to be proven) for each exercise. Their ergonomic habits were evaluated based on the workspace range and armrest load-validated criteria for evaluating the proficiency of using the armrest. They then repeated the same tasks on a da Vinci Surgical Skill Simulator for a final-level test. Their final scores were compared with their initial scores and the scores of 5 experts on the da Vinci Surgical Skill Simulator. A total of 14 hours of training on the dVT significantly improved the surgeons' performance scores to the expert level with a significantly reduced workload, but their ergonomic score was still far from the expert level. Sufficient training on the dVT improves novices' performance, reduces psychological stress, and inculcates better ergonomic habits. Among the evaluated criteria, novices had the most difficulty in achieving expert levels of ergonomic skills. The training benefits of robotic surgery simulators should be determined with quantified variables. The detection of the limitations during robotic training curricula could guide the targeted training and improve the training effect. Copyright © 2017. Published by Elsevier Inc.

The influence of folate serum levels on depressive mood and mental processing in patients with epilepsy treated with enzyme-inducing anti-epileptic drugs.

PubMed

Rösche, J; Uhlmann, C; Weber, R; Fröscher, W

2003-04-01

Folate deficiency is common in patients with epilepsy and also occurs in patients with depression or cognitive deficits. This study investigates whether low serum folate levels may contribute to depressive mood and difficulties in mental processing in patients with epilepsy treated with anti-epileptic drugs inducing the cytochrome P450. We analysed the serum folate levels, the score in the Self Rating Depression Scale (SDS) and the results of a bedside test in mental processing in 54 patients with epilepsy. There was a significant negative correlation between the serum folate levels and the score in SDS and significant positive correlations between the score in SDS and the time needed to process an interference task or a letter-reading task. Low serum folate levels may contribute to depressive mood and therefore to difficulties in mental processing. Further studies utilizing total plasma homocysteine as a sensitive measure of functional folate deficiency and more elaborate tests of mental processing are required to elucidate the impact of folate metabolism on depressive mood and cognitive function in patients with epilepsy.

The psychological well-being of children orphaned by AIDS in Cape Town, South Africa.

PubMed

Cluver, Lucie; Gardner, Frances

2006-07-19

An estimated 2 million children are parentally bereaved by AIDS in South Africa. Little is known about mental health outcomes for this group. This study aimed to investigate mental health outcomes for urban children living in deprived settlements in Cape Town. 30 orphaned children and 30 matched controls were compared using standardised questionnaires (SDQ) on emotional and behavioural problems, peer and attention difficulties, and prosocial behaviour. The orphan group completed a modified version of a standardised questionnaire (IES-8), measuring Post-Traumatic Stress symptoms. Group differences were tested using t-tests and Pearson's chi-square. Both groups scored highly for peer problems, emotional problems and total scores. However, orphans were more likely to view themselves as having no good friends (p = .002), to have marked concentration difficulties (p = .03), and to report frequent somatic symptoms (p = .05), but were less likely to display anger through loss of temper (p = .03). Orphans were more likely to have constant nightmares (p = .01), and 73% scored above the cut-off for Post-Traumatic Stress Disorder. Findings suggest important areas for larger-scale research for parentally-bereaved children.

Motor performance and correlates of mental health in children who are deaf or hard of hearing.

PubMed

Fellinger, Matthäus J; Holzinger, Daniel; Aigner, Martin; Beitel, Christoph; Fellinger, Johannes

2015-10-01

This cross-sectional study investigates the relationship between motor performance and mental health in a representative population of children with hearing impairment. Ninety-three pupils (45 males, 48 females) aged 6 years to 16 years (mean 11 y 3 mo, SD 2 y 9 mo) with hearing impairment of at least 40 dB and a Nonverbal IQ greater than 70 were assessed for motor performance with the Zürich Neuromotor Assessment (ZNA) and for mental health with the parent version of the Strengths and Difficulties Questionnaire (SDQ). Children with hearing impairment had lower motor performance scores in all four ZNA subscales compared with ZNA norms (z-scores -1.42 to -2.67). After controlling for Nonverbal IQ, ZNA pure motor performance correlated negatively with the SDQ total difficulties score. Pure motor, pegboard, and dynamic balance subscales correlated negatively with peer-relationship problems. Dynamic balance correlated negatively with emotional problems. Performance in pure motor and dynamic balance skills correlated negatively with age. Except for static balance, no correlation was found between motor performance and the degree of hearing impairment. Results confirm that a high percentage of children with hearing impairment have poor motor performance. These problems are associated with difficulties in social relationships. Early recognition of these problems may lead to interventions to assist children with hearing impairment with their peer relationships. © 2015 Mac Keith Press.

Sleep disturbances in preschool age children with cerebral palsy: a questionnaire study.

PubMed

Romeo, Domenico M; Brogna, Claudia; Musto, Elisa; Baranello, Giovanni; Pagliano, Emanuela; Casalino, Tiziana; Ricci, Daniela; Mallardi, Maria; Sivo, Serena; Cota, Francesco; Battaglia, Domenica; Bruni, Oliviero; Mercuri, Eugenio

2014-09-01

The study aimed to analyze (i) the prevalence of sleep disorders in pre-school children with cerebral palsy (CP) using the Sleep Disturbance Scale for Children (SDSC), (ii) the possible association with motor, cognitive and behavioral problems, and (iii) the possible differences with typically developing children matched for age and gender. One-hundred children with CP (age range: 3-5 years, mean: 3.8 years) were assessed using the SDSC, the Gross Motor Function Classification System (GMFCS), the Wechsler Preschool and Primary Scale of Intelligence, and the Child Behaviour Check List (CBCL) to assess sleep, motor, cognitive, and behavioral problems, respectively. Further 100 healthy children matched for age and sex were assessed using the SDSC. An abnormal total sleep score was found in 13% of children with CP while 35% had an abnormal score on at least one SDSC factor. SDSC total score was significantly associated with pathological internalizing scores on CBCL and active epilepsy on multivariate analysis. CP group reported higher significant median scores on SDSC total, parasomnias, and difficulty in initiating and maintaining sleep factors. In pre-school children sleep disorders are more common in children with CP than in healthy control group and are often associated with epilepsy and behavioral problems. Copyright © 2014 Elsevier B.V. All rights reserved.

The Accuracy of Estimated Total Test Statistics. Final Report.

ERIC Educational Resources Information Center

Kleinke, David J.

In a post-mortem study of item sampling, 1,050 examinees were divided into ten groups 50 times. Each time, their papers were scored on four different sets of item samples from a 150-item test of academic aptitude. These samples were selected using (a) unstratified random sampling and stratification on (b) content, (c) difficulty, and (d) both.…

Mixed ethnicity and behavioural problems in the Millennium Cohort Study

PubMed Central

Zilanawala, Afshin; Sacker, Amanda; Kelly, Yvonne

2018-01-01

Background The population of mixed ethnicity individuals in the UK is growing. Despite this demographic trend, little is known about mixed ethnicity children and their problem behaviours. We examine trajectories of behavioural problems among non-mixed and mixed ethnicity children from early to middle childhood using nationally representative cohort data in the UK. Methods Data from 16 330 children from the Millennium Cohort Study with total difficulties scores were analysed. We estimated trajectories of behavioural problems by mixed ethnicity using growth curve models. Results White mixed (mean total difficulties score: 8.3), Indian mixed (7.7), Pakistani mixed (8.9) and Bangladeshi mixed (7.2) children had fewer problem behaviours than their non-mixed counterparts at age 3 (9.4, 10.1, 13.1 and 11.9, respectively). White mixed, Pakistani mixed and Bangladeshi mixed children had growth trajectories in problem behaviours significantly different from that of their non-mixed counterparts. Conclusions Using a detailed mixed ethnic classification revealed diverging trajectories between some non-mixed and mixed children across the early life course. Future studies should investigate the mechanisms, which may influence increasing behavioural problems in mixed ethnicity children. PMID:26912571

Memory Complaints Associated with Seeking Clinical Care

PubMed Central

Pires, Carolina; Silva, Dina; Maroco, João; Ginó, Sandra; Mendes, Tiago; Schmand, Ben A.; Guerreiro, Manuela; de Mendonça, Alexandre

2012-01-01

Diagnosis of mild cognitive impairment relies on the presence of memory complaints. However, memory complaints are very frequent in healthy people. The objective of this study was to determine the severity and type of memory difficulties presented by elderly patients who seek for clinical help, as compared to the memory difficulties reported by subjects in the community. Assessment of subjective memory complaints was done with the subjective memory complaints scale (SMC). The mini-mental state examination was used for general cognitive evaluation and the geriatric depression scale for the assessment of depressive symptoms. Eight-hundred and seventy-one nondemented subjects older than 50 years were included. Participants in the clinical setting had a higher total SMC score (10.3 ± 4.2) than those in the community (5.1 ± 3.0). Item 3 of the SMC, Do you ever forget names of family members or friends? contributed significantly more to the variance of the total SMC score in the clinical sample (18%) as compared to the community sample (11%). Forgetting names of family members or friends plays an important role in subjective memory complaints in the clinical setting. This symptom is possibly perceived as particularly worrisome and likely drives people to seek for clinical help. PMID:22536537

The normalization of data in the Constant-Murley score for the shoulder. A study conducted on 563 healthy subjects.

PubMed

Grassi, F A; Tajana, M S

2003-01-01

The study was conducted in order to evaluate the theoretical design of the Constant-Murley system and to reveal any difficulties in obtaining data when it is used in 563 subjects not affected with shoulder pathology. The total mean score for the subjects examined was 85.2 points (minimum 75, maximum 100 points). Values revealed a decreasing trend beginning at 50 years of age for men and 30 for women. Only 4 subjects achieved a maximum score of 100. The measurements taken allowed us to elaborate a reference table based on sex and age, which was required to calculate the correct score. These values differ from those reported by the inventors of the system and they reveal the need to compile personal tables for the normalization of scores.

Cerebral malaria is associated with long-term mental health disorders: a cross sectional survey of a long-term cohort.

PubMed

Idro, Richard; Kakooza-Mwesige, Angelina; Asea, Benjamin; Ssebyala, Keron; Bangirana, Paul; Opoka, Robert O; Lubowa, Samson K; Semrud-Clikeman, Margaret; John, Chandy C; Nalugya, Joyce

2016-03-31

Cerebral malaria (CM) and severe malarial anaemia (SMA) are associated with neuro-developmental impairment in African children, but long-term mental health disorders in these children are not well defined. A cohort of children previously exposed to CM (n = 173) or SMA (n = 99) had neurologic assessments performed and screening for behaviour difficulties using the Strengths and Difficulties Questionnaire (SDQ) a median of 21 months after the disease episode. These findings were compared to concurrently recruited community children (CC, n = 108). Participants with SDQ total difficulties score ≥ 17 had a mental health interview with the child and adolescent version of the Mini-International Neuropsychiatric Interview (MINI-KID) and a sample had brain magnetic resonance imaging (MRI). Fifty-five children had SDQ score ≥ 17. On the MINI-KID, these children were classified as having no difficulties (n = 18), behaviour difficulties only (n = 13) or a mental health disorder (n = 24). Behaviour difficulties were seen in similar frequencies in CM (3.5%), SMA (4.0%) and CC (2.8%). In contrast, mental health disorders were most frequent in CM (10.4%), followed by SMA (4.0%) and CC (1.8%). Externalizing disorders (conduct, oppositional defiance and attention deficit hyperactivity) were the most common mental health disorders. The median total coma duration was 72 (IQR 36.0-115.0) h in patients with mental health disorders compared to 48 (IQR 28.5-78.7) h in those without, p = 0.039. Independent risk factors for mental health disorder included neurologic deficit at discharge (OR 4.09 (95% CI 1.60, 10.5) and seizure recurrences during hospitalization, (OR 2.80, 95% CI 1.13, 6.97). Brain MRI findings consistent with small vessel ischaemic neural injury was seen in over half of these children. Cerebral malaria may predispose children to mental health disorders, possibly as a consequence of ischaemic neural injury. There is urgent need for programmes of follow-up, diagnosis and interventions for these children.

Psychological adjustment and behaviours in children of migrant workers in China.

PubMed

Wang, F; Zhou, X; Hesketh, T

2017-11-01

In China, there are around 274 million rural-urban migrants, an estimated 61 million children left behind in rural areas by parents, and 29 million children who accompany their parents to cities. The aim of this study was to compare the psychosocial adjustment and behaviours of left-behind children and migrant children. Full data were available for 761 left-behind children and 1,392 migrant children aged 11 to 17 in Zhejiang Province, eastern China. Participants completed a questionnaire focusing on migration status, risks behaviours, and psychological well-being, measured with the Strengths and Difficulties Questionnaire. There were more left behind girls and more urban migrant boys (p < .001). The mean scores on the Strengths and Difficulties Questionnaire were all higher in left-behind children than migrant children: for emotional symptoms (3.82 vs. 3.03, p < .001), conduct problems (2.55 vs. 2.41, p = .048), hyperactivity (4.25 vs. 3.81, p < .001), and total difficulties (13.46 vs. 12.00, p = .020), whereas the prosocial score was lower (6.68 vs. 6.90, p < .001), all indicating lower levels of well-being in left-behind children. Overall, 11.4% of left-behind children and 8.8% of migrant children scored in the abnormal range for total difficulties. Left behind girls were particularly vulnerable to emotional problems. Left-behind children were more likely to admit to stealing and cheating on exams, but there were no differences in other risks behaviours, such as smoking and drinking. Migration with parents, rather than separation from parents, was associated with better psychological well-being and fewer behavioural problems. Our findings have relevance for migrant parents in helping to inform decisions about where to raise their children as well as for policymakers in countries where migration is a major issue. When children are left behind, models of community support need to be considered, especially for those who are most vulnerable. © 2017 John Wiley & Sons Ltd.

Differential Gender Effects in the Relationship between Perceived Immune Functioning and Autistic Traits.

PubMed

Mackus, Marlou; Kruijff, Deborah de; Otten, Leila S; Kraneveld, Aletta D; Garssen, Johan; Verster, Joris C

2017-04-12

Altered immune functioning has been demonstrated in individuals with autism spectrum disorder (ASD). The current study explores the relationship between perceived immune functioning and experiencing ASD traits in healthy young adults. N = 410 students from Utrecht University completed a survey on immune functioning and autistic traits. In addition to a 1-item perceived immune functioning rating, the Immune Function Questionnaire (IFQ) was completed to assess perceived immune functioning. The Dutch translation of the Autism-Spectrum Quotient (AQ) was completed to examine variation in autistic traits, including the domains "social insights and behavior", "difficulties with change", "communication", "phantasy and imagination", and "detail orientation". The 1-item perceived immune functioning score did not significantly correlate with the total AQ score. However, a significant negative correlation was found between perceived immune functioning and the AQ subscale "difficulties with change" (r = -0.119, p = 0.019). In women, 1-item perceived immune functioning correlated significantly with the AQ subscales "difficulties with change" (r = -0.149, p = 0.029) and "communication" (r = -0.145, p = 0.032). In men, none of the AQ subscales significantly correlated with 1-item perceived immune functioning. In conclusion, a modest relationship between perceived immune functioning and several autistic traits was found.

Behavioral difficulties in 7-year old children in relation to developmental exposure to perfluorinated alkyl substances.

PubMed

Oulhote, Youssef; Steuerwald, Ulrike; Debes, Frodi; Weihe, Pal; Grandjean, Philippe

2016-12-01

Perfluorinated alkyl substances (PFAS) are suspected endocrine disruptors that are highly persistent and neurotoxic in animals. Human epidemiological studies of exposure-related deviations of children's behaviors are sparse. We assessed the associations between prenatal, 5- and 7-year PFAS exposures and behavioral problem scores in 7-year Faroese children. Concentrations of perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), and perfluorodecanoic acid (PFDA), perfluorooctane sulfonate (PFOS), and perfluorohexane sulfonic acid (PFHxS) were measured in maternal serum and in serum from children at ages 5 and 7years (n=539, 508, and 491, respectively). We used multivariable regressions and structural equations models to estimate the covariate-adjusted associations between serum-PFAS concentrations and behavioral difficulties, as assessed by the strengths and difficulties questionnaire (SDQ) at age 7. Serum-PFOS and PFHxS concentrations declined over time, whereas PFOA, PFNA, and PFDA tended to increase. No associations were observed between prenatal PFAS concentrations and SDQ scores. However, a two-fold increase in 5-year serum-PFOA, PFNA, and PFDA concentrations was associated with increases in total SDQ scores by 1.03 (95% CI: 0.11, 1.95), 0.72 (95% CI: 0.07, 1.38) and 0.78 points (95% CI: 0.01, 1.55), respectively. For SDQ subscales, significant associations were found in regard to hyperactivity, peer relationship, and conduct problems, as well as internalizing and externalizing problems and autism screening composite scores. Cross-sectional analyses at age 7years showed possible sex-dimorphic associations between PFAS concentrations and SDQ scores, where girls had consistently positive associations with SDQ scores whereas boys exhibited a pattern of negative or null associations. Higher serum PFAS concentrations at ages 5- and 7-years, but not prenatally, were associated with parent-reported behavioral problems at age 7. Copyright © 2016 Elsevier Ltd. All rights reserved.

Behavioral difficulties in 7-year old children in relation to developmental exposure to perfluorinated alkyl substances

PubMed Central

Oulhote, Youssef; Steuerwald, Ulrike; Debes, Frodi; Weihe, Pal; Grandjean, Philippe

2016-01-01

Background Perfluorinated alkyl substances (PFAS) are suspected endocrine disruptors that are highly persistent and neurotoxic in animals. Human epidemiological studies of exposure-related deviations of children’s behaviors are sparse. We assessed the associations between prenatal, 5- and 7-year PFAS exposures and behavioral problem scores in 7-year Faroese children. Methods Concentrations of perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), and perfluorodecanoic acid (PFDA), perfluorooctane sulfonate (PFOS), and perfluorohexane sulfonic acid (PFHxS) were measured in maternal serum and in serum from children at ages 5 and 7 years (n=539, 508, and 491, respectively). We used multivariable regressions and structural equations models to estimate the covariate-adjusted associations between serum-PFAS concentrations and behavioral difficulties, as assessed by the strengths and difficulties questionnaire (SDQ) at age 7. Results Serum-PFOS and PFHxS concentrations declined over time, whereas PFOA, PFNA, and PFDA tended to increase. No associations were observed between prenatal PFAS concentrations and SDQ scores. However, a two-fold increase in 5-year serum-PFOA, PFNA, and PFDA concentrations was associated with increases in total SDQ scores by 1.03 (95% CI: 0.11, 1.95), 0.72 (95% CI: 0.07, 1.38) and 0.78 points (95% CI: 0.01, 1.55), respectively. For SDQ subscales, significant associations were found in regard to hyperactivity, peer relationship, and conduct problems, as well as internalizing and externalizing problems and autism screening composite scores. Cross-sectional analyses at age 7 years showed possible sex-dimorphic associations between PFAS concentrations and SDQ scores, where girls had consistently positive associations with SDQ scores whereas boys exhibited a pattern of negative or null associations. Conclusions Higher serum PFAS concentrations at ages 5- and 7-years, but not prenatally, were associated with parent-reported behavioral problems at age 7. PMID:27692925

Psychological problems in children with hemiplegia: a European multicentre survey.

PubMed

Parkes, J; White-Koning, M; McCullough, N; Colver, A

2009-06-01

To describe the prevalence and determinants of psychological problems in European children with hemiplegia. Cross-sectional survey. Home visits in nine European regions by research associates who administered standard questionnaires to parents. 279 children with hemiplegia aged 8-12 years were recruited from population-based case registers. Strengths and Difficulties Questionnaire comprising emotion, conduct, hyperactivity, peer problems and prosocial domains. An "impact score" (IS) measures the social and psychological impact of the child's difficulties. Children with hemiplegia had higher mean scores on the total difficulties score (TDS) compared with a normative sample (p<0.001). 48% and 57% of children, respectively, had borderline-abnormal TDS and IS. Significant, independent associations were observed between intellectual impairment and an increased risk for hyperactivity (odds ratio; OR 8.4, 95% CI 3.4 to 20.8), peer problems (OR 3.1, 95% CI 1.7 to 5.5), psychological and social impact (OR 3.0, 95% CI 1.6 to 5.6) when children with an intellectual quotient (IQ) <50 were compared with those with an IQ >70. Boys had an increased risk for conduct (OR 2.1, 95% CI 1.2 to 3.7) and hyperactivity disorders (OR 2.5, 95% CI 1.4 to 4.6). Poor self-esteem was associated with an increased risk for peer problems (OR 5.8, 95% CI 2.5 to 13.4) and poor prosocial skills (OR 7.5, 95% CI 2.4 to 23.2) compared with those with high self-esteem. Other determinants of psychological adjustment were impaired communication, severe pain and living with a single parent. Many of the psychological problems identified are amenable to treatment. Special attention should be given to those at highest risk of developing psychological difficulties.

A Graphical Approach to Item Analysis. Research Report. ETS RR-04-10

ERIC Educational Resources Information Center

Livingston, Samuel A.; Dorans, Neil J.

2004-01-01

This paper describes an approach to item analysis that is based on the estimation of a set of response curves for each item. The response curves show, at a glance, the difficulty and the discriminating power of the item and the popularity of each distractor, at any level of the criterion variable (e.g., total score). The curves are estimated by…

Sexual function of premature ejaculation patients assayed with Chinese Index of Premature Ejaculation.

PubMed

Yuan, Yi-Ming; Xin, Zhong-Cheng; Jiang, Hui; Guo, Yan-Jie; Liu, Wu-Jiang; Tian, Long; Zhu, Ji-Chuan

2004-06-01

To assess the psychometric properties of the Chinese Index of Premature Ejaculation (CIPE). The sexual function of 167 patients with and 114 normal controls without premature ejaculation (PE) were evaluated with CIPE. All subjects were married and had regular sexual activity. The CIPE has 10 questions, focusing on libido, erectile function, ejaculatory latency, sexual satisfaction and difficulty in delaying ejaculation, self-confidence and depression. Each question was responded to on a 5 point Likert-type scale. The individual question score and the total scale score were analyzed between the two groups. There were no significant differences between the age, duration of marriage and educational level (P> 0.05) of patients with and without PE and normal controls. The mean latency of patients with PE and normal controls were 1.6 +/- 1.2 and 10.2 +/- 9.5 minutes, respectively. Significant differences between patients with (26.7 +/- 4.6) PE and normal controls (41.9 +/- 4.0) were observed on the total score of CIPE (P< 0.01). Using binary logistic regression analysis, PE was significantly related to five questions of the original measure. They are the so-called the CIPE-5 and include: ejaculatory latency, sexual satisfaction of patients and sexual partner, difficulty in delaying ejaculation, anxiety and depression. Receiver Operating Characteristic (ROC) curve analysis of CIPE-5 questionnaire indicated that the sensitivity and specificity of CIPE were 97.60 % and 94.74 %, respectively. Employing the total score of CIPE-5, patients with PE could be divided into three groups: mild (>15 point) 19.8 %, moderate (10-14 point) 62.8 % and severe (< 9 point) 16.7 %. The CIPE-5 is a useful method for the evaluation of sexual function of patients with PE and can be used as a clinical endpoint for clinical trials studying the efficacy of pharmacological intervention.

A laboratory study for assessing speech privacy in a simulated open-plan office.

PubMed

Lee, P J; Jeon, J Y

2014-06-01

The aim of this study is to assess speech privacy in open-plan office using two recently introduced single-number quantities: the spatial decay rate of speech, DL(2,S) [dB], and the A-weighted sound pressure level of speech at a distance of 4 m, L(p,A,S,4) m [dB]. Open-plan offices were modeled using a DL(2,S) of 4, 8, and 12 dB, and L(p,A,S,4) m was changed in three steps, from 43 to 57 dB.Auditory experiments were conducted at three locations with source–receiver distances of 8, 16, and 24 m, while background noise level was fixed at 30 dBA.A total of 20 subjects were asked to rate the speech intelligibility and listening difficulty of 240 Korean sentences in such surroundings. The speech intelligibility scores were not affected by DL(2,S) or L(p,A,S,4) m at a source–receiver distance of 8 m; however, listening difficulty ratings were significantly changed with increasing DL(2,S) and L(p,A,S,4) m values. At other locations, the influences of DL(2,S) and L(p,A,S,4) m on speech intelligibility and listening difficulty ratings were significant. It was also found that the speech intelligibility scores and listening difficulty ratings were considerably changed with increasing the distraction distance (r(D)). Furthermore, listening difficulty is more sensitive to variations in DL(2,S) and L(p,A,S,4) m than intelligibility scores for sound fields with high speech transmission performances. The recently introduced single-number quantities in the ISO standard, based on the spatial distribution of sound pressure level, were associated with speech privacy in an open-plan office. The results support single-number quantities being suitable to assess speech privacy, mainly at large distances. This new information can be considered when designing open-plan offices and making acoustic guidelines of open-plan offices.

Reliability and Validity of Composite Scores from the NIH Toolbox Cognition Battery in Adults

PubMed Central

Heaton, Robert K.; Akshoomoff, Natacha; Tulsky, David; Mungas, Dan; Weintraub, Sandra; Dikmen, Sureyya; Beaumont, Jennifer; Casaletto, Kaitlin B.; Conway, Kevin; Slotkin, Jerry; Gershon, Richard

2014-01-01

This study describes psychometric properties of the NIH Toolbox Cognition Battery (NIHTB-CB) Composite Scores in an adult sample. The NIHTB-CB was designed for use in epidemiologic studies and clinical trials for ages 3 to 85. A total of 268 self-described healthy adults were recruited at four university-based sites, using stratified sampling guidelines to target demographic variability for age (20–85 years), gender, education, and ethnicity. The NIHTB-CB contains seven computer-based instruments assessing five cognitive sub-domains: Language, Executive Function, Episodic Memory, Processing Speed, and Working Memory. Participants completed the NIHTB-CB, corresponding gold standard validation measures selected to tap the same cognitive abilities, and sociodemographic questionnaires. Three Composite Scores were derived for both the NIHTB-CB and gold standard batteries: “Crystallized Cognition Composite,” “Fluid Cognition Composite,” and “Total Cognition Composite” scores. NIHTB Composite Scores showed acceptable internal consistency (Cronbach’s alphas = 0.84 Crystallized, 0.83 Fluid, 0.77 Total), excellent test–retest reliability (r: 0.86–0.92), strong convergent (r: 0.78–0.90) and discriminant (r: 0.19–0.39) validities versus gold standard composites, and expected age effects (r = 0.18 crystallized, r = − 0.68 fluid, r = − 0.26 total). Significant relationships with self-reported prior school difficulties and current health status, employment, and presence of a disability provided evidence of external validity. The NIH Toolbox Cognition Battery Composite Scores have excellent reliability and validity, suggesting they can be used effectively in epidemiologic and clinical studies. PMID:24960398

The analysis of 146 patients with difficult laparoscopic cholecystectomy.

PubMed

Bat, Orhan

2015-01-01

Laparoscopic cholecystectomy (LC) is very commonly performed surgical intervention. Acute or chronic cholecystitis, adhesions due to previous upper abdomen surgeries, Mirrizi's syndrome and obesity are common clinical conditions that can be associated with difficult cholecystectomy. In this study, we evaluated and scored the patients with difficult surgical exploration during laparoscopic cholecystectomy. All patients who underwent LC from 2010 to 2015 were retrospectively rewieved. According to intraoperative findings DLC cases were described and classified. Class I difficulty: Adhesion of omentum majus, transverse colon, duodenum to the fundus of the gallbladder. Class II difficulty: Adhesions in Calot's triangle and difficulty in dissection of cystic artery and cystic duct Class III difficulty: Difficulty in dissection of gallbladder bed (scleroathrophic gallbladder, hemorrhage from liver during dissection of gallbladder, chirotic liver). Class IV difficulty: Difficulty in exploration of gallbladder due to intraabdominal adhesions including technical problems. A total of 146 patients were operated with DLC. The most common difficulty type was Class I difficulty (88 patients/60.2%). Laparoscopic cholecystectomy was converted to laparotomy in 98 patients. Operation time was found to be related with conversion to open surgery (P<0.05). Wound infection rate was also statistically higher in conversion group (P<0.05). The opertion time was found to be longest with Class II difficulty. Conversion rate to open surgery was also highest with Class II difficulty group. Class II difficulty characterized by severe adhesions in calot's triangle is most serious problem among all DLC cases. They have longer operation time and higher conversion rate.

Assessing spelling in kindergarten: further comparison of scoring metrics and their relation to reading skills.

PubMed

Clemens, Nathan H; Oslund, Eric L; Simmons, Leslie E; Simmons, Deborah

2014-02-01

Early reading and spelling development share foundational skills, yet spelling assessment is underutilized in evaluating early reading. This study extended research comparing the degree to which methods for scoring spelling skills at the end of kindergarten were associated with reading skills measured at the same time as well as at the end of first grade. Five strategies for scoring spelling responses were compared: totaling the number of words spelled correctly, totaling the number of correct letter sounds, totaling the number of correct letter sequences, using a rubric for scoring invented spellings, and calculating the Spelling Sensitivity Score (Masterson & Apel, 2010b). Students (N=287) who were identified at kindergarten entry as at risk for reading difficulty and who had received supplemental reading intervention were administered a standardized spelling assessment in the spring of kindergarten, and measures of phonological awareness, decoding, word recognition, and reading fluency were administered concurrently and at the end of first grade. The five spelling scoring metrics were similar in their strong relations with factors summarizing reading subskills (phonological awareness, decoding, and word reading) on a concurrent basis. Furthermore, when predicting first-grade reading skills based on spring-of-kindergarten performance, spelling scores from all five metrics explained unique variance over the autoregressive effects of kindergarten word identification. The practical advantages of using a brief spelling assessment for early reading evaluation and the relative tradeoffs of each scoring metric are discussed. Copyright © 2013 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Comparison of a math fact rehearsal and a mnemonic strategy approach for improving math fact fluency.

PubMed

Nelson, Peter M; Burns, Matthew K; Kanive, Rebecca; Ysseldyke, James E

2013-12-01

The current study used a randomized controlled trial to compare the effects of a practice-based intervention and a mnemonic strategy intervention on the retention and application of single-digit multiplication facts with 90 third- and fourth-grade students with math difficulties. Changes in retention and application were assessed separately using one-way ANCOVAs in which students' pretest scores were included as the covariate. Students in the practice-based intervention group had higher retention scores (expressed as the total number of digits correct per minute) relative to the control group. No statistically significant between-group differences were observed for application scores. Practical and theoretical implications for interventions targeting basic multiplication facts are discussed. © 2013.

Is greater improvement in early self-regulation associated with fewer behavioral problems later in childhood?

PubMed

Sawyer, Alyssa C P; Miller-Lewis, Lauren R; Searle, Amelia K; Sawyer, Michael G; Lynch, John W

2015-12-01

The aim of this study was to determine whether the extent of improvement in self-regulation achieved between ages 4 and 6 years is associated with the level of behavioral problems later in childhood. Participants were 4-year-old children (n = 510) attending preschools in South Australia. Children's level of self-regulation was assessed using the parent-completed Devereux Early Childhood Assessment when children were aged 4, 5, and 6. Children's level of behavioral problems was assessed using total, internalizing, and externalizing scores on parent- and teacher-rated Strengths and Difficulties Questionnaires (SDQs) when children were 6 years old. Random effects regression was used to describe the changes to children's self-regulation between 4 and 6 years. Linear regression models were then used to determine the strength of the association between the extent of self-regulation improvement and level of behavioral problems. Greater improvement in self-regulation, adjusted for family characteristics and baseline self-regulation scores, was associated with lower levels of parent- (B = -3.57, 95% confidence interval [CI] [-4.49, -2.65]) and teacher-rated SDQ total difficulties scores at 6 years (B = -2.42, 95% CI [-3.50, -1.34]). These effects remained after adjustment for level of parent-rated behavioral problems at 4 years. Similar effects were found for internalizing and externalizing scores at age 6 years. The results highlight the importance of improvements in self-regulation from 4-6 years for childhood behavioral problems during the early school years. Children with lower levels of improvement in self-regulation early in life are at risk for higher levels of behavioral problems both at home and at school. (c) 2015 APA, all rights reserved).

Developing a schedule to identify social communication difficulties and autism spectrum disorder in young children with visual impairment.

PubMed

Absoud, Michael; Parr, Jeremy R; Salt, Alison; Dale, Naomi

2011-03-01

Available observational tools used in the identification of social communication difficulties and diagnosis of autism spectrum disorder (ASD) rely partly on visual behaviours and therefore may not be valid in children with visual impairment. A pilot observational instrument, the Visual Impairment and Social Communication Schedule (VISS), was developed to aid in identifying social communication difficulties and ASD in young children with visual impairment affected by congenital disorders of the peripheral visual system (disorders of the globe, retina, and anterior optic nerve). The VISS was administered to 23 consecutive children (age range 1 y 9 mo-6 y 11 mo, mean 4 y 1 mo [SD 1.6]; 12 males, 11 females) with visual impairment (nine with severe and 14 with profound visual impairment). Item analysis was carried out by fit of the items to the Rasch model. Validity of the VISS was explored by comparison with the Childhood Autism Rating Scale (CARS) score, and the clinical ASD diagnosis (n=9). Correlation between the VISS and CARS total scores was highly significant (Spearman's rho=-0.89; p=0.01). Below threshold rating on the VISS (score of 35) showed good agreement with the clinical ASD diagnosis (sensitivity 89%, specificity 100%). This preliminary study shows the VISS to be a promising schedule to aid the identification of ASD in young children with visual impairment. © The Authors. Journal compilation © Mac Keith Press 2010.

Psychometric characteristics of Clinical Reasoning Problems (CRPs) and its correlation with routine multiple choice question (MCQ) in Cardiology department.

PubMed

Derakhshandeh, Zahra; Amini, Mitra; Kojuri, Javad; Dehbozorgian, Marziyeh

2018-01-01

Clinical reasoning is one of the most important skills in the process of training a medical student to become an efficient physician. Assessment of the reasoning skills in a medical school program is important to direct students' learning. One of the tests for measuring the clinical reasoning ability is Clinical Reasoning Problems (CRPs). The major aim of this study is to measure psychometric qualities of CRPs and define correlation between this test and routine MCQ in cardiology department of Shiraz medical school. This study was a descriptive study conducted on total cardiology residents of Shiraz Medical School. The study population consists of 40 residents in 2014. The routine CRPs and the MCQ tests was designed based on similar objectives and were carried out simultaneously. Reliability, item difficulty, item discrimination, and correlation between each item and the total score of CRPs were all measured by Excel and SPSS software for checking psycometeric CRPs test. Furthermore, we calculated the correlation between CRPs test and MCQ test. The mean differences of CRPs test score between residents' academic year [second, third and fourth year] were also evaluated by Analysis of variances test (One Way ANOVA) using SPSS software (version 20)(α=0.05). The mean and standard deviation of score in CRPs was 10.19 ±3.39 out of 20; in MCQ, it was 13.15±3.81 out of 20. Item difficulty was in the range of 0.27-0.72; item discrimination was 0.30-0.75 with question No.3 being the exception (that was 0.24). The correlation between each item and the total score of CRP was 0.26-0.87; the correlation between CRPs test and MCQ test was 0.68 (p<0.001). The reliability of the CRPs was 0.72 as calculated by using Cronbach's alpha. The mean score of CRPs was different among residents based on their academic year and this difference was statistically significant (p<0.001). The results of this present investigation revealed that CRPs could be reliable test for measuring clinical reasoning in residents. It can be included in cardiology residency assessment programs.

Assessment of health-related quality of life and psychological well-being of children and adolescents with obesity enrolled in a New Zealand community-based intervention programme: an observational study.

PubMed

Anderson, Yvonne C; Wynter, Lisa E; Treves, Katharine F; Grant, Cameron C; Stewart, Joanna M; Cave, Tami L; Wouldes, Trecia A; Derraik, José G B; Cutfield, Wayne S; Hofman, Paul L

2017-08-09

To describe health-related quality of life (HRQOL) and psychological well-being of children and adolescents at enrolment in a multidisciplinary community-based obesity programme and to determine association with ethnicity. This programme targeted indigenous people and those from most deprived households. Further, this cohort was compared with other populations/normative data. This study examines baseline demographic data of an unblinded randomised controlled clinical trial. Participants (recruited from January 2012-August 2014) resided in Taranaki, New Zealand, and for this study we only included those with a body mass index (BMI) ≥98th percentile (obese). HRQOL and psychological well-being were assessed using the Pediatric Quality of Life Inventory (PedsQL V.4.0 TM ) (parent and child reports), and Achenbach's Child Behavior Checklist (CBCL)/Youth Self Report (YSR). Assessments were undertaken for 233 participants (45% Māori, 45% New Zealand European, 10% other ethnicities, 52% female, 30% from the most deprived household quintile), mean age 10.6 years. The mean BMI SD score (SDS) was 3.12 (range 2.01-5.34). Total PedsQL generic scaled score (parent) was lower (mean=63.4, SD 14.0) than an age-matched group of Australian children without obesity from the Health of Young Victorians study (mean=83.1, SD 12.5). In multivariable models, child and parental generic scaled scores decreased in older children (β=-0.70 and p=0.031, β=-0.64 and p=0.047, respectively). Behavioural difficulties (CBCL/YSR total score) were reported in 43.5% of participants, with the rate of emotional/behavioural difficulties six times higher than reported norms (p<0.001). In this cohort, children and adolescents with obesity had a low HRQOL, and a concerning level of psychological difficulties, irrespective of ethnicity. Obesity itself rather than ethnicity or deprivation appeared to contribute to lower HRQOL scores. This study highlights the importance of psychologist involvement in obesity intervention programmes. Australian NZ Clinical Trials Registry ANZCTR 12611000862943; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The psychological well-being of children orphaned by AIDS in Cape Town, South Africa

PubMed Central

Cluver, Lucie; Gardner, Frances

2006-01-01

Background An estimated 2 million children are parentally bereaved by AIDS in South Africa. Little is known about mental health outcomes for this group. Methods This study aimed to investigate mental health outcomes for urban children living in deprived settlements in Cape Town. 30 orphaned children and 30 matched controls were compared using standardised questionnaires (SDQ) on emotional and behavioural problems, peer and attention difficulties, and prosocial behaviour. The orphan group completed a modified version of a standardised questionnaire (IES-8), measuring Post-Traumatic Stress symptoms. Group differences were tested using t-tests and Pearson's chi-square. Results Both groups scored highly for peer problems, emotional problems and total scores. However, orphans were more likely to view themselves as having no good friends (p = .002), to have marked concentration difficulties (p = .03), and to report frequent somatic symptoms (p = .05), but were less likely to display anger through loss of temper (p = .03). Orphans were more likely to have constant nightmares (p = .01), and 73% scored above the cut-off for Post-Traumatic Stress Disorder. Conclusion Findings suggest important areas for larger-scale research for parentally-bereaved children. PMID:16848910

Using listening difficulty ratings of conditions for speech communication in rooms

NASA Astrophysics Data System (ADS)

Sato, Hiroshi; Bradley, John S.; Morimoto, Masayuki

2005-03-01

The use of listening difficulty ratings of speech communication in rooms is explored because, in common situations, word recognition scores do not discriminate well among conditions that are near to acceptable. In particular, the benefits of early reflections of speech sounds on listening difficulty were investigated and compared to the known benefits to word intelligibility scores. Listening tests were used to assess word intelligibility and perceived listening difficulty of speech in simulated sound fields. The experiments were conducted in three types of sound fields with constant levels of ambient noise: only direct sound, direct sound with early reflections, and direct sound with early reflections and reverberation. The results demonstrate that (1) listening difficulty can better discriminate among these conditions than can word recognition scores; (2) added early reflections increase the effective signal-to-noise ratio equivalent to the added energy in the conditions without reverberation; (3) the benefit of early reflections on difficulty scores is greater than expected from the simple increase in early arriving speech energy with reverberation; (4) word intelligibility tests are most appropriate for conditions with signal-to-noise (S/N) ratios less than 0 dBA, and where S/N is between 0 and 15-dBA S/N, listening difficulty is a more appropriate evaluation tool. .

Age- and sex-related emotional and behavioral problems in children with autism spectrum disorders: comparison with control children.

PubMed

Horiuchi, Fumie; Oka, Yasunori; Uno, Hiroyuki; Kawabe, Kentaro; Okada, Fumi; Saito, Isao; Tanigawa, Takeshi; Ueno, Shu-ichi

2014-07-01

Children with autism spectrum disorders (ASD) often present with emotional and behavioral problems, which could change the clinical course, especially during childhood, and affect future quality of life. The aim of this study was to clarify the age- and sex-related differences of these problems in ASD. The study subjects were 173 patients with ASD (age: 4-16 years) and 173 age- and sex-matched community children (control group). The parent version of the Strengths and Difficulties Questionnaire was used for comparison of the emotional and behavioral problems between the two groups. The Strengths and Difficulties Questionnaire scores were significantly higher in children with ASD than controls at all ages. The score of total difficulties was significantly higher in girls with ASD than in boys, while the score in male controls was significantly higher than in female controls. Age-related differences in emotional and behavioral problems were observed both in children with ASD and controls, but the characteristics were different: in children with ASD, emotional symptoms and peer problems in both sexes and conduct problems in girls increased significantly with age, while none of the problems in the controls changed with age except for a decrease in the score of hyperactivity/inattention developmentally in both sexes. Prosocial behaviors of children with ASD and controls showed small changes with age. Emotional and behavioral problems are common in children with ASD and showed age- and sex-related differences. Our study emphasizes the importance of recognizing those differences among children with ASD for early intervention. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

Cancer-related symptoms predict psychological wellbeing among prostate cancer survivors: results from the PiCTure study.

PubMed

Sharp, Linda; O'Leary, Eamonn; Kinnear, Heather; Gavin, Anna; Drummond, Frances J

2016-03-01

Prostate cancer treatments are associated with a range of symptoms and physical side-effects. Cancer can also adversely impact on psychological wellbeing. Because many prostate cancer-related symptoms and side-effects are potentially modifiable, we investigated associations between symptoms and psychological wellbeing among prostate cancer survivors. Postal questionnaires were distributed to men diagnosed with prostate cancer 2-18 years previously identified through cancer registries. General and prostate cancer-specific symptoms were assessed using the EORTC QLQ-C30 and QLQ-PR25, with higher symptom scores indicating more/worse symptomatology. Psychological wellbeing was assessed by the DASS-21. Associations between symptoms and each outcome were investigated using multivariate logistic regression, controlling for socio-demographic and clinical factors. A total 3348 men participated (response rate = 54%). Seventeen percent (95%CI 15.2%-17.9%), 16% (95%CI 15.1%-17.8%) and 11% (95%CI 9.5%-11.8%) of survivors scored in the range for depression, anxiety and distress on the DASS scales, respectively. In multivariate models, risk of depression on the DASS scale was significantly higher in men with higher urinary and androgen deprivation therapy (ADT)-related symptoms, and higher scores for fatigue, insomnia and financial difficulties. Risk of anxiety on the DASS scale was higher in men with higher scores for urinary, bowel and ADT-related symptoms and fatigue, dyspnoea and financial difficulties. Risk of distress on the DASS scale was positively associated with urinary, bowel and ADT-related symptoms, fatigue, insomnia and financial difficulties. Cancer-related symptoms significantly predict psychological wellbeing among prostate cancer survivors. Greater use of interventions and medications and to alleviate symptoms might improve psychological wellbeing of prostate cancer survivors. Copyright © 2015 John Wiley & Sons, Ltd.

Sexual function after cervical spine surgery: Independent predictors of functional impairment.

PubMed

Keefe, Malla K; Zygourakis, Corinna C; Theologis, Alexander A; Canepa, Emma; Shaw, Jeremy D; Goldman, Lauren H; Burch, Shane; Berven, Sigurd; Chou, Dean; Tay, Bobby; Mummaneni, Praveen; Deviren, Vedat; Ames, Christopher P

2017-02-01

Sexual function (SF) is an important component of patient-focused health related quality of life (HRQoL), but it has not been well studied in spine surgery. This study aims to assess SF after cervical spine surgery and identify predictors of SF. This single-center retrospective study evaluates SF of adults who underwent cervical spine surgery 2007-2012. Predictor variables included demographics, medical/surgical history, operative information, HRQoL measures (Neck Disability Index, SF-12), validated SF surveys [Female Sexual Function Index (FSFI) and Brief Sexual Function Inventory (BSFI) for males], and a study-specific SF questionnaire. 59 patients (31M, 28F; mean age=56±8.4) had significantly lower SF scores compared to age-matched peers: average BSFI = 2.26±1.22 (vs. 06±0.74), average FSFI=13.05±11.42 (<26.55 indicating sexual dysfunction). In men, lower mental SF-12 and higher NDI, back pain, and number of operated levels were associated with lower BSFI scores (all p<0.05). In women, higher total number of medications and pain medications were associated with lower FSFI scores (both p<0.05). 46% of patients reported difficulty performing a sexual position after surgery that they had previously enjoyed. 39% of men had difficulty on top during intercourse, and 32% of participants reported difficulty performing oral sex. 39% of patients reported worse SF, while only 5% reported an improvement in postoperative SF. Men and women who underwent cervical spine surgery had lower SF scores than age-matched peers, likely attributable to general mental health, regional neck disability, back pain, and medications. A large portion of patients reported subjectively worsened SF after surgery. Copyright © 2016 Elsevier Ltd. All rights reserved.

Major Barriers Responsible for Malnutrition in Hemodialysis Patients: Challenges to Optimal Nutrition

PubMed Central

Ekramzadeh, Maryam; Mazloom, Zohreh; Jafari, Peyman; Ayatollahi, Maryam; Sagheb, Mohammad Mahdi

2014-01-01

Background: Nutritional barriers may contribute to malnutrition in hemodialysis (HD) patients. Higher rates of morbidity and mortality rates have been reported in malnourished HD patients. These patients are faced with different challenges affecting their nutritional status. Objectives: The aim of this cross-sectional study was to identify most important barriers responsible for malnutrition in HD patients. Patients and Methods: We randomly selected 255 of 800 stable HD patients from three HD centers with an age range of 18-85 years, who had been on hemodialysis for at least three months without any acute illness. Each patient was interviewed to evaluate malnutrition [subjective global assessment (SGA), malnutrition inflammation score (MIS)], and potential medical, behavioral and socioeconomic barriers. Body composition of patients was checked through bioelectrical impedance analysis (BIA). Routine clinical markers of malnutrition such as serum albumin and total protein were measured using standard automated techniques. Binary logistic regression model was used to find the association between nutritional markers and potential barriers. Results: Patients with higher SGA had lower knowledge about general nutrition [odds ratio (OR), 1.3], potassium (OR, 1.89), difficulty chewing (OR, 1.16), and shopping (OR, 1.16). Those with greater MIS scores had poor appetite (OR, 1.3), depression (OR, 1.21), and difficulty with cooking (OR, 1.15). Lower BCM (body cell mass) was associated with poor appetite (OR, 0.92) and needed help for cooking (OR, 0.88). Patients with higher BFMI (body fat mass index) had insufficient general nutrition (OR, 1.15), and protein (OR, 1.27) knowledge, and needed help for shopping (OR, 1.14). Moreover, patients with higher SGA scores were those with older age and longer duration of HD. Conclusions: Three medical barriers (poor appetite, depression and difficulty chewing), one behavioral barrier (poor total nutrition, protein, and potassium knowledge), and one socioeconomic barrier (needing help for shopping and cooking) were independently associated with nutritional markers. PMID:25738117

The role of public and private natural space in children's social, emotional and behavioural development in Scotland: A longitudinal study.

PubMed

Richardson, Elizabeth A; Pearce, Jamie; Shortt, Niamh K; Mitchell, Richard

2017-10-01

Poor mental health in childhood has implications for health and wellbeing in later life. Natural space may benefit children's social, emotional and behavioural development. We investigated whether neighbourhood natural space and private garden access were related to children's developmental change over time. We asked whether relationships differed between boys and girls, or by household educational status. We analysed longitudinal data for 2909 urban-dwelling children (aged 4 at 2008/9 baseline) from the Growing Up in Scotland (GUS) survey. The survey provided social, emotional and behavioural difficulty scores (Strengths and Difficulties Questionnaire (SDQ)), and private garden access. Area (%) of total natural space and parks within 500m of the child's home was quantified using Scotland's Greenspace Map. Interactions for park area, total natural space area, and private garden access with age and age 2 were modelled to quantify their independent contributions to SDQ score change over time. Private garden access was strongly related to most SDQ domains, while neighbourhood natural space was related to better social outcomes. We found little evidence that neighbourhood natural space or garden access influenced the trajectory of developmental change between 4 and 6 years, suggesting that any beneficial influences had occurred at younger ages. Stratified models showed the importance of parks for boys, and private gardens for the early development of children from low-education households. We conclude that neighbourhood natural space may reduce social, emotional and behavioural difficulties for 4-6 year olds, although private garden access may be most beneficial. Copyright © 2017. Published by Elsevier Inc.

Fluency and Accuracy in Alphabet Writing by Keyboarding: A Cross-Sectional Study in Spanish-Speaking Children with and without Learning Disabilities

ERIC Educational Resources Information Center

Bisschop, Elaine; Morales, Celia; Gil, Verónica; Jiménez-Suárez, Elizabeth

2017-01-01

The aim of this study was to analyze whether children with and without difficulties in handwriting, spelling, or both differed in alphabet writing when using a keyboard. The total sample consisted of 1,333 children from Grades 1 through 3. Scores on the spelling and handwriting factors from the "Early Grade Writing Assessment" (Jiménez,…

Prenatal and Postnatal PCB-153 and p,p'-DDE Exposures and Behavior Scores at 5–9 Years of Age among Children in Greenland and Ukraine.

PubMed

Rosenquist, Aske Hess; Høyer, Birgit Bjerre; Julvez, Jordi; Sunyer, Jordi; Pedersen, Henning Sloth; Lenters, Virissa; Jönsson, Bo A G; Bonde, Jens Peter; Toft, Gunnar

2017-10-03

Studies have reported some evidence of adverse effects of organochlorine exposures on child development, but the results have been inconsistent, and few studies have evaluated associations with child behavior. We investigated the association between prenatal and early-life exposures to 2,2',4,4',5,5'-hexachlorobiphenyl (PCB-153) and 1,1-dichloro-2,2-bis( p -chlorophenyl)-ethylene ( p,p '-DDE) and behaviors in children between 5 and 9 y of age. In the Biopersistent organochlorines in diet and human fertility: Epidemiologic studies of time to pregnancy and semen quality in Inuit and European populations (INUENDO) cohort, consisting of mother-child pairs from Greenland and Ukraine ( n =1,018), maternal serum PCB-153 and p,p '-DDE concentrations were measured during pregnancy, and cumulative postnatal exposures during the first 12 months after delivery were estimated using a pharmacokinetic model. Parents completed the Strengths and Difficulties Questionnaire (SDQ), and children's behaviors were dichotomized as abnormal (high) versus normal/borderline for five SDQ subscales and the total difficulties score. The total difficulties score, an overall measure of abnormal behavior, was not clearly associated with pre- or postnatal exposures to PCB-153 or to p,p '-DDE. However, pooled adjusted odds ratios (ORs) for high conduct problem scores with a doubling of exposure were 1.19 (95% CI: 0.99, 1.42) and 1.16 (95% CI: 0.96, 1.41) for pre- and postnatal PCB-153, respectively, and 1.25 (95% CI: 1.04, 1.51) and 1.24 (95% CI: 1.01, 1.51) for pre- and postnatal p,p '-DDE, respectively. Corresponding ORs for high hyperactivity scores were 1.24 (95% CI: 0.94, 1.62) and 1.08 (95% CI: 0.81, 1.45) for pre- and postnatal PCB-153, respectively, and 1.43 (95% CI: 1.06, 1.92) and 1.27 (95% CI: 0.93, 1.73) for pre- and postnatal p,p '-DDE, respectively. Prenatal and early postnatal exposures to p,p '-DDE and PCB-153 were associated with a higher prevalence of abnormal scores for conduct and hyperactivity at 5–9 y of age in our study population. These findings provide further support for the importance of minimizing organochlorine exposures to young children and to women of childbearing age. https://doi.org/10.1289/EHP553.

Prenatal and Postnatal PCB-153 and p,p′-DDE Exposures and Behavior Scores at 5–9 Years of Age among Children in Greenland and Ukraine

PubMed Central

Høyer, Birgit Bjerre; Julvez, Jordi; Sunyer, Jordi; Pedersen, Henning Sloth; Lenters, Virissa; Jönsson, Bo A.G.; Bonde, Jens Peter; Toft, Gunnar

2017-01-01

Background: Studies have reported some evidence of adverse effects of organochlorine exposures on child development, but the results have been inconsistent, and few studies have evaluated associations with child behavior. Objective: We investigated the association between prenatal and early-life exposures to 2,2′,4,4′,5,5′-hexachlorobiphenyl (PCB-153) and 1,1-dichloro-2,2-bis(p-chlorophenyl)-ethylene (p,p′-DDE) and behaviors in children between 5 and 9 y of age. Methods: In the Biopersistent organochlorines in diet and human fertility: Epidemiologic studies of time to pregnancy and semen quality in Inuit and European populations (INUENDO) cohort, consisting of mother–child pairs from Greenland and Ukraine (n=1,018), maternal serum PCB-153 and p,p′-DDE concentrations were measured during pregnancy, and cumulative postnatal exposures during the first 12 months after delivery were estimated using a pharmacokinetic model. Parents completed the Strengths and Difficulties Questionnaire (SDQ), and children’s behaviors were dichotomized as abnormal (high) versus normal/borderline for five SDQ subscales and the total difficulties score. Results: The total difficulties score, an overall measure of abnormal behavior, was not clearly associated with pre- or postnatal exposures to PCB-153 or to p,p′-DDE. However, pooled adjusted odds ratios (ORs) for high conduct problem scores with a doubling of exposure were 1.19 (95% CI: 0.99, 1.42) and 1.16 (95% CI: 0.96, 1.41) for pre- and postnatal PCB-153, respectively, and 1.25 (95% CI: 1.04, 1.51) and 1.24 (95% CI: 1.01, 1.51) for pre- and postnatal p,p′-DDE, respectively. Corresponding ORs for high hyperactivity scores were 1.24 (95% CI: 0.94, 1.62) and 1.08 (95% CI: 0.81, 1.45) for pre- and postnatal PCB-153, respectively, and 1.43 (95% CI: 1.06, 1.92) and 1.27 (95% CI: 0.93, 1.73) for pre- and postnatal p,p′-DDE, respectively. Conclusion: Prenatal and early postnatal exposures to p,p′-DDE and PCB-153 were associated with a higher prevalence of abnormal scores for conduct and hyperactivity at 5–9 y of age in our study population. These findings provide further support for the importance of minimizing organochlorine exposures to young children and to women of childbearing age. https://doi.org/10.1289/EHP553 PMID:28974479

What Factors Are Associated with Autonomous and Controlled Motivation for Hearing Help-Seekers?

PubMed

Ridgway, Jason; Hickson, Louise; Lind, Christopher

Hearing impairment is prevalent in older adults. Motivation is important in people's choice to seek help for their hearing and whether to adopt or not adopt hearing aids. To investigate associations between sociodemographic and audiometric characteristics and autonomous and controlled motivation among a sample of hearing help-seekers. A quantitative approach was taken for this cross-sectional cohort study. A total of 253 adult first-time hearing help-seekers were recruited to the study. Participants provided sociodemographic information and completed questionnaires adapted from self-determination theory that measured autonomous motivation (motivation that originates from within the self and is aligned with personal values and beliefs) and controlled motivation (motivation that stems from external pressures such as rewards or punishment, or conflicted inner feelings such as guilt or shame). Participants with higher autonomous motivation scores were younger, wanted hearing aids more, and reported greater hearing difficulty in everyday life than those with lower scores. Participants with higher controlled motivation scores were more often referred to the service by others and wanted hearing aids more than those with lower controlled motivation scores. Controlled motivation scores were not associated with perceptions of hearing difficulty in everyday life. Relationships among motivation and sociodemographic factors highlight the importance of characterizing autonomous and controlled motivation in first-time hearing help-seekers. Attention to personal characteristics in order to understand motivational processes involved in rehabilitation decisions such as hearing aid adoption may aid in consultations. American Academy of Audiology

The Context Dependency of the Self-Report Version of the Strength and Difficulties Questionnaire (SDQ): A Cross-Sectional Study between Two Administration Settings

PubMed Central

Hoofs, H.; Jansen, N. W. H.; Mohren, D. C. L.; Jansen, M. W. J.; Kant, I. J.

2015-01-01

Background The Strength and Difficulties Questionnaire (SDQ) is a screening instrument for psychosocial problems in children and adolescents, which is applied in “individual” and “collective” settings. Assessment in the individual setting is confidential for clinical applications, such as preventive child healthcare, while assessment in the collective setting is anonymous and applied in (epidemiological) research. Due to administration differences between the settings it remains unclear whether results and conclusions actually can be used interchangeably. This study therefore aims to investigate whether the SDQ is invariant across settings. Methods Two independent samples were retrieved (mean age = 14.07 years), one from an individual setting (N = 6,594) and one from a collective setting (N = 4,613). The SDQ was administered in the second year of secondary school in both settings. Samples come from the same socio-geographic population in the Netherlands. Results Confirmatory factor analysis showed that the SDQ was measurement invariant/equivalent across settings and gender. On average, children in the individual setting scored lower on total difficulties (mean difference = 2.05) and the psychosocial problems subscales compared to those in the collective setting. This was also reflected in the cut-off points for caseness, defined by the 90th percentiles, which were lower in the individual setting. Using cut-off points from the collective in the individual setting therefore resulted in a small number of cases, 2 to 3%, while ∼10% is expected. Conclusion The SDQ has the same connotation across the individual and collective setting. The observed structural differences regarding the mean scores, however, undermine the validity of the cross-use of absolute SDQ-scores between these settings. Applying cut-off scores from the collective setting in the individual setting could, therefore, result in invalid conclusions and potential misuse of the instrument. To correctly apply cut-off scores these should be retrieved from the applied setting. PMID:25886464

Neurological abnormalities in recent-onset schizophrenia and asperger-syndrome.

PubMed

Hirjak, Dusan; Wolf, Robert Christian; Koch, Sabine C; Mehl, Laura; Kelbel, Janna K; Kubera, Katharina Maria; Traeger, Tanja; Fuchs, Thomas; Thomann, Philipp Arthur

2014-01-01

Neurological abnormalities including a variety of subtle deficits such as discrete impairments in sensory integration, motor coordination (MOCO), and sequencing of complex motor acts are frequently found in patients with schizophrenia (SZ) and commonly referred to as neurological soft signs (NSS). Asperger-syndrome (AS) is characterized by sensory-motor difficulties as well. However, the question whether the two disorders share a common or a disease-specific pattern of NSS remains unresolved. A total of 78 age- and education-matched participants [26 patients with recent-onset SZ, 26 individuals with AS, and 26 healthy controls (HC)] were recruited for the study. Analyses of covariance (ANCOVAs), with age, years of education, and medication included as covariates, were used to examine group differences on total NSS and the five subscale scores. Discriminant analyses were employed to identify the NSS subscales that maximally discriminate between the three groups. Significant differences among the three groups were found in NSS total score and on the five NSS subscales. The clinical groups differed significantly in the NSS subscale MOCO. The correct discriminant rate between patients with SZ and individuals with AS was 61.5%. The correct discriminant rate was 92.3% between individuals with AS and HC, and 80.8% between SZ patients and HC, respectively. Our findings provide new evidence for the presence of NSS in AS and lend further support to previously reported difficulties in movement control in this disorder. According to the present results, SZ and AS seem to be characterized by both quantitative and qualitative NSS expression.

Examining the psychological and social impact of relative age in primary school children: a cross-sectional survey.

PubMed

Price, A; Allen, K; Ukoumunne, O C; Hayes, R; Ford, T

2017-11-01

A number of studies demonstrate that children who are younger within their school year have poorer academic attainment and are more likely to have special educational needs. Few, however, have considered the impact relative age may have on child mental health, behaviour and happiness in school. This paper utilized data from the Supporting Teachers and Children in Schools study (2075 pupils aged 5 to 9 years from 80 primary schools) to explore the relationship among relative age, behaviour and happiness in school. Behavioural and emotional development was assessed by using the teacher-reported and parent-reported Strengths and Difficulties Questionnaire and the Pupil Behaviour Questionnaire. Children's happiness within school was assessed by using the How I Feel About My School Questionnaire. Relatively younger children had higher Total Difficulties scores on the Strengths and Difficulties Questionnaire than their peers. There was a mean increase per 30-day decrease in relative age of 0.09 (95% CI: 0.03 to 0.16; p = 0.007) in teacher-reported and 0.08 (0.001 to 0.16; p = 0.05) in parent-reported scores. There was little evidence of a relationship between relative age and children's behaviour and happiness in school. For children with complex difficulties, being relatively young for their school year may be an additional stressor that may undermine mental health. © 2017 John Wiley & Sons Ltd.

Testing accommodation or modification? The effects of integrated object representation on enhancing geometry performance in children with and without geometry difficulties.

PubMed

Zhang, Dake; Wang, Qiu; Ding, Yi; Liu, Jeremy Jian

2014-01-01

According to the National Council of Teachers of Mathematics, geometry and spatial sense are fundamental components of mathematics learning. However, learning disabilities (LD) research has shown that many K-12 students encounter particular geometry difficulties (GD). This study examined the effect of an integrated object representation (IOR) accommodation on the test performance of students with GD compared to students without GD. Participants were 118 elementary students who took a researcher-developed geometry problem solving test under both a standard testing condition and an IOR accommodation condition. A total of 36 students who were classified with GD scored below 40% correct in the geometry problem solving test in the standard testing condition, and 82 students who were classified without GD scored equal to or above 40% correct in the same test and condition. All students were tested in both standard testing condition and IOR accommodation condition. The results from both ANOVA and regression discontinuity (RD) analyses suggested that students with GD benefited more than students without GD from the IOR accommodation. Implications of the study are discussed in terms of providing accommodations for students with mathematics learning difficulties and recommending RD design in LD research. © Hammill Institute on Disabilities 2013.

The analysis of 146 patients with difficult laparoscopic cholecystectomy

PubMed Central

Bat, Orhan

2015-01-01

Introduction: Laparoscopic cholecystectomy (LC) is very commonly performed surgical intervention. Acute or chronic cholecystitis, adhesions due to previous upper abdomen surgeries, Mirrizi’s syndrome and obesity are common clinical conditions that can be associated with difficult cholecystectomy. In this study, we evaluated and scored the patients with difficult surgical exploration during laparoscopic cholecystectomy. Material and Method: All patients who underwent LC from 2010 to 2015 were retrospectively rewieved. According to intraoperative findings DLC cases were described and classified. Class I difficulty: Adhesion of omentum majus, transverse colon, duodenum to the fundus of the gallbladder. Class II difficulty: Adhesions in Calot’s triangle and difficulty in dissection of cystic artery and cystic duct Class III difficulty: Difficulty in dissection of gallbladder bed (scleroathrophic gallbladder, hemorrhage from liver during dissection of gallbladder, chirotic liver). Class IV difficulty: Difficulty in exploration of gallbladder due to intraabdominal adhesions including technical problems. Results: A total of 146 patients were operated with DLC. The most common difficulty type was Class I difficulty (88 patients/60.2%). Laparoscopic cholecystectomy was converted to laparotomy in 98 patients. Operation time was found to be related with conversion to open surgery (P<0.05). Wound infection rate was also statistically higher in conversion group (P<0.05). The opertion time was found to be longest with Class II difficulty. Conversion rate to open surgery was also highest with Class II difficulty group. Conclusion: Class II difficulty characterized by severe adhesions in calot’s triangle is most serious problem among all DLC cases. They have longer operation time and higher conversion rate. PMID:26629124

Strengths and Difficulties Questionnaire: internal validity and reliability for New Zealand preschoolers.

PubMed

Kersten, Paula; Vandal, Alain C; Elder, Hinemoa; McPherson, Kathryn M

2018-04-21

This observational study examines the internal construct validity, internal consistency and cross-informant reliability of the Strengths and Difficulties Questionnaire (SDQ) in a New Zealand preschool population across four ethnicity strata (New Zealand European, Māori, Pasifika, Asian). Rasch analysis was employed to examine internal validity on a subsample of 1000 children. Internal consistency (n=29 075) and cross-informant reliability (n=17 006) were examined using correlations, intraclass correlation coefficients and Cronbach's alpha on the sample available for such analyses. Data were used from a national SDQ database provided by the funder, pertaining to New Zealand domiciled children aged 4 and 5 and scored by their parents and teachers. The five subscales do not fit the Rasch model (as indicated by the overall fit statistics), contain items that are biased (differential item functioning (DIF)) by key variables, suffer from a floor and ceiling effect and have unacceptable internal consistency. After dealing with DIF, the Total Difficulty scale does fit the Rasch model and has good internal consistency. Parent/teacher inter-rater reliability was unacceptably low for all subscales. The five SDQ subscales are not valid and not suitable for use in their own right in New Zealand. We have provided a conversion table for the Total Difficulty scale, which takes account of bias by ethnic group. Clinicians should use this conversion table in order to reconcile DIF by culture in final scores. It is advisable to use both parents and teachers' feedback when considering children's needs for referral of further assessment. Future work should examine whether validity is impacted by different language versions used in the same country. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Simple and useful evaluation of motor difficulty in childhood (9-12 years old children ) by interview score on motor skills and soft neurological signs--aim for the diagnosis of developmental coordination disorder].

PubMed

Kashiwagi, Mitsuru; Suzuki, Shuhei

2009-09-01

Many children with developmental disorders are known to have motor impairment such as clumsiness and poor physical ability;however, the objective evaluation of such difficulties is not easy in routine clinical practice. In this study, we aimed to establish a simple method for evaluating motor difficulty of childhood. This method employs a scored interview and examination for detecting soft neurological signs (SNSs). After a preliminary survey with 22 normal children, we set the items and the cutoffs for the interview and SNSs. The interview consisted of questions pertaining to 12 items related to a child's motor skills in his/her past and current life, such as skipping, jumping a rope, ball sports, origami, and using chopsticks. The SNS evaluation included 5 tests, namely, standing on one leg with eyes closed, diadochokinesia, associated movements during diadochokinesia, finger opposition test, and laterally fixed gaze. We applied this method to 43 children, including 25 cases of developmental disorders. Children showing significantly high scores in both the interview and SNS were assigned to the "with motor difficulty" group, while those with low scores in both the tests were assigned to the "without motor difficulty" group. The remaining children were assigned to the "with suspicious motor difficulty" group. More than 90% of the children in the "with motor difficulty" group had high impairment scores in Movement Assessment Battery for Children (M-ABC), a standardized motor test, whereas 82% of the children in the "without motor difficulty" group revealed no motor impairment. Thus, we conclude that our simple method and criteria would be useful for the evaluation of motor difficulty of childhood. Further, we have discussed the diagnostic process for developmental coordination disorder using our evaluation method.

Concerns Expressed by Parents of Children with Pervasive Developmental Disorders for Different Time Periods of the Day: A Case–Control Study

PubMed Central

Sasaki, Yoshinori; Usami, Masahide; Sasayama, Daimei; Okada, Takashi; Iwadare, Yoshitaka; Watanabe, Kyota; Ushijima, Hirokage; Tanaka, Tetsuya; Harada, Maiko; Tanaka, Hiromi; Kodaira, Masaki; Sugiyama, Nobuhiro; Sawa, Tetsuji; Saito, Kazuhiko

2015-01-01

Background/Aim The Questionnaire: Children with Difficulties (QCD) is a parent-assessed questionnaire designed to evaluate child’s difficulties in functioning during specific periods of the day. This study aimed to evaluate difficulties in daily functioning of children and adolescents with pervasive developmental disorder (PDD) using the QCD. Results were compared with those for a community sample. Methods A case–control design was used. The cases comprised elementary school students (182 males, 51 females) and junior high school students (100 males, 39 females) with PDD, whereas a community sample of elementary school students (568 males, 579 females) and junior high school students (180 males, 183 females) was enrolled as controls. Their behavior was assessed using the QCD, the Tokyo Autistic Behavior Scale (TABS), the ADHD-rating scale (ADHD-RS), and the Oppositional Defiant Behavior Inventory (ODBI) for elementary and junior high school students, respectively. Effects of gender and diagnosis on the QCD scores were analyzed. Correlation coefficients between QCD and TABS, ADHD-RS, and ODBI scores were analyzed. Results The QCD scores for the children with PDD were significantly lower compared with those from the community sample (P < 0.001). Significantly strong correlations were observed in more areas of the ADHD-RS and ODBI scores compared with the TABS scores. Conclusions Children with PDD experienced greater difficulties in completing basic daily activities; moreover, their QCD scores revealed stronger associations with their ADHD-RS and ODBI scores in comparison with their TABS scores. The difficulties of PDD, ADHD and OBDI symptoms combined in children makes it necessary to assess all diagnoses before any therapy for PDD is initiated in order to be able to evaluate its results properly. PMID:25898260

Balancing the Demands of Two Tasks: An Investigation of Cognitive-Motor Dual-Tasking in Relapsing Remitting Multiple Sclerosis.

PubMed

Butchard-MacDonald, Emma; Paul, Lorna; Evans, Jonathan J

2018-03-01

People with relapsing remitting multiple sclerosis (PwRRMS) suffer disproportionate decrements in gait under dual-task conditions, when walking and a cognitive task are combined. There has been much less investigation of the impact of cognitive demands on balance. This study investigated whether: (1) PwRRMS show disproportionate decrements in postural stability under dual-task conditions compared to healthy controls, and (2) dual-task decrements are associated with everyday dual-tasking difficulties. The impact of mood, fatigue, and disease severity on dual-tasking was also examined. A total of 34 PwRRMS and 34 matched controls completed cognitive (digit span) and balance (movement of center of pressure on Biosway on stable and unstable surfaces) tasks under single- and dual-task conditions. Everyday dual-tasking was measured using the Dual-Tasking Questionnaire. Mood was measured by the Hospital Anxiety & Depression Scale. Fatigue was measured via the Modified Fatigue Index Scale. No differences in age, gender, years of education, estimated pre-morbid IQ, or baseline digit span between groups. Compared with controls, PwRRMS showed significantly greater decrement in postural stability under dual-task conditions on an unstable surface (p=.007), but not a stable surface (p=.679). Balance decrement scores were not correlated with everyday dual-tasking difficulties or fatigue. Stable surface balance decrement scores were significantly associated with levels of anxiety (rho=0.527; p=.001) and depression (rho=0.451; p=.007). RRMS causes dual-tasking difficulties, impacting balance under challenging conditions, which may contribute to increased risk of gait difficulties and falls. The relationship between anxiety/depression and dual-task decrement suggests that emotional factors may be contributing to dual-task difficulties. (JINS, 2018, 24, 247-258).

Predicting the difficulty of a lead extraction procedure: the LED index.

PubMed

Bontempi, Luca; Vassanelli, Francesca; Cerini, Manuel; D'Aloia, Antonio; Vizzardi, Enrico; Gargaro, Alessio; Chiusso, Francesco; Mamedouv, Rashad; Lipari, Alessandro; Curnis, Antonio

2014-08-01

According to recent surveys, many sites performing permanent lead extractions do not meet the minimum prerequisites concerning personnel training, procedures' volume, or facility requirements. The current Heart Rhythm Society consensus on lead extractions suggests that patients should be referred to more experienced sites when a better outcome could be achieved. The purpose of this study was to develop a score aimed at predicting the difficulty of a lead extraction procedure through the analysis of a high-volume center database. This score could help to discriminate patients who should be sent to a referral site. A total of 889 permanent leads were extracted from 469 patients. All procedures were performed from January 2009 to May 2012 by two expert electrophysiologists, at the University Hospital of Brescia. Factors influencing the difficulty of a procedure were assessed using a univariate and a multivariate logistic regression model. The fluoroscopy time of the procedure was taken as an index of difficulty. A Lead Extraction Difficulty (LED) score was defined, considering the strongest predictors. Overall, 873 of 889 (98.2%) leads were completely removed. Major complications were reported in one patient (0.2%) who manifested cardiac tamponade. Minor complications occurred in six (1.3%) patients. No deaths occurred. Median fluoroscopic time was 8.7 min (3.3-17.3). A procedure was classified as difficult when fluoroscopy time was more than 31.2 min [90th percentile (PCTL)].At a univariate analysis, the number of extracted leads and years from implant were significantly associated with an increased risk of fluoroscopy time above 90th PCTL [odds ratio (OR) 1.51, 95% confidence interval (CI) 1.08-2.11, P = 0.01; and OR 1.19, 95% CI 1.12-1.25, P < 0.001, respectively). After adjusting for patient age and sex, and combining with other covariates potentially influencing the extraction procedure, a multivariate analysis confirmed a 71% increased risk of fluoroscopy time above 90th PCTL for each additional lead extracted (OR 1.71, 95% CI 1.06-2.77, P = 0.028) and a 23% increased risk for each year of lead age (OR 1.23, 95% CI 1.15-1.31, P < 0.001). Further nonindependent factors increasing the risk were the presence of active fixation leads and dual-coil implantable cardiac defibrillator leads. Conversely, vegetations significantly favored lead extraction.The LED score was defined as: number of extracted leads within a procedure + lead age (years from implant) + 1 if dual-coil - 1 if vegetation. The LED score independently predicted complex procedure (with fluoroscopic time >90th PCTL) both at univariate and multivariate analysis. A receiver-operating characteristic analysis showed an area under the curve of 0.81. A LED score greater than 10 could predict fluoroscopy time above 90th PCTL with a sensitivity of 78.3% and a specificity of 76.7%. The LED score is easy to compute and potentially predicts fluoroscopy time above 90th PCTL with a relatively high accuracy.

Understanding the Relationship between Social Cognition and Word Difficulty. A Language Based Analysis of Individuals with Autism Spectrum Disorder.

PubMed

Aramaki, E; Shikata, S; Miyabe, M; Usuda, Y; Asada, K; Ayaya, S; Kumagaya, S

2015-01-01

Few quantitative studies have been conducted on the relationship between society and its languages. Individuals with autistic spectrum disorder (ASD) are known to experience social hardships, and a wide range of clinical information about their quality of life has been provided through numerous narrative analyses. However, the narratives of ASD patients have thus far been examined mainly through qualitative approaches. In this study, we analyzed adults with ASD to quantitatively examine the relationship between language abilities and ASD severity scores. We generated phonetic transcriptions of speeches by 16 ASD adults at an ASD workshop, and divided the participants into 2 groups according to their Social Responsiveness Scale(TM), 2nd Edition (SRS(TM)-2) scores (where higher scores represent more severe ASD): Group A comprised high-scoring ASD adults (SRS(TM)-2 score: ≥ 76) and Group B comprised low- and intermediate-scoring ASD adults (SRS(TM)-2 score: < 76). Using natural language processing (NLP)-based analytical methods, the narratives were converted into numerical data according to four language ability indicators, and the relationships between the language ability scores and ASD severity scores were compared. Group A showed a marginally negative correlation with the level of Japanese word difficulty (p < .10), while the "social cognition" subscale of the SRS(TM)-2 score showed a significantly negative correlation (p < .05) with word difficulty. When comparing only male participants, Group A demonstrated a significantly lower correlation with word difficulty level than Group B (p < .10). Social communication was found to be strongly associated with the level of word difficulty in speech. The clinical applications of these findings may be available in the near future, and there is a need for further detailed study on language metrics designed for ASD adults.

Language Outcomes at 7 Years: Early Predictors and Co-Occurring Difficulties.

PubMed

McKean, Cristina; Reilly, Sheena; Bavin, Edith L; Bretherton, Lesley; Cini, Eileen; Conway, Laura; Cook, Fallon; Eadie, Patricia; Prior, Margot; Wake, Melissa; Mensah, Fiona

2017-03-01

To examine at 7 years the language abilities of children, the salience of early life factors and language scores as predictors of language outcome, and co-occurring difficulties METHODS: A longitudinal cohort study of 1910 infants recruited at age 8 to 10 months. Exposures included early life factors (sex, prematurity, birth weight/order, twin birth, socioeconomic status, non-English speaking background,family history of speech/language difficulties); maternal factors (mental health, vocabulary, education, and age); and child language ability at 2 and 4 years. Outcomes were 7-year standardized receptive or expressive language scores (low language: ≥1.25 SD below the mean), and co-occurring difficulties (autism, literacy, social, emotional, and behavioral adjustment, and health-related quality of life). Almost 19% of children (22/1204;18.9%) met criteria for low language at 7 years. Early life factors explained 9-13% of variation in language scores, increasing to 39-58% when child language scores at ages 2 and 4 were included. Early life factors moderately discriminated between children with and without low language (area under the curve: 0.68-0.72), strengthening to good discrimination with language scores at ages 2 and 4 (area under the curve: 0.85-0.94). Low language at age 7 was associated with concurrent difficulties in literacy, social-emotional and behavioral difficulties, and limitations in school and psychosocial functioning. Child language ability at 4 years more accurately predicted low language at 7 than a range of early child, family, and environmental factors. Low language at 7 years was associated with a higher prevalence of co-occurring difficulties. Copyright © 2017 by the American Academy of Pediatrics.

Memory in children with epilepsy: a systematic review.

PubMed

Menlove, Leanne; Reilly, Colin

2015-02-01

Research suggests an increased risk for cognitive impairment in childhood epilepsy with memory being one area of cognition most likely to be affected. Understanding the prevalence and predictors of memory difficulties may help improve awareness of the difficulties and allow efficacious supports to be put in place. A systematic review was carried out using the search terms 'memory', 'children' and 'epilepsy' in the database PUBMED. Eighty-eight studies met inclusion criteria. The review focuses on comparisons of memory scores of children with epilepsy and controls, and comparison of memory scores of children with epilepsy to normative scores. Predictors of memory impairment and the effect of surgery on memory functioning are also reviewed. The majority (78%) of studies reviewed revealed that children with epilepsy scored lower than controls and normative scores on measures of memory. Post-surgery, memory scores were reported to improve in 50% of studies. Predictors of memory impairment included a greater number of AEDs used, younger age of onset, increased seizure frequency and longer duration of epilepsy. Children with epilepsy have a high frequency of memory impairments. However, the exact prevalence of difficulties is not clear due to the lack of population-based data. Most studies have not controlled for IQ and thus it is unclear if difficulties are always related to global cognitive difficulties. There is need for future population-based studies and studies focussing on the neurobiology of memory problems in children with epilepsy. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Development of the caffeine withdrawal symptom questionnaire: caffeine withdrawal symptoms cluster into 7 factors.

PubMed

Juliano, Laura M; Huntley, Edward D; Harrell, Paul T; Westerman, Ashley T

2012-08-01

Habitual caffeine consumers who abstain from caffeine experience withdrawal symptoms such as headache, fatigue, difficulty concentrating, mood disturbances, and flu-like symptoms (Juliano and Griffiths, 2004). The caffeine withdrawal syndrome has been documented across many experimental studies; however, little is known about how withdrawal symptoms co-vary during a discrete episode. Furthermore, a validated measure of caffeine withdrawal is lacking. To develop, evaluate, and reduce a 23-item measure of caffeine withdrawal symptoms; the Caffeine Withdrawal Symptom Questionnaire (CWSQ), to a set of composite variables. Caffeine consumers (N=213) completed the CWSQ after 16h of caffeine abstinence. A subset of participants also completed the CWSQ during a preceding baseline period and/or after double-blind consumption of caffeinated coffee. Principal components analysis resulted in a solution comprised of 7-factors: (1) Fatigue/drowsiness; (2) Low alertness/difficulty concentrating; (3) Mood disturbances; (4) Low sociability/motivation to work; (5) Nausea/upset stomach; (6) Flu-like feelings; and (7) Headache. With the exception of nausea/upset stomach, the CWSQ total score and individual composite scores were significantly greater during caffeine abstinence relative to both baseline and double-blind consumption of caffeinated coffee, thereby demonstrating sensitivity of the measure. Compared to non-daily coffee consumers, daily consumers had greater increases in total withdrawal, fatigue/drowsiness, low alertness/difficulty concentrating, mood disturbances, and headache. Future directions include replication, assessment on a clinical population, and further examination of psychometric properties of the CWSQ. The CWSQ should facilitate the assessment and diagnosis of caffeine withdrawal and increase our knowledge of the caffeine withdrawal syndrome. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

The Impact of Potassium Iodide on Thyroidectomy for Graves’ disease: Implications for Safety and Operative Difficulty

PubMed Central

Randle, Reese W; Bates, Maria F; Long, Kristin L; Pitt, Susan C; Schneider, David F; Sippel, Rebecca S

2017-01-01

Background Potassium iodide (KI) is often prescribed prior to thyroidectomy for Graves’ disease, but the effect of KI on the ease and safety of thyroidectomy for Graves’ is largely unknown. Methods We conducted a prospective cohort study of patients with Graves’ disease undergoing thyroidectomy. For the first 8-months no patients received KI; for the next 8-months, KI was added to the pre-operative protocol for all patients. Outcomes included operative difficulty (based on the Thyroidectomy Difficulty Scale) and complications. Results A total of 31 patients in the no-KI group and 28 in the KI group were included. According to the Thyroidectomy Difficulty Scale, gland vascularity decreased in the KI group (mean score 2.6 vs. 3.3, p=0.04), but there were no significant differences in thyroid friability, fibrosis, size, or overall difficulty (p=NS for all). Despite similar operative difficulty, patients prescribed KI were less likely to experience transient hypoparathyroidism (7.1% vs. 25.9%, p=0.018) and transient hoarseness (0% vs. 16.1%, p=0.009) compared with the no-KI group. Conclusion KI administration decreases gland vascularity but does not change the overall difficulty of thyroidectomy. However, KI was associated with less transient hypoparathyroidism and transient hoarseness, suggesting that KI improves the safety of thyroidectomy for Graves’ disease. PMID:29108701

Consumption of Soft Drinks and Hyperactivity, Mental Distress, and Conduct Problems Among Adolescents in Oslo, Norway

PubMed Central

Lien, Lars; Lien, Nanna; Heyerdahl, Sonja; Thoresen, Magne; Bjertness, Espen

2006-01-01

Objectives. We examined whether high levels of consumption of sugar-containing soft drinks were associated with mental distress, hyperactivity, and conduct problems among adolescents. Methods. A cross-sectional population-based survey was conducted with 10th-grade students in Oslo, Norway (n = 5498). We used the Hopkins Symptom Checklist and the Strengths and Difficulties Questionnaire to assess mental health outcomes. Results. There was a J-shaped dose–response relationship between soft drink consumption and mental distress, conduct problems, and total mental health difficulties score; that is, adolescents who did not consume soft drinks had higher scores (indicating worse symptoms) than those who consumed soft drinks at moderate levels but lower scores than those with high consumption levels. The relationship was linear for hyperactivity. In a logistic regression model, the association between soft drink consumption and mental health problems remained significant after adjustment for behavioral, social, and food-related variables. The highest adjusted odds ratios were observed for conduct problems among boys and girls who consumed 4 or more glasses of sugar-containing soft drinks per day. Conclusions. High consumption levels of sugar-containing soft drinks were associated with mental health problems among adolescents even after adjustment for possible confounders. PMID:17008578

Six months methylphenidate treatment improves emotion dysregulation in adolescents with attention deficit/hyperactivity disorder: a prospective study.

PubMed

Suzer Gamli, Ipek; Tahiroglu, Aysegul Yolga

2018-01-01

Individuals with attention deficit/hyperactivity disorder (ADHD) may suffer from emotional dysregulation (ED), although this symptom is not listed among the diagnostic criteria. Methylphenidate (MPH) is useful in reducing emotional symptoms in ADHD. The aim of the present study was to determine both psychosocial risk factors and presence of ED in adolescents with ADHD before and after MPH treatment. Eighty-two patients aged 12-18 years with ADHD were included as participants. The Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime, the Difficulties in Emotion Regulation Scale (DERS), sociodemographic form, and the Inventory of Statements About Self-Injury were administered. Results were compared before and after 6 months MPH treatment. A significant improvement was detected on DERS for impulsivity (15.9±6.8 initial vs 14.2±6.5 final test, p <0.01) and total score (88.4±23.3 initial vs 82.4±2.7 final test, p <0.05) across all patients taking MPH regardless of subtype and sex. Despite treatment, a significant difference remained for impulsivity, strategies, and total score in patients with comorbid oppositional defiant disorder (ODD) compared with those without ODD, but no difference was detected for conduct disorder comorbidity. In patients who self-harm, scores for goals, impulsivity, strategies, clarity, and total score were higher before treatment: furthermore, impulsivity and total score remained high after treatment. In maltreated patients, goals, impulsivity, strategies, and total scores were significantly higher before treatment; however, their symptoms were ameliorated after treatment with MPH. Individuals with severe ED may "self-medicate" by smoking and/or self-harming. MPH led to significant improvements in ED possibly owing, in part, to a decrease in impulsivity, so that individuals felt more able to supervise their emotions and engage in goal-directed behaviors. ED should be considered particularly in patients with additional psychosocial factors and ODD comorbidity, and included in the treatment plan.

Anatomic severity grading score predicts technical difficulty, early outcomes, and hospital resource utilization of endovascular aortic aneurysm repair.

PubMed

Ahanchi, Sadaf S; Carroll, Megan; Almaroof, Babatunde; Panneton, Jean M

2011-11-01

In 2002, a system for the grading of abdominal aortic aneurysms (AAAs) was developed by the Society for Vascular Surgery (SVS). Because the correlation of the anatomic severity grading (ASG) score to patient outcomes has yet to be validated, we provide our experience with calculating the ASG score using three-dimensional (3-D) image-rendering software and provide the practical translation of this score into early outcomes and hospital charges. All patients who underwent an endovascular aneurysm repair (EVAR) for infrarenal AAAs between 2009 and 2010 were retrospectively reviewed for demographics, intraoperative data, and 30-day outcomes. ASG scores were calculated from morphologic measurements, and two independent patient groups were created: those with a low ASG score (score <14) and a high ASG score (score ≥14). We identified 108 patients (mean age, 75 years), of whom 56 were in the low-score ASG group and 52 were in the high-score ASG group. Operative outcomes significantly different in the low-score group vs high-score group were number of endograft implants (three vs four, P = .001), operative time (113 vs 210 minutes, P < .0001), blood loss (227 vs 866 mL, P = .0002), and contrast volume (100 vs 131 mL, P = .032). In the low-score group compared with the high-score group, access site adjuncts were 14% vs 50% (P < .0001), and intraoperative adjuncts were 54% vs 80% (P = .004). Most adjuncts (75%) were endovascular. No EVARs were converted to open. Mean hospital stay was 2 days for the low-score group and 5 days for the high-score group (P = .012). The 30-day operative mortality was zero. No aneurysm-related deaths occurred during follow-up. In the low-score vs high-score groups, mean operating room supply charge was $16,646 vs $25,765 (P = .006), and the mean total hospital charge was $70,956 vs $105,153 (P = .016). The anatomic severity grading score can be easily and rapidly calculated from computed tomography images with the aid of 3-D image-rendering software. The anatomic severity grading score correlates with the technical difficulty of EVAR and the extent of hospital resource utilization. Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

A case-control study of the difficulties in daily functioning experienced by children with depressive disorder.

PubMed

Usami, Masahide; Iwadare, Yoshitaka; Watanabe, Kyota; Ushijima, Hirokage; Kodaira, Masaki; Okada, Takashi; Sasayama, Daimei; Sugiyama, Nobuhiro; Saito, Kazuhiko

2015-07-01

The parent-assessed children-with-difficulties questionnaire (Questionnaire-Children with Difficulties; QCD) is designed to evaluate a child׳s difficulties in functioning during specific periods of the day. This study aimed to use the QCD to evaluate the difficulties in daily functioning experienced by children with depressive disorders. A case-control design was used. The cases comprised 90 junior high school students with depressive disorder, whereas a community sample of 363 junior high school students was enrolled as controls. Behaviors were assessed using the QCD, Depression Self-Rating Scale (DSRS), Tokyo Autistic Behavior Scale (TABS), attention deficit hyperactivity disorder-rating scale (ADHD-RS), and Oppositional Defiant Behavior Inventory (ODBI). We then analyzed the effects of sex and diagnosis on the QCD scores as well as the correlation coefficients between the QCD and the other questionnaires. We included 90 cases (33 boys, 57 girls) with depressive disorders and 363 controls (180 boys, 183 girls). The QCD scores for the children with depressive disorders were significantly lower compared with those from the community sample (P<0.001). The morning, school-time, and night subscores of the QCD were lower for the children with both depressive disorders and truancy problems than for those with depressive disorders alone (P<0.001). Significant correlations were observed between the following: the night QCD subscore and the DSRS scores among boys, the morning QCD subscore and ADHD-RS inattention scores for all groups, and the evening QCD subscore and the TABS score. Parents reported that children with depressive disorders experienced greater difficulties in completing basic daily activities compared with community controls. These difficulties were dependent on sex, symptoms, and the time of day. The use of QCD to assess children with depressive disorders enables clinicians to clarify the time periods at which the children face difficulties. Copyright © 2015 Elsevier B.V. All rights reserved.

The role of attachment relationship in adolescents' problem behavior development: a cross-sectional study of Kenyan adolescents in Nairobi city.

PubMed

Wambua, Grace Nduku; Obondo, Anne; Bifulco, Antonia; Kumar, Manasi

2018-01-01

There is a significant link between insecure attachment and the development of psychopathology in adolescence. We investigated the relationship between adolescent attachment styles and the development of emotional and behavioral problems among adolescents in Kenya. We also examined the modifying influence of socio-economic-status (SES). One hundred and thirty-seven adolescents who were attending two schools participated in the study. One school (low SES school) catered for children from predominantly low-income households, while the second school (middle SES school) catered for children from predominantly middle-income households. The data were collected using three instruments: researcher designed questionnaire to obtain socio-demographic information, the Strength and Difficulties Questionnaire (SDQ) that is designed to assess symptoms of disorder, and the Vulnerable Attachment Scale Questionnaire (VASQ) that is designed to measure attachment style. Adolescents from the low SES school had higher vulnerable attachment scores than those from the middle SES school ( t (135) = - 2.5, P  =  0.02 ). Male students had higher vulnerable attachment scores than females ( P  =  0.03 ). Adolescents who had experienced adversity in childhood had higher vulnerable attachment scores than those who had not ( P  <  0.00 ). Results from Pearson's correlation showed moderate to strong positive correlations between attachment insecurity and emotional and behavioral problems with participants who had higher emotional symptoms (r = 0.47, P  < 0.01), conduct problem score (r = 0.33, P  < 0.01), hyperactivity (r = 0.26, P  < 0.01) and total difficulty scores (r = 0.47, P  < 0.01), experiencing significantly higher levels of attachment insecurity than those with lower scores. This study supports the notion that attachment insecurity increases the adolescents' susceptibility to develop psychological problems.

Assessment of the global intelligence and selective cognitive capacities in preterm 8-year-old children.

PubMed

Begega, Azucena; Méndez López, Magdalena; de Iscar, María Jesús; Cuesta-Izquierdo, Marcelino; Solís, Gonzalo; Fernández-Colomer, Belén; Álvarez, Luis; Méndez, Marta; Arias, Jorge L

2010-11-01

The aim of this study was to assess various cognitive abilities such as attention, IQ, reasoning, and memory related to academic achievement in 8- and 9-year-old preterm children. A total of 141 children were assessed. The preterm group (=37 weeks) comprised 63 children and was compared to 78 full-term children. Attention was evaluated using the d2 Selective Attention test, and the IQ by the L-M form of the Stanford-Binet Intelligence Scale, establishing a profile of abilities: perception, memory, comprehension, reasoning, and verbal fluency. Significant differences in IQ were found between the preterm and full-term children. Of the cognitive abilities assessed, the only significant differences were found in verbal fluency, with preterm boys showing lower verbal fluency scores than full-term children. In conclusion, all preterm groups have attention ability similar to that of full-term children. However, preterm children obtain lower scores in intelligence measures. In addition, preterm boys have verbal fluency difficulties. Taking into account the increase in preterm births, suitable intervention programs must be planned to attend the difficulties found.

Normative Performance on the Brief Smell Identification Test (BSIT) in a Multi-Ethnic Bilingual Cohort: A Project FRONTIER Study

PubMed Central

Menon, Chloe; Westervelt, Holly James; Jahn, Danielle R.; Dressel, Jeffrey A.; O’Bryant, Sid E.

2013-01-01

The Brief Smell Identification Test (BSIT) is a commonly used measure of olfactory functioning in elderly populations. Few studies have provided normative data for this measure, and minimal data are available regarding the impact of sociodemographic factors on test scores. This study presents normative data for the BSIT in a sample of English- and Spanish-speaking Hispanic and non-Hispanic Whites. A Rasch analysis was also conducted to identify the items that best discriminated between varying levels of olfactory functioning, as measured by the BSIT. The total sample included 302 older adults seen as part of an ongoing study of rural cognitive aging, Project FRONTIER. Hierarchical regression analyses revealed that BSIT scores require adjustment by age and gender, but years of education, ethnicity, and language did not significantly influence BSIT performance. Four items best discriminated between varying levels of smell identification, accounting for 59.44% of total information provided by the measure. However, items did not represent a continuum of difficulty on the BSIT. The results of this study indicate that the BSIT appears to be well-suited for assessing odor identification deficits in older adults of diverse backgrounds, but that fine-tuning of this instrument may be recommended in light of its items’ difficulty and discrimination parameters. Clinical and empirical implications are discussed. PMID:23634698

The roles of working memory and intervening task difficulty in determining the benefits of repetition

PubMed Central

Bui, Dung C.; Maddox, Geoffrey B.; Balota, David A.

2014-01-01

Memory is better when learning events are spaced, as compared with massed (i.e., the spacing effect). Recent theories posit that retrieval of an item’s earlier presentation contributes to the spacing effect, which suggests that individual differences in the ability to retrieve an earlier event may influence the benefit of spaced repetition. The present study examined (1) the difficulty of task demands between repetitions, which should modulate the ability to retrieve the earlier information, and (2) individual differences in working memory in a spaced repetition paradigm. Across two experiments, participants studied a word set twice, each separated by an interval where duration was held constant, and the difficulty of the intervening task was manipulated. After a short retention interval following the second presentation, participants recalled the word set. Those who scored high on working memory measures benefited more from repeated study than did those who scored lower on working memory measures, regardless of task difficulty. Critically, a crossover interaction was observed between working memory and intervening task difficulty: Individuals with low working memory scores benefited more when task difficulty was easy than when it was difficult, but individuals with high working memory scores produced the opposite effect. These results suggest that individual differences in working memory should be considered in optimizing the benefits of repetition learning. PMID:23224905

Basic needs and their predictors for intubated patients in surgical intensive care units.

PubMed

Liu, Jin-Jen; Chou, Fan-Hao; Yeh, Shu-Hui

2009-01-01

This study was conducted to investigate the basic needs and communication difficulties of intubated patients in surgical intensive care units (ICUs) and to identify predictors of the basic needs from the patient characteristics and communication difficulties. In this descriptive correlational study, 80 surgical ICU patients were recruited and interviewed using 3 structured questionnaires: demographic information, scale of basic needs, and scale of communication difficulties. The intubated patients were found to have moderate communication difficulties. The sense of being loved and belonging was the most common need in the intubated patients studied (56.00 standardized scores). A significantly positive correlation was found between communication difficulties and general level of basic needs (r = .53, P < .01), and another positive correlation was found between the length of stay in ICUs and the need for love and belonging (r = .25, P < .05). The basic needs of intubated patients could be significantly predicted by communication difficulties (P = .002), use of physical restraints (P = .010), lack of intubation history (P = .005), and lower educational level (P = .005). These 4 predictors accounted for 47% of the total variance in basic needs. The intubated patients in surgical ICUs had moderate basic needs and communication difficulties. The fact that the basic needs could be predicted by communication difficulties, physical restraints, and educational level suggests that nurses in surgical ICUs need to improve skills of communication and limit the use of physical restraints, especially in patients with a lower educational level.

Psychometric characteristics of Clinical Reasoning Problems (CRPs) and its correlation with routine multiple choice question (MCQ) in Cardiology department

PubMed Central

DERAKHSHANDEH, ZAHRA; AMINI, MITRA; KOJURI, JAVAD; DEHBOZORGIAN, MARZIYEH

2018-01-01

Introduction: Clinical reasoning is one of the most important skills in the process of training a medical student to become an efficient physician. Assessment of the reasoning skills in a medical school program is important to direct students’ learning. One of the tests for measuring the clinical reasoning ability is Clinical Reasoning Problems (CRPs). The major aim of this study is to measure psychometric qualities of CRPs and define correlation between this test and routine MCQ in cardiology department of Shiraz medical school. Methods: This study was a descriptive study conducted on total cardiology residents of Shiraz Medical School. The study population consists of 40 residents in 2014. The routine CRPs and the MCQ tests was designed based on similar objectives and were carried out simultaneously. Reliability, item difficulty, item discrimination, and correlation between each item and the total score of CRPs were all measured by Excel and SPSS software for checking psycometeric CRPs test. Furthermore, we calculated the correlation between CRPs test and MCQ test. The mean differences of CRPs test score between residents’ academic year [second, third and fourth year] were also evaluated by Analysis of variances test (One Way ANOVA) using SPSS software (version 20)(α=0.05). Results: The mean and standard deviation of score in CRPs was 10.19 ±3.39 out of 20; in MCQ, it was 13.15±3.81 out of 20. Item difficulty was in the range of 0.27-0.72; item discrimination was 0.30-0.75 with question No.3 being the exception (that was 0.24). The correlation between each item and the total score of CRP was 0.26-0.87; the correlation between CRPs test and MCQ test was 0.68 (p<0.001). The reliability of the CRPs was 0.72 as calculated by using Cronbach's alpha. The mean score of CRPs was different among residents based on their academic year and this difference was statistically significant (p<0.001). Conclusion: The results of this present investigation revealed that CRPs could be reliable test for measuring clinical reasoning in residents. It can be included in cardiology residency assessment programs. PMID:29344528

Impact of 2013 south Asian haze crisis: study of physical and psychological symptoms and perceived dangerousness of pollution level.

PubMed

Ho, Roger C; Zhang, Melvyn W; Ho, Cyrus S; Pan, Fang; Lu, Yanxia; Sharma, Vijay K

2014-03-19

The widespread forest fires in Indonesia in June 2013 led to widespread haze to neighbouring countries. This is the first study in the medical literature reporting the acute physical and psychological symptoms of the general population during a haze crisis. We evaluated the factors that are associated with psychological stress of haze exposure. This study was conducted between June 21 to June 26, 2013. Participants were recruited by an online recruitment post and snowball sampling techniques. Participants were required to complete an online survey which was composed of demographics questionnaire, physical symptom checklist, perceived dangerous Pollutant Standard Index (PSI) value and views on the N-95 mask and the Impact of Event Scale-Revised (IES-R). A total of 298 participants returned the completed study questionnaire. The respondents reported a mean number of 4.03 physical symptoms (S.D. = 2.6). The five most common physical symptoms include mouth or throat discomfort (68.8%), nose discomfort (64.1%), eye discomfort (60.7%), headache (50.3%) and breathing difficulty (40.3%). The total IES-R score was 18.47 (S.D. = 11.69) which indicated that the study population experienced mild psychological stress but not to the extent of acute stress reaction syndrome. The perceived dangerous PSI level and number of physical symptoms were significantly associated with the mean intrusion score, mean hyper-arousal score, total mean IES-R score and total IES-R score (p < 0.05). Our findings suggest that a haze crisis is associated with acute physical symptoms and mild psychological stress. The number of physical symptoms and the perceived dangerous PSI values are important factors associated with psychological stress.

Impact of 2013 south Asian haze crisis: study of physical and psychological symptoms and perceived dangerousness of pollution level

PubMed Central

2014-01-01

Background The widespread forest fires in Indonesia in June 2013 led to widespread haze to neighbouring countries. This is the first study in the medical literature reporting the acute physical and psychological symptoms of the general population during a haze crisis. We evaluated the factors that are associated with psychological stress of haze exposure. Methods This study was conducted between June 21 to June 26, 2013. Participants were recruited by an online recruitment post and snowball sampling techniques. Participants were required to complete an online survey which was composed of demographics questionnaire, physical symptom checklist, perceived dangerous Pollutant Standard Index (PSI) value and views on the N-95 mask and the Impact of Event Scale-Revised (IES-R). Results A total of 298 participants returned the completed study questionnaire. The respondents reported a mean number of 4.03 physical symptoms (S.D. = 2.6). The five most common physical symptoms include mouth or throat discomfort (68.8%), nose discomfort (64.1%), eye discomfort (60.7%), headache (50.3%) and breathing difficulty (40.3%). The total IES-R score was 18.47 (S.D. = 11.69) which indicated that the study population experienced mild psychological stress but not to the extent of acute stress reaction syndrome. The perceived dangerous PSI level and number of physical symptoms were significantly associated with the mean intrusion score, mean hyper-arousal score, total mean IES-R score and total IES-R score (p < 0.05). Conclusions Our findings suggest that a haze crisis is associated with acute physical symptoms and mild psychological stress. The number of physical symptoms and the perceived dangerous PSI values are important factors associated with psychological stress. PMID:24642046

Neurological Abnormalities in Recent-Onset Schizophrenia and Asperger-Syndrome

PubMed Central

Hirjak, Dusan; Wolf, Robert Christian; Koch, Sabine C.; Mehl, Laura; Kelbel, Janna K.; Kubera, Katharina Maria; Traeger, Tanja; Fuchs, Thomas; Thomann, Philipp Arthur

2014-01-01

Background: Neurological abnormalities including a variety of subtle deficits such as discrete impairments in sensory integration, motor coordination (MOCO), and sequencing of complex motor acts are frequently found in patients with schizophrenia (SZ) and commonly referred to as neurological soft signs (NSS). Asperger-syndrome (AS) is characterized by sensory-motor difficulties as well. However, the question whether the two disorders share a common or a disease-specific pattern of NSS remains unresolved. Method: A total of 78 age- and education-matched participants [26 patients with recent-onset SZ, 26 individuals with AS, and 26 healthy controls (HC)] were recruited for the study. Analyses of covariance (ANCOVAs), with age, years of education, and medication included as covariates, were used to examine group differences on total NSS and the five subscale scores. Discriminant analyses were employed to identify the NSS subscales that maximally discriminate between the three groups. Results: Significant differences among the three groups were found in NSS total score and on the five NSS subscales. The clinical groups differed significantly in the NSS subscale MOCO. The correct discriminant rate between patients with SZ and individuals with AS was 61.5%. The correct discriminant rate was 92.3% between individuals with AS and HC, and 80.8% between SZ patients and HC, respectively. Conclusion: Our findings provide new evidence for the presence of NSS in AS and lend further support to previously reported difficulties in movement control in this disorder. According to the present results, SZ and AS seem to be characterized by both quantitative and qualitative NSS expression. PMID:25147527

Prevalence and Factors Associated with Female Sexual Dysfunction in Beijing, China

PubMed Central

Lou, Wen-Jia; Chen, Bo; Zhu, Lan; Han, Shao-Mei; Xu, Tao; Lang, Jing-He; Zhang, Lei

2017-01-01

Background: Female sexual dysfunction (FSD) is a highly prevalent and often underestimated problem. However, large-scale, population-based epidemiological surveys of FSD are scarce in China. The present study was conducted to evaluate the prevalence and the potential risk factors of FSD across a selection of social groups in Beijing, China, based on the Female Sexual Function Index (FSFI). Methods: A cross-sectional study based on the multiple-stage cluster sampling was performed with adult women throughout the Dongcheng and Shunyi districts of Beijing. The Chinese version of FSFI was used, as well as questions on demographic characteristics, the disease-related context, and social relationships. Results: A total of 6000 consecutive women entered this study, with an actual response from 5024 women, corresponding to a response rate of 83.7%. A total of 4697 (78.3%) questionnaires were effective. The prevalence of adult FSD in Beijing was 2973 (63.3%) using a score of 26.55 as the boundary value, whereas the total mean FSFI score was 23.92 ± 6.37. However, 1423 (30.3%) women did not seek help. By multivariate logistic regression analysis, the possible potential risk factors included age (odds ratio [OR] = 1.051), dissatisfaction with the spouse's sexual ability (OR = 3.520), poor marital affection (OR = 2.087), spouse sexual difficulties (OR = 1.720), dissatisfaction with married life (OR = 1.476), living in a rural area (OR = 1.292), chronic pelvic pain (OR = 1.261), chronic disease (OR = 1.534), previous pelvic surgery (OR = 1.605), vaginal delivery (OR = 2.285), lower education (OR = 3.449) and postmenopausal (OR = 3.183). Conclusions: As suggested by the FSFI scores, female sexual problems are highly prevalent in Beijing. Dissatisfaction with the spouse's sexual ability, poor marital affection, sexual difficulties of the spouse, dissatisfaction with the marriage, rural life, CPP, and postmenopausal were conceivable risk factors for FSD in Beijing women. PMID:28584199

Percutaneous Coronary Revascularization for Chronic Total Occlusions: A Novel Predictive Score of Technical Failure Using Advanced Technologies.

PubMed

Galassi, Alfredo R; Boukhris, Marouane; Azzarelli, Salvatore; Castaing, Marine; Marzà, Francesco; Tomasello, Salvatore D

2016-05-09

The aims of this study were to describe the 10-year experience of a single operator dedicated to chronic total occlusion (CTO) and to establish a model for predicting technical failure. During the last decade, the interest in percutaneous coronary interventions (PCIs) of chronic total occlusions (CTOs) has increased, allowing the improvement of success rate. One thousand nineteen patients with CTO underwent 1,073 CTO procedures performed by a single CTO-dedicated operator. The study population was subdivided into 2 groups by time period: period 1 (January 2005 to December 2009, n = 378) and period 2 (January 2010 to December 2014, n = 641). Observations were randomly assigned to a derivation set and a validation set (in a 2:1 ratio). A prediction score was established by assigning points for each independent predictor of technical failure in the derivation set according to the beta coefficient and summing all points accrued. Lesions attempted in period 2 were more complex in comparison with those in period 1. Compared with period 1, both technical and clinical success rates significantly improved (from 87.8% to 94.4% [p = 0.001] and from 77.6% to 89.9% [p < 0.001], respectively). A prediction score for technical failure including age ≥75 years (1 point), ostial location (1 point), and collateral filling Rentrop grade <2 (2 points) was established, stratifying procedures into 4 difficulty groups: easy (0), intermediate (1), difficult (2), and very difficult (3 or 4), with decreasing technical success rates. In derivation and validation sets, areas under the curve were comparable (0.728 and 0.772, respectively). With growing expertise, the success rate has increased despite increasing complexity of attempted lesions. The established model predicted the probability of technical failure and thus might be applied to grading the difficulty of CTO procedures. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Difficulty buying food, BMI, and eating habits in young children.

PubMed

Fuller, Anne; Maguire, Jonathon L; Carsley, Sarah; Chen, Yang; Lebovic, Gerald; Omand, Jessica; Parkin, Patricia; Birken, Catherine S

2018-01-22

To determine whether parent report of difficulty buying food was associated with child body mass index (BMI) z-score or with eating habits in young children. This was a cross-sectional study in primary care offices in Toronto, Ontario. Subjects were children aged 1-5 years and their caregivers, recruited through the TARGet Kids! Research Network from July 2008 to August 2011. Regression models were developed to test the association between parent report of difficulty buying food because of cost and the following outcomes: child BMI z-score, parent's report of child's intake of fruit and vegetables, fruit juice and sweetened beverages, and fast food. Confounders included child's age, sex, birth weight, maternal BMI, education, ethnicity, immigration status, and neighbourhood income. The study sample consisted of 3333 children. Data on difficulty buying food were available for 3099 children, and 431 of these (13.9%) were from households reporting difficulty buying food. There was no association with child BMI z-score (p = 0.86). Children from households reporting difficulty buying food (compared with never having difficulty buying food) had increased odds of consuming three or fewer servings of fruits and vegetables per day (odds ratio [OR]: 1.31, 95% confidence interval [CI]: 1.03-1.69), more than one serving of fruit juice/sweetened beverage per day (OR: 1.60, 95% CI: 1.28-2.00), and, among children 1-2 years old, one or more servings of fast food per week (OR: 2.91, 95% CI: 1.67-5.08). Parental report of difficulty buying food is associated with less optimal eating habits in children but not with BMI z-score.

Cross-sectional study on the relationship between life events and mental health of secondary school students in Shanghai, China.

PubMed

Zhou, Linlin; Fan, Juan; Du, Yasong

2012-06-01

The relationship of demographic factors and negative life events to the mental health of mainland Chinese school students has not been fully explored. Assess the prevalence of different types of life stressors among secondary school students and identify the demographic characteristics and types of life events that are most closely associated with perceived psychological difficulties in these students. This cross-sectional study administered two self-completion questionnaires to a stratified random cluster sample of 1818 students from four secondary schools in two districts of Shanghai: the Strengths and Difficulties Questionnaire (SDQ) and an abbreviated version of the Adolescent Self-rating Life Events Checklist (ASLEC) that assesses 11 negative life events. Academic stress (74%), criticism from others (66%), family conflict (29%) and peer bullying & discrimination or interpersonal conflict (26%) were the most frequently reported negative life events, but their prevalence varied significantly by gender, type of school and urban versus rural residence. Similarly the level of reported psychological stress associated with life events, the total perceived psychological difficulty, and the level of pro-social behavior in the students varied significantly between different groups of students. Multivariate linear regression analysis identified the following independent predictors of high perceived psychological difficulty in the prior 6 months (in order of importance): high total stress score from negative life events in the prior year, experiencing peer bullying & discrimination or interpersonal conflict, not experiencing the death of a family member, male gender, attending a school in a rural district, and not suffering from a major disease or physical impairment. The independent predictors of a high level of pro-social behavior were high total stress score from negative life events, attending an urban school, female gender, attending a regular-tier school (vs. a high-tier school), experiencing peer bullying & discrimination or interpersonal conflict, not experiencing the death of a family member, and attending a middle school (vs. a high school). Negative life events are one of many factors associated with perceived stress and level of pro-social behavior in secondary school students. Prospective studies are needed to clarify the causal pathways that connect stress with negative life events in students and to develop and test cohort-specific interventions aimed at decreasing stress and increasing pro-social behaviors.

Cross-sectional study on the relationship between life events and mental health of secondary school students in Shanghai, China

PubMed Central

Zhou, Linlin; Fan, Juan; Du, Yasong

2012-01-01

Background The relationship of demographic factors and negative life events to the mental health of mainland Chinese school students has not been fully explored. Aim Assess the prevalence of different types of life stressors among secondary school students and identify the demographic characteristics and types of life events that are most closely associated with perceived psychological difficulties in these students. Methods This cross-sectional study administered two self-completion questionnaires to a stratified random cluster sample of 1818 students from four secondary schools in two districts of Shanghai: the Strengths and Difficulties Questionnaire (SDQ) and an abbreviated version of the Adolescent Self-rating Life Events Checklist (ASLEC) that assesses 11 negative life events. Results Academic stress (74%), criticism from others (66%), family conflict (29%) and peer bullying & discrimination or interpersonal conflict (26%) were the most frequently reported negative life events, but their prevalence varied significantly by gender, type of school and urban versus rural residence. Similarly the level of reported psychological stress associated with life events, the total perceived psychological difficulty, and the level of pro-social behavior in the students varied significantly between different groups of students. Multivariate linear regression analysis identified the following independent predictors of high perceived psychological difficulty in the prior 6 months (in order of importance): high total stress score from negative life events in the prior year, experiencing peer bullying & discrimination or interpersonal conflict, not experiencing the death of a family member, male gender, attending a school in a rural district, and not suffering from a major disease or physical impairment. The independent predictors of a high level of pro-social behavior were high total stress score from negative life events, attending an urban school, female gender, attending a regular-tier school (vs. a high-tier school), experiencing peer bullying & discrimination or interpersonal conflict, not experiencing the death of a family member, and attending a middle school (vs. a high school). Conclusion Negative life events are one of many factors associated with perceived stress and level of pro-social behavior in secondary school students. Prospective studies are needed to clarify the causal pathways that connect stress with negative life events in students and to develop and test cohort-specific interventions aimed at decreasing stress and increasing pro-social behaviors. PMID:25324621

Surgical management of congenital heart disease: evaluation according to the Aristotle score.

PubMed

Heinrichs, Jutta; Sinzobahamvya, Nicodème; Arenz, Claudia; Kallikourdis, Antonios; Photiadis, Joachim; Schindler, Ehrenfried; Hraska, Vicktor; Asfour, Boulos

2010-01-01

The Aristotle basic complexity (ABC) score (1.5-15 points) is the sum of potentials for early mortality, morbidity and anticipated surgical technique difficulty. The Aristotle comprehensive complexity (ACC) score (1.5-25 points) is the sum of ABC score and patient-adjusted complexity score; it comprises six complexity levels. We used the ACC score to evaluate quality in surgical management of congenital heart disease. Procedures performed in year 2002 and 2007 were analysed. Proportion of procedures requiring at least 1 week of stay in the intensive care unit was chosen as the marker of morbidity. We adopted threshold duration of 120 min for cardio-pulmonary bypass (CPB) cases and the same duration for operations without CPB as surrogate of surgical technical difficulty. The ACC scores were correlated to mortality, morbidity and technical difficulty. This study included 758 patients who underwent 787 primary procedures. The mean ABC and ACC scores amounted to 7.61+/-2.46 and 9.51+/-3.84. Early mortality was 3.05% (24/787), 95% confidence interval (CI): 1.97-4.51%. Zero at ACC levels 1 and 2, it increased from 1.2% (2/161) for level 3 up to 22.2% (2/9) for level 6. Morbidity index was evaluated at 25.9% (204/787), 95% CI: 22.9-29.1%. 1.9% at level 1, it escalated up to 77.8% at level 6. Index of technique difficulty was estimated at 35.2% (277/787), 95% CI: 31.8-38.6%, ranging from 4.8% for level 1 to 66.7% for level 6. A high correlation was found between the ACC scores and mortality, indices of morbidity and technique difficulty, Spearman's correlation coefficient r being 0.9856, 1 and 0.9429, respectively. Mortality (p=0.037) and morbidity (p=0.041) were lower in year 2007 than in 2002 with ABC (p=0.18) and ACC (p=0.37) surgical performance being not significantly different. The Aristotle score is still under development. Morbidity evaluation should be ideally based on observed postoperative complications; estimation of surgical technical difficulty chosen in this study may not be generalised. Nevertheless, the actual Aristotle comprehensive complexity score, as evaluated in its three components, accurately determined the outcome of surgical management of congenital heart disease. It appears to be an adequate tool to evaluate quality in paediatric cardiac surgery, over time. Copyright 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

The cross-lagged relationship between father absence and child problem behaviour in the early years.

PubMed

Flouri, E; Narayanan, M K; Midouhas, E

2015-11-01

Father absence has negative consequences for children's behaviour. Yet research has not examined how father absence and child behaviour may influence each other. This study models the cross-lagged relationship between father absence (non-residence) and child problem behaviour in the early years. We used data from the UK's Millennium Cohort Study, at children's ages 3, 5 and 7 years (Sweeps 2-4). The sample was 15,293 families in which both biological parents were co-resident at Sweep 1, when the child was aged 9 months. Child problem behaviour was assessed using the clinical cut-offs of the Strengths and Difficulties Questionnaire (SDQ). We also investigated gender differences in the association between father absence and problem behaviour. Father absence at age 3 predicted a higher probability of the child scoring above cut-off for total difficulties at age 5, as did father absence at age 5 for total difficulties at age 7. There were no significant effects for total difficulties on father absence. Similar father absence effects were found for individual SDQ subscales. Using these subscales, we found few child behaviour effects, mostly during the preschool years: children's severe externalizing and social (but not emotional) problems were associated with a greater probability of the father being absent in the next sweep. All cross-lagged relationships were similar for boys and girls. Father absence seems to be mainly the cause rather than the outcome of child problem behaviour in young UK families, and to affect boys and girls similarly. There were some child (mostly externalizing) behaviour effects on father absence, particularly in the early years. © 2015 John Wiley & Sons Ltd.

The cross‐lagged relationship between father absence and child problem behaviour in the early years

PubMed Central

Narayanan, M. K.; Midouhas, E.

2015-01-01

Abstract Background Father absence has negative consequences for children's behaviour. Yet research has not examined how father absence and child behaviour may influence each other. This study models the cross‐lagged relationship between father absence (non‐residence) and child problem behaviour in the early years. Methods We used data from the UK's Millennium Cohort Study, at children's ages 3, 5 and 7 years (Sweeps 2–4). The sample was 15 293 families in which both biological parents were co‐resident at Sweep 1, when the child was aged 9 months. Child problem behaviour was assessed using the clinical cut‐offs of the Strengths and Difficulties Questionnaire (SDQ). We also investigated gender differences in the association between father absence and problem behaviour. Results Father absence at age 3 predicted a higher probability of the child scoring above cut‐off for total difficulties at age 5, as did father absence at age 5 for total difficulties at age 7. There were no significant effects for total difficulties on father absence. Similar father absence effects were found for individual SDQ subscales. Using these subscales, we found few child behaviour effects, mostly during the preschool years: children's severe externalizing and social (but not emotional) problems were associated with a greater probability of the father being absent in the next sweep. All cross‐lagged relationships were similar for boys and girls. Conclusions Father absence seems to be mainly the cause rather than the outcome of child problem behaviour in young UK families, and to affect boys and girls similarly. There were some child (mostly externalizing) behaviour effects on father absence, particularly in the early years. PMID:25708874

[Prevalence of emotional and behavioral symptomatology in Spanish adolescents].

PubMed

Ortuño-Sierra, Javier; Fonseca-Pedrero, Eduardo; Paíno, Mercedes; Aritio-Solana, Rebeca

2014-01-01

The main purpose of this study was to examine the prevalence of symptoms of an emotional and behavioral nature, as well as prosocial type capabilities, measured using the Strengths and Difficulties Questionnaire, in non-clinical adolescents. The final sample was composed of a total of 508 students, 208 male (40.9%). The age of participants ranged from 11 to 18 years (M=13.91 years; SD=1.71). The results show that a significant number of adolescents self-reported emotional and behavioral problems. The mean scores of the Strengths and Difficulties Questionnaire subscales varied according the gender and age of the adolescents. In the present study, the prevalence of psychological difficulties among adolescents was similar to that reported in other national and international studies. In view of these results, there is a need to develop programs for the early detection of these types of problems in schools in children and adolescents ages. Copyright © 2013 SEP y SEPB. Published by Elsevier España. All rights reserved.

History of Not Completing Courses as Predictor of Academic Difficulty among First-Year Students.

ERIC Educational Resources Information Center

Jackson, Evelyn W.; Dawson-Saunders, Beth

1987-01-01

A study found that variables significant in predicting minority students with academic difficulty include science grade-point average, Medical College Admission Test (MCAT) reading subtest score, and number of course withdrawals. For majority students, they include MCAT biology subtest score and number of incompletes taken in courses. (MSE)

Alexithymia associated with nightmare distress in idiopathic REM sleep behavior disorder.

PubMed

Godin, Isabelle; Montplaisir, Jaques; Gagnon, Jean-François; Nielsen, Tore

2013-12-01

Idiopathic REM sleep behavior disorder (iRBD) is characterized by atypical REM sleep motor activity, vivid dreams and nightmares, and dream-enacting behaviors that can result in injuries to the patient and bed partner. It is also a known predictor of Parkinson disease (PD). Alexithymia has been associated with disturbances in sleep and dreaming (e.g., nightmares) and is a non-motor symptom of PD. We assessed alexithymia and disturbed dreaming in iRBD patients with the aim of determining if these two factors are elevated and interrelated among this population. Questionnaire study of clinically diagnosed patients. Clinical sleep disorders center. Thirty-two iRBD patients and 30 healthy age- and sex-matched control participants. Participants completed the 20-item Toronto Alexithymia Scale (TAS-20), the Dream Questionnaire, and the Beck Depression Inventory. iRBD patients obtained higher TAS-20 total scores (62.16 ± 13.90) than did controls (52.84 ± 7.62; F 1,59 = 10.44, P < 0.01), even when controlling for depressive symptoms, and more frequently attained the suggested cutoff for alexithymia than did controls (P < 0.01). iRBD patients obtained higher scores on the Difficulty Identifying Feelings alexithymia subscale. For both iRBD and control groups, the Difficulty Indentifying Feelings subscale correlated positively with the Nightmare Distress scale of the Dream Questionnaire. Elevated alexithymia scores among idiopathic rapid eye movement sleep behavior disorder patients, and especially a difficulty in identifying feelings, parallels evidence of dysautonomia in this population. The higher incidence of distressing nightmares and the association of nightmares with alexithymia further extend similar findings for both clinical and non-clinical samples and suggest that an affect regulation disturbance may be common to the two sets of symptoms.

The relationship between sarcopenia,undernutrition, physical mobility and basic activities of daily living in a group of elderly women of Mexico City.

PubMed

Velázquez Alva, María del Consuelo; Irigoyen Camacho, Maria Esther; Delgadillo Velázquez, Jaime; Lazarevich, Irina

2013-01-01

Sarcopenia is a geriatric syndrome, which affects the functional status and mobility of individuals. To identify the prevalence of sarcopenia and undernutrition, and to assess the association between sarcopenia and mobility, and sarcopenia and basic activities of daily living (ADL) in a group of elderly women. A cross-sectional study was performed in patients attending a geriatric service at a government hospital in Mexico City. Sarcopenia was identified applying Baumgartner's equation by obtaining skeletal muscle mass index (SMI) and undernutrition was diagnosed using mini-nutritional assessment instrument (MNA). The SENECA questionnaire and Katz index were used to evaluate mobility and ADL, respectively. lineal regression models were constructed fitting SMI as a dependent variable and SENECA, and ADL scores as independent variables, adjusted for age. 90 women with a mean age of 78.2 (± 6.8) were studied. Undernutrition was identified in 15.5% of the patients. The prevalence of sarcopenia was 41.1%. Patients with sarcopenia presented a high prevalence of undernutrition (p < 0.001). Sarcopenia was associated with difficulty in climbing stairs (OR = 2.63, p = 0.03), adjusted for age. The mobility score was associated with sarcopenia, in the group without sarcopenia the mean score was 16.3, and with sarcopenia it was 18.3, (p = 0.04). Regarding ADL, 64.9% of the patients with intermediate independence and dependence had sarcopenia, while 35.1% with total independence presented sarcopenia (p < 0.001). The elder women with sarcopenia had a higher prevalence of undernutrition. Sarcopenia was associated with difficulties in mobility, particularly difficulties in climbing stairs. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

Encountering unexpected difficult airway: relationship with the intubation difficulty scale

PubMed Central

Koh, Wonuk; Kim, Hajung; Kim, Kyongsun; Ro, Young-Jin

2016-01-01

Background An unexpected difficult intubation can be very challenging and if it is not managed properly, it may expose the encountered patient to significant risks. The intubation difficulty scale (IDS) has been used as a validated method to evaluate a global degree of intubation difficulty. The aims of this study were to evaluate the prevalence and characteristics of unexpected difficult intubation using the IDS. Methods We retrospectively reviewed 951 patients undergoing elective surgery in a single medical center. Patients expected to have a difficult intubation or who had history of difficult intubation were excluded. Each patient was assessed by the IDS scoring system with seven variables. Total prevalence of difficult intubation and the contributing individual factors were further analyzed. Results For the 951 patients, the difficult intubation cases presenting IDS > 5 was 5.8% of total cases (n = 55). The prevalence of Cormack-Lehane Grade 3 or 4 was 16.2% (n = 154). Most of the difficult intubation cases were managed by simple additional maneuvers and techniques such as stylet application, additional lifting force and laryngeal pressure. Conclusions Unexpected difficult airway was present in 5.8% of patients and most was managed effectively. Among the components of IDS, the Cormack-Lehane grade was most sensitive for predicting difficult intubation. PMID:27274369

Correcting the MoCA for education: effect on sensitivity.

PubMed

Gagnon, Genevieve; Hansen, Kevin T; Woolmore-Goodwin, Sarah; Gutmanis, Iris; Wells, Jennie; Borrie, Michael; Fogarty, Jennifer

2013-09-01

The goal of this study was to quantify the impact of the suggested education correction on the sensitivity and specificity of the Montreal Cognitive Assessment (MoCA). Twenty-five outpatients with dementia and 39 with amnestic mild cognitive impairment (aMCI) underwent a diagnostic evaluation, which included the MoCA. Thirty-seven healthy controls also completed the MoCA and psychiatric, medical, neurological, functional, and cognitive difficulties were ruled out. For the total MoCA score, unadjusted for education, a cut-off score of 26 yielded the best balance between sensitivity and specificity (80% and 89% respectively) in identifying cognitive impairment (people with either dementia or aMCI, versus controls). When applying the education correction, sensitivity decreased from 80% to 69% for a small specificity increase (89% to 92%). The cut-off score yielding the best balance between sensitivity and specificity for the education adjusted MoCA score fell to 25 (61% and 97%, respectively). Adjusting the MoCA total score for education had a detrimental effect on sensitivity with only a slight increase in specificity. Clinically, this loss in sensitivity can lead to an increased number of false negatives, as education level does not always correlate to premorbid intellectual function. Clinical judgment about premorbid status should guide interpretation. However, as this effect may be cohort specific, age and education corrected norms and cut-offs should be developed to help guide MoCA interpretation.

Are behaviour problems in extremely low-birthweight children related to their motor ability?

PubMed

Danks, Marcella; Cherry, Kate; Burns, Yvonne R; Gray, Peter H

2017-04-01

To investigate whether behaviour problems are independently related to mild motor impairment in 11-13-year-old children born preterm with extremely low birthweight (ELBW). The cross-sectional study included 48 (27 males) non-disabled, otherwise healthy ELBW children (<1000 g) and 55 (28 males) term-born peers. Parents reported behaviour using the Child Behaviour Checklist (CBCL). Children completed the Movement Assessment Battery for Children (Movement ABC). Extremely low birthweight children had poorer behaviour scores (CBCL Total Problem T score: mean difference = 5.89, 95% confidence interval = 10.29, 1.49, p = 0.009) and Movement ABC Total Motor Impairment Scores (ELBW group median = 17.5, IQR = 12.3; term-born group median = 7.5, IQR = 9, p < 0.01) than term-born peers. Behaviour was related to motor score (regression coefficient 2.16; 95% confidence interval 0.34, 3.97, p = 0.02) independent of gender, socio-economic factors or birthweight. Motor score had the strongest association with attention (ρ = 0.51; p < 0.01) and social behaviours (ρ = 0.50; p < 0.01). Behaviour problems of otherwise healthy 11- to 13-year-old ELBW children are not related to prematurity independent of their motor difficulties. Supporting improved motor competence in ELBW preteen children may support improved behaviour, particularly attention and social behaviours. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Childhood maltreatment severity and alcohol use in adult psychiatric inpatients: The mediating role of emotion regulation difficulties.

PubMed

Dutcher, Christina D; Vujanovic, Anka A; Paulus, Daniel J; Bartlett, Brooke A

2017-09-01

Emotion regulation difficulties are a potentially key mechanism underlying the association between childhood maltreatment and alcohol use in adulthood. The current study examined the mediating role of emotion regulation difficulties in the association between childhood maltreatment severity (i.e., Childhood Trauma Questionnaire total score) and past-month alcohol use severity, including alcohol consumption frequency and alcohol-related problems (i.e., number of days of alcohol problems, ratings of "bother" caused by alcohol problems, ratings of treatment importance for alcohol problems). Participants included 111 acute-care psychiatric inpatients (45.0% female; Mage=33.5, SD=10.6), who reported at least one DSM-5 posttraumatic stress disorder Criterion A traumatic event, indexed via the Life Events Checklist for DSM-5. Participants completed questionnaires regarding childhood maltreatment, emotion regulation difficulties, and alcohol use. A significant indirect effect of childhood maltreatment severity via emotion regulation difficulties in relation to alcohol use severity (β=0.07, SE=0.04, 99% CI [0.01, 0.21]) was documented. Specifically, significant indirect effects were found for childhood maltreatment severity via emotion regulation difficulties in relation to alcohol problems (β's between 0.05 and 0.12; all 99% bootstrapped CIs with 10,000 resamples did not include 0) but not alcohol consumption. Emotion regulation difficulties may play a significant role in the association between childhood maltreatment severity and alcohol outcomes. Clinical implications are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

Emotional and behavioural difficulties in children and adolescents with hearing impairment: a systematic review and meta-analysis.

PubMed

Stevenson, Jim; Kreppner, Jana; Pimperton, Hannah; Worsfold, Sarah; Kennedy, Colin

2015-05-01

The aim of this study is to estimate the extent to which children and adolescents with hearing impairment (HI) show higher rates of emotional and behavioural difficulties compared to normally hearing children. Studies of emotional and behavioural difficulties in children and adolescents were traced from computerized systematic searches supplemented, where appropriate, by studies referenced in previous narrative reviews. Effect sizes (Hedges' g) were calculated for all studies. Meta-analyses were conducted on the weighted effect sizes obtained for studies adopting the Strength and Difficulties Questionnaire (SDQ) and on the unweighted effect sizes for non-SDQ studies. 33 non-SDQ studies were identified in which emotional and behavioural difficulties in children with HI could be compared to normally hearing children. The unweighted average g for these studies was 0.36. The meta-analysis of the 12 SDQ studies gave estimated effect sizes of 0.23 (95% CI 0.07, 0.40), 0.34 (95% CI 0.19, 0.49) and -0.01 (95% CI -0.32, 0.13) for Parent, Teacher and Self-ratings of Total Difficulties, respectively. The SDQ sub-scale showing consistent differences across raters between groups with HI and those with normal hearing was Peer Problems. Children and adolescents with HI have scores on emotional and behavioural difficulties measures about a quarter to a third of a standard deviation higher than hearing children. Children and adolescents with HI are in need of support to help their social relationships particularly with their peers.

The impact of adolescent stuttering and other speech problems on psychological well-being in adulthood: evidence from a birth cohort study.

PubMed

McAllister, Jan; Collier, Jacqueline; Shepstone, Lee

2013-01-01

Developmental stuttering is associated with increased risk of psychological distress and mental health difficulties. Less is known about the impact of other developmental speech problems on psychological outcomes, or the impact of stuttering and speech problems once other predictors have been adjusted for. To determine the impact of parent-reported adolescent stuttering and other speech difficulties on psychological distress and associated symptoms as measured by the Rutter Malaise Inventory. A British birth cohort dataset provided information about 217 cohort members who stuttered and 301 cohort members who had other kinds of speech problem at age 16 according to parental report, and 15,694 cohort members who had experienced neither stuttering nor other speech difficulties. The main analyses concerned associations between adolescent stuttering or speech difficulty and score on the Rutter Malaise Inventory at age 42. Other factors that had previously been shown to be associated with score on the Malaise Inventory were also included in the analyses. In the adjusted analyses that controlled for other predictors, cohort members who were reported to stutter had higher malaise scores than controls overall, indicating a higher level of psychological distress, but they were not at significantly more likely to have malaise scores in the range indicating a risk of serious mental health difficulties. Cohort members who were reported to have other speech difficulties during adolescence had malaise scores that overall did not differ significantly from those of controls in the adjusted analyses, but they were at significantly greater risk of serious mental health difficulties. These findings support those of other studies that indicate an association between stuttering and psychological distress. This study is the first to have shown that adolescents who experience speech difficulties other than stuttering are more likely than controls to be at risk of poorer mental health in adulthood. The results suggest a need for therapeutic provision to address psychosocial issues for both stuttering and other developmental speech disorders in adulthood, as well as further research into the consequences in adulthood of stuttering and other developmental speech disorders. © 2013 Royal College of Speech and Language Therapists.

Development and Psychometric Evaluation of the Gay Male Sexual Difficulties Scale.

PubMed

McDonagh, Lorraine K; Stewart, Ian; Morrison, Melanie A; Morrison, Todd G

2016-08-01

Sexual difficulties (i.e., disturbances in normal sexual responding) have the potential to significantly and negatively affect men's social and psychological well-being. However, a review of published measurement tools indicates that most have limited applicability to gay men, and none offer a nuanced understanding of sexual difficulties, as experienced by members of this population. To address this omission, the Gay Male Sexual Difficulties Scale (GMSDS) was developed using a sequential mixed-methods approach. The 25-item GMSDS uses a 6-point frequency Likert-type response format and examines: difficulties with receptive and insertive anal intercourse (5 items each); erectile difficulties (4 items); foreskin difficulties (4 items); body embarrassment (4 items); and seminal fluid concerns (3 items). The measure's scale score dimensionality, assessed using both exploratory and confirmatory factor analyses, as well as scale score reliability and validity (e.g., known-groups and convergent) was tested and deemed to be satisfactory. Limitations of the current series of studies and directions for future research are discussed.

A comparison of VRML and animation of rotation for teaching 3-dimensional crystal lattice structures

NASA Astrophysics Data System (ADS)

Sauls, Barbara Lynn

Chemistry students often have difficulty visualizing abstract concepts of molecules and atoms, which may lead to misconceptions. The three-dimensionality of these structures presents a challenge to educators. Typical methods of teaching include text with two-dimensional graphics and structural models. Improved methods to allow visualization of 3D structures may improve learning of these concepts. This research compared the use of Virtual Reality Modeling Language (VRML) and animation of rotation for teaching three-dimensional structures. VRML allows full control of objects by altering angle, size, rotation, and provides the ability to zoom into and through objects. Animations may only be stopped, restarted and replayed. A web-based lesson teaching basic concepts of crystals, which requires comprehension of their three-dimensional structure was given to 100 freshmen chemistry students. Students were stratified by gender then randomly to one of two lessons, which were identical except for the multimedia method used to show the lattices and unit cells. One method required exploration of the structures using VRML, the other provided animations of the same structures rotating. The students worked through an examination as the lesson progressed. A Welch t' test was used to compare differences between groups. No significant difference in mean achievement was found between the two methods, between genders, or within gender. There was no significant difference in mean total SAT in the animation and VRML group. Total time on task had no significant difference nor did enjoyment of the lesson. Students, however, spent 14% less time maneuvering VRML structures than viewing the animations of rotation. Neither method proved superior for presenting three-dimensional information. The students spent less time maneuvering the VRML structures with no difference in mean score so the use of VRML may be more efficient. The investigator noted some manipulation difficulties using VRML to rotate structures. Some students had difficulty obtaining the correct angle required to properly interpret spatial relationships. This led to frustration and caused some students to quit trying before they could answer questions fully. Even though there were some difficulties, outcomes were not affected. Higher scores, however, may have been achieved had the students been proficient in VRML maneuvering.

Different femorotibial contact points between fixed- and mobile-bearing TKAs do not show clinical impact.

PubMed

van Stralen, R A; Heesterbeek, P J C; Wymenga, A B

2015-11-01

In anteroposterior (AP)-gliding mobile-bearing total knee arthroplasty (TKA), the femoral component can theoretically slide forward resulting in a more anterior contact point, causing pain due to impingement. A lower lever arm of the extensor apparatus can also attribute to higher patella pressures and pain. The goal of this study was to determine the contact point in a cohort of mobile- and fixed-bearing TKAs, to determine whether the contact point lies more anteriorly in mobile-bearing TKA and to confirm whether this results in anterior knee pain. We used 38 fixed-bearing TKA and 40 mobile-bearing TKA from a randomized trial with straight lateral knee X-rays and measured the contact point. The functional outcome was measured by Knee Society Score at 12 months postoperatively. Pain scores were analysed using a VAS score (0-100 mm) in all patients at rest and when moving. Difficulty at rising up out of a chair was also assessed using a VAS score. The contact point in mobile-bearing TKA was situated at 59.5 % of the AP distance of the tibia and in the fixed-bearing TKA group at 66.1 % (P< 0.05). Patients with mobile- and fixed-bearing TKAs had similar knee scores, pain scores and difficulty in chair rise. No significant correlation was found between contact point and knee pain. The hypothesis of a more anterior contact point in the mobile-bearing cohort was confirmed but no correlation with functional and pain scores in this cohort could be found. The tibiofemoral contact point could not be correlated with a different clinical outcome and higher incidence of anterior knee pain. This study further adds to the knowledge on possible differences between mobile- and fixed-bearing prostheses. Next to that, bad outcomes could not be explained by CP. Case series, Level IV.

Are vision-specific quality of life questionnaires important in assessing rehabilitation for patients with hemianopia post stroke?

PubMed

George, Stacey; Hayes, Allison; Chen, Celia; Crotty, Maria

2011-01-01

To explore the relationship between disability and functional measures with vision-specific quality of life (QoL) measures for people with hemianopia and stroke. The Behavioral Inattention Test (BIT) and the Mayo-Portland Adaptability Inventory (MPAI) were compared with scores on 2 vision-specific QoL measures, the National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and Veteran Low Vision Visual Function Questionnaire (VA LV VFQ-48). Rehabilitation hospitals in Adelaide, South Australia. Stroke patients (n = 24) with homonymous hemianopia. Most of the BIT and MPAI scores were significantly associated with the NEI VFQ-25 and VA LV VFQ-48 scores. Behavioral test scores of the BIT and the MPAI total score correlated with more aspects of the QoL measures than the other components of the BIT and the MPAI. BIT and MPAI measure constructs associated with QoL for people with hemianopia following stroke. Vision-specific QoL questionnaires can complement the functional instruments by identifying the domains of difficulty, based on the instrument's subscale, that can guide rehabilitation therapists to address the person's deficit.

Youths’ Experiences of School Re-Integration Following Psychiatric Hospitalization

PubMed Central

Preyde, Michèle; Parekh, Shrenik; Heintzman, John

2018-01-01

Objective The purpose of this study was to report youths’ experiences of school re-integration post-discharge from psychiatric hospital. No reports of school reintegration from the patient perspective could be located; hence, a second objective was to explore school-related and clinical factors associated with youth who reported an unfavourable school re-integration experiences. Methods Patients were recruited while in hospital for acute psychiatric care. They provided informed consent to be contacted post discharge regarding their perceptions of their school reintegration experience. About ten weeks after discharge youth were surveyed via telephone (n=40) or online (n=22) surveys. Results Of the 121 youth who agreed to be contacted after discharge, 62 youth completed the post-discharge survey. Almost half (n=29) of the youth reported that they had considerable difficulty with school reintegration. Youth reported managing social situations, academic pressures and emotions as substantial problems. Youth who reported a negative transition experience had significantly worse scores on self-reported Total and emotion subscale of the Strength and Difficulties Questionnaire, and concern about the impact of emotions on school re-entry, and significantly less psychiatrist-reported improvement than youth who reported a neutral or positive transition experience. There were no differences between the two groups on school-related variables. Youth with prior admission reported greater difficulties with peers and significantly worse clinical factors than youth without prior admissions. Conclusions High emotional difficulty scores and concern about the impact of emotions on reintegration prior to discharge distinguished youths with negative school reintegration experiences. These patients may benefit from greater assistance with managing their emotional problems, and coping and social skills training before and during school reintegration. PMID:29375630

Self-Regulation and Executive Functioning as Related to Survival in Motor Neuron Disease: Preliminary Findings.

PubMed

Garcia-Willingham, Natasha E; Roach, Abbey R; Kasarskis, Edward J; Segerstrom, Suzanne C

2018-05-16

Disease progression varies widely among patients with motor neuron disease (MND). Patients with MND and coexisting dementia have shorter survival. However, implications of mild cognitive and behavioral difficulties are unclear. The present study examined the relative contribution of executive functioning and self-regulation difficulties on survival over a 6-year period among patients with MND, who scored largely within normal limits on cognitive and behavioral indices. Patients with MND (N=37, age=59.97±11.57, 46% female) completed the Wisconsin Card Sorting Task (WCST) as an executive functioning perseveration index. The Behavior Rating Inventory of Executive Functions (BRIEF-A) was used as a behavioral measure of self-regulation in two subdomains self-regulatory behavior (Behavioral Regulation) and self-regulatory problem-solving (Metacognition). Cox proportional hazard regression analyses were used. In total, 23 patients died during follow-up. In Cox proportional hazard regressions adjusted for a priori covariates, each 10-point T-score increment in patient-reported BRIEF-A self-regulatory behavior and problem-solving difficulties increased mortality risk by 94% and103%, respectively (adjusted HR=1.94, 95% CI [1.07, 3.52]; adjusted HR=2.03, 95% CI [1.19, 3.48]). In sensitivity analyses, patient-reported self-regulatory problem-solving remained significant independent of disease severity and a priori covariates (adjusted HR=1.68, 95% CI [1.01, 2.78], though the predictive value of self-regulatory behavior was attenuated in adjusted models (HR=1.67, 95% CI [0.85, 3.27). Caregiver-reported BRIEF-A ratings of patients and WCST perseverative errors did not significantly predict survival. Preliminary evidence suggests patient-reported self-regulatory problem-solving difficulties indicate poorer prognosis in MND. Further research is needed to uncover mechanisms that negatively affect patient survival.

Prenatal exposure to very severe maternal obesity is associated with adverse neuropsychiatric outcomes in children.

PubMed

Mina, T H; Lahti, M; Drake, A J; Räikkönen, K; Minnis, H; Denison, F C; Norman, J E; Reynolds, R M

2017-01-01

Prenatal maternal obesity has been linked to adverse childhood neuropsychiatric outcomes, including increased symptoms of attention deficit hyperactivity disorder (ADHD), internalizing and externalizing problems, affective disorders and neurodevelopmental problems but few studies have studied neuropsychiatric outcomes among offspring born to very severely obese women or assessed potential familial confounding by maternal psychological distress. We evaluated neuropsychiatric symptoms in 112 children aged 3-5 years whose mothers had participated in a longitudinal study of obesity in pregnancy (50 very severe obesity, BMI ⩾40 kg/m2, obese class III and 62 lean, BMI 18.5-25 kg/m2). The mothers completed the Conners' Hyperactivity Scale, Early Symptomatic Syndrome Eliciting Neurodevelopmental Clinical Examination Questionnaire (ESSENCE-Q), Child's Sleep Habits Questionnaire (CSHQ), Strengths and Difficulties Questionnaire (SDQ), and Child Behavior Checklist (CBCL) to assess child neuropsychiatric symptoms. Covariates included child's sex, age, birthweight, gestational age, socioeconomic deprivation levels, maternal age, parity, smoking status during pregnancy, gestational diabetes and maternal concurrent symptoms of anxiety and depression assessed using State Anxiety of Spielberger State-Trait Anxiety Index (STAI) and General Health Questionnaire (GHQ), respectively. Children exposed to prenatal maternal very severe obesity had significantly higher scores in the Conners' Hyperactivity Scale; ESSENCE-Q; total sleep problems in CSHQ; hyperactivity, conduct problems and total difficulties scales of the SDQ; higher externalizing and total problems, anxious/depressed, aggressive behaviour and other problem syndrome scores and higher DSM-oriented affective, anxiety and ADHD problems in CBCL. Prenatal maternal very severe obesity remained a significant predictor of child neuropsychiatric problems across multiple scales independent of demographic factors, prenatal factors and maternal concurrent symptoms of anxiety and depression. Prenatal maternal very severe obesity is a strong predictor of increased neuropsychiatric problems in early childhood.

Vulnerability for autism traits in boys and men with an extra X chromosome (47,XXY): the mediating role of cognitive flexibility.

PubMed

van Rijn, Sophie; Bierman, Marit; Bruining, Hilgo; Swaab, Hanna

2012-10-01

The XXY chromosomal pattern (Klinefelter syndrome, KS) has been associated with specific effects on physical, neurobiological, endocrinological and psychological development. This study was focused on the described risk for autism in KS, and the cognitive mechanisms that mediate this risk. Our aim was to assess whether autistic features in KS result from impairments in executive functioning, more specifically difficulties in cognitive flexibility. In total, 71 boys and men with KS and 61 non-clinical controls participated in the study. Autistic features were assessed using the Autism-spectrum Quotient (AQ). Mental flexibility was measured using the Wisconsin Card Sorting Test (WCST). The level of autism traits was significantly increased in the KS group, the effect size for total AQ score was 1.6. The KS group also showed significantly more difficulties in cognitive flexibility, as indicated by and increased number of perseverative (but not non-perseverative) errors in the WCST. This effect was independent of intellectual functioning, age or testosterone supplements. Within the KS group, the number of perseverative errors was significantly (positively) correlated with total AQ score. Our findings suggest that KS can be associated with dysfunctions in mental flexibility, and that individuals with more mental flexibility problems also have more autism traits. This insight is relevant for diagnosis, prevention and treatment of severe problems in individuals with KS. Implications also extend beyond this specific syndrome. As executive dysfunctions in KS have also been linked to ADHD symptoms and thought disorder, this could be a shared mechanism contributing to overlap in symptoms and comorbidity between different psychiatric conditions. Copyright © 2012 Elsevier Ltd. All rights reserved.

The association between dietary intake of folate and physical activity with psychological dimensions of depressive symptoms among students from Iran.

PubMed

Yary, Teymoor

2013-01-01

Depression in students is a major public health problem. Although several risk factors associated with depression have been identified, the cause of depression is still not clear. Several studies have demonstrated that physical activity and nutrient intake, such as increased levels of B vitamins in serum, decrease symptoms of depression. The aim of this study was to investigate the association between physical activity and dietary intake of vitamins B₆, B₉, and B₁₂ and symptoms of depression among postgraduate students. The results of this study suggest that intake of vitamin B9 may modulate the total score of Center for Epidemiological Studies Depression Scale (CES-D) and two subscales of the CES-D including depressive affect and interpersonal difficulties. This study also showed that moderate/high levels of physical activity were inversely and significantly associated with symptoms of depression (total scores) and three subscales of the CES-D including depressive affect, positive affect, and somatic complaints.

Association between Satisfaction with State of Health and Meals, Physical Condition and Food Diversity, Health Behavior, and Perceptions of Shopping Difficulty among Older People Living Alone in Japan.

PubMed

Ishikawa, M; Yokoyama, T; Takemi, Y; Fukuda, Y; Nakaya, T; Kusama, K; Yoshiike, N; Nozue, M; Yoshiba, K; Murayama, N

2017-01-01

This study aimed to examine perceptions of shopping difficulty, and the relationships with satisfaction with state of health and meals, physical condition, food diversity and health behavior in older people living alone in Japan. A cross-sectional, multilevel survey was designed. The questionnaire was distributed by mail and self-completed by participants. The sample was drawn from seven towns and cities across Japan. A geographic information system was used to select the sample of older people living alone, by proximity to a supermarket. In total, 2,346 older people (827 men and 1,519 women) completed the questionnaire. The dependent variable was whether shopping was easy or difficult. A logistic regression analysis was performed, adjusting for age, socioeconomic status and proximity of residence to a supermarket using stepwise variable analyses. The response rate was 67.8%. Overall, 14.5% of men and 21.7% of women considered shopping difficult. The stepwise logistic analysis showed that the factors most strongly related to shopping difficulty were a subjective feeling of poor health (men: OR = 3.01, women: OR = 2.16) and lack of satisfaction with meals (men: OR = 2.82, women: OR = 3.69). Other related physical condition and dietary factors were requiring nursing care (men: OR = 3.69, women: OR = 1.54), a high level of frailty, measured using the frailty index score (women: OR = 0.36) and low food diversity score (men: OR = 1.84, women: OR = 1.36). The study found that older people's assessment of their shopping difficulty was related to satisfaction aspects, including a subjective feeling of poor health, and lack of satisfaction with meals, as well as physical condition. These have a greater influence on shopping difficulty than income in both sexes, and proximity to a supermarket in women.

Conflict resolution abilities in children with Specific Language Impairment.

PubMed

Paula, Erica Macêdo de; Befi-Lopes, Debora Maria

2013-01-01

To investigate the conflict resolution abilities of children with Specific Language Impairment, and to verify whether the time of speech-language therapy correlates to the performance on the conflict resolution task. Participants included 20 children with Specific Language Impairment (Research Group) and 40 children with normal language development (Control Group), with ages ranging from 7 years to 8 years and 11 months. To assess the conflict resolution abilities, five hypothetical contexts of conflict were presented. The strategies used by the children were classified and scored by the following levels: level 0 (solutions that do not match the other levels), level 1 (physical solutions), level 2 (unilateral solutions), level 3 (cooperative solutions), and level 4 (mutual solutions). Statistical analysis showed group effect for the variable total score. There was a difference between the groups for modal development level, with higher level of modal development observed in the Control Group. There was no correlation between the period of speech-language therapy attendance and the total score. Children with Specific Language Impairment present difficulties in solving problems, in view of the fact that they mainly use physical and unilateral strategies. There was no correlation between the time of speech-language therapy and performance in the task.

Personality correlates of study difficulty and academic performance in university students. I. The Middlesex Hospital Questionnaire and Dynamic Personality Inventory.

PubMed

Stringer, P; Crown, S; Lucas, C J; Supramanium, S

1977-09-01

The personality correlates of study difficulty and academic performance in university students have been measured in terms of psychiatric symptomatology and premorbid characteristics. The UCLSQ, MHQ and DPI were administered to two groups of male and female students presenting at an health centre: one (n = 72) of patients seeking psychological help, the other (n = 73) a control group. Significant differences between the two groups were formed on the MHQ, confirming previous results; and these were supplemented by differences on the DPI. Motivational and psychoneurotic components of study difficulty were significantly related to MHQ scores in both groups. DPI scores were more closely related to study difficulty in the patients than controls; and served particularly to characterize their sylbism and work satisfaction. The DPI added to the picture of a subgroup of students observed both in an earlier and the present study: academically successful patients scoring high on phobic anxiety.

[Clinical observation on treatment of functional constipation with compound plantain-senna granules].

PubMed

Zhang, Chao-xian

2009-12-01

To investigate the efficacy and safety of compound plantain-senna granule (CPSG) in the treatment of functional constipation. Eighty patients with confirmed diagnosis of functional constipation were assigned to 2 groups. The 40 patients in the treatment group were treated with CPSG 5 g per day, while the 40 patients in the control group were treated with equal volume of starch granule, for 2 weeks totally. The defecating frequency and stool property, the scores of fecal discharge difficulty and accompanied symptoms, the gastrointestinal transmission time, and adverse reaction of treatment in the two groups were observed before and after treatment. Parameters of defecating frequency, stool property, the scores of fecal discharge difficulty, accompanied symptoms and the gastrointestinal transmission time were unchanged after treatment in the control group (P > 0.05); while in the treatment group, they improved significantly (P < 0.05) and showed significant difference to those in the control group respectively (P < 0. 05). No serious adverse reaction occurred in both groups. CPSG can obviously increase the defecating frequency, change the stool property, alleviate the fecal discharging difficult symptom and accompanied symptom, and shorten the gastrointestinal transmission time in patients with functional constipation with good security and tolerability.

Phenotypic continuum between autism and schizophrenia: Evidence from the Movie for the Assessment of Social Cognition (MASC).

PubMed

Martinez, Gilles; Alexandre, Charlotte; Mam-Lam-Fook, Célia; Bendjemaa, Narjes; Gaillard, Raphaël; Garel, Patricia; Dziobek, Isabel; Amado, Isabelle; Krebs, Marie-Odile

2017-07-01

Schizophrenic (SCZ) and autism (ASD) spectrum disorders share several features including social cognition impairments. In SCZ, the link between symptomatic dimensions and social cognition deficits remains unclear. The Movie for the Assessment of Social Cognition (MASC) test, available in several languages including English, investigates mental state attribution capabilities in complex interpersonal situations. After its translation into French, we used MASC to direct compare social cognition in 36 young participants with SCZ to 19 with ASD and 20 healthy controls (HC) matched for gender, age (18-25y.o.) and level of education. The MASC discriminated each group from the others, patients with SCZ exhibiting difficulties compared to ASD (MASC total score 28.1 (4) and 24.2 (6.6), respectively; p<.001). In the whole sample, MASC scores were inversely correlated with autistic traits, evaluated by autism quotient, and with disorganization symptoms. Finally, in SCZ, over-mentalizing difficulties were correlated with age at disease onset. Our results demonstrate the validity of the French version of the MASC and bring direct evidence supporting the hypothesis of a phenotypic continuum between autism and schizophrenia. Copyright © 2017 Elsevier B.V. All rights reserved.

Item difficulty and item validity for the Children's Group Embedded Figures Test.

PubMed

Rusch, R R; Trigg, C L; Brogan, R; Petriquin, S

1994-02-01

The validity and reliability of the Children's Group Embedded Figures Test was reported for students in Grade 2 by Cromack and Stone in 1980; however, a search of the literature indicates no evidence for internal consistency or item analysis. Hence the purpose of this study was to examine the item difficulty and item validity of the test with children in Grades 1 and 2. Confusion in the literature over development and use of this test was seemingly resolved through analysis of these descriptions and through an interview with the test developer. One early-appearing item was unreasonably difficult. Two or three other items were quite difficult and made little contribution to the total score. Caution is recommended, however, in any reordering or elimination of items based on these findings, given the limited number of subjects (n = 84).

How Common are WM Deficits in Children with Difficulties in Reading and Mathematics?

PubMed

Gathercole, Susan E; Woolgar, Francesca; Kievit, Rogier A; Astle, Duncan; Manly, Tom; Holmes, Joni

2016-12-01

The extent to which deficits in working memory (WM) are characteristic of children with reading and mathematics difficulties was investigated in a large sample aged 5-15 years reported to have problems in attention, learning and memory. WM performance was highly correlated with reading and mathematics scores. Although deficits in individual tests of short-term memory (STM) and WM occurred in less than half of the children with detected learning difficulties, three-quarters of the children with low reading and mathematics scores obtained one or more WM scores in the deficit range. These findings are consistent with proposals that WM or the broader cognitive dimensions it taps impede school-based learning, and point to the importance of managing WM loads in the classroom.

Hydrocortisone as an Intervention for Dexamethasone-Induced Adverse Effects in Pediatric Patients With Acute Lymphoblastic Leukemia: Results of a Double-Blind, Randomized Controlled Trial.

PubMed

Warris, Lidewij T; van den Heuvel-Eibrink, Marry M; Aarsen, Femke K; Pluijm, Saskia M F; Bierings, Marc B; van den Bos, Cor; Zwaan, Christian M; Thygesen, Helene H; Tissing, Wim J E; Veening, Margreet A; Pieters, Rob; van den Akker, Erica L T

2016-07-01

Dexamethasone is a key component in the treatment of pediatric acute lymphoblastic leukemia (ALL), but can induce serious adverse effects. Recent studies have led to the hypothesis that neuropsychological adverse effects may be a result of cortisol depletion of the cerebral mineralocorticoid receptors. We examined whether including a physiologic dose of hydrocortisone in dexamethasone treatment can reduce neuropsychologic and metabolic adverse effects in children with ALL. We performed a multicenter, double-blind, randomized controlled trial with a crossover design. Of 116 potentially eligible patients (age 3 to 16 years), 50 were enrolled and were treated with two consecutive courses of dexamethasone in accordance with Dutch Childhood Oncology Group ALL protocols. Patients were randomly assigned to receive either hydrocortisone or placebo in a circadian rhythm (10 mg/m(2)/d) during both dexamethasone courses. Primary outcome measure was parent-reported Strength and Difficulties Questionnaire in Dutch, which assesses psychosocial problems. Other end points included questionnaires, neuropsychological tests, and metabolic parameters. Of 48 patients who completed both courses, hydrocortisone had no significant effect on outcome; however, a more detailed analysis revealed that in 16 patients who developed clinically relevant psychosocial adverse effects, addition of hydrocortisone substantially reduced their Strength and Difficulties Questionnaire in Dutch scores in the following domains: total difficulties, emotional symptoms, conduct problems, and impact of difficulties. Moreover, in nine patients who developed clinically relevant, sleep-related difficulties, addition of hydrocortisone reduced total sleeping problems and disorders of initiating and maintaining sleep. In contrast, hydrocortisone had no effect on metabolic parameters. Our results suggest that adding a physiologic dose of hydrocortisone to dexamethasone treatment can reduce the occurrence of serious neuropsychological adverse effects and sleep-related difficulties in pediatric patients with ALL. © 2016 by American Society of Clinical Oncology.

How reliable and valid is the teacher version of the Strengths and Difficulties Questionnaire in primary school children?

PubMed

van den Heuvel, Meta; Jansen, Danielle E M C; Stewart, Roy E; Smits-Engelsman, Bouwien C M; Reijneveld, Sijmen A; Flapper, Boudien C T

2017-01-01

The Strengths and Difficulties Questionnaire (SDQ) is validated for parents, but not yet for teachers in a broad age range of children. We conducted a cross-sectional study with 4-10 years old school children to investigate if the SDQ-T can be used instead of the validated but lengthy Teacher's Report Form (TRF) to acquire information about emotional and behavioral problems in the school community. Teachers of 453 children from primary schools were approached. Teachers of 394 children (response rate 86.9%) with a mean age of 7.1 years filled in the SDQ-T (n = 387), the TRF (n = 349) or both (n = 342). We assessed reliability by calculating internal consistency and concurrent validity (using correlation coefficients, sensitivity, specificity) of the SDQ-T compared with the TRF. Internal consistency of the SDQ-T Total Difficulties Score (SDQ-T TDS; Cronbach α = 0.80), hyperactivity/ inattention- (α = 0.86) and prosocial behavior (α = 0.81) was very good. Concurrent validity demonstrated a strong correlation of all subscales of the SDQ-T with the corresponding scale on the TRF (range 0.54-0.73), except for peer problems (0.46). Using a SDQ-T TDS cut-off score > 14, the SDQ-T had a good sensitivity (90%) and specificity (94%). The good reliability, validity and brevity of the SDQ-T make it an easily applicable questionnaire for obtaining information about emotional and behavioral problems from teachers in primary school children.

New evidence of factor structure and measurement invariance of the SDQ across five European nations.

PubMed

Ortuño-Sierra, Javier; Fonseca-Pedrero, Eduardo; Aritio-Solana, Rebeca; Velasco, Alvaro Moreno; de Luis, Edurne Chocarro; Schumann, Gunter; Cattrell, Anna; Flor, Herta; Nees, Frauke; Banaschewski, Tobias; Bokde, Arun; Whelan, Rob; Buechel, Christian; Bromberg, Uli; Conrod, Patricia; Frouin, Vincent; Papadopoulos, Dimitri; Gallinat, Juergen; Garavan, Hugh; Heinz, Andreas; Walter, Henrik; Struve, Maren; Gowland, Penny; Paus, Tomáš; Poustka, Luise; Martinot, Jean-Luc; Paillère-Martinot, Marie-Laure; Vetter, Nora C; Smolka, Michael N; Lawrence, Claire

2015-12-01

The main purpose of the present study was to analyse the internal structure and to test the measurement invariance of the Strengths and Difficulties Questionnaire (SDQ), self-reported version, in five European countries. The sample consisted of 3012 adolescents aged between 12 and 17 years (M = 14.20; SD = 0.83). The five-factor model (with correlated errors added), and the five-factor model (with correlated errors added) with the reverse-worded items allowed to cross-load on the Prosocial subscale, displayed adequate goodness of-fit indices. Multi-group confirmatory factor analysis showed that the five-factor model (with correlated errors added) had partial strong measurement invariance by countries. A total of 11 of the 25 items were non-invariant across samples. The level of internal consistency of the Total difficulties score was 0.84, ranging between 0.69 and 0.78 for the SDQ subscales. The findings indicate that the SDQ's subscales need to be modified in various ways for screening emotional and behavioural problems in the five European countries that were analysed.

Reliability and Validity Evidence of Scores on the Slovene Version of the Questionnaire about Interpersonal Difficulties for Adolescents

ERIC Educational Resources Information Center

Zupancic, Maja; Ingles, Candido S.; Bajec, Bostjan; Levpuscek, Melita Puklek

2011-01-01

This study analyzed the psychometric properties of scores on the Slovene version of the "Questionnaire about Interpersonal Difficulties for Adolescents" (QIDA) in a sample of 1,334 adolescents (44% boys), ranging in age from 12 to 18 years (M = 15.61). Confirmatory factor analyses replicated the correlated five-factor structure of the QIDA:…

Did parents and teachers struggle with child survivors 20 months after the 2011 earthquake and tsunami in Japan? A retrospective observational study.

PubMed

Usami, Masahide; Iwadare, Yoshitaka; Kodaira, Masaki; Watanabe, Kyota; Ushijima, Hirokage; Tanaka, Tetsuya; Harada, Maiko; Tanaka, Hiromi; Sasaki, Yoshinori; Saito, Kazuhiko

2014-01-01

On March 11, 2011, Japan was struck by the earthquake and tsunami. Twenty months after the disaster, we collected information on the difficulties faced by parents and teachers in dealing with the post-traumatic symptoms of child survivors. The aim of this study was to evaluate the relationship between post-traumatic symptoms in children and parents' and teachers' difficulties in dealing with children who survived the huge disaster. The subjects included 12,524 children from elementary, middle, and junior high schools in Ishinomaki City. The Post Traumatic Stress Symptoms for Children 15 items (PTSSC-15), a self-rating questionnaire on post-traumatic symptoms, was distributed among the children, and Strength and Difficulties Questionnaire (SDQ), a self-rating questionnaire on difficulties in dealing with children, was given to their parents and teachers. With PTSSC-15, a valid response was obtained from 10,909 (89.5%) participants. With SDQ for teachers and parents, valid responses were obtained from 10,577 (86.7%) and 7052 (83.9%) participants, respectively. PTSSC-15 scores were significantly higher (P<0.001) in girls than in boys from the junior high school. These effect sizes were less than 0.30. Correlations of teachers' SDQ scores and PTSSC-15 scores were significantly low (r<0.21, P<0.001) for both genders and all children. Likewise, correlations between SDQ scores assigned by parents (excluding "prosocial behavior") and PTSSC-15 scores were significantly low (r<0.21, P<0.001) for both genders and at all school levels. This study elucidated that the difficulties faced by parents and teachers while dealing with child survivors significantly low correlate with the child's post-traumatic symptoms caused by the 2011 earthquake and tsunami. Thus, it is important that clinicians should not only evaluate post-traumatic symptoms with a self-rating questionnaire but also try to objectively evaluate whether there were day-to-day difficulties caused by the post-traumatic symptoms.

The Association Between Transportation and Life-Space Mobility in Community-Dwelling Older People With or Without Walking Difficulties.

PubMed

Viljanen, Anne; Mikkola, Tuija M; Rantakokko, Merja; Portegijs, Erja; Rantanen, Taina

2016-09-01

The aim of this study is to examine whether a persons' most frequently used mode of transportation is associated with life-space mobility and whether the association differs between persons with or without walking difficulties. Life-space mobility was measured with the Life-Space Assessment in 848 community-dwelling men and women aged 75 to 90 years. Six separate mobility groups were formed according to the most frequently used mode of transportation (car driver, car passenger, public transportation) combined with the presence or absence of difficulties walking 2 km. Car drivers without walking difficulties had the highest life-space mobility scores, and car passengers with walking difficulties had the lowest scores. Mode of transportation influenced the odds for restricted life space differently depending on whether or not the person had walking difficulties. To support community mobility among older persons, it would be important to improve different transportation options to meet older persons' individual wishes, needs, and resources. © The Author(s) 2015.

Chewing in adolescents with overweight and obesity: An exploratory study with behavioral approach.

PubMed

Pedroni-Pereira, Aline; Araujo, Darlle Santos; Scudine, Kelly Guedes de Oliveira; Prado, Daniela Galvão de Almeida; Lima, Débora Alves Nunes Leite; Castelo, Paula Midori

2016-12-01

Physiological and behavioral aspects of masticatory function may have an impact on nutritional status, which has been little studied. The aim was to perform a comprehensive evaluation of objective, subjective and behavioral aspects of masticatory function in 231 adolescents, aged 14-17 years and compare these parameters between normal-weight (n = 115) and adolescents with overweight/obesity (n = 116). Objective aspects were examined by the Oro-facial Myofunctional Evaluation-expanded protocol (OMES-e), determining the masticatory type, chewing time/frequency, abnormal movements, and other; masticatory performance (color changeable chewing gum) and bite force were also explored. The subjective and behavioral evaluations were assessed using the Quality of Mastication Function Questionnaire, which explores the masticatory behavior and frequency/intensity of difficulty in chewing different types of foods. Results were submitted to normality tests, Chi-square, unpaired t-test and Mann-Whitney. A multiple linear regression model was used to evaluate which of the variables under study contributed to the variation in Percent Body Fat (α = 0.05). The results showed that OMES-e total score differed significantly between groups, that is, individuals with overweight showed more changes in oro-facial myofunctional aspects than normal-weight ones. Unilateral mastication was more frequent among females with overweight/obesity. They also showed greater difficulty on Habits and Fruit domains, reporting the need of adding sauce to the meal to facilitate swallowing and peeling and cutting fruit (apples) in small pieces in order to better chew them. OMES-e total score also showed a significant relationship with Percent Body Fat. Masticatory performance evaluated by chewing gum and bite force did not differ between groups. This study showed that adolescents with excess weight presented changes in masticatory behavior and greater difficulty in performing the masticatory function comparing to normal-weight ones. Copyright © 2016 Elsevier Ltd. All rights reserved.

Mental health outcomes of developmental coordination disorder in late adolescence.

PubMed

Harrowell, Ian; Hollén, Linda; Lingam, Raghu; Emond, Alan

2017-09-01

To assess the relationship between developmental coordination disorder (DCD) and mental health outcomes in late adolescence. Data were analyzed from the Avon Longitudinal Study of Parents and Children. Moderate-to-severe DCD was defined at 7 to 8 years according to the DSM-IV-TR criteria. Mental health was assessed at 16 to 18 years using self-reported questionnaires: Strengths and Difficulties Questionnaire, Short Moods and Feelings Questionnaire, and the Warwick-Edinburgh Mental Well-being Scale. Logistic and linear regressions assessed the associations between DCD and mental health, using multiple imputation to account for missing data. Adjustments were made for socio-economic status, IQ, and social communication difficulties. Adolescents with DCD (n=168) had an increased risk of mental health difficulties (total Strengths and Difficulties Questionnaire score) than their peers (n=3750) (odds ratio 1.78, 95% confidence interval 1.12-2.83, adjusted for socio-economic status and IQ). This was, in part, mediated through poor social communication skills. Adolescent females with DCD (n=59) were more prone to mental health difficulties than males. Greater mental well-being was associated with better self-esteem (β 0.82, p<0.001). Individuals with DCD, particularly females, had increased risk of mental health difficulties in late adolescence. Interventions that aim to promote resilience in DCD should involve improving social communication skills and self-esteem. © 2017 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.

Light drinking versus abstinence in pregnancy – behavioural and cognitive outcomes in 7-year-old children: a longitudinal cohort study

PubMed Central

Kelly, Y; Iacovou, M; Quigley, MA; Gray, R; Wolke, D; Kelly, J; Sacker, A

2013-01-01

Objective To assess whether light drinking in pregnancy is linked to unfavourable developmental outcomes in children. Design Prospective population-based cohort. Setting UK. Population Ten thousand five hundred and thirty-four 7-year-olds. Methods Quasi-experimental using propensity score matching (PSM) to compare children born to light (up to 2 units per week) and non-drinkers. Main outcome measures Behavioural difficulties rated by parents and teachers; cognitive test scores for reading, maths and spatial skills. Results Ordinary least squares (OLS) regression and PSM analyses are presented. For behavioural difficulties, unadjusted estimates for percentage standard deviation (SD) score differences ranged from 2 to 14%. On adjustment for potential confounders, differences were attenuated, with a loss of statistical significance, except for teacher-rated boys' difficulties. For boys, parent-rated behavioural difficulties: unadjusted, −11.5; OLS, −4.3; PSM, −6.8; teacher-rated behavioural difficulties: unadjusted, −13.9; OLS, −9.6; PSM, −10.8. For girls, parent-rated behavioural difficulties: unadjusted, −9.6; OLS, −2.9; PSM, −4.5; teacher-rated behavioural difficulties: unadjusted, −2.4; OLS, 4.9; PSM, 3.9. For cognitive test scores, unadjusted estimates for differences ranged between 12 and 21% of an SD score for reading, maths and spatial skills. After adjustment for potential confounders, estimates were reduced, but remained statistically significantly different for reading and for spatial skills in boys. For boys, reading: unadjusted, 20.9; OLS, 8.3; PSM, 7.3; maths: unadjusted, 14.7; OLS, 5.0; PSM, 6.5; spatial skills: unadjusted, 16.2; OLS, 7.6; PSM, 8.1. For girls, reading: unadjusted, 11.6; OLS, −0.3; PSM, −0.5; maths: unadjusted, 12.9; OLS, 4.3; PSM, 3.9; spatial skills: unadjusted, 16.2; OLS, 7.7; PSM, 6.4. Conclusion The findings suggest that light drinking during pregnancy is not linked to developmental problems in mid-childhood. These findings support current UK Department of Health guidelines on drinking during pregnancy. PMID:23590126

Light drinking versus abstinence in pregnancy - behavioural and cognitive outcomes in 7-year-old children: a longitudinal cohort study.

PubMed

Kelly, Y; Iacovou, M; Quigley, M A; Gray, R; Wolke, D; Kelly, J; Sacker, A

2013-10-01

To assess whether light drinking in pregnancy is linked to unfavourable developmental outcomes in children. Prospective population-based cohort. UK. Ten thousand five hundred and thirty-four 7-year-olds. Quasi-experimental using propensity score matching (PSM) to compare children born to light (up to 2 units per week) and non-drinkers. Behavioural difficulties rated by parents and teachers; cognitive test scores for reading, maths and spatial skills. Ordinary least squares (OLS) regression and PSM analyses are presented. For behavioural difficulties, unadjusted estimates for percentage standard deviation (SD) score differences ranged from 2 to 14%. On adjustment for potential confounders, differences were attenuated, with a loss of statistical significance, except for teacher-rated boys' difficulties. For boys, parent-rated behavioural difficulties: unadjusted, -11.5; OLS, -4.3; PSM, -6.8; teacher-rated behavioural difficulties: unadjusted, -13.9; OLS, -9.6; PSM, -10.8. For girls, parent-rated behavioural difficulties: unadjusted, -9.6; OLS, -2.9; PSM, -4.5; teacher-rated behavioural difficulties: unadjusted, -2.4; OLS, 4.9; PSM, 3.9. For cognitive test scores, unadjusted estimates for differences ranged between 12 and 21% of an SD score for reading, maths and spatial skills. After adjustment for potential confounders, estimates were reduced, but remained statistically significantly different for reading and for spatial skills in boys. For boys, reading: unadjusted, 20.9; OLS, 8.3; PSM, 7.3; maths: unadjusted, 14.7; OLS, 5.0; PSM, 6.5; spatial skills: unadjusted, 16.2; OLS, 7.6; PSM, 8.1. For girls, reading: unadjusted, 11.6; OLS, -0.3; PSM, -0.5; maths: unadjusted, 12.9; OLS, 4.3; PSM, 3.9; spatial skills: unadjusted, 16.2; OLS, 7.7; PSM, 6.4. The findings suggest that light drinking during pregnancy is not linked to developmental problems in mid-childhood. These findings support current UK Department of Health guidelines on drinking during pregnancy. © 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2013 RCOG.

Recognizing Disordered Eating in Primary Care Patients with Obesity

PubMed Central

Chacko, Sara A.; Chiodi, Sarah N.; Wee, Christina C.

2015-01-01

Objective In clinical practice, behavioral approaches to obesity treatment focus heavily on diet and exercise recommendations. However, these approaches may not be effective for patients with disordered eating behaviors. Little is known about the prevalence of disordered eating behaviors in primary care patients with obesity or whether they affect difficulty making dietary changes. Methods We conducted a telephone interview of 337 primary care patients aged 18–65 years with BMI≥35kg/m2 in Greater-Boston, 2009–2011 (58% response rate, 69% women). We administered the Three-Factor Eating Questionnaire R-18 (Scores 0–100) and the Impact of Weight on Quality of Life-Lite (IWQOL-lite) (Scores 0–100). We measured difficulty making dietary changes using four questions regarding perceived difficulty changing diet (Scores 0–10). Results 50% of patients reported high emotional eating (score>50) and 28% reported high uncontrolled eating (score>50). Women were more likely to report emotional [OR=4.14 (2.90, 5.92)] and uncontrolled eating [OR=2.11 (1.44, 3.08)] than men. African Americans were less likely than Caucasians to report emotional [OR=0.29 (95% CI: 0.19, 0.44)] and uncontrolled eating [OR=0.11 (0.07, 0.19)]. For every 10-point reduction in QOL score (IWQOL-lite), emotional and uncontrolled eating scores rose significantly by 7.82 and 5.48, respectively. Furthermore, participants who reported emotional and uncontrolled eating reported greater difficulty making dietary changes. Conclusions Disordered eating behaviors are prevalent among obese primary care patients and disproportionately affect women, Caucasians, and patients with poor QOL. These eating behaviors may impair patients' ability to make clinically recommended dietary changes. Clinicians should consider screening for disordered eating behaviors and tailoring obesity treatment accordingly. PMID:25572624

[Quantitative research on operation behavior of acupuncture manipulation].

PubMed

Li, Jing; Grierson, Lawrence; Wu, Mary X; Breuer, Ronny; Carnahan, Heather

2014-03-01

To explore a method of quantitative evaluation on operation behavior of acupuncture manipulation and further analyze behavior features of professional acupuncture manipulation. According to acupuncture basic manipulations, Scales for Operation Behavior of Acupuncture Basic Manipulation was made and Delphi method was adopted to test its validity. Two independent estimators utilized this scale to assess operation behavior of acupuncture manipulate among 12 acupuncturists and 12 acupuncture-novices and calculate interrater reliability, also the differences of total score of operation behavior in the two groups as well as single-step score, including sterilization, needle insertion, needle manipulation and needle withdrawal, were compared. The validity of this scale was satisfied. The inter-rater reliability was 0. 768. The total score of operation behavior in acupuncturist group was significantly higher than that in the acupuncture-novice group (13.80 +/- 1.05 vs 11.03 +/- 2.14, P < 0.01). The scores of needle insertion and needle manipulation in the acupuncturist group were significantly higher than those in the acupuncture-novice group (4.28 +/- 0.91 vs 2.54 +/- 1.51, P < 0.01; 2.56 +/- 0.65 vs 1.88 +/- 0.88, P < 0.05); however, the scores of sterilization and needle withdrawal in the acupuncturist group were not different from those in the acupuncture-novice group. This scale is suitable for quantitative evaluation on operation behavior of acupuncture manipulation. The behavior features of professional acupuncture manipulation are mainly presented with needle insertion and needle manipulation which has superior difficulty, high coordination and accuracy.

A cumulative risk factor model for early identification of academic difficulties in premature and low birth weight infants.

PubMed

Roberts, G; Bellinger, D; McCormick, M C

2007-03-01

Premature and low birth weight children have a high prevalence of academic difficulties. This study examines a model comprised of cumulative risk factors that allows early identification of these difficulties. This is a secondary analysis of data from a large cohort of premature (<37 weeks gestation) and LBW (<2500 g) children. The study subjects were 8 years of age and 494 had data available for reading achievement and 469 for mathematics. Potential predictor variables were categorized into 4 domains: sociodemographic, neonatal, maternal mental health and early childhood (ages 3 and 5). Regression analysis was used to create a model to predict reading and mathematics scores. Variables from all domains were significant in the model, predicting low achievement scores in reading (R (2) of 0.49, model p-value < .0001) and mathematics (R (2) of 0.44, model p-value < .0001). Significant risk factors for lower reading scores, were: lower maternal education and income, and Black or Hispanic race (sociodemographic); lower birth weight and male gender (neonatal); lower maternal responsivity (maternal mental health); lower intelligence, visual-motor skill and higher behavioral disturbance scores (early childhood). Lower mathematics scores were predicted by lower maternal education, income and age and Black or Hispanic race (sociodemographic); lower birth weight and higher head circumference (neonatal); lower maternal responsivity (maternal mental health); lower intelligence, visual-motor skill and higher behavioral disturbance scores (early childhood). Sequential early childhood risk factors in premature and LBW children lead to a cumulative risk for academic difficulties and can be used for early identification.

[Executive functioning and motivation in preschool children at risk for learning difficulties in mathematics].

PubMed

Presentación-Herrero, M Jesús; Mercader-Ruiz, Jessica; Siegenthaler-Hierro, Rebeca; Fernández-Andrés, Inmaculada; Miranda-Casas, Ana

2015-02-25

Early identification of the factors involved in the development of learning difficulties in mathematics is essential to be able to understand their origin and implement successful interventions. This study analyses the capacity of executive functioning and of variables from the motivational belief system to differentiate and classify preschool children with and without risk of having difficulties in mathematics. A total of 146 subjects from the third year of preschool education took part in the study, divided into risk/no risk according to the score obtained on the operations subtest of the TEDI-MATH test. Working memory (verbal and visuospatial) and inhibition (with auditory and visual stimuli) neuropsychological tasks were applied. Teachers filled in a questionnaire on the children's motivation with regard to learning. Significant differences were found between the two groups on the working memory and inhibition-auditory factors, as well as on all the motivation variables. The results also show a similar power of classification, with percentages above 80%, for both groups of variables. The implications of these findings for educational practice are discussed.

Analysis of Hand Size and Ergonomics of Instruments in Pediatric Minimally Invasive Surgery.

PubMed

Filisetti, Claudia; Cho, Alexander; Riccipetitoni, Giovanna; Saxena, Amulya K

2015-10-01

Moving from the study conducted in 2004 on adult surgeons we want to analyze the ergonomics applied in pediatric minimally invasive surgery. An online survey was conducted among the members of the European Paediatric Surgeons' Association that included 14 questions pertaining to demographic, surgical glove size, double glove use, prior hand surgery, and the ease or difficulty in using different types of laparoscopic instruments. A total of 138 pediatric surgeons completed the survey. The difficulty score (DS) was similar between the 3.5- and 5-mm instruments. Other specialized instruments such as Ligasure, Ultracision, Clip applicators, endobags, and staplers were found to have higher DS. The needle holder was the only instrument that is part of the normal 5-mm operating sets, which was found to have a higher DS. Our survey found increased DS with the endobag and stapler, but this was not significant. Also prior hand surgery or double glove use was not associated with difficulty in usage of minimally invasive instruments when compared with normal hands in this survey.

Behavioral phenotype in adults with Prader-Willi syndrome.

PubMed

Sinnema, Margje; Einfeld, Stewart L; Schrander-Stumpel, Constance T R M; Maaskant, Marian A; Boer, Harm; Curfs, Leopold M G

2011-01-01

Prader-Willi syndrome (PWS) is characterized by temper tantrums, impulsivity, mood fluctuations, difficulty with change in routine, skinpicking, stubbornness and aggression. Many studies on behavior in PWS are limited by sample size, age range, a lack of genetically confirmed diagnosis of PWS and inconsistent assessment of behavior. The aim of this study was to explore systematically the relation between behavioral problems and age groups, genetic subtypes and BMI categories in an adult PWS population. Participants were contacted via the Dutch Prader-Willi Parent Association and through physicians specialized in persons with ID. Behaviors were studied using the Developmental Behavior Checklist for Adults (DBC-A). The forms were completed by the main caregivers of 98 adults with a genetically confirmed diagnosis of PWS. Differences between age groups were statistically significant (ANOVA, p=0.03). DBC-A total scores were higher in the consecutive age groups, with the most behavioral problems in the oldest age groups. Differences between genetic subtypes were also statistically significant (ANOVA, p<0.01). Persons with mUPD had higher total scores on the DBC-A than persons with a deletion. Those with a Type I deletion showed higher total DBC-A scores than persons with a Type II deletion. There were no statistically significant differences in DBC-A total scores between the different BMI categories. Individuals with a BMI<25 had higher scores on the self-absorbed subscale compared to persons with a BMI between 25 and 30. Unlike previous descriptions of the behavioral phenotype in adults with PWS, we did not find a reduction in behavioral problems in older adults. Therefore, special attention should be paid to behavioral problems as part of general management of adults with PWS. Longitudinal studies are warranted to gain more insight into the natural history and course of behavioral problems in adults and older people with PWS over the long term and possible risk and preventive factors. Copyright © 2010 Elsevier Ltd. All rights reserved.

Evaluation of reading, writing, and watching TV using the Dutch ICF Activity Inventory.

PubMed

Bruijning, Janna E; van Rens, Ger H M B; Knol, Dirk L; van Nispen, Ruth M A

2014-11-01

To investigate the longitudinal outcomes of rehabilitation (from baseline to 4 and 12 months) at a multidisciplinary rehabilitation center. The three goals ("Reading," "Writing," and "Watching TV") were measured with the Dutch ICF Activity Inventory (D-AI). In addition, outcomes were compared with the Low Vision Quality-of-Life questionnaire (LVQOL) for better insight into the (longitudinal) interpretation. In a cohort of 241 visually impaired persons, corrected and uncorrected linear mixed models were used to determine longitudinal rehabilitation outcomes for the D-AI goals "Reading," "Writing," and "Watching TV," and difficulty and underlying tasks, as well as for the LVQOL scales "Basic aspects" and "Reading and fine work." At baseline, Spearman correlations were determined for similar scales of the D-AI and LVQOL. Importance scores of goals were stable over time. Difficulty scores decreased over time, but the differences were not significant at each measurement moment. For reading, difficulty of underlying tasks seemed to reflect the (change in) difficulty at the goal level; however, change in writing tasks did not reflect the change in the umbrella goal. Each of the three subscales of underlying tasks of the goal "Watching TV" changed in a different way. Changes in similar LVQOL scales were comparable, although less pronounced and more influenced by depression. Prescription or advice of low-vision aids and training in visual devices was not related (p > 0.01) with any of the outcome measures. It seems reasonable to conclude that the decrease in perceived difficulty was an effect of rehabilitation. The D-AI goal scores for difficulty were less influenced by depression and may be more sensitive to measure change over time compared with the LVQOL. Importance scores may not be useful for evaluation purposes.

Breast feeding and child behaviour in the Millennium Cohort Study.

PubMed

Heikkilä, Katriina; Sacker, Amanda; Kelly, Yvonne; Renfrew, Mary J; Quigley, Maria A

2011-07-01

To examine whether breast feeding is associated with behavioural development in children aged 5 years. The authors used data from a large, prospective, nationally representative UK cohort, the Millennium Cohort Study. 10 037 mother-child pairs from white ethnic background (9525 term and 512 preterm children) were included in the analyses. Duration of breast feeding (at all or exclusively) was ascertained from parental interview at study baseline, when the children were aged 9 months. Child behaviour was assessed using a parent-completed questionnaire, the Strengths and Difficulties Questionnaire (SDQ). The authors used logistic regression to investigate the associations of breastfeeding duration with abnormal parent-rated SDQ total and subscores at age 5 in term and preterm children separately. Abnormal SDQ scores were less common in term children (n=1129/9525, 12%) than pre-term (n=78/512, 15%) children. Term children breast fed for 4 months or longer (n=2741/9525, 29%) had lower odds of an abnormal total SDQ score (multivariable-adjusted OR compared with never breastfed children (n=3292/9525, 35%) 0.67, 95% CI: 0.54 to 0.83). This effect was similar for all the SDQ subscores. In preterm children, longer duration of breast feeding was generally associated with lower odds of abnormal SDQ total and subscores but the effect estimates were imprecise. The associations between exclusive breast feeding and abnormal SDQ scores were similar to those of any breast feeding and abnormal SDQ scores. The findings suggest that, at least in term children, longer duration of breast feeding is associated with fewer parent-rated behavioural problems in children aged 5 years.

[The perceived burden of care and its correlates in schizophrenia].

PubMed

Gülseren, Leyla; Cam, Birmay; Karakoç, Berna; Yiğit, Tamer; Danacı, Ayşen Esen; Cubukçuoğlu, Zeynep; Taş, Cumhur; Gülseren, Seref; Mete, Levent

2010-01-01

The present study aimed to investigate the perceived level of burden of care and its correlates in family members of schizophrenia patients. The study included 239 schizophrenic patients that were followed-up at the psychiatric outpatient clinics of Izmir Ataturk Education and Research Hospital, and Celal Bayar University Medical School, and 239 of their primary caregivers. Patients were assessed using the Positive and Negative Syndrome Scale (PANNS), Global Assessment of Functioning Scale (GAF), Social Functioning Scale (SFS), Brief Cognitive State Examination (BCE), and UKU Side Effect Rating Scale. Their primary caregivers were assessed using the Perceived Family Burden Scale (PFBS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Caregiver PFBS scores ere correlated with male patients, female caregivers, inadequate social support, economic difficulty, the presence of chronic physical disorder in the caregivers, patient violence toward the caregivers, total duration of illness, the number of patient hospitalizations, PANNS total and subscale scores, and SFS, BDI, and BAI scores. Perceived burden of care was predicted by the severity of the patients' positive symptoms, SFS independence/competence and interpersonal functioning subscale scores, and caregivers' anxiety and depression levels. In order to decrease the burden of care in schizophrenia we recommend effective management of patient symptoms, enhancement of patient social functioning, interventions that target caregivers with high levels anxiety and depression, and social support provided by healthcare professionals.

Do patients with brain metastases selected for whole brain radiotherapy have worse baseline quality of life as compared to those for radiosurgery or neurosurgery (with or without whole brain radiotherapy)?

PubMed

Chow, Ronald; Tsao, May; Pulenzas, Natalie; Zhang, Liying; Sahgal, Arjun; Cella, David; Soliman, Hany; Danjoux, Cyril; DeAngelis, Carlo; Vuong, Sherlyn; Chow, Edward

2016-01-01

The purpose was to examine the baseline characteristics, symptoms and quality of life (QOL) in patients who receive different treatments for brain metastases. Eligible patients were divided and analysed based on their treatment: whole brain radiotherapy (WBRT) alone versus stereotactic radiosurgery (SRS) or neurosurgery with or without WBRT. The Functional Assessment of Cancer Therapy-Brain (FACT-Br) items were grouped according to different domains for summary scores. The domains used for summary scores were physical, social/family, emotional, functional well-being (FWB) and additional concerns. A total of 120 patients were enrolled, with 37 treated with WBRT alone and 83 with SRS or neurosurgery with or without WBRT. Of the 50 baseline FACT-Br items, only five items (I feel ill; I get support from my friends; I worry about dying; I have difficulty expressing my thoughts, I am able to put my thoughts into action) were statistically worse in patients treated with WBRT alone (P<0.05). Patients who received SRS or surgery with or without WBRT had statistically (P<0.05) higher scores for the FWB domain, additional concerns domain, and FACT-G total scores, indicating better QOL. Patients selected for WBRT alone reported statistically different baseline QOL as compared to patients who were treated with SRS or neurosurgery (with or without WBRT).

Factors Affecting Item Difficulty in English Listening Comprehension Tests

ERIC Educational Resources Information Center

Sung, Pei-Ju; Lin, Su-Wei; Hung, Pi-Hsia

2015-01-01

Task difficulty is a critical issue affecting test developers. Controlling or balancing the item difficulty of an assessment improves its validity and discrimination. Test developers construct tests from the cognitive perspective, by making the test constructing process more scientific and efficient; thus, the scores obtained more precisely…

Repressive coping and alexithymia in idiopathic environmental intolerance

PubMed Central

Zachariae, Robert; Rasmussen, Alice; Johansen, Jeanne Duus; Elberling, Jesper

2010-01-01

Objective To examine if the non-expression of negative emotions (i.e., repressive coping) and differences in the ability to process and regulate emotions (i.e., alexithymia) is associated with idiopathic environmental intolerance (IEI). Methods The study included participants who had previously participated in a general population-based study and reported symptoms of environmental intolerance (n = 787) and patients with IEI (n = 237). The participants completed questionnaires assessing IEI, namely, a measure of repressive coping combining scores on the Marlowe–Crowne Social Desirability Scale (MCSDS) and the Taylor Manifest Anxiety Scale (TMAS), the Toronto Alexithymia Scale (TAS-20), and a negative affectivity scale (NAS). Multiple, hierarchical linear regression analyses were conducted using IEI variables as the dependent variables. Results The TMAS and MCSDS scores were independently associated with the IEI variables, but there was no evidence of a role of the repressive coping construct. While the total alexithymia score was unrelated to IEI, the TAS-20 subscale of difficulties identifying feelings (DIF) was independently associated with symptoms attributed to IEI. Negative affectivity was a strong independent predictor of the IEI variables and a mediator of the association between DIF and IEI. Conclusion Our results provide no evidence for a role of repressive coping in IEI, and our hypothesis of an association with alexithymia was only partly supported. In contrast, strong associations between IEI and negative emotional reactions, defensiveness and difficulties identifying feelings were found, suggesting a need for exploring the influence of these emotional reactions in IEI. PMID:21432559

Alverine citrate plus simethicone reduces cecal intubation time in colonoscopy - a randomized study.

PubMed

Altintaş, Engin; Uçbilek, Enver; Sezgin, Orhan; Sayici, Yasin

2008-09-01

Successful colonoscopy depends on the insertion of the instrument to the cecum, a detailed examination, and minimal discomfort to the patient during the procedure. The aim of this study was to determine the effects of alverine citrate plus simethicone on the cecal intubation time, colonic spasm and bowel cleanliness. A prospective, randomized, controlled trial in a consecutive series of patients was conducted to compare alverine citrate as an antispasmodic agent for relaxation of spasm with elective colonoscopy. The drug used consisted of 60 mg alverine citrate plus 300 mg simethicone. Sodium phosphate soda and enema were recommended for bowel cleansing. During colonoscopy, spasticity, difficulty of the procedure, pain, and cleanliness of the colon were scored between 0-4. The time required to reach the cecum was recorded as minutes. Of 165 total patients, 83 and 82 patients were randomized as the drug group (mean age: 51.85+/-13.47 years) and control group (mean age: 51.68+/-16.28 years), respectively. There was a statistically significant difference between the groups in the mean time to reach the cecum in favor of the drug group (7.48+/-3.45 minutes vs. 6.20+/-3.24 minutes; p=0.02). The time to reach the cecum prolonged with an increase in pain score and difficulty score (p=0.0001 and p=0.001, respectively). Alverine citrate plus simethicone reduced the intubation time significantly by 19%, from 7.48 minutes to 6.20 minutes.

Early preschool processing abilities predict subsequent reading outcomes in bilingual Spanish-Catalan children with Specific Language Impairment (SLI).

PubMed

Aguilar-Mediavilla, Eva; Buil-Legaz, Lucía; Pérez-Castelló, Josep A; Rigo-Carratalà, Eduard; Adrover-Roig, Daniel

2014-01-01

Children with Specific Language Impairment (SLI) have severe language difficulties without showing hearing impairments, cognitive deficits, neurological damage or socio-emotional deprivation. However, previous studies have shown that children with SLI show some cognitive and literacy problems. Our study analyses the relationship between preschool cognitive and linguistic abilities and the later development of reading abilities in Spanish-Catalan bilingual children with SLI. The sample consisted of 17 bilingual Spanish-Catalan children with SLI and 17 age-matched controls. We tested eight distinct processes related to phonological, attention, and language processing at the age of 6 years and reading at 8 years of age. Results show that bilingual Spanish-Catalan children with SLI show significantly lower scores, as compared to typically developing peers, in phonological awareness, phonological memory, and rapid automatized naming (RAN), together with a lower outcome in tasks measuring sentence repetition and verbal fluency. Regarding attentional processes, bilingual Spanish-Catalan children with SLI obtained lower scores in auditory attention, but not in visual attention. At the age of 8 years Spanish-Catalan children with SLI had lower scores than their age-matched controls in total reading score, letter identification (decoding), and in semantic task (comprehension). Regression analyses identified both phonological awareness and verbal fluency at the age of 6 years to be the best predictors of subsequent reading performance at the age of 8 years. Our data suggest that language acquisition problems and difficulties in reading acquisition in bilingual children with SLI might be related to the close interdependence between a limitation in cognitive processing and a deficit at the linguistic level. After reading this article, readers will be able to: identify their understanding of the relation between language difficulties and reading outcomes; explain how processing abilities influence reading performance in bilingual Spanish-Catalan children with SLI; and recognize the relation between language and reading via a developmental model in which the phonological system is considered central for the development of decoding abilities and comprehension. Copyright © 2014 Elsevier Inc. All rights reserved.

Convergence of Self-Reports and Informant Reports on the Personality Assessment Screener.

PubMed

Kelley, Shannon E; Edens, John F; Morey, Leslie C

2017-12-01

The present study is the first to investigate the Personality Assessment Screener, a brief self-report measure of risk for emotional and behavioral dysfunction, in relation to the informant report version of this instrument, the Personality Assessment Screener-Other. Among a sample of undergraduate roommate dyads ( N = 174), self-report and informant report total scores on the Personality Assessment Screener/Personality Assessment Screener-Other moderately converged ( r = 0.45), with generally greater agreement between perspectives observed for externalizing behaviors compared with internalizing distress. In addition, selves tended to report more psychological difficulties relative to informant ratings ( d = 0.45) with an average absolute discrepancy between sources of 6.31 ( SD = 4.96) out of a possible range of 66. Discrepancies between self-report and informant report were significantly associated with characteristics of the dyadic relationship (e.g., length of acquaintanceship) as well as the severity of self-reported psychological difficulties and positive impression management.

Verification of learner’s differences by team-based learning in biochemistry classes

PubMed Central

2017-01-01

Purpose We tested the effect of team-based learning (TBL) on medical education through the second-year premedical students’ TBL scores in biochemistry classes over 5 years. Methods We analyzed the results based on test scores before and after the students’ debate. The groups of students for statistical analysis were divided as follows: group 1 comprised the top-ranked students, group 3 comprised the low-ranked students, and group 2 comprised the medium-ranked students. Therefore, group T comprised 382 students (the total number of students in group 1, 2, and 3). To calibrate the difficulty of the test, original scores were converted into standardized scores. We determined the differences of the tests using Student t-test, and the relationship between scores before, and after the TBL using linear regression tests. Results Although there was a decrease in the lowest score, group T and 3 showed a significant increase in both original and standardized scores; there was also an increase in the standardized score of group 3. There was a positive correlation between the pre- and the post-debate scores in group T, and 2. And the beta values of the pre-debate scores and “the changes between the pre- and post-debate scores” were statistically significant in both original and standardized scores. Conclusion TBL is one of the educational methods for helping students improve their grades, particularly those of low-ranked students. PMID:29207457

Vision and academic performance of learning disabled children.

PubMed

Wharry, R E; Kirkpatrick, S W

1986-02-01

The purpose of this study was to assess difference in academic performance among myopic, hyperopic, and emmetropic children who were learning disabled. More specifically, myopic children were expected to perform better on mathematical and spatial tasks than would hyperopic ones and that hyperopic and emmetropic children would perform better on verbal measures than would myopic ones. For 439 learning disabled students visual anomalies were determined via a Generated Retinal Reflex Image Screening System. Test data were obtained from school files. Partial support for the hypothesis was obtained. Myopic learning disabled children outperformed hyperopic and emmetropic children on the Key Math test. Myopic children scored better than hyperopic children on the WRAT Reading subtest and on the Durrell Analysis of Reading Difficulty Oral Reading Comprehension, Oral Rate, Flashword, and Spelling subtests, and on the Key Math Measurement and Total Scores. Severity of refractive error significantly affected the Wechsler Intelligence Scale for Children--Revised Full Scale, Performance Scale, Verbal Scale, and Digit Span scores but did not affect any academic test scores. Several other findings were also reported. Those with nonametropic problems scored higher than those without problems on the Key Math Time subtest. Implications supportive of the theories of Benbow and Benbow and Geschwind and Behan were stated.

Bayley-III motor scale and neurological examination at 2 years do not predict motor skills at 4.5 years.

PubMed

Burakevych, Nataliia; Mckinlay, Christopher Joel Dorman; Alsweiler, Jane Marie; Wouldes, Trecia Ann; Harding, Jane Elizabeth

2017-02-01

To determine whether Bayley Scales of Infant and Toddler Development (3rd edition) (Bayley-III) motor scores and neurological examination at 2 years corrected age predict motor difficulties at 4.5 years corrected age. A prospective cohort study of children born at risk of neonatal hypoglycaemia in Waikato Hospital, Hamilton, New Zealand. Assessment at 2 years was performed using the Bayley-III motor scale and neurological examination, and at 4.5 years using the Movement Assessment Battery for Children (2nd edition) (MABC-2). Of 333 children, 8 (2%) had Bayley-III motor scores below 85, and 50 (15%) had minor deficits on neurological assessment at 2 years; 89 (27%) scored less than or equal to the 15th centile, and 54 (16%) less than or equal to the 5th centile on MABC-2 at 4.5 years. Motor score, fine and gross motor subtest scores, and neurological assessments at 2 years were poorly predictive of motor difficulties at 4.5 years, explaining 0 to 7% of variance in MABC-2 scores. A Bayley-III motor score below 85 predicted MABC-2 scores less than or equal to the 15th centile with a positive predictive value of 30% and a negative predictive value of 74% (7% sensitivity and 94% specificity). Bayley-III motor scale and neurological examination at 2 years were poorly predictive of motor difficulties at 4.5 years. © 2016 Mac Keith Press.

Bayley-III motor scale and neurological examination at 2 years do not predict motor skills at 4.5 years

PubMed Central

Burakevych, Nataliia; Mckinlay, Christopher Joel Dorman; Alsweiler, Jane Marie; Wouldes, Trecia An; Harding, Jane Elizabeth

2016-01-01

Aim To determine whether Bayley Scales of Infant and Toddler Development (3rd edition) (Bayley-III) motor scores and neurological examination at 2 years' corrected age predict motor difficulties at 4.5 years' corrected age. Method A prospective cohort study of children born at risk of neonatal hypoglycaemia in Waikato Hospital, Hamilton, New Zealand. Assessment at 2 years was performed using the Bayley-III motor scale and neurological examination, and at 4.5 years using the Movement Assessment Battery for Children (2nd edition) (MABC-2). Results Of 333 children, 8 (2%) had Bayley-III motor scores below 85, and 50 (15%) had minor deficits on neurological assessment at 2 years; 89 (27%) scored less than or equal to the 15th centile, and 54 (16%) less than or equal to the 5th centile on MABC-2 at 4.5 years. Motor score, fine and gross motor subtest scores, and neurological assessments at 2 years were poorly predictive of motor difficulties at 4.5 years, explaining 0 to 7% of variance in MABC-2 scores. A Bayley-III motor score below 85 predicted MABC-2 scores less than or equal to the 15th centile with a positive predictive value of 30% and a negative predictive value of 74% (7% sensitivity and 94% specificity). Interpretation Bayley-III motor scale and neurological examination at 2 years were poorly predictive of motor difficulties at 4.5 years. PMID:27543144

[Effects of reading difficulties on scholastic self-evaluation and mental health in elementary school children].

PubMed

Yamashita, Toshiya; Hayashi, Takashi

2014-05-01

We aimed to examine the effects of reading difficulties on scholastic self-evaluation and mental health in elementary school students. Following guidelines for diagnosing reading disorders in elementary school students, we administered reading test batteries consisting of single sounds, single words, and single sentences to 41 fifth-grade elementary school students in Japan. The students' levels of scholastic self-evaluation, self-esteem, and depressive symptoms were assessed using self-rating questionnaires. By evaluating students' reading speed and the number of reading errors they made, we found that six students (14.6%) had reading difficulties (RD group) as per the guidelines for diagnosing reading disorders. The scholastic self-evaluation scores of this RD group were significantly lower than that of the non-RD group. No significant differences were found between the groups on self-esteem or depressive symptoms scores, which we considered to be indicators of mental health, Speed in reading single sounds and single words, and the number of reading errors in reading single sounds had significant negative correlations with scholastic self-evaluation scores. We found that reading difficulties might result in decreased scholastic self-evaluation in elementary school students; however, reading difficulties did not directly influence self-esteem or depression.

Item Response Theory Modeling of the Philadelphia Naming Test.

PubMed

Fergadiotis, Gerasimos; Kellough, Stacey; Hula, William D

2015-06-01

In this study, we investigated the fit of the Philadelphia Naming Test (PNT; Roach, Schwartz, Martin, Grewal, & Brecher, 1996) to an item-response-theory measurement model, estimated the precision of the resulting scores and item parameters, and provided a theoretical rationale for the interpretation of PNT overall scores by relating explanatory variables to item difficulty. This article describes the statistical model underlying the computer adaptive PNT presented in a companion article (Hula, Kellough, & Fergadiotis, 2015). Using archival data, we evaluated the fit of the PNT to 1- and 2-parameter logistic models and examined the precision of the resulting parameter estimates. We regressed the item difficulty estimates on three predictor variables: word length, age of acquisition, and contextual diversity. The 2-parameter logistic model demonstrated marginally better fit, but the fit of the 1-parameter logistic model was adequate. Precision was excellent for both person ability and item difficulty estimates. Word length, age of acquisition, and contextual diversity all independently contributed to variance in item difficulty. Item-response-theory methods can be productively used to analyze and quantify anomia severity in aphasia. Regression of item difficulty on lexical variables supported the validity of the PNT and interpretation of anomia severity scores in the context of current word-finding models.

Redintegration, task difficulty, and immediate serial recall tasks.

PubMed

Ritchie, Gabrielle; Tolan, Georgina Anne; Tehan, Gerald

2015-03-01

While current theoretical models remain somewhat inconclusive in their explanation of short-term memory (STM), many theories suggest at least a contribution of long-term memory (LTM) to the short-term system. A number of researchers refer to this process as redintegration (e.g., Schweickert, 1993). Under short-term recall conditions, the current study investigated the effects of redintegration and task difficulty in order to extend research conducted by Neale and Tehan (2007). Thirty participants in Experiment 1 and 26 participants in Experiment 2 completed a serial recall task in which retention interval, presentation rate, and articulatory suppression were used to modify task difficulty. Redintegration was examined by manipulating the characteristics of the to-be-remembered items; lexicality in Experiment 1 and wordlikeness in Experiment 2. Responses were scored based on correct-in-position recall, item scoring, and order accuracy scoring. In line with the Neale and Tehan results, as the difficulty of the task increased so did the effects of redintegration. This was evident in that the advantage for words in Experiment 1 and wordlikeness in Experiment 2 decreased as task difficulty increased. This relationship was observed for item but not order memory, and findings were discussed in relation to the theory of redintegration. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

[Evaluation of coordination and balance in preterm children].

PubMed

Rodríguez Fernández, Cristina; Mata Zubillaga, Daniel; Rodríguez Fernández, Luis Miguel; Regueras Santos, Laura; Reguera García, Maria Mercedes; de Paz Fernández, José Antonio; Lapeña López de Armentia, Santiago

2016-08-01

Recent studies show that many preterm children without apparent neurological sequelae present some difficulties in different areas, such as coordination or balance during their school years. The Movement Assessment Battery for Children-2 (MABC-2) has demonstrated to be a useful tool to validate the coordination, while the stabilometric platform was the reference standard test for validating the balance. Case-control study carried out on preterm children from 7 to 10 years old and healthy term infant controls of the same ages. The same age band of MABC-2 was applied and the static balance by the stabilometric platform was analysed. A total of 89 subjects were included, 30 preterm children≤1,500g birthweight, 29 preterm children>1,500g birthweight, and 30 controls. Preterm children obtained the lowest scores on an overall basis in hand dexterity and balance tests in MABC-2, regardless of their birthweight. Lower gestational age was associated with poorer outcomes in hand dexterity and total scores in MABC-2. Balance results were similar using the stabilometric platform, regardless of prematurity. A little more than 10% preterm and term children could have coordination disorders or be at risk of developing them using the MABC-2. Despite the visual-motor coordination being similar, preterm children could face greater difficulties in hand dexterity while, in the absence of neurological comorbidity, preterm and term children balance could be comparable. Copyright © 2015 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Effects of a 10-week toe-out gait modification intervention in people with medial knee osteoarthritis: a pilot, feasibility study.

PubMed

Hunt, M A; Takacs, J

2014-07-01

To examine the feasibility of a 10-week gait modification program in people with medial tibiofemoral knee osteoarthritis (OA), and to assess changes in clinical and biomechanical outcomes. Fifteen people with medial knee OA completed 10 weeks of gait modification focusing on increasing toe-out angle during stance 10° compared to their self-selected angle measured at baseline. In addition to adherence and performance difficulty outcomes, knee joint symptoms (Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale and total score, numerical rating scale (NRS) of pain), and knee joint loading during gait (late stance peak knee adduction moment (KAM)) were assessed. Participants were able to perform the toe-out gait modification program with minimal to moderate difficulty, and exhibited significant increases in self-selected toe-out angle during walking (P < 0.001). Joint discomfort was reported by five participants (33%) in the hip or knee joints, though none lasted longer than 2 weeks. Participants reported statistically significant reductions in WOMAC pain (P = 0.02), NRS pain (P < 0.001), WOMAC total score (P = 0.02), and late stance KAM (P = 0.04). These preliminary findings suggest that toe-out gait modification is feasible in people with medial compartment knee OA. Preliminary changes in clinical and biomechanical outcomes provide the impetus for conducting larger scale studies of gait modification in people with knee OA to confirm these findings. Copyright © 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Observed Score Equating Using a Mini-Version Anchor and an Anchor with Less Spread of Difficulty: A Comparison Study

ERIC Educational Resources Information Center

Liu, Jinghua; Sinharay, Sandip; Holland, Paul; Feigenbaum, Miriam; Curley, Edward

2011-01-01

Two different types of anchors are investigated in this study: a mini-version anchor and an anchor that has a less spread of difficulty than the tests to be equated. The latter is referred to as a midi anchor. The impact of these two different types of anchors on observed score equating are evaluated and compared with respect to systematic error…

Facial Emotion Recognition and Expression in Parkinson's Disease: An Emotional Mirror Mechanism?

PubMed

Ricciardi, Lucia; Visco-Comandini, Federica; Erro, Roberto; Morgante, Francesca; Bologna, Matteo; Fasano, Alfonso; Ricciardi, Diego; Edwards, Mark J; Kilner, James

2017-01-01

Parkinson's disease (PD) patients have impairment of facial expressivity (hypomimia) and difficulties in interpreting the emotional facial expressions produced by others, especially for aversive emotions. We aimed to evaluate the ability to produce facial emotional expressions and to recognize facial emotional expressions produced by others in a group of PD patients and a group of healthy participants in order to explore the relationship between these two abilities and any differences between the two groups of participants. Twenty non-demented, non-depressed PD patients and twenty healthy participants (HC) matched for demographic characteristics were studied. The ability of recognizing emotional facial expressions was assessed with the Ekman 60-faces test (Emotion recognition task). Participants were video-recorded while posing facial expressions of 6 primary emotions (happiness, sadness, surprise, disgust, fear and anger). The most expressive pictures for each emotion were derived from the videos. Ten healthy raters were asked to look at the pictures displayed on a computer-screen in pseudo-random fashion and to identify the emotional label in a six-forced-choice response format (Emotion expressivity task). Reaction time (RT) and accuracy of responses were recorded. At the end of each trial the participant was asked to rate his/her confidence in his/her perceived accuracy of response. For emotion recognition, PD reported lower score than HC for Ekman total score (p<0.001), and for single emotions sub-scores happiness, fear, anger, sadness (p<0.01) and surprise (p = 0.02). In the facial emotion expressivity task, PD and HC significantly differed in the total score (p = 0.05) and in the sub-scores for happiness, sadness, anger (all p<0.001). RT and the level of confidence showed significant differences between PD and HC for the same emotions. There was a significant positive correlation between the emotion facial recognition and expressivity in both groups; the correlation was even stronger when ranking emotions from the best recognized to the worst (R = 0.75, p = 0.004). PD patients showed difficulties in recognizing emotional facial expressions produced by others and in posing facial emotional expressions compared to healthy subjects. The linear correlation between recognition and expression in both experimental groups suggests that the two mechanisms share a common system, which could be deteriorated in patients with PD. These results open new clinical and rehabilitation perspectives.

The association of sleep difficulties with health-related quality of life among patients with fibromyalgia

PubMed Central

2012-01-01

Background Difficulty sleeping is common among patients with fibromyalgia (FM); however, its impact on health-related quality of life (HRQoL) is not well understood. The aim of the current study was to assess the burden of sleep difficulty symptoms on HRQoL among patients with FM. Methods The current study included data from the 2009 National Health and Wellness Survey (N=75,000), which is a cross-sectional, Internet-based survey representative of the adult US population. The prevalence of sleep difficulty symptoms among patients with FM (n=2,196) were compared with matched controls (n=2,194), identified using propensity-score matching. Additionally, the relationship between the number of sleep difficulty symptoms (none, one, or two or more) and HRQoL (using the SF-12v2) was assessed using regression modeling, controlling for demographic and health history variables. Results Of the 2,196 patients with FM, 11.2% reported no sleep difficulty symptoms, 25.7% reported one sleep difficulty symptom, and 63.05% reported two or more sleep difficulty symptoms. The prevalence of sleep difficulty symptoms was significantly higher than matched controls. Patients with one and two sleep difficulty symptoms both reported significantly worse HRQoL summary and domain scores relative to those with no sleep difficulty symptoms (all p<.05). Further, the relationship between sleep difficulty symptoms and HRQoL was significantly different between those with FM than matched controls, suggesting a uniqueness of the burden of sleep difficulties within the FM population. Conclusions Among the FM population, sleep difficulty symptoms were independently associated with clinically-meaningful decrements in mental and physical HRQoL. These results suggest that greater emphasis in the treatment of sleep difficulty symptoms among the FM population may be warranted. PMID:23072292

The association of sleep difficulties with health-related quality of life among patients with fibromyalgia.

PubMed

Wagner, Jan-Samuel; DiBonaventura, Marco D; Chandran, Arthi B; Cappelleri, Joseph C

2012-10-17

Difficulty sleeping is common among patients with fibromyalgia (FM); however, its impact on health-related quality of life (HRQoL) is not well understood. The aim of the current study was to assess the burden of sleep difficulty symptoms on HRQoL among patients with FM. The current study included data from the 2009 National Health and Wellness Survey (N=75,000), which is a cross-sectional, Internet-based survey representative of the adult US population. The prevalence of sleep difficulty symptoms among patients with FM (n=2,196) were compared with matched controls (n=2,194), identified using propensity-score matching. Additionally, the relationship between the number of sleep difficulty symptoms (none, one, or two or more) and HRQoL (using the SF-12v2) was assessed using regression modeling, controlling for demographic and health history variables. Of the 2,196 patients with FM, 11.2% reported no sleep difficulty symptoms, 25.7% reported one sleep difficulty symptom, and 63.05% reported two or more sleep difficulty symptoms. The prevalence of sleep difficulty symptoms was significantly higher than matched controls. Patients with one and two sleep difficulty symptoms both reported significantly worse HRQoL summary and domain scores relative to those with no sleep difficulty symptoms (all p<.05). Further, the relationship between sleep difficulty symptoms and HRQoL was significantly different between those with FM than matched controls, suggesting a uniqueness of the burden of sleep difficulties within the FM population. Among the FM population, sleep difficulty symptoms were independently associated with clinically-meaningful decrements in mental and physical HRQoL. These results suggest that greater emphasis in the treatment of sleep difficulty symptoms among the FM population may be warranted.

Alexithymia Associated with Nightmare Distress in Idiopathic REM Sleep Behavior Disorder

PubMed Central

Godin, Isabelle; Montplaisir, Jaques; Gagnon, Jean-François; Nielsen, Tore

2013-01-01

Study Objectives: Idiopathic REM sleep behavior disorder (iRBD) is characterized by atypical REM sleep motor activity, vivid dreams and nightmares, and dream-enacting behaviors that can result in injuries to the patient and bed partner. It is also a known predictor of Parkinson disease (PD). Alexithymia has been associated with disturbances in sleep and dreaming (e.g., nightmares) and is a non-motor symptom of PD. We assessed alexithymia and disturbed dreaming in iRBD patients with the aim of determining if these two factors are elevated and interrelated among this population. Design: Questionnaire study of clinically diagnosed patients. Setting: Clinical sleep disorders center. Patients or participants: Thirty-two iRBD patients and 30 healthy age- and sex-matched control participants. Measurements and Results: Participants completed the 20-item Toronto Alexithymia Scale (TAS-20), the Dream Questionnaire, and the Beck Depression Inventory. iRBD patients obtained higher TAS-20 total scores (62.16 ± 13.90) than did controls (52.84 ± 7.62; F1,59 = 10.44, P < 0.01), even when controlling for depressive symptoms, and more frequently attained the suggested cutoff for alexithymia than did controls (P < 0.01). iRBD patients obtained higher scores on the Difficulty Identifying Feelings alexithymia subscale. For both iRBD and control groups, the Difficulty Indentifying Feelings subscale correlated positively with the Nightmare Distress scale of the Dream Questionnaire. Conclusions: Elevated alexithymia scores among idiopathic rapid eye movement sleep behavior disorder patients, and especially a difficulty in identifying feelings, parallels evidence of dysautonomia in this population. The higher incidence of distressing nightmares and the association of nightmares with alexithymia further extend similar findings for both clinical and non-clinical samples and suggest that an affect regulation disturbance may be common to the two sets of symptoms. Citation: Godin I; Montplaisir J; Gagnon JF; Nielsen T. Alexithymia associated with nightmare distress in idiopathic REM sleep behavior disorder. SLEEP 2013;36(12):1957-1962. PMID:24293771

Racism, ethnic density and psychological well-being through adolescence: evidence from the Determinants of Adolescent Social Well-Being and Health longitudinal study.

PubMed

Astell-Burt, Thomas; Maynard, Maria J; Lenguerrand, Erik; Harding, Seeromanie

2012-01-01

To investigate the effect of racism, own-group ethnic density, diversity and deprivation on adolescent trajectories in psychological well-being. Multilevel models were used in longitudinal analysis of psychological well-being (total difficulties score (TDS) from Goodman's Strengths and Difficulties Questionnaire, higher scores correspond to greater difficulties) for 4782 adolescents aged 11-16 years in 51 London (U.K.) schools. Individual level variables included ethnicity, racism, gender, age, migrant generation, socio-economic circumstances, family type and indicators of family interactions (shared activities, perceived parenting). Contextual variables were per cent eligible for free school-meals, neighbourhood deprivation, per cent own-group ethnic density, and ethnic diversity. Ethnic minorities were more likely to report racism than whites. Ethnic minority boys (except Indian boys) and Indian girls reported better psychological well-being throughout adolescence compared to their white peers. Notably, lowest mean TDS scores were observed for Nigerian/Ghanaian boys, among whom the reporting of racism increased with age. Adjusted for individual characteristics, psychological well-being improved with age across all ethnic groups. Racism was associated with poorer psychological well-being trajectories for all ethnic groups (p<0.001), reducing with age. For example, mean difference in TDS (95% confidence interval) between boys who experienced racism and those who did not at age 12 years=1.88 (+1.75 to +2.01); at 16 years = +1.19 (+1.07 to +1.31). Less racism was generally reported in schools and neighbourhoods with high than low own-group density. Own ethnic density and diversity were not consistently associated with TDS for any ethnic group. Living in more deprived neighbourhoods was associated with poorer psychological well-being for whites and black Caribbeans (p<0.05). Racism, but not ethnic density and deprivation in schools or neighbourhoods, was an important influence on psychological well-being. However, exposure to racism did not explain the advantage in psychological well-being of ethnic minority groups over whites.

Health-related quality of life of children with physical disabilities: a longitudinal study

PubMed Central

2014-01-01

Background Outcomes of health and rehabilitation services for children and youth with disabilities increasingly include assessments of health-related quality of life (HRQoL). The purpose of this research was to 1) describe overall patterns of HRQoL, 2) examine changes in parent’s perceptions of child’s HRQoL across 18 months and 3) explore factors that predict these changes. Methods Participants in this study included 427 parents of children (229 boys and 198 girls) with a physically-based disability between the ages of 6 to 14 years. The Child Health Questionnaire (CHQ) was administered three times, at nine month intervals. Comparisons to the CHQ normative data were analyzed at Time 1 using t-tests, and change over time was examined using linear mixed-effects models. Possible predictors were modeled: 1) child’s factors measured by the Activities Scale for Kids, Strengths and Difficulties Questionnaire, and general health measured by SF-36, 2) family characteristics measured by the Impact on Family Scale and 3) environmental barriers measured by the Craig Hospital Inventory of Environmental Factors. Results CHQ scores of the study’s participants demonstrated significantly lower summary scores from the normative sample for both CHQ Physical and Psychosocial summary scores. On average, children did not change significantly over time for physical summary scores. There was an average increase in psychosocial health that was statistically significant, but small. However, there was evidence of heterogeneity among children. Environmental barriers, behavioral difficulties, family functioning/impact, general health and child physical functioning had negative and significant associations with physical QoL at baseline. Change in physical QoL scores over time was dependent on children’s behavioral difficulties, family functioning and environmental barriers. Environmental barriers, behavioral difficulties, family functioning/impact and general health had significant associations with psychosocial scores at baseline, but none served as predictors of change over time. Conclusions Children with physical disabilities differ from the normative group on parent ratings of their physical and psychosocial health. While there was little average change in CHQ scores over 18 months, there is evidence of heterogeneity among children. Factors such as environmental barriers, family functioning/impact, child physical functioning and behavioral difficulties and general health significantly influence QoL scores as measured by the CHQ. PMID:24476085

Health-related quality of life of children with physical disabilities: a longitudinal study.

PubMed

Law, Mary; Hanna, Steven; Anaby, Dana; Kertoy, Marilyn; King, Gillian; Xu, Liqin

2014-01-30

Outcomes of health and rehabilitation services for children and youth with disabilities increasingly include assessments of health-related quality of life (HRQoL). The purpose of this research was to 1) describe overall patterns of HRQoL, 2) examine changes in parent's perceptions of child's HRQoL across 18 months and 3) explore factors that predict these changes. Participants in this study included 427 parents of children (229 boys and 198 girls) with a physically-based disability between the ages of 6 to 14 years. The Child Health Questionnaire (CHQ) was administered three times, at nine month intervals. Comparisons to the CHQ normative data were analyzed at Time 1 using t-tests, and change over time was examined using linear mixed-effects models. Possible predictors were modeled: 1) child's factors measured by the Activities Scale for Kids, Strengths and Difficulties Questionnaire, and general health measured by SF-36, 2) family characteristics measured by the Impact on Family Scale and 3) environmental barriers measured by the Craig Hospital Inventory of Environmental Factors. CHQ scores of the study's participants demonstrated significantly lower summary scores from the normative sample for both CHQ Physical and Psychosocial summary scores. On average, children did not change significantly over time for physical summary scores. There was an average increase in psychosocial health that was statistically significant, but small. However, there was evidence of heterogeneity among children. Environmental barriers, behavioral difficulties, family functioning/impact, general health and child physical functioning had negative and significant associations with physical QoL at baseline. Change in physical QoL scores over time was dependent on children's behavioral difficulties, family functioning and environmental barriers. Environmental barriers, behavioral difficulties, family functioning/impact and general health had significant associations with psychosocial scores at baseline, but none served as predictors of change over time. Children with physical disabilities differ from the normative group on parent ratings of their physical and psychosocial health. While there was little average change in CHQ scores over 18 months, there is evidence of heterogeneity among children. Factors such as environmental barriers, family functioning/impact, child physical functioning and behavioral difficulties and general health significantly influence QoL scores as measured by the CHQ.

Metacognitive Reading and Study Strategies and Academic Achievement of University Students With and Without a History of Reading Difficulties.

PubMed

Bergey, Bradley W; Deacon, S Hélène; Parrila, Rauno K

2017-01-01

University students who report a history of reading difficulties have been demonstrated to have poorer word reading and reading comprehension skills than their peers; yet, without a diagnosed learning disability, these students do not have access to the same support services, potentially placing them at academic risk. This study provides a comprehensive investigation of first-year academic achievement for students with a history of reading difficulties (n = 244) compared to students with no such history (n = 603). We also examine reported use of metacognitive reading and study strategies and their relations with GPA. Results indicate that students with a history of reading difficulties earn lower GPA and successfully complete fewer credits compared to students with no history of reading difficulty. These patterns varied somewhat by faculty of study. Students with a history of reading difficulties also reported lower scores across multiple metacognitive reading and study strategy scales, yet these scores were not associated with their academic performance. Together, these results demonstrate the importance of identifying students with a history of reading difficulties and that commonly used study strategy inventories have limited value in predicting their academic success. © Hammill Institute on Disabilities 2015.

Very low birth weight children: behavior problems and school difficulty in a national sample.

PubMed

McCormick, M C; Gortmaker, S L; Sobol, A M

1990-11-01

We addressed three questions concerning the behavioral and academic status of low and very low birth weight infants through a secondary analysis of the 1981 National Health Interview Survey--Child Health Supplement: (1) in children born with very low birth weight, what is the risk of behavior problems and school difficulty compared with that in heavier low birth weight and normal birth weight children? (2) What are the correlates of school difficulty? (3) Are behavior problems associated with school difficulty when variables are controlled for these correlates? The analysis revealed that 34% of very low birth weight children could be characterized as having school difficulty, compared with 20% and 14% of the other groups, respectively, and that they were more likely to have higher scores on the hyperactive subscale of the Behavior Problems Index. Although a broad array of sociodemographic factors correlated with school difficulty, very low birth weight and hyperactivity scores contributed independently to the risk of academic problems. We conclude that very low birth weight infants are at risk of having school problems that are in part associated with hyperactive behavior.

How reliable and valid is the teacher version of the Strengths and Difficulties Questionnaire in primary school children?

PubMed Central

van den Heuvel, Meta; Jansen, Danielle E. M. C.; Stewart, Roy E.; Smits-Engelsman, Bouwien C. M.; Reijneveld, Sijmen A.; Flapper, Boudien C. T.

2017-01-01

Introduction The Strengths and Difficulties Questionnaire (SDQ) is validated for parents, but not yet for teachers in a broad age range of children. We conducted a cross-sectional study with 4–10 years old school children to investigate if the SDQ-T can be used instead of the validated but lengthy Teacher’s Report Form (TRF) to acquire information about emotional and behavioral problems in the school community. Methods Teachers of 453 children from primary schools were approached. Teachers of 394 children (response rate 86.9%) with a mean age of 7.1 years filled in the SDQ-T (n = 387), the TRF (n = 349) or both (n = 342). We assessed reliability by calculating internal consistency and concurrent validity (using correlation coefficients, sensitivity, specificity) of the SDQ-T compared with the TRF. Results Internal consistency of the SDQ-T Total Difficulties Score (SDQ-T TDS; Cronbach α = 0.80), hyperactivity/ inattention- (α = 0.86) and prosocial behavior (α = 0.81) was very good. Concurrent validity demonstrated a strong correlation of all subscales of the SDQ-T with the corresponding scale on the TRF (range 0.54–0.73), except for peer problems (0.46). Using a SDQ-T TDS cut-off score > 14, the SDQ-T had a good sensitivity (90%) and specificity (94%). Discussion The good reliability, validity and brevity of the SDQ-T make it an easily applicable questionnaire for obtaining information about emotional and behavioral problems from teachers in primary school children. PMID:28453573

Aggression in schools: psychosocial outcomes of bullying among Indian adolescents.

PubMed

Malhi, Prahbhjot; Bharti, Bhavneet; Sidhu, Manjit

2014-11-01

To examine the prevalence of school bullying and to investigate the behavioral, emotional, socio-economic and demographic correlates of bullying behaviors among Indian school going adolescents. Self-reports on bullying involvement were collected from 9th to 10th class students (N = 209; Mean = 14.82 y, SD = 0.96) from Government and Private schools of a north Indian city. Four groups of adolescents were identified: bullies, victims, bully-victims, and non-involved students. The self concept of the child was measured by the Indian adaptation of the Piers Harris Children's Self Concept Scale (CSCS) and emotional and behavioral difficulties by the Youth self report measure of the Strengths and Difficulties Questionnaire. The overall prevalence of any kind of bullying behavior was 53 %. One-fifth (19.2 %) of the children were victims of bullying. Boys were more likely to be bully-victims (27.9 %) and girls were more likely to be victims (21.6 %). Bullying status was significantly related to the total self concept scores of the students (F = 5.12, P = 0.002). Victimized adolescents reported the lowest self concept scores. Bully-victims had a higher risk for conduct problems and hyperactivity and were the most likely to have academic difficulties. Bullies had relatively better school grades and high self esteem but had higher risk for hyperactivity and conduct problems as compared to controls. Bullying and victimization was widespread among the Indian school going youth. Given the concurrent psychosocial adjustment problems associated with bullying, there is an urgent need for developing intervention programs and sensitizing school personnel.

'Junk food' diet and childhood behavioural problems: results from the ALSPAC cohort.

PubMed

Wiles, N J; Northstone, K; Emmett, P; Lewis, G

2009-04-01

To determine whether a 'junk food' diet at age 4(1/2) is associated with behavioural problems at age 7. Data on approximately 4000 children participating in the Avon Longitudinal Study of Parents and Children, a birth cohort recruited in Avon, UK in 1991/92 were used. Behavioural problems were measured at age 7 using the Strengths and Difficulties Questionnaire (SDQ; maternal completion). Total difficulties and scores for the five sub-scales (hyperactivity, conduct and peer problems, emotional symptoms and pro-social behaviour) were calculated. Principal components analysis of dietary data (frequency of consumption of 57 foods/drinks) collected at age 4(1/2) by maternal report was used to generate a 'junk food' factor. Data on confounders were available from questionnaires. A one standard deviation increase in 'junk food' intake at age 4(1/2) years was associated with increased hyperactivity at age 7 (odds ratio: 1.19; 95% confidence interval: 1.10, 1.29). This persisted after adjustment for confounders including intelligence quotient score (odds ratio: 1.13; 95% confidence interval: 1.01, 1.15). There was little evidence to support an association between 'junk food' intake and overall behavioural difficulties or other sub-scales of the SDQ. Children eating a diet high in 'junk food' in early childhood were more likely to be in the top 33% on the SDQ hyperactivity sub-scale at age 7. This may reflect a long-term nutritional imbalance, or differences in parenting style. This finding requires replication before it can provide an avenue for intervention.

“Junk food” diet and childhood behavioural problems: Results from the ALSPAC cohort

PubMed Central

Wiles, Nicola J; Northstone, Kate; Emmett, Pauline; Lewis, Glyn

2007-01-01

Objective To determine whether a “junk food” diet at age 4½ is associated with behavioural problems at age 7. Subjects and Methods Data on approximately 4000 children participating in the Avon Longitudinal Study of Parents and Children (ALSPAC), a birth cohort recruited in Avon, UK in 1991/92, were used. Behavioural problems were measured at age 7 using the Strengths & Difficulties Questionnaire (SDQ) (maternal completion). Total difficulties and scores for the 5 sub-scales (hyperactivity, conduct & peer problems, emotional symptoms, & prosocial behaviour) were calculated. Principal components analysis of dietary data (frequency of consumption of 57 foods/drinks) collected at age 4½ by maternal report was used to generate a “junk food” factor. Data on confounders were available from questionnaires. Results A one standard deviation increase in “junk food” intake at age 4½ years was associated with increased hyperactivity at age 7 (odds ratio: 1.19 (95% confidence interval: 1.10, 1.29)). This persisted after adjustment for confounders including IQ score (odds ratio: 1.13 (95% confidence interval: 1.01, 1.15)). There was little evidence to support an association between “junk food” intake and overall behavioural difficulties or other sub-scales of the SDQ. Conclusions Children eating a diet high in “junk food” in early childhood were more likely to be in the top 33% on the SDQ hyperactivity sub-scale at age 7. This may reflect a long-term nutritional imbalance, or differences in parenting style. This finding requires replication before it can provide an avenue for intervention. PMID:18059416

Confidence Scoring of Speaking Performance: How Does Fuzziness become Exact?

ERIC Educational Resources Information Center

Jin, Tan; Mak, Barley; Zhou, Pei

2012-01-01

The fuzziness of assessing second language speaking performance raises two difficulties in scoring speaking performance: "indistinction between adjacent levels" and "overlap between scales". To address these two problems, this article proposes a new approach, "confidence scoring", to deal with such fuzziness, leading to "confidence" scores between…

Examining subjective wellbeing and health-related quality of life in women with endometriosis.

PubMed

Rush, Georgia; Misajon, RoseAnne

2018-03-01

The purpose of this study was to explore the subjective wellbeing, health-related quality of life and lived experience of women living with endometriosis. In 2015 five hundred participants between the ages of 18-63 (M = 30.5, SD = 7.46) were recruited through Endometriosis Australia and social media, completing an online questionnaire comprising the Personal Wellbeing Index, the Endometriosis Health Profile-30 and various open-ended questions. Results found that women with endometriosis reported low levels of subjective wellbeing (mean PWI total scores of 51.5 ± 2.03), considerably below the normative range of 70-80 for western populations. The mean Endometriosis Health Profile total score indicated a very low health-related quality of life amongst the women in this sample (78.9, ±13.14). There was also a significant relationship between scores on the Endometriosis Health Profile and Personal Wellbeing Index. The findings from the qualitative data suggest that endometriosis impacts negatively on women's lives in several areas such as; social life, relationships and future plans, this in turn affects women's overall life quality. The study highlights the strong negative impact that endometriosis can have on women's subjective wellbeing and health related quality of life, contributing to productivity issues, relationship difficulties and social dissatisfaction and increasing the risk of psychological comorbidities.

Evaluation of early childhood social-communication difficulties in children born preterm using the Quantitative Checklist for Autism in Toddlers.

PubMed

Wong, Hilary S; Huertas-Ceballos, Angela; Cowan, Frances M; Modi, Neena

2014-01-01

To characterize early childhood social-communication skills and autistic traits in children born very preterm using the Quantitative Checklist for Autism in Toddlers (Q-CHAT) and explore neonatal and sociodemographic factors associated with Q-CHAT scores. Parents of children born before 30 weeks gestation and enrolled in a study evaluating routinely collected neurodevelopmental data between the post-menstrual ages of 20 and 28 months were invited to complete the Q-CHAT questionnaire. Children with severe neurosensory disabilities and cerebral palsy were excluded. Participants received neurodevelopmental assessments using the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III). Q-CHAT scores of this preterm cohort were compared with published general population scores. The association between Bayley-III cognitive and language scores and neonatal and sociodemographic factors with Q-CHAT scores were examined. Q-CHAT questionnaires were completed from 141 participants. At a mean post-menstrual age of 24 months, the Q-CHAT scores of the preterm cohort (mean 33.7, SD 8.3) were significantly higher than published general population scores (mean 26.7; SD 7.8), indicating greater social-communication difficulty and autistic behavior. Preterm children received higher scores, particularly in the categories of restricted, repetitive, stereotyped behavior, communication, and sensory abnormalities. Lower Bayley-III language scores and non-white ethnicity were associated with higher Q-CHAT scores. Preterm children display greater social-communication difficulty and autistic behavior than the general population in early childhood as assessed by the Q-CHAT. The implications for longer-term outcome will be important to assess. Copyright © 2014 Mosby, Inc. All rights reserved.

Effect of age, sex and level of surgical difficulty on inflammatory complications after third molar surgery.

PubMed

Osunde, Otasowie D; Saheeb, Birch D

2015-03-01

Patients' factors such as age and sex and surgical variables such as level of difficulty have been linked with surgical outcome in third molar surgery. The aim of this study was to determine the effect of these variables on inflammatory complications in patients undergoing third molar surgery. Patients referred to our institution for surgical extraction of their impacted lower third molar between January 2007 and December 2008 were the subjects of the study. Patients' demographics as well as types of impaction, indication and level of difficulty based on Pederson criteria were obtained. Post operative pain, swelling and mouth opening limitation were evaluated at day 1, day 2, day 3, day 5 and 1 week after the surgery and analyzed. A p value of less than 0.05 was considered significant. A total of 150 patients aged 16-38 years (25.9 ± 4.47) met the inclusion criteria. Male accounted for 66 (44.0 %) while females were 84 (56.0 %), giving male to female ratio of 1:1.3. Age, sex and difficulty index had no effect on pain and trismus throughout the periods of postoperative evaluation (p > 0.05). Postoperative swelling was not affected by gender but patients above 25 years who had high scores of difficulty index had more facial swelling. The results of this study shows that age, gender and the level of surgical difficulty have no effect on pain and mouth opening limitation after third molar surgery.

Sleep Patterns, Sleep Disturbances, and Associated Factors Among Chinese Urban Kindergarten Children.

PubMed

Liu, Zhijun; Wang, Guanghai; Geng, Li; Luo, Junna; Li, Ningxiu; Owens, Judith

2016-01-01

This study aimed to characterize sleep patterns and disturbances among Chinese urban kindergarten children and examine potentially associated factors. Caregivers of 513 children (47.96% male) aged 3-6 years (mean age = 4.46, SD = 0.9) completed the Children's Sleep Habits Questionnaire (CSHQ) and the Strengths and Difficulties Questionnaire (SDQ). Almost 80% (78.8%) of the children scored above the original CSHQ cutoff point for global sleep disturbance. Regression analysis indicated that child's age, and the presence of emotional problems, hyperactivity and peer problems, cosleeping, and interparental inconsistency of attitudes toward child rearing accounted for significant variance in the CSHQ total score (R(2) = 22%). These findings indicate that there is an apparently high prevalence of sleep disturbances in Chinese urban kindergarten children; and sleep disturbances are associated with both child-related and parenting practice variables.

Prevalence and correlates of delayed sleep phase in high school students.

PubMed

Saxvig, Ingvild W; Pallesen, Ståle; Wilhelmsen-Langeland, Ane; Molde, Helge; Bjorvatn, Bjørn

2012-02-01

To investigate prevalence and correlates of delayed sleep phase, characterized by problems falling asleep in the evening and rising at adequate times in the morning, in a large sample of Norwegian high school students. A randomized sample of 1285 high school students (aged 16-19 years) participated in an internet based study answering questions about sleep habits, height, weight, smoking, alcohol use, school grades, and anxiety and depression symptoms. Delayed sleep phase was operationalized as difficulties falling asleep before 2 a.m. at least three nights per week together with much or very much difficulty waking up in the morning. The results show a prevalence of delayed sleep phase of 8.4%. In all, 68% of these students (5.7% of the total sample) also reported problems advancing their sleep period as well as one daytime consequence (oversleeping at least two days a week or experiencing much/very much sleepiness at school). Delayed sleep phase was associated with lower average school grades, smoking, alcohol usage, and elevated anxiety and depression scores. Delayed sleep phase appears to be common amongst Norwegian adolescents and is associated with negative outcomes such as lower average school grades, smoking, alcohol usage, and elevated anxiety and depression scores. Copyright © 2011 Elsevier B.V. All rights reserved.

Is severity of motor coordination difficulties related to co-morbidity in children at risk for developmental coordination disorder?

PubMed

Schoemaker, Marina M; Lingam, Raghu; Jongmans, Marian J; van Heuvelen, Marieke J G; Emond, Alan

2013-10-01

Aim of the study was to investigate whether 7-9 year old children with severe motor difficulties are more at risk of additional difficulties in activities in daily living, academic skills, attention and social skills than children with moderate motor difficulties. Children (N=6959) from a population based cohort, the Avon Longitudinal Study of Parents and Children (ALSPAC), were divided into three groups based on their scores on the ALSPAC Coordination Test at age 7: control children (scores above 15th centile; N=5719 [82.1%]); children with moderate (between 5th and 15th centile; N=951 [13.7%]); and children with severe motor difficulties (below 5th centile N=289 [4.2%]). Children with neurological disorders or an IQ<70 were excluded. Logistic regression was used to compare children with moderate and severe motor coordination difficulties with each other and with control children regarding their risk of co-morbidity defined as significant (<10th centile) difficulties with activities of daily living (ADL); academic skills (reading, spelling and handwriting); attention; social skills (social cognition and nonverbal skills). Children with severe motor difficulties demonstrated a higher risk of difficulties in ADL, handwriting, attention, reading, and social cognition than children with moderate motor difficulties, who in turn had a higher risk of difficulties than control children in five out of seven domains. Screening and intervention of co-morbid problems is recommended for children with both moderate and severe motor difficulties. Copyright © 2013. Published by Elsevier Ltd.

Stability and Predictive Validity of the Parent-Child Sleep Interactions Scale: A Longitudinal Study Among Preschoolers.

PubMed

Barrios, Chelsey S; Jay, Samantha Y; Smith, Victoria C; Alfano, Candice A; Dougherty, Lea R

2018-01-01

Little research has examined the processes underlying children's persistent sleep problems and links with later psychopathology. The current study examined the stability of parent-child sleep interactions as assessed with the parent-reported Parent-Child Sleep Interactions Scale (PSIS) and examined whether sleep interactions in preschool-age children predict sleep problems and psychiatric symptoms later in childhood. Participants included 108 preschool-age children (50% female) and their parents. Parents completed the PSIS when children were 3-5 years (T1) and again when they were 6-9 years (T2). The PSIS includes three subscales-Sleep Reinforcement (reassurance of child sleep behaviors), Sleep Conflict (parent-child conflict at bedtime), Sleep Dependence (difficulty going to sleep without parent)-and a total score. Higher scores indicate more problematic bedtime interactions. Children's sleep problems and psychiatric symptoms at T1 and T2 were assessed with a clinical interview. PSIS scores were moderately stable from T1 to T2, and the factor structure of the PSIS remained relatively consistent over time. Higher total PSIS scores at T1 predicted increases in children's sleep problems at T2. Higher PSIS Sleep Conflict scores at T1 predicted increases in oppositional defiant disorder symptoms at T2. Children with more sleep problems and higher PSIS Sleep Reinforcement scores at T1 showed increases in attention deficit/hyperactivity disorder, depressive, and anxiety symptoms at T2. These findings provide evidence for the predictive validity of the PSIS and highlight the importance of early parent-child sleep interactions in the development of sleep and psychiatric symptoms in childhood. Parent-child sleep interactions may serve as a useful target for interventions.

[Identification of difficulties at the beginning of breastfeeding by means of protocol application].

PubMed

Carvalhaes, Maria Antonieta de Barros Leite; Corrêa, Cláudia Regina Hostin

2003-01-01

To assess a group of mothers/newborns with the necessity of special support at the beginning of breastfeeding by means of protocol application recommended by UNICEF and to verify assisting practices associated with difficulties of breastfeeding.\\par In this descriptive study, the sample comprised 50 mother/newborn pairs randomly selected in a maternity where low risk deliveries are cared by SUS (Brazilian Unified Health System). The breastfeeding observation protocol was used to record the behavior of each pair, including the frequency of negative behavior regarding breastfeeding. Next, each aspect was scored as good, regular or poor. The association between negative scores and particular assisting practices was also investigated. A critical level of p < 0.05 was used.\\par The frequency of pairs presenting evidence of severe problems (poor score) at the beginning of breastfeeding ranged from 2% to 22% according to the aspects assessed. The most frequently observed difficulties were mother and infant's bad positioning during breastfeeding and inappropriate mother/newborn interaction. These problems were significantly more frequent after surgical deliveries (p < 0.05). Milk formula and/or glucose solution was also associated with the worst scores in some breastfeeding aspects. \\par The protocol application to observe and evaluate breastfeeding identified a high prevalence of mothers/newborn pairs with difficulties to begin breastfeeding, especially when the delivery was surgically performed and when the newborn was offered supplementary liquids.

Correlations between psychopathology and self-reported quality of life among adolescents in youth correctional facilities in Lagos, Nigeria: A short report.

PubMed

Atilola, Olayinka; Ola, Bolanle; Abiri, Gbonjubola; Adewuya, Abiodun O

2018-02-01

The relationship between psychopathology and quality of life (QoL) and well-being among young incarcerated offenders has hardly been explored. Our aim was to test the hypothesis that higher self-rated psychopathology would be associated with lower QoL among adolescents resident within youth correctional facilities in Lagos. Psychopathology was assessed using the Strength and Difficulty Questionnaire (SDQ), while QoL was measured by using the Paediatric Quality of Life. One hundred and sixty-five adolescents completed the study, mostly boys (n = 124; 75%) with a mean age of 14.3 ± 2.1 years. Nearly, a fifth (30, 18%) of respondents had abnormal total SDQ scores (≥17), suggestive of definite psychiatric disorder, while another 44 (27%) had highly probable psychopathology (total SDQ scores 15-16). There was strong negative correlation (r = -0.51, p < 0.001) between total SDQ scores and overall self-reported QoL among respondents. Although we were unable to infer direction of relationship between psychopathology and QoL among these adolescents, it is plausible to suppose that treatment of mental health problems could have a positive impact on rehabilitation and reintegration. Given the rate of likely psychopathology, mental health screening within young offender institutions should be routine, and followed, as necessary with full assessment and resultant treatment. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Prospective Study of Insufficient Sleep and Neurobehavioral Functioning Among School-Age Children.

PubMed

Taveras, Elsie M; Rifas-Shiman, Sheryl L; Bub, Kristen L; Gillman, Matthew W; Oken, Emily

2017-08-01

To examine associations between insufficient sleep and neurobehavioral functioning in childhood as reported by mothers and teachers. Participants were 1046 children in a prebirth cohort study. Main exposures were insufficient sleep durations at 3 time points: 6 months to 2 years, defined as sleep <11 h/d, 11 to <12 h/d (vs ≥12); 3 to 4 years, defined as sleep <10 h/d, 10 to <11 h/d (vs ≥11); and 5 to 7 years, sleep <9 h/d, 9 to <10 h/d (vs ≥10). Outcomes at age 7 years were executive function, behavior, and social-emotional functioning, assessed using the Behavioral Rating Inventory of Executive Function (BRIEF) and the Strengths and Difficulties Questionnaire (SDQ). Higher scores indicate poorer functioning. Mothers and teachers completed both instruments independently. At age 7 years, mean (SD) mother and teacher report of the BRIEF global executive composite scale were 48.3 (7.9) and 50.7 (9.4) points, respectively, and of the SDQ total difficulties score was 6.5 (4.7) and 6.2 (5.7). In multivariable models, children who slept <10 h/d at 3 to 4 years had worse maternal-reported scores for the BRIEF (2.11 points; 95% confidence interval, 0.17-4.05) and SDQ (1.91 points; 95% confidence interval, 0.78-3.05) than those with age-appropriate sleep. Children who slept <9 h/d at 5 to 7 years also had worse scores. At both ages, associations with teacher-reported results were consistent with those of mothers. Infants who slept 11 to <12 h/d had higher teacher- but not mother-reported scores. Insufficient sleep in the preschool and early school years is associated with poorer mother- and teacher-reported neurobehavioral processes in midchildhood. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

The effect of school meals with fatty fish on adolescents' self-reported symptoms for mental health: FINS-TEENS - a randomized controlled intervention trial.

PubMed

Skotheim, Siv; Handeland, Katina; Kjellevold, Marian; Øyen, Jannike; Frøyland, Livar; Lie, Øyvind; Eide Graff, Ingvild; Baste, Valborg; Stormark, Kjell Morten; Dahl, Lisbeth

2017-01-01

There is a growing body of evidence linking fish consumption and n-3 LCPUFAs to mental health. Still, the results from randomized trials with n-3 LCPUFAs show conflicting results, and it is possible that the combined effect of several nutrients in fish may explain the observed associations. To aim of the present study was to investigate if school meals with fatty fish three times per week for 12 weeks could alter mental health in a sample of typically developing adolescents. In the Fish Intervention Studies-TEENS (FINS-TEENS), adolescents from eight secondary schools (n=425) in Norway, were randomized to receive school meals with fatty fish, meat or n-3 LCPUFA supplements. Mental health was assessed with the Strengths and Difficulties Questionnaire (SDQ) and the differences between the groups were assessed with linear mixed effect models, unadjusted and adjusted for baseline and dietary compliance. The results showed no effects of school meals with fatty fish compared to similar meals with meat or n-3 LCPUFAs on the adolescents' self-reported symptom scores for mental health. Among adolescents scoring above the SDQ cut-offs (high-scorers), the fish- improved less than the meat group in the self-reported symptom scores for total difficulties- and emotional problems. However, the findings should be regarded as preliminary, as the analyses for the high-scorer group were underpowered. In conclusion, serving school meals with fatty fish did not alter mental health in a typically developing sample of adolescents. It is possible that serving healthy school meals with meat is more beneficial than similar meals with fatty fish in adolescents scoring high on mental health problems. However, the results should be seen as preliminary, as the dietary compliance in the fish group was low and the analyses in the high score group underpowered. Thus, further studies should investigate the associations between fish consumption and adolescents' mental health.

The Strengths and Difficulties Self-Report Questionnaire as a screening instrument in Norwegian community samples.

PubMed

Rønning, John A; Handegaard, Bjørn Helge; Sourander, Andre; Mørch, Willy-Tore

2004-04-01

This study reports on the application of the Norwegian self-report version of the Strengths and Difficulties Questionnaire (SDQ-S). The application of the SDQ-S was not motivated by a wish to reveal the prevalence of psychiatric disorders, but rather to set the stage for routine screening as part of schools' efforts to inform themselves about the life of adolescents at school. The survey included 4167 young people aged 11 to 16 years, attending 66 primary and secondary schools in Northern Norway. The respondents comprised 80.2% of the total population in these grades in the target area. Structural analysis of the instrument, including confirmatory factor analysis, internal consistency and intra- and cross-scale correlations revealed somewhat variable psychometric properties. Model modification suggested several ways of improving the structural psychometric properties of the SDQ-S. Norwegian cut-off points were similar to those found in other Scandinavian studies. About one third of the subjects reported at least minor perceived difficulties, while about 5% reported definite or severe difficulties. These difficulties were strongly associated with all symptom scales. Girls reported a significantly higher level of emotional problems and better prosocial functioning. Boys reported significantly higher scores on the externalising scales and on peer problems. The SDQ-S may be judged as an efficient and economical screening instrument for preventive research on large community samples. However, efforts should be made to improve its psychometric structure.

Difficult Myotomy Is Not Determined by Preoperative Therapy and Does Not Impact Outcome

PubMed Central

Villadolid, Desiree V.; Al-Saadi, Sam; Rosemurgy, Alexander S.

2007-01-01

Objectives: The impact of preoperative endoscopic therapy on the difficulty of laparoscopic Heller myotomy and the impact of the difficulty of the myotomy on long-term outcome has not been determined. This study was undertaken to determine whether preoperative therapy impacts the difficulty of laparoscopic Heller myotomy and whether preoperative therapy or difficulty of myotomy impacts long-term outcomes. Methods: Since 1992, 305 patients, 56% male, median age 49 years, underwent laparoscopic Heller myotomy and were prospectively followed. The difficulty of the laparoscopic Heller myotomy was scored by the operating surgeon for the most recent 170 consecutive patients on a scale of 1 (easiest) to 5 (most difficult). Patients scored their symptoms before and after myotomy using a Likert scale from 0 (never/not bothersome) to 10 (always/very bothersome). Results: Before myotomy, 66% of patients underwent endoscopic therapy: 33% dilation, 11% Botox, and 22% both. Preoperative endoscopic therapy did not correlate with the difficulty of the myotomy (P=NS). Median follow-up was 25 months. Regardless of the difficulty of the myotomy, dysphagia improved with myotomy (P<0.0001). By regression analysis, the frequency and severity of postmyotomy dysphagia correlated with neither preoperative endoscopic therapy nor the difficulty of the myotomy. Conclusions: Laparoscopic Heller myotomy improves the frequency and severity of dysphagia. The difficulty of laparoscopic Heller myotomy is not impacted by preoperative therapy, and neither preoperative therapy nor difficulty of the myotomy impact long-term outcome. PMID:17931516

Sequential population study of the impact of earthquakes on the emotional and behavioural well-being of 4-year-olds in Canterbury, New Zealand.

PubMed

Thomson, Janine; Seers, Kara; Frampton, Chris; Hider, Phil; Moor, Stephanie

2016-01-01

Exposure to a large natural disaster can lead to behavioural disturbances, developmental delay and anxiety among young children. Although most children are resilient, some will develop mental health problems. Major earthquakes occurred in Canterbury, New Zealand, in September 2010 and February 2011. A community screening tool assessing behavioural and emotional problems in children, the Strengths and Difficulties Questionnaire, has been reported by parents (SDQ-P) and teachers (SDQ-T) of all 4-year-olds in the region since 2008. Mean total and subtest scores for the SDQ-P and SDQ-T were compared across periods before, during and after the earthquakes in sequential population cohorts of children. Comparisons across the periods were made in relation to the proportions of children defined by New Zealand norms as 'abnormal'. Results were also compared between zones considered to have been exposed to higher or lower impact from the earthquakes. Parent mean total SDQ scores did not change between periods before, during and after the earthquakes. Teacher mean SDQ total scores significantly reduced (improved) when compared between baseline and post-earthquake periods. Mean SDQ pro-social scores from both teachers and parents increased (strengthened) when compared between baseline and post-earthquake periods. Results did not significantly vary according to a measure of impact from the earthquakes. The main finding that a population-based measure of behavioural and emotional problems among children was not deleteriously impacted by the earthquakes is surprising and is not consistent with other research findings. Further work is needed to explore the health needs of children in Canterbury based on methodological improvements. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Investigating the impact of automated feedback on students' scientific argumentation

NASA Astrophysics Data System (ADS)

Zhu, Mengxiao; Lee, Hee-Sun; Wang, Ting; Liu, Ou Lydia; Belur, Vinetha; Pallant, Amy

2017-08-01

This study investigates the role of automated scoring and feedback in supporting students' construction of written scientific arguments while learning about factors that affect climate change in the classroom. The automated scoring and feedback technology was integrated into an online module. Students' written scientific argumentation occurred when they responded to structured argumentation prompts. After submitting the open-ended responses, students received scores generated by a scoring engine and written feedback associated with the scores in real-time. Using the log data that recorded argumentation scores as well as argument submission and revisions activities, we answer three research questions. First, how students behaved after receiving the feedback; second, whether and how students' revisions improved their argumentation scores; and third, did item difficulties shift with the availability of the automated feedback. Results showed that the majority of students (77%) made revisions after receiving the feedback, and students with higher initial scores were more likely to revise their responses. Students who revised had significantly higher final scores than those who did not, and each revision was associated with an average increase of 0.55 on the final scores. Analysis on item difficulty shifts showed that written scientific argumentation became easier after students used the automated feedback.

The ADHD Concomitant Difficulties Scale (ADHD-CDS), a Brief Scale to Measure Comorbidity Associated to ADHD.

PubMed

Fenollar-Cortés, Javier; Fuentes, Luis J

2016-01-01

Although the critical feature of attention-deficit/hyperactivity disorder (ADHD) is a persistent pattern of inattention and/or hyperactivity/impulsivity behavior, the disorder is clinically heterogeneous, and concomitant difficulties are common. Children with ADHD are at increased risk for experiencing lifelong impairments in multiple domains of daily functioning. In the present study we aimed to build a brief ADHD impairment-related tool -ADHD concomitant difficulties scale (ADHD-CDS)- to assess the presence of some of the most important comorbidities that usually appear associated with ADHD such as emotional/motivational management, fine motor coordination, problem-solving/management of time, disruptive behavior, sleep habits, academic achievement and quality of life. The two main objectives of the study were (i) to discriminate those profiles with several and important ADHD functional difficulties and (ii) to create a brief clinical tool that fosters a comprehensive evaluation process and can be easily used by clinicians. The total sample included 399 parents of children with ADHD aged 6-18 years (M = 11.65; SD = 3.1; 280 males) and 297 parents of children without a diagnosis of ADHD (M = 10.91; SD = 3.2; 149 male). The scale construction followed an item improved sequential process. Factor analysis showed a 13-item single factor model with good fit indices. Higher scores on inattention predicted higher scores on ADHD-CDS for both the clinical sample (β = 0.50; p < 0.001) and the whole sample (β = 0.85; p < 0.001). The ROC curve for the ADHD-CDS (against the ADHD diagnostic status) gave an area under the curve (AUC) of.979 (95%, CI = [0.969, 0.990]). The ADHD-CDS has shown preliminary adequate psychometric properties, with high convergent validity and good sensitivity for different ADHD profiles, which makes it a potentially appropriate and brief instrument that may be easily used by clinicians, researchers, and health professionals in dealing with ADHD.

The ADHD Concomitant Difficulties Scale (ADHD-CDS), a Brief Scale to Measure Comorbidity Associated to ADHD

PubMed Central

Fenollar-Cortés, Javier; Fuentes, Luis J.

2016-01-01

Introduction: Although the critical feature of attention-deficit/hyperactivity disorder (ADHD) is a persistent pattern of inattention and/or hyperactivity/impulsivity behavior, the disorder is clinically heterogeneous, and concomitant difficulties are common. Children with ADHD are at increased risk for experiencing lifelong impairments in multiple domains of daily functioning. In the present study we aimed to build a brief ADHD impairment-related tool -ADHD concomitant difficulties scale (ADHD-CDS)- to assess the presence of some of the most important comorbidities that usually appear associated with ADHD such as emotional/motivational management, fine motor coordination, problem-solving/management of time, disruptive behavior, sleep habits, academic achievement and quality of life. The two main objectives of the study were (i) to discriminate those profiles with several and important ADHD functional difficulties and (ii) to create a brief clinical tool that fosters a comprehensive evaluation process and can be easily used by clinicians. Methods: The total sample included 399 parents of children with ADHD aged 6–18 years (M = 11.65; SD = 3.1; 280 males) and 297 parents of children without a diagnosis of ADHD (M = 10.91; SD = 3.2; 149 male). The scale construction followed an item improved sequential process. Results: Factor analysis showed a 13-item single factor model with good fit indices. Higher scores on inattention predicted higher scores on ADHD-CDS for both the clinical sample (β = 0.50; p < 0.001) and the whole sample (β = 0.85; p < 0.001). The ROC curve for the ADHD-CDS (against the ADHD diagnostic status) gave an area under the curve (AUC) of.979 (95%, CI = [0.969, 0.990]). Discussion: The ADHD-CDS has shown preliminary adequate psychometric properties, with high convergent validity and good sensitivity for different ADHD profiles, which makes it a potentially appropriate and brief instrument that may be easily used by clinicians, researchers, and health professionals in dealing with ADHD. PMID:27378972

Impact of virtual reality simulation on learning barriers of phacoemulsification perceived by residents.

PubMed

Ng, Danny Siu-Chun; Sun, Zihan; Young, Alvin Lerrmann; Ko, Simon Tak-Chuen; Lok, Jerry Ka-Hing; Lai, Timothy Yuk-Yau; Sikder, Shameema; Tham, Clement C

2018-01-01

To identify residents' perceived barriers to learning phacoemulsification surgical procedures and to evaluate whether virtual reality simulation training changed these perceptions. The ophthalmology residents undertook a simulation phacoemulsification course and proficiency assessment on the Eyesi system using the previously validated training modules of intracapsular navigation, anti-tremor, capsulorrhexis, and cracking/chopping. A cross-sectional, multicenter survey on the perceived difficulties in performing phacoemulsification tasks on patients, based on the validated International Council of Ophthalmology's Ophthalmology Surgical Competency Assessment Rubric (ICO-OSCAR), using a 5-point Likert scale (1 = least and 5 = most difficulty), was conducted among residents with or without prior simulation training. Mann-Whitney U tests were carried out to compare the mean scores, and multivariate regression analyses were performed to evaluate the association of lower scores with the following potential predictors: 1) higher level trainee, 2) can complete phacoemulsification most of the time (>90%) without supervisor's intervention, and 3) prior simulation training. The study was conducted in ophthalmology residency training programs in five regional hospitals in Hong Kong. Of the 22 residents, 19 responded (86.3%), of which 13 (68.4%) had completed simulation training. Nucleus cracking/chopping was ranked highest in difficulty by all respondents followed by capsulorrhexis completion and nucleus rotation/manipulation. Respondents with prior simulation training had significantly lower difficulty scores on these three tasks (nucleus cracking/chopping 3.85 vs 4.75, P = 0.03; capsulorrhexis completion 3.31 vs 4.40, P = 0.02; and nucleus rotation/manipulation 3.00 vs 4.75, P = 0.01). In multivariate analyses, simulation training was significantly associated with lower difficulty scores on these three tasks. Residents who had completed Eyesi simulation training had higher confidence in performing the most difficult tasks perceived during phacoemulsification.

Impact of virtual reality simulation on learning barriers of phacoemulsification perceived by residents

PubMed Central

Ng, Danny Siu-Chun; Sun, Zihan; Young, Alvin Lerrmann; Ko, Simon Tak-Chuen; Lok, Jerry Ka-Hing; Lai, Timothy Yuk-Yau; Sikder, Shameema; Tham, Clement C

2018-01-01

Objective To identify residents’ perceived barriers to learning phacoemulsification surgical procedures and to evaluate whether virtual reality simulation training changed these perceptions. Design The ophthalmology residents undertook a simulation phacoemulsification course and proficiency assessment on the Eyesi system using the previously validated training modules of intracapsular navigation, anti-tremor, capsulorrhexis, and cracking/chopping. A cross-sectional, multicenter survey on the perceived difficulties in performing phacoemulsification tasks on patients, based on the validated International Council of Ophthalmology’s Ophthalmology Surgical Competency Assessment Rubric (ICO-OSCAR), using a 5-point Likert scale (1 = least and 5 = most difficulty), was conducted among residents with or without prior simulation training. Mann–Whitney U tests were carried out to compare the mean scores, and multivariate regression analyses were performed to evaluate the association of lower scores with the following potential predictors: 1) higher level trainee, 2) can complete phacoemulsification most of the time (>90%) without supervisor’s intervention, and 3) prior simulation training. Setting The study was conducted in ophthalmology residency training programs in five regional hospitals in Hong Kong. Results Of the 22 residents, 19 responded (86.3%), of which 13 (68.4%) had completed simulation training. Nucleus cracking/chopping was ranked highest in difficulty by all respondents followed by capsulorrhexis completion and nucleus rotation/manipulation. Respondents with prior simulation training had significantly lower difficulty scores on these three tasks (nucleus cracking/chopping 3.85 vs 4.75, P = 0.03; capsulorrhexis completion 3.31 vs 4.40, P = 0.02; and nucleus rotation/manipulation 3.00 vs 4.75, P = 0.01). In multivariate analyses, simulation training was significantly associated with lower difficulty scores on these three tasks. Conclusion Residents who had completed Eyesi simulation training had higher confidence in performing the most difficult tasks perceived during phacoemulsification. PMID:29785084

The association of early childhood cognitive development and behavioural difficulties with pre-adolescent problematic eating attitudes.

PubMed

Richmond, Rebecca C; Skugarevsky, Oleg; Yang, Seungmi; Kramer, Michael S; Wade, Kaitlin H; Patel, Rita; Bogdanovich, Natalia; Vilchuck, Konstantin; Sergeichick, Natalia; Smith, George Davey; Oken, Emily; Martin, Richard M

2014-01-01

Few studies have prospectively investigated associations of child cognitive ability and behavioural difficulties with later eating attitudes. We investigated associations of intelligence quotient (IQ), academic performance and behavioural difficulties at 6.5 years with eating attitudes five years later. We conducted an observational cohort study nested within the Promotion of Breastfeeding Intervention Trial, Belarus. Of 17,046 infants enrolled at birth, 13,751 (80.7%) completed the Children's Eating Attitude Test (ChEAT) at 11.5 years, most with information on IQ (n = 12,667), academic performance (n = 9,954) and behavioural difficulties (n = 11,098) at 6.5 years. The main outcome was a ChEAT score ≥ 85th percentile, indicative of problematic eating attitudes. Boys with higher IQ at 6.5 years reported fewer problematic eating attitudes, as assessed by ChEAT scores ≥ 85th percentile, at 11.5 years (OR per SD increase in full-scale IQ = 0.87; 0.79, 0.94). No such association was observed in girls (1.01; 0.93, 1.10) (p for sex-interaction = 0.016). In both boys and girls, teacher-assessed academic performance in non-verbal subjects was inversely associated with high ChEAT scores five years later (OR per unit increase in mathematics ability = 0.88; 0.82, 0.94; and OR per unit increase in ability for other non-verbal subjects = 0.86; 0.79, 0.94). Behavioural difficulties were positively associated with high ChEAT scores five years later (OR per SD increase in teacher-assessed rating = 1.13; 1.07, 1.19). Lower IQ, worse non-verbal academic performance and behavioural problems at early school age are positively associated with risk of problematic eating attitudes in early adolescence.

Fluency and Accuracy in Alphabet Writing by Keyboarding: A Cross-Sectional Study in Spanish-Speaking Children With and Without Learning Disabilities.

PubMed

Bisschop, Elaine; Morales, Celia; Gil, Verónica; Jiménez-Suárez, Elizabeth

The aim of this study was to analyze whether children with and without difficulties in handwriting, spelling, or both differed in alphabet writing when using a keyboard. The total sample consisted of 1,333 children from Grades 1 through 3. Scores on the spelling and handwriting factors from the Early Grade Writing Assessment (Jiménez, in press) were used to assign the participants to one of four groups with different ability patterns: poor handwriters, poor spellers, a mixed group, and typically achieving students. Groups were equalized by a matching strategy, resulting in a final sample of 352 children. A MANOVA was executed to analyze effects of group and grade on orthographic motor integration (fluency of alphabet writing) and the number of omissions when writing the alphabet (accuracy of alphabet writing) by keyboard writing mode. The results indicated that poor handwriters did not differ from typically achieving children in both variables, whereas the poor spellers did perform below the typical achievers and the poor handwriters. The difficulties of poor handwriters seem to be alleviated by the use of the keyboard; however, children with spelling difficulties might need extra instruction to become fluent keyboard writers.

Development and Psychometric Properties of the Instrumental Activities of Daily Living: Compensation Scale

PubMed Central

Schmitter-Edgecombe, Maureen; Parsey, Carolyn; Lamb, Richard

2014-01-01

The Instrumental Activities of Daily Living – Compensation (IADL-C) scale was developed to capture early functional difficulties and to quantify compensatory strategy use that may mitigate functional decline in the aging population. The IADL-C was validated in a sample of cognitively healthy older adults (N=184) and individuals with mild cognitive impairment (MCI; N=92) and dementia (N=24). Factor analysis and Rasch item analysis led to the 27-item IADL-C informant questionnaire with four functional domain subscales (money and self-management, home daily living, travel and event memory, and social skills). The subscales demonstrated good internal consistency (Rasch reliability 0.80 to 0.93) and test-retest reliability (Spearman coefficients 0.70 to 0.91). The IADL-C total score and subscales showed convergent validity with other IADL measures, discriminant validity with psychosocial measures, and the ability to discriminate between diagnostic groups. The money and self management subscale showed notable difficulties for individuals with MCI, whereas difficulties with home daily living became more prominent for dementia participants. Compensatory strategy use increased in the MCI group and decreased in the dementia group. PMID:25344901

The long-term neurodevelopmental and psychological outcomes of gastroschisis: A cohort study.

PubMed

Harris, Emma L; Hart, Susannah J; Minutillo, Corrado; Ravikumara, Madur; Warner, Teresa M; Williams, Yvette; Nathan, Elizabeth A; Dickinson, Jan E

2016-04-01

Previous gastroschisis specific neurodevelopmental studies have focused on the first 3years of life. The aim of this study was to assess the intellectual, behavioral and neurological outcomes of older children and adolescents born with gastroschisis. Of 99 gastroschisis survivors born in Western Australia, 1992 to 2005, and who were at least 5years old, 42 agreed to take part in this study. The study assessed: intellectual ability, with age appropriate Wechsler intelligence scales; neurological status; hearing; vision; behavioral status with the Strengths and Difficulties Questionnaire (SDQ); and parenting style with the Parenting Relationship Questionnaire (PRQ). All results were compared to normative means. Median age at follow-up was 10years (range 5-17). No child had evidence of cerebral palsy or hearing loss; 1 child had amblyopia. Psychometric tests were completed in 39 children: mean full scale IQ was 98.2 (standard deviation [SD] 10.7); the working memory index was the only subscale to show a significant decrease from the normative mean (mean 95.5, SD 12.4, p=0.038). The mean SDQ behavioral scores were significantly lower for 3 of 5 domains and the Total Difficulties score. PRQ scores were significantly abnormal for 4 of 7 domains: Communication, Discipline, Satisfaction with School and Relational Frustration. Overall intellectual abilities were within a normal range. The decrease in working memory index and the behavioral and parenting relationship impairments could be an effect of perinatal factors, gastroschisis management and complications or the complexity of the socio-economic environment. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

Tissue adhesive skills study: the physician learning curve.

PubMed

Lin, Michelle; Coates, Wendy C; Lewis, Roger J

2004-04-01

To compare 2 educational approaches (structured group session vs. individual instruction) of learning application techniques of 2-octylcyanoacrylate (OCA) on wounds repaired in the emergency department. This prospective, nonrandomized, observational study was conducted in an urban hospital emergency department. Medical students, residents, and faculty were trained in the use of OCA either in a standardized group session or individually, based on their availability to attend the group session. Physicians completed a data collection form that included wound characteristics, type of instruction, and number of lacerations previously repaired with OCA. Impressions of time required, difficulty, and postrepair cosmesis were each recorded on a 5-point Likert scale. The 3 scales were totaled to yield a 15-point summary outcome measure. Univariate nonparametric comparisons of measures were performed between physicians with and without group instruction and between those with and without prior OCA experience. Using 35 subjects in each group, this study had a power of 0.95 to detect a difference of 1.5 points in the 15-point summary score, using alpha = 0.05. Eighty-one subjects were enrolled; the median summary score was 13 (IQR 12 to 15). There was no statistically significant difference in the summary score, nor any of its 3 components (time saved, difficulty, cosmesis), when comparing physicians with and without group instruction, nor when comparing first-time users to those with prior experience. OCA application is an easily acquired skill. Physicians were satisfied with their proficiency in OCA application, regardless of type of instruction received or number of previous lacerations repaired with OCA.

Prenatal exposure to maternal smoking and childhood behavioural problems: a quasi-experimental approach.

PubMed

McCrory, Cathal; Layte, Richard

2012-11-01

This retrospective cross-sectional paper examines the relationship between maternal smoking during pregnancy and children's behavioural problems at 9 years of age independent of a wide range of possible confounders. The final sample comprised 7,505 nine-year-old school children participating in the first wave of the Growing Up in Ireland study. The children were selected through the Irish national school system using a 2-stage sampling method and were representative of the nine-year population. Information on maternal smoking during pregnancy was obtained retrospectively at 9 years of age via parental recall and children's behavioural problems were assessed using the Strengths and Difficulties Questionnaire across separate parent and teacher-report instruments. A quasi-experimental approach using propensity score matching was used to create treatment (smoking) and control (non-smoking) groups which did not differ significantly in their propensity to smoke in terms of 16 observed characteristics. After matching on the propensity score, children whose mothers smoked during pregnancy were 3.5 % (p < 0.001) and 3.4 % (p < 0.001) more likely to score in the problematic range on the SDQ total difficulties index according to parent and teacher-report respectively. Maternal smoking during pregnancy was more strongly associated with externalising than internalising behavioural problems. Analysis of the dose-response relationship showed that the differential between matched treatment and control groups increased with level of maternal smoking. Given that smoking is a modifiable risk factor, the promotion of successful cessation in pregnancy may prevent potentially adverse long-term consequences.

The Índice Flesch-Szigriszt and Spanish Lexile Analyzer to evaluate Spanish patient education materials in otolaryngology.

PubMed

Nassif, Samih J; Wong, Kevin; Levi, Jessica R

2018-01-01

Evaluate the reading difficulty of Spanish patient education materials using the validated Índice Flesch-Szigriszt (INFLESZ) and Spanish Lexile Analyzer, and to identify relationships between English and Spanish readability formulas. Cross-sectional analysis. All otolaryngology-related patient education articles written in Spanish from the health libraries of the top 10 US News & World Report-ranked hospitals, top 10 Doximity-ranked otolaryngology residencies, the American Academy of Otolaryngology-Head and Neck Surgery website, and the US National Library of Medicine online section on ears, nose and throat were collected. Reading difficulty was assessed using the INFLESZ and Spanish Lexile Analyzer. Additional readability assessments included the traditional English tools: Flesch-Kincaid Grade Level, Flesch Reading Ease Score, and the Simple Measure of Gobbledygook score. A total of 497 articles were reviewed. The average INFLESZ score for all articles was 57.75, which is considered normal and requires the reading ability of a student who finished Escuela Secundaria Obligatoria or 10th grade equivalent in the United States. The average Spanish Lexile measure for all articles was 1062L, equivalent to a reading level between the 6th and 12th grade. English readability tools calculated a more difficult reading level compared to Spanish tools when performed on the same text. Current Spanish patient education materials in otolaryngology may be too difficult for the average Spanish-speaking reader to understand. Future improvements may be warranted to improve the readability of educational materials and increase health literacy. NA. Laryngoscope, 128:E21-E26, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Screening for Anger and Sleep Difficulties.

PubMed

Steele, Nicole M; Fogarty, Gerard J

2017-03-01

Mental health screens are designed to detect individuals at risk of psychological disorders. In the military setting of this study, these disorders were post-traumatic stress disorder (PTSD) and alcohol use. This study extends the literature on deployment-related mental health screening by including measures of sleep difficulties and anger as predictors of postdeployment PTSD and alcohol abuse. Evidence that measures of anger and sleep difficulties contribute incremental validity to the prediction of postdeployment mental health problems, including substance abuse, would be helpful in designing interventions to assist the rehabilitation of returning personnel. A test battery containing the PTSD Checklist-Civilian (PCL-C) to screen for PTSD, the Kessler 10 to screen for psychological distress, a Sleep Difficulties scale, an exposure to trauma scale, and an anger scale was administered to 212 personnel nearing completion of a deployment to the Middle East. A second battery containing the PCL-C, the Kessler 10, and a measure of alcohol consumption (Alcohol Use Disorders Identification Test [AUDIT]) was administered to the same personnel 3 to 6 months after return to Australia. Hierarchical regression analyses assessed the predictive validity of measures of psychological distress (anxiety and depression), PTSD symptomatology, sleep disturbance, and anger in relation to postdeployment measures of PTSD symptomatology and alcohol use. Time 1 measures predicted 24.4% of the variance in postdeployment PCL-C scores and 13.1% of the variance in AUDIT scores, with the Sleep Difficulties scale contributing to the prediction of the PCL-C score and the anger scale helping to predict AUDIT scores. On the basis of these findings, we recommend the inclusion of improved measures of both anger and sleep difficulties in end-of-deployment mental health screens. A less behaviorally specific and more wide-ranging anger scale is recommended for future studies that aim to evaluate the role of anger in screening batteries. Our findings suggest that the Sleep Difficulties scale used in this study would be a worthwhile addition to mental health screening because it is moderately correlated with both Time 1 and Time 2 measures of PTSD symptomatology and psychological distress. Furthermore, there is minimal stigma associated with the experience of sleep difficulties. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Psychosis risk screening: Validation of the youth psychosis at-risk questionnaire - brief in a community-derived sample of adolescents.

PubMed

Fonseca-Pedrero, Eduardo; Ortuño-Sierra, Javier; Chocarro, Edurne; Inchausti, Felix; Debbané, Martin; Bobes, Julio

2017-12-01

There have been several attempts to identify individuals potentially at high risk for psychotic-spectrum disorders using brief screening measures. However, relatively few studies have tested the psychometric properties of the psychosis screening measures in representative samples of adolescents. The main purpose of the present study was to analyse the prevalence, factorial structure, measurement invariance across gender, and reliability of the Youth Psychosis At-Risk Questionnaire - Brief (YPARQ-B) in a community-derived sample of adolescents. Additionally, the relationship between YPARQ-B, depressive symptoms, psychopathology, stress manifestations, and prosocial skills was analysed. One thousand and twenty students from high schools participated in a cross-sectional survey. The YPARQ-B, the Reynolds Adolescent Depression Scale, the Strengths and Difficulties Questionnaire, and the Student Stress Inventory - Stress Manifestations were used. A total of 85.1% of the total sample self-reported at least one subclinical psychotic experience. We observed a total of 10.9% of adolescents with a cutoff score of ≥11 or 6.8% with a cutoff score of ≥13. The analysis of internal structure of the YPARQ-B yielded an essentially unidimensional structure. The YPARQ-B scores showed measurement invariance across gender. The internal consistency of the YPARQ-B total score was 0.94. Furthermore, self-reported subclinical psychotic experiences were associated with depressive symptoms, emotional and behavioural problems, poor prosocial skills, and stress manifestations. These results would appear to indicate that YPARQ-B is a brief and easy tool to assess self-reported subclinical psychotic experiences in adolescents from the general population. The assessment of these experiences in community settings, and its associations with psychopathology, may help us to enhance the possibility of an early identification of adolescents potentially at risk for psychosis and mental health problems. Copyright © 2016 John Wiley & Sons, Ltd.

Z-Score Demystified: A Critical Analysis of the Sri Lankan University Admission Policy

ERIC Educational Resources Information Center

Warnapala, Yajni; Silva, Karishma

2011-01-01

In the year 2001, the University Grants Commission of Sri Lanka successfully appealed to change the method of determining the cut-off scores for university admissions from raw scores to standardized z-scores. This standardization allegedly eliminated the discrepancy caused due to the assumption of equal difficulty levels across all subjects. This…

Facilitating the Interpretation of English Language Proficiency Scores: Combining Scale Anchoring and Test Score Mapping Methodologies

ERIC Educational Resources Information Center

Powers, Donald; Schedl, Mary; Papageorgiou, Spiros

2017-01-01

The aim of this study was to develop, for the benefit of both test takers and test score users, enhanced "TOEFL ITP"® test score reports that go beyond the simple numerical scores that are currently reported. To do so, we applied traditional scale anchoring (proficiency scaling) to item difficulty data in order to develop performance…

Validation of scores of use of inhalation devices: valoration of errors *

PubMed Central

Zambelli-Simões, Letícia; Martins, Maria Cleusa; Possari, Juliana Carneiro da Cunha; Carvalho, Greice Borges; Coelho, Ana Carla Carvalho; Cipriano, Sonia Lucena; de Carvalho-Pinto, Regina Maria; Cukier, Alberto; Stelmach, Rafael

2015-01-01

Abstract Objective: To validate two scores quantifying the ability of patients to use metered dose inhalers (MDIs) or dry powder inhalers (DPIs); to identify the most common errors made during their use; and to identify the patients in need of an educational program for the use of these devices. Methods: This study was conducted in three phases: validation of the reliability of the inhaler technique scores; validation of the contents of the two scores using a convenience sample; and testing for criterion validation and discriminant validation of these instruments in patients who met the inclusion criteria. Results: The convenience sample comprised 16 patients. Interobserver disagreement was found in 19% and 25% of the DPI and MDI scores, respectively. After expert analysis on the subject, the scores were modified and were applied in 72 patients. The most relevant difficulty encountered during the use of both types of devices was the maintenance of total lung capacity after a deep inhalation. The degree of correlation of the scores by observer was 0.97 (p < 0.0001). There was good interobserver agreement in the classification of patients as able/not able to use a DPI (50%/50% and 52%/58%; p < 0.01) and an MDI (49%/51% and 54%/46%; p < 0.05). Conclusions: The validated scores allow the identification and correction of inhaler technique errors during consultations and, as a result, improvement in the management of inhalation devices. PMID:26398751

[Revision hip arthroplasty by Waldemar Link custom-made total hip prosthesis].

PubMed

Medenica, Ivica; Luković, Milan; Radoicić, Dragan

2010-02-01

The number of patients undergoing hip arthroplasty revision is constantly growing. Especially, complex problem is extensive loss of bone stock and pelvic discontinuity that requires reconstruction. The paper presented a 50-year old patient, who ten years ago underwent a total cement artrhroplasty of the left hip. A year after the primary operation the patient had difficulties in walking without crutches. Problems intensified in the last five years, the patient had severe pain, totally limited movement in the left hip and could not walk at all. Radiographically, we found loose femoral component, massive loss of bone stock of proximal femur, acetabular protrusion and a consequent pelvic discontinuity. Clinically, a completely disfunctional left hip joint was registered (Harris hip score--7.1). We performed total rearthroplasty by a custom-made Waldemar Link total hip prosthesis with acetabular antiprotrusio cage and compensation of bone defects with a graft from the bone bank. A year after the operation, we found clinically an extreme improvement in Harris hip score--87.8. Radiographically, we found stability of implanted components, a complete graft integration and bone bridging across the site of pelvic discontinuity. Pelvic discontinuity and massive loss of proximal femoral bone stock is a challenging and complex entity. Conventional prostheses cannot provide an adequate fixation and stability of the hip. Application of custom-made prosthesis (measured specificaly for a patient) and additional alografting bone defects is a good method in revision surgery after unsuccessful hip arthroplasty with extensive bone defects.

Medical students perception of test anxiety triggered by different assessment modalities.

PubMed

Guraya, Salman Y; Guraya, Shaista S; Habib, Fawzia; AlQuiliti, Khalid W; Khoshhal, Khalid I

2018-05-06

Test anxiety is well known among medical students. However, little is known about test anxiety produced by different components of exam individually. This study aimed to stratify varying levels of test anxiety provoked by each exam modality and to explore the students perceptions about confounding factors. A self-administered questionnaire was administered to medical students. The instrument contained four main themes; lifestyle, psychological and specific factors of information needs, learning styles, and perceived difficulty level of each assessment tool. A highest test anxiety score of 5 was ranked for "not scheduling available time" and "insufficient exercise" by 28.8 and 28.3% students, respectively. For "irrational thoughts about exam" and "fear to fail", a highest test anxiety score of 5 was scored by 28.8 and 25.7% students, respectively. The highest total anxiety score of 1255 was recorded for long case exam, followed by 975 for examiner-based objective structured clinical examination. Excessive course load and course not well covered by faculty were thought to be the main confounding factors. The examiner-based assessment modalities induced high test anxiety. Faculty is urged to cover core contents within stipulated time and to rigorously reform and update existing curricula to prepare relevant course material.

Factors affecting oral health-related quality of life among pregnant women.

PubMed

Acharya, S; Bhat, P V; Acharya, S

2009-05-01

To assess oral health status and to describe the possible factors that could affect the oral health-related quality of life (OHRQoL) among a group of pregnant rural women in South India. A total of 259 pregnant women (mean age 26 +/- 5.5 years) who participated in the cross-sectional study were administered the Oral Health Impact Profile (OHIP-14) questionnaire and were clinically examined for caries and periodontal status. The highest oral impact on quality of life was reported for 'painful mouth' (mean: 1.7) and 'difficulty in eating' (mean: 1.1). On comparing the mean OHIP-14 scores against the various self-reported oral problems, it was seen that the mean OHIP-14 scores were significantly higher among those who reported various oral problems than those who did not. Those with previous history of pregnancies had more severe levels of gingivitis than those who were pregnant for the first time. Also gingival index scores, community periodontal index of treatment needs scores and previous pregnancies was associated with poorer OHRQoL scores. Increased health promotion interventions and simple educational preventive programmes on oral self-care and disease prevention during pregnancy can go a long way in improving oral health and lessening its impact on the quality of life in this important population.

Comparison of disease activity measures for anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis.

PubMed

Merkel, P A; Cuthbertson, D D; Hellmich, B; Hoffman, G S; Jayne, D R W; Kallenberg, C G M; Krischer, J P; Luqmani, R; Mahr, A D; Matteson, E L; Specks, U; Stone, J H

2009-01-01

Currently, several different instruments are used to measure disease activity and extent in clinical trials of anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis, leading to division among investigative groups and difficulty comparing study results. An exercise comparing six different vasculitis instruments was performed. A total of 10 experienced vasculitis investigators from 5 countries scored 20 cases in the literature of Wegener granulomatosis or microscopic polyangiitis using 6 disease assessment tools: the Birmingham Vasculitis Activity Score (BVAS), The BVAS for Wegener granulomatosis (BVAS/WG), BVAS 2003, a Physician Global Assessment (PGA), the Disease Extent Index (DEI) and the Five Factor Score (FFS). Five cases were rescored by all raters. Reliability of the measures was extremely high (intraclass correlations for the six measures all = 0.98). Within each instrument, there were no significant differences or outliers among the scores from the 10 investigators. Test/retest reliability was high for each measure: range = 0.77 to 0.95. The scores of the five acute activity measures correlated extremely well with one another. Currently available tools for measuring disease extent and activity in ANCA-associated vasculitis are highly correlated and reliable. These results provide investigators with confidence to compare different clinical trial data and helps form common ground as international research groups develop new, improved and universally accepted vasculitis disease assessment instruments.

Enhanced cognitive behavioral therapy for eating disorders adapted for a group setting.

PubMed

Wade, Stephanie; Byrne, Sue; Allen, Karina

2017-08-01

This randomized control trial is an evaluation of the effectiveness of enhanced cognitive behavioral treatment (CBT-E) for eating disorders adapted for a group setting. The study aimed to examine the effects of group CBT-E on eating disorder psychopathology and additional maintaining pathology. A transdiagnostic sample of individuals with eating disorders with a BMI ≥ 18 kg/m 2 (N = 40) were randomized to an immediate-start or delayed-start condition so as to compare therapeutic effects of group CBT-E with a waitlist control. Global Eating Disorder Examination Questionnaire (EDE-Q) scores, BMI, and measures of Clinical Perfectionism, Self-Esteem, Interpersonal Difficulties, and Mood Intolerance were measured across the 8-week control period, throughout the group treatment and at 3-months post-treatment. Over 70% of those who entered the trial completed treatment. The first eight weeks of group CBT-E were more effective at reducing Global EDE-Q scores than no treatment (waitlist control). By post-treatment, good outcome (a Global EDE-Q within 1 SD of Australian community norms plus BMI ≥ 18.5) was achieved by 67.9% of treatment completers and 66.7% of the total sample. Symptom abstinence within the previous month was reported by 14.3% of treatment completers and 10.3% of the total sample. Significant reductions in Clinical Perfectionism, Self-Esteem, Interpersonal Difficulties, and Mood Intolerance were also observed. This study demonstrated that a group version of CBT-E can be effective at reducing eating disorder psychopathology in a transdiagnostic sample of individuals with eating disorders. Group CBT-E could provide a means of increasing availability of evidence-based treatment for eating disorders. © 2017 Wiley Periodicals, Inc.

Household Food Insecurity and Mental Health Problems Among Adolescents: What Do Parents Report?

PubMed

Poole-Di Salvo, Elizabeth; Silver, Ellen J; Stein, Ruth E K

2016-01-01

To investigate whether adolescents living in households with food insecurity have poorer parent-reported mental health (MH) than peers. We analyzed cross-sectional data from ∼8600 adolescents who participated in the 2007 (8th grade) wave of the Early Childhood Longitudinal Study-Kindergarten. Household food insecurity (HFI) was assessed by parental report on the 18-item US Household Food Security Scale. Total Difficulties score >13 on the parent-reported Strengths and Difficulties Questionnaire (SDQ) indicated problems with adolescent MH. SDQ subscale scores (Emotional, Conduct, Hyperactivity, Peer Problems) were also calculated. Associations between HFI and MH were explored in bivariate and multivariable analyses. Interactions of HFI and gender and HFI and receipt of free/reduced-price school lunch were analyzed with regard to problems with MH. A total of 10.2% of adolescents lived with HFI; 11.2% had SDQ >13. Adolescents with HFI had higher rates of overall MH problems (28.7% vs 9.2%), emotional problems (21.6% vs 6.6%), conduct problems (26.5% vs 11.6%), hyperactivity (22.4% vs 11.3%), and peer problems (19.8% vs 8.6%) (all P < .01). After adjustment for confounders, the association between HFI and overall MH problems (odds ratio 2.3; 95% confidence interval 1.6-3.3) remained. Interactions of HFI and gender and HFI and free/reduced-price school lunch were not significant. HFI was associated with increased risk of parent-reported MH problems among both male and female adolescents. Free/reduced-price school lunch did not significantly alter this relationship. Effective interventions to promote MH and reduce HFI among adolescents are necessary. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Modular Training for Robot-Assisted Radical Prostatectomy: Where to Begin?

PubMed

Lovegrove, Catherine; Ahmed, Kamran; Novara, Giacomo; Guru, Khurshid; Mottrie, Alex; Challacombe, Ben; der Poel, Henk Van; Peabody, James; Dasgupta, Prokar

Effective training is paramount for patient safety. Modular training entails advancing through surgical steps of increasing difficulty. This study aimed to construct a modular training pathway for use in robot-assisted radical prostatectomy (RARP). It aims to identify the sequence of procedural steps that are learnt before surgeons are able to perform a full procedure without an intervention from mentor. This is a multi-institutional, prospective, observational, longitudinal study. We used a validated training tool (RARP Score). Data regarding surgeons' stage of training and progress were collected for analysis. A modular training pathway was constructed with consensus on the level of difficulty and evaluation of individual steps. We identified and recorded the sequence of steps performed by fellows during their learning curves. We included 15 urology fellows from UK, Europe, and Australia. A total of 15 surgeons were assessed by mentors in 425 RARP cases over 8 months (range: 7-79) across 15 international centers. There were substantial differences in the sequence of RARP steps according to the chronology of the procedure, difficulty level, and the order in which surgeons actually learned steps. Steps were not attempted in chronological order. The greater the difficulty, the later the cohort first undertook the step (p = 0.021). The cohort undertook steps of difficulty level I at median case number 1. Steps of difficulty levels II, III, and IV showed more variation in median case number of the first attempt. We recommend that, in the operating theater, steps be learned in order of increasing difficulty. A new modular training route has been designed. This incorporates the steps of RARP with the following order of priority: difficulty level > median case number of first attempt > most frequently undertaken in surgical training. An evidence-based modular training pathway has been developed that facilitates a safe introduction to RARP for novice surgeons. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Selective impairment of decision making under ambiguity in alexithymia.

PubMed

Zhang, Lei; Wang, Xue; Zhu, Yu; Li, Hongchen; Zhu, Chunyan; Yu, Fengqiong; Wang, Kai

2017-11-28

Alexithymia is characterised by difficulties identifying and describing emotions. Few studies have investigated how alexithymia influences decision-making under different conditions (ambiguity and risk). This study aimed to examine whether alexithymia contributes to impairment in decision-making. This study included 42 participants with high scores in the Chinese version of Toronto Alexithymia Scale (alexithymia group), and 44 matched subjects with low scores (control group). Decision-making was measured using the Iowa Gambling Task (IGT) and the Game of Dice Task (GDT). The main findings of this study revealed selective deficits in IGT performance for the alexithymia group, while GDT performance was unimpaired when compared with the control group. In IGT, total netscores were lower for the alexithymia group compared to the control group, particularly with regard to block 5. Moreover, the alexithymia individuals selected significantly more adverse cards than the controls, indicating significant decision-making impairments. Alexithymia selectively influences decision-making under ambiguity.

Measuring stigma in children receiving mental health treatment: Validation of the Paediatric Self-Stigmatization Scale (PaedS).

PubMed

Kaushik, A; Papachristou, E; Dima, D; Fewings, S; Kostaki, E; Ploubidis, G B; Kyriakopoulos, M

2017-06-01

Research on the impact of stigma associated with mental illness in children is scarce. Considering the known negative effects of stigma associated with mental illness in adults, it is crucial to explore the stigma experienced by children who access mental health treatment. However, no scale measuring self-stigmatization in younger children is available to date. This study aimed to develop and validate such a scale, the Paediatric Self-Stigmatization Scale (PaedS). A total of 156 children (119 receiving outpatient and 37 receiving inpatient treatment), aged 8-12 years, completed the PaedS, the Self-Perception Profile for Children and the Pediatric Quality of Life Inventory (PedsQL - Child Report, ages 8-12). In addition, parents completed the PedsQL (Parent Report for Children, ages 8-12), the Strengths and Difficulties Questionnaire (SDQ) and a modified subscale of the PaedS measuring the children's rejection by others due to their mental health difficulties. A confirmatory factor analysis showed that a four-factor structure, comprising Societal Devaluation, Personal Rejection, Self-Stigma and Secrecy scales, had excellent fit to the data (CFI=0.95; TLI=0.95; RMSEA=0.05). Child-reported PaedS scores were positively correlated with parental-reported PaedS scores and negatively with PedsQL, the SDQ, and 5 out of 6 subscales of the Self-Perception Profile for Children, suggesting adequate convergent validity (all P-values<0.05). The PaedS is a valid instrument, which is hoped to advance the understanding of self-stigmatization in children with mental health difficulties and contribute to its prevention. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Racial/Ethnic Differences in the Predictive Validity of MCAT Scores.

ERIC Educational Resources Information Center

Jones, Robert F.; Mitchell, Karen

Medical College Admission Test (MCAT) score differences were examined for Black and White examinees who entered American medical schools in 1978 and 1979. The incidence of academic difficulty resulting in delayed graduation, withdrawal, or dismissal was also examined. The MCAT provides six scores: biology, chemistry, physics, science problems,…

Evaluation of the International Outcome Inventory for Hearing Aids in a veteran sample.

PubMed

Smith, Sherri L; Noe, Colleen M; Alexander, Genevieve C

2009-06-01

The International Outcome Inventory for Hearing Aids (IOI-HA) was developed as a global hearing aid outcome measure targeting seven outcome domains. The published norms were based on a private-pay sample who were fitted with analog hearing aids. The purpose of this study was to evaluate the psychometric properties of the IOI-HA and to establish normative data in a veteran sample. Survey. The participants were 131 male veterans (mean age of 74.3 years, SD = 7.4) who were issued hearing aids with digital signal processing (DSP). Hearing aids with DSP that were fitted bilaterally between 2005 and 2007. Veterans were mailed two copies of the IOI-HA. The participants were instructed to complete the first copy of the questionnaire immediately and the second copy in two weeks. The completed questionnaires were mailed to the laboratory. The psychometric properties of the questionnaire were evaluated. As suggested by Cox and colleagues, the participants were divided into two categories based on their unaided subjective hearing difficulty. The two categories were (1) those with less hearing difficulty (none-to-moderate category) and (2) those who report more hearing difficulty (moderately severe+ category). The norms from the current veteran sample then were compared to the original, published sample. For each hearing difficulty category, the critical difference values were calculated for each item and for the total score. A factor analysis showed that the IOI-HA in the veteran sample had the identical subscale structure as reported in the original sample. For the total scale, the internal consistency was good (Chronbach's alpha = 0.83), and the test-retest reliability was high (lambda = 0.94). Group and individual norms were developed for both hearing difficulty categories in the veteran sample. For each IOI-HA item, the critical difference scores were < 1.0. This finding suggests that for any item on the IOI-HA, there is a 95 percent chance that an observed change of one response unit between two test sessions reflects a true change in outcome for a given domain. The results of this study confirmed that the psychometric properties of the IOI-HA questionnaire are strong and are essentially the same for the veteran sample and the original private-pay sample. The veteran norms, however, produced higher outcomes than those established originally, possibly because of differences in the population samples and/or hearing aid technology. Clinical and research applications of the current findings are presented. Based on the results from the current study, the norms established here should replace the original norms for use in veterans with current hearing aid technology.

Poor Auditory Task Scores in Children with Specific Reading and Language Difficulties: Some Poor Scores Are More Equal than Others

ERIC Educational Resources Information Center

McArthur, Genevieve M.; Hogben, John H.

2012-01-01

Children with specific reading disability (SRD) or specific language impairment (SLI), who scored poorly on an auditory discrimination task, did up to 140 runs on the failed task. Forty-one percent of the children produced widely fluctuating scores that did not improve across runs (untrainable errant performance), 23% produced widely fluctuating…

Evaluating the Advisory Flags and Machine Scoring Difficulty in the "e-rater"® Automated Scoring Engine. Research Report. ETS RR-16-30

ERIC Educational Resources Information Center

Zhang, Mo; Chen, Jing; Ruan, Chunyi

2016-01-01

Successful detection of unusual responses is critical for using machine scoring in the assessment context. This study evaluated the utility of approaches to detecting unusual responses in automated essay scoring. Two research questions were pursued. One question concerned the performance of various prescreening advisory flags, and the other…

Word retrieval in picture descriptions produced by individuals with Alzheimer's disease

PubMed Central

Kavé, Gitit; Goral, Mira

2016-01-01

What can tests of single-word production tell us about word retrieval in connected speech? We examined this question in 20 people with Alzheimer's disease (AD) and in 20 cognitively intact individuals. All participants completed tasks of picture naming and semantic fluency, and provided connected speech through picture descriptions. Picture descriptions were analyzed for total word output, percentages of content words, percentages of nouns, and percentages of pronouns out of all words, type-token ratio of all words and type-token ratio of nouns alone, mean frequency of all words and mean frequency of nouns alone, and mean word length. Individuals with AD performed worse than did cognitively intact individuals on the picture naming and semantic fluency tasks. They also produced a lower proportion of content words overall, a lower proportion of nouns, and a higher proportion of pronouns, as well as more frequent and shorter words on picture descriptions. Group differences in total word output and type-token ratios did not reach significance. Correlations between scores on tasks of single-word retrieval and measures of retrieval in picture descriptions emerged in the AD group but not in the control group. Scores on a picture naming task were associated with difficulties in word retrieval in connected speech in AD, while scores on a task of semantic verbal fluency were less useful in predicting measures of retrieval in context in this population. PMID:27171756

Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Improving Sexual Function in Women: A Pilot Study.

PubMed

Dongre, Swati; Langade, Deepak; Bhattacharyya, Sauvik

2015-01-01

Many women experience sexual dysfunction where there are orgasm disorders and sexual difficulties. Ashwagandha (Withania somnifera) is a herb known to improve the body's physical and psychological condition. The purpose of the study was to determine the efficacy and safety of a high-concentration ashwagandha root extract (HCARE) supplementation for improving sexual function in healthy females. In this pilot study, 50 study subjects were randomized to either (i) HCARE-treated group or (ii) placebo- (starch-) treated group. The subjects consumed either HCARE or placebo capsules of 300mg twice daily for 8 weeks. Sexual function was assessed using two psychometric scales, the Female Sexual Function Index (FSFI) Questionnaire and the Female Sexual Distress Scale (FSDS), and by the number of total and successful sexual encounters. The analysis indicates that treatment with HCARE leads to significantly higher improvement, relative to placebo, in the FSFI Total score (p < 0.001), FSFI domain score for "arousal" (p < 0.001), "lubrication" (p < 0.001), "orgasm" (p = 0.004), and "satisfaction" (p < 0.001), and also FSDS score (p < 0.001) and the number of successful sexual encounters (p < 0.001) at the end of the treatment. This study demonstrated that oral administration of HCARE may improve sexual function in healthy women. The present study is registered in the Clinical Trial Registry, Government of India, with a number CTRI/2015/07/006045.

The degree of social difficulties experienced by cancer patients and their spouses.

PubMed

Takeuchi, Takashi; Ichikura, Kanako; Amano, Kanako; Takeshita, Wakana; Hisamura, Kazuho

2018-06-08

Although recent studies have increasingly reported physical and psychological problems associated with cancer and its treatment, social problems of cancer patients and their families have not been sufficiently elucidated. The present study aimed to identify cancer-associated social problems from the perspectives of both patients and their spouses and to compare and analyze differences in their problems. This was a cross-sectional internet-based study. Subjects were 259 patients who developed cancer within the previous five years and 259 patients' spouses; the data were derived from two surveys in 2010 (patients) and 2016 (spouses) whose participants were not part of the same dyad but matched by propensity scores, estimated for age, sex, and the presence or absence of recurrence. We investigated the social difficulties of cancer patients and patients' spouses. Regarding social difficulties experienced by cancer patients and spouses, the 60 patient survey items were categorized into 14 labels by the Jiro Kawakita (KJ) method, which is a qualitative synthesis method developed by Kawakita to classify categorical data. Although patients had higher scores on most subcategories, young spouses aged 39 or younger and female spouses had difficulty scores as high as the corresponding patients on many subcategories. Health care providers should show sufficient concern for both patients and their spouses, particularly young and female spouses.

Gross and fine motor skills in children treated for acute lymphoblastic leukaemia.

PubMed

De Luca, Cinzia R; McCarthy, Maria; Galvin, Jane; Green, Jessica L; Murphy, Alexandra; Knight, Sarah; Williams, Jacqueline

2013-06-01

Chemotherapy treatment for acute lymphoblastic leukaemia (ALL) may disrupt motor development, with suggestions that gross and fine motor deficits are different depending on time since treatment. Thirty-seven participants aged between 2.5 to 5 years at the time of diagnosis were assessed using the Movement Assessment Battery for Children, 2nd Edition (MABC-2) and the Bruininks-Oseretsky Test of Motor Proficiency, 2nd Edition, Short Form (BOT-2 SF), and divided into groups (i.e., months-off-treatment): (1) 0-12, (2) 13-24, and (3) 25-60 for comparison. MABC-2 and BOT-2 SF mean total scores fell within the average range. Twenty-six percent of the sample performed in the impaired range on the MABC-2. Group 2 had significantly lower Manual Dexterity scores than the normative population and lower BOT-2 SF scores than Group 1. Most children treated for ALL display appropriate motor skills, yet around a quarter experience general motor difficulties. Time-off-treatment did not affect the prevalence of motor impairments on any measure.

Assessment of Attention to Clothing and Impact of Its Restrictive Factors in Iranian Patients with Traumatic Spinal Cord Injury (ACIRF-SCI): Introduction of a New Questionnaire.

PubMed

Laleh, Leila; Latifi, Sahar; Koushki, Davood; Matin, Marzieh; Javidan, Abbas Norouzi; Yekaninejad, Mir Saeed

2015-01-01

Patients with spinal cord injury (SCI) deal with various restrictive factors regarding their clothing, such as disability and difficulty with access to shopping centers. We designed a questionnaire to assess attention to clothing and impact of its restrictive factors among Iranian patients with SCI (ACIRF-SCI). The ACIRF-SCI has 5 domains: functional, medical, attitude, aesthetic, and emotional. The first 3 domains reflect the impact of restrictive factors (factors that restrict attention to clothing), and the last 2 domains reflect attention to clothing and fashion. Functional restrictive factors include disability and dependence. Medical restrictive factors include existence of specific medical conditions that interfere with clothing choice. Construct validity was assessed by factorial analysis, and reliability was expressed by Cronbach's alpha. A total of 100 patients (75 men and 25 women) entered this study. Patients with a lower injury level had a higher total score (P < .0001), and similarly, patients with paraplegia had higher scores than those with tetraplegia (P < .0001), which illustrates an admissible discriminant validity. Postinjury duration was positively associated with total scores (r = 0.21, P = .04). Construct validity was 0.97, and Cronbach's alpha was 0.61. Iranian patients with SCI who have greater ability and independence experience a lower impact of restrictive factors related to clothing. The ACIRF-SCI reveals that this assumption is statistically significant, which shows its admissible discriminant validity. The measured construct validity (0.97) and reliability (internal consistency expressed by alpha = 0.61) are acceptable.

Assessment of Attention to Clothing and Impact of Its Restrictive Factors in Iranian Patients with Traumatic Spinal Cord Injury (ACIRF-SCI): Introduction of a New Questionnaire

PubMed Central

Laleh, Leila; Koushki, Davood; Matin, Marzieh; Javidan, Abbas Norouzi; Yekaninejad, Mir Saeed

2015-01-01

Background: Patients with spinal cord injury (SCI) deal with various restrictive factors regarding their clothing, such as disability and difficulty with access to shopping centers. Objectives: We designed a questionnaire to assess attention to clothing and impact of its restrictive factors among Iranian patients with SCI (ACIRF-SCI). Methods: The ACIRF-SCI has 5 domains: functional, medical, attitude, aesthetic, and emotional. The first 3 domains reflect the impact of restrictive factors (factors that restrict attention to clothing), and the last 2 domains reflect attention to clothing and fashion. Functional restrictive factors include disability and dependence. Medical restrictive factors include existence of specific medical conditions that interfere with clothing choice. Construct validity was assessed by factorial analysis, and reliability was expressed by Cronbach’s alpha. Results: A total of 100 patients (75 men and 25 women) entered this study. Patients with a lower injury level had a higher total score (P < .0001), and similarly, patients with paraplegia had higher scores than those with tetraplegia (P < .0001), which illustrates an admissible discriminant validity. Postinjury duration was positively associated with total scores (r = 0.21, P = .04). Construct validity was 0.97, and Cronbach’s alpha was 0.61. Conclusion: Iranian patients with SCI who have greater ability and independence experience a lower impact of restrictive factors related to clothing. The ACIRF-SCI reveals that this assumption is statistically significant, which shows its admissible discriminant validity. The measured construct validity (0.97) and reliability (internal consistency expressed by alpha = 0.61) are acceptable. PMID:26363593

ERP investigation of attentional disengagement from suicide-relevant information in patients with major depressive disorder.

PubMed

Baik, Seung Yeon; Jeong, Minkyung; Kim, Hyang Sook; Lee, Seung-Hwan

2018-01-01

Previous studies suggest the presence of attentional bias towards suicide-relevant information in suicidal individuals. However, the findings are limited by their reliance on behavioral measures. This study investigates the role of difficulty in disengaging attention from suicide-relevant stimuli using the P300 component of event-related potentials (ERPs). Forty-four adults with Major Depressive Disorder (MDD) were administered the spatial cueing task using suicide-relevant and negatively-valenced words as cue stimuli. Disengagement difficulty was measured using reaction time and P300 during invalid trials. P300 amplitudes at Pz were higher in suicide-relevant compared to negatively-valenced word condition on invalid trials for participants with low rates of suicidal behavior. However, no such difference was found among participants with high rates of suicidal behavior. P300 amplitudes for suicide-relevant word condition were negatively correlated with "lifetime suicide ideation and attempt" at Pz. No significant results were found for the reaction time data, indicating that the ERP may be more sensitive in capturing the attentional disengagement effect. The groups were divided according to Suicidal Behaviors Questionnaire-Revised (SBQ-R) total score. Neutral stimulus was not included as cue stimuli. Most participants were under medication during the experiment. Our results indicate that patients with MDD and low rates of suicidal behavior show difficulty in disengaging attention from suicide-relevant stimuli. We suggest that suicide-specific disengagement difficulties may be related to recentness of suicide attempt and that acquired capability for suicide may contribute to reduced disengagement difficulties. Copyright © 2017 Elsevier B.V. All rights reserved.

Risk factors associated with academic difficulty in an Australian regionally located medical school.

PubMed

Malau-Aduli, Bunmi S; O'Connor, Teresa; Ray, Robin A; van der Kruk, Yolanda; Bellingan, Michelle; Teague, Peta-Ann

2017-12-28

Despite the highly selective admission processes utilised by medical schools, a significant cohort of medical students still face academic difficulties and are at a higher risk of delayed graduation or outright dismissal. This study used survival analysis to identify the non-academic and academic risk factors (and their relative risks) associated with academic difficulty at a regionally located medical school. Retrospective non-academic and academic entry data for all medical students who were enrolled at the time of the study (2009-2014) were collated and analysed. Non-academic variables included age at commencement of studies, gender, Indigenous status, origin, first in family to go to University (FIF), non-English speaking background (NESB), socio-economic status (SES) and rurality expressed as Australian Standard Geographical Classification-Remoteness Area (ASGC-RA). Academic variables included tertiary entrance exam score expressed as overall position (OP) and interview score. In addition, post-entry mid- and end-of-year summative assessment data in the first and second years of study were collated. The results of the survival analysis indicated that FIF, Indigenous and very remote backgrounds, as well as low post-entry Year 1 (final) and Year 2 (mid-year and final) examination scores were strong risk factors associated with academic difficulty. A high proportion of the FIF students who experienced academic difficulty eventually failed and exited the medical program. Further exploratory research will be required to identify the specific needs of this group of students in order to develop appropriate and targeted academic support programs for them. This study has highlighted the need for medical schools to be proactive in establishing support interventions/strategies earlier rather than later, for students experiencing academic difficulty because, the earlier such students can be flagged, the more likely they are able to obtain positive academic outcomes.

Impaired Glucose Regulation is Associated with Poorer Performance on the Stroop Task

PubMed Central

Gluck, Marci E.; Ziker, Cindy; Schwegler, Matthew; Thearle, Marie; Votruba, Susanne B.; Krakoff, Jonathan

2013-01-01

Background Type 2 diabetes is a risk factor for development of cognitive dysfunction. Impairments in glucose regulation have been associated with poorer performance on tests of executive function and information processing speed. Methods We administered the Stroop Color Word Task, where higher interference scores are indicative of decreased selective attention, to 98 non-diabetic volunteers (64m; %fat=37±12; age=36±9 y, race=41 NA/30 C/13 H/14 AA) on our inpatient unit. After 3d on a weight maintaining diet, % body fat was measured by DXA and a 75g oral glucose tolerance test (OGTT) was administered. Impaired glucose regulation (IGR) was defined as: fasting plasma glucose ≥100 and ≤125 mg/dL and/or 2h plasma glucose between ≥140 and ≤199 mg/dL (IGR; n = 48; NGR; n = 50). Total and incremental area under the curve (AUC) for insulin and glucose were calculated. Results Stroop interference scores were not significantly associated with any measure of adiposity or insulin concentrations. Individuals with IGR had significantly higher interference scores than those with normal glucose regulation (NGR; p=0.003). Higher interference scores were significantly correlated with fasting plasma glucose concentrations (r=0.26, p = 0.007) and total glucose AUC (r=0.30, p = 0.02) and only trending so for iAUC and 2h plasma glucose (r=0.18, p=0.08; r=0.17, p=0.09 respectively). In separate multivariate linear models, fasting plasma glucose (p = 0.002) and total glucose AUC (p = 0.0005) remained significant predictors of Stroop interference scores, even after adjustment for age, sex, race, education and %fat. Conclusions Individuals with IGR had decreased performance on a test of selective attention. Fasting plasma glucose was more strongly associated with lower performance scores than 2h plasma glucose. Our results indicate that even mild hyperglycemia in the non-diabetic range is associated with attentional processing difficulties in a sample of younger adults. Whether these impairments precede or are induced by impaired glucose regulation is not clear. PMID:24036382

Impaired glucose regulation is associated with poorer performance on the Stroop Task.

PubMed

Gluck, Marci E; Ziker, Cindy; Schwegler, Matthew; Thearle, Marie; Votruba, Susanne B; Krakoff, Jonathan

2013-10-02

Type 2 diabetes is a risk factor for development of cognitive dysfunction. Impairments in glucose regulation have been associated with poorer performance on tests of executive function and information processing speed. We administered the Stroop Color Word Task, where higher interference scores are indicative of decreased selective attention, to 98 non-diabetic volunteers (64 m; %fat=37 ± 12; age=36 ± 9 yrs, race=41 NA/30 C/13 H/14 AA) on our inpatient unit. After 3d on a weight maintaining diet, % body fat was measured by DXA and a 75 g oral glucose tolerance test (OGTT) was administered. Impaired glucose regulation (IGR) was defined as: fasting plasma glucose ≥ 100 and ≤ 125 mg/dL and/or 2h plasma glucose between ≥ 140 and ≤ 199 mg/dL (IGR; n=48; NGR; n=50). Total and incremental area under the curve (AUC) for insulin and glucose were calculated. Stroop interference scores were not significantly associated with any measure of adiposity or insulin concentrations. Individuals with IGR had significantly higher interference scores than those with normal glucose regulation (NGR; p=0.003). Higher interference scores were significantly correlated with fasting plasma glucose concentrations (r=0.26, p=0.007) and total glucose AUC (r=0.30, p=0.02) and only trending so for iAUC and 2h plasma glucose (r=0.18, p=0.08; r=0.17, p=0.09 respectively). In separate multivariate linear models, fasting plasma glucose (p=0.002) and total glucose AUC (p=0.0005) remained significant predictors of Stroop interference scores, even after adjustment for age, sex, race, education and %fat. Individuals with IGR had decreased performance on a test of selective attention. Fasting plasma glucose was more strongly associated with lower performance scores than 2h plasma glucose. Our results indicate that even mild hyperglycemia in the non-diabetic range is associated with attentional processing difficulties in a sample of younger adults. Whether these impairments precede or are induced by impaired glucose regulation is not clear. © 2013.

Development and Validation of the Patient Experience with Treatment and Self-Management (PETS): A Patient-Reported Measure of Treatment Burden

PubMed Central

Eton, David T.; Yost, Kathleen J.; Lai, Jin-shei; Ridgeway, Jennifer L.; Egginton, Jason S.; Rosedahl, Jordan K.; Linzer, Mark; Boehm, Deborah H.; Thakur, Azra; Poplau, Sara; Odell, Laura; Montori, Victor M.; May, Carl R.; Anderson, Roger T.

2017-01-01

Purpose The purpose of this study was to develop and validate a new comprehensive patient-reported measure of treatment burden – the Patient Experience with Treatment and Self-Management (PETS). Methods A conceptual framework was used to derive the PETS with items reviewed and cognitively tested with patients. A survey battery, including a pilot version of the PETS, was mailed to 838 multi-morbid patients from two healthcare institutions for validation. Results A total of 332 multi-morbid patients returned completed surveys. Diagnostics supported deletion and consolidation of some items and domains. Confirmatory factor analysis supported a domain model for scaling comprised of 9 factors: medical information, medications, medical appointments, monitoring health, interpersonal challenges, medical/healthcare expenses, difficulty with healthcare services, role/social activity limitations, and physical/mental exhaustion. Scales showed good internal consistency (alpha range: 0.79 – 0.95). Higher PETS scores, indicative of greater treatment burden, were correlated with more distress, less satisfaction with medications, lower self-efficacy, worse physical and mental health, and lower convenience of healthcare (Ps<.001). Patients with lower health literacy, less adherence to medications, and more financial difficulties reported higher PETS scores (Ps<.01). Conclusion A comprehensive patient-reported measure of treatment burden can help to better characterize the impact of treatment and self-management burden on patient well-being and guide care toward minimally disruptive medicine. PMID:27566732

Development and validation of the Patient Experience with Treatment and Self-management (PETS): a patient-reported measure of treatment burden.

PubMed

Eton, David T; Yost, Kathleen J; Lai, Jin-Shei; Ridgeway, Jennifer L; Egginton, Jason S; Rosedahl, Jordan K; Linzer, Mark; Boehm, Deborah H; Thakur, Azra; Poplau, Sara; Odell, Laura; Montori, Victor M; May, Carl R; Anderson, Roger T

2017-02-01

The purpose of this study was to develop and validate a new comprehensive patient-reported measure of treatment burden-the Patient Experience with Treatment and Self-management (PETS). A conceptual framework was used to derive the PETS with items reviewed and cognitively tested with patients. A survey battery, including a pilot version of the PETS, was mailed to 838 multi-morbid patients from two healthcare institutions for validation. A total of 332 multi-morbid patients returned completed surveys. Diagnostics supported deletion and consolidation of some items and domains. Confirmatory factor analysis supported a domain model for scaling comprised of 9 factors: medical information, medications, medical appointments, monitoring health, interpersonal challenges, medical/healthcare expenses, difficulty with healthcare services, role/social activity limitations, and physical/mental exhaustion. Scales showed good internal consistency (α range 0.79-0.95). Higher PETS scores, indicative of greater treatment burden, were correlated with more distress, less satisfaction with medications, lower self-efficacy, worse physical and mental health, and lower convenience of healthcare (Ps < 0.001). Patients with lower health literacy, less adherence to medications, and more financial difficulties reported higher PETS scores (Ps < 0.01). A comprehensive patient-reported measure of treatment burden can help to better characterize the impact of treatment and self-management burden on patient well-being and guide care toward minimally disruptive medicine.

Anosognosia in mild cognitive impairment and mild Alzheimer's disease: frequency and neuropsychological correlates.

PubMed

Orfei, Maria Donata; Varsi, Ambra Erika; Blundo, Carlo; Celia, Elisabetta; Casini, Anna Rosa; Caltagirone, Carlo; Spalletta, Gianfranco

2010-12-01

To evaluate severity of anosognosia and to identify its neuropsychological correlates in preclinical and clinical Alzheimer's Disease (AD). The Clinical Insight Rating Scale, the Anosognosia Questionnaire for Dementia (AQ-D), and the Mental Deterioration Battery were used to assess anosognosia and cognitive performances in mild AD (N = 38), amnesic mild cognitive impairment (a-MCI; N = 35), and multiple domain MCI (md-MCI; N = 38). Patients with mild AD were more anosognosic than both MCI groups, which, however, did not differ from one other. A categorical diagnosis of anosognosia was made in 42% of patients with mild AD, 3% of md-MCI, but in no subjects with a-MCI. Reduced verbal episodic memory raw score was associated with decreased awareness of cognitive difficulties (AQ-D total and intellectual functioning scores) only in MCI. In mild AD, anosognosia was linked only to increased age and reduced basic activities of daily living performances. The diagnosis of anosognosia is frequent in patients with mild AD but not in those with MCI. In the latter case, the authors cannot speak of true anosognosia but only of decreased awareness of illness. Furthermore, reduced awareness of cognitive difficulties is linked with verbal memory performances in patients with MCI but not in those with AD, suggesting for the latter the involvement of factors other than neuropsychological. Thus, neuropsychiatric dimensions commonly present in patients with AD should be investigated along with anosognosia.

Working memory network alterations in high-functioning adolescents with an autism spectrum disorder.

PubMed

Barendse, Evelien M; Schreuder, Lisanne J; Thoonen, Geert; Hendriks, Marc P H; Kessels, Roy P C; Backes, Walter H; Aldenkamp, Albert P; Jansen, Jacobus F A

2018-02-01

People with autism spectrum disorder (ASD) typically have deficits in the working memory (WM) system. WM is found to be an essential chain in successfully navigating in the social world. We hypothesize that brain networks for WM have an altered network integrity in ASD compared to controls. Thirteen adolescents (one female) with autistic disorder (n = 1), Asperger's disorder (n = 7), or pervasive developmental disorder not otherwise specified (n = 5), and 13 typically developing healthy control adolescents (one female) participated in this study. Functional magnetic resonance imaging (MRI) was performed using an n-back task and in resting state. The analysis of the behavioral data revealed deficits in WM performance in ASD, but only when tested to the limit. Adolescents with ASD showed lower binary global efficiency in the WM network than the healthy control group with n-back and resting-state data. This correlated with diagnostic scores for total problems, reciprocity, and language. Adolescents with higher-functioning autism have difficulty with the WM system, which is typically compensated. Functional MRI markers of brain network organization in ASD are related to characteristics of autism as represented in diagnostic scores. Therefore, functional MRI provides neuronal correlates for memory difficulties in adolescents with ASD. © 2017 The Authors. Psychiatry and Clinical Neurosciences published by John Wiley & Sons Australia, Ltd on behalf of Japanese Society of Psychiatry and Neurology.

Active eye fixation performance in 940 young men: effects of IQ, schizotypy, anxiety and depression.

PubMed

Smyrnis, N; Kattoulas, E; Evdokimidis, I; Stefanis, N C; Avramopoulos, D; Pantes, G; Theleritis, C; Stefanis, C N

2004-05-01

A total of 940 young men performed a task in which they actively maintained fixation for 50 s in three conditions: a). on a visual target, b). on a visual target while distracting targets appeared briefly on the periphery and c). with no visual target present. The same individuals completed psychometric evaluation tests measuring IQ, schizotypy and current state-dependent psychopathology. The proportion of fixation time decreased and saccade frequency increased in condition b compared wih condition a, and sequentially in condition c compared with condition b. A trend towards a decrease in proportion of fixation time and increase in saccade frequency was found as the subjects maintained fixation during the task and this time-dependent deterioration of performance was again most pronounced in condition c, less so in condition b and absent in condition a. Psychometric test scores were significantly correlated with fixation performance in the population. Worse performance in all three fixation conditions was observed for individuals with lower IQ scores. A deterioration of fixation performance with time in condition b was correlated with disorganization characteristics of schizotypy, suggesting that these individuals had difficulty maintaining active fixation in the presence of increased inhibitory load. A connection of such a difficulty with the frontal lobes and their role in the control of voluntary inhibitory functions is discussed.

Facial Emotion Recognition and Expression in Parkinson’s Disease: An Emotional Mirror Mechanism?

PubMed Central

Ricciardi, Lucia; Visco-Comandini, Federica; Erro, Roberto; Morgante, Francesca; Bologna, Matteo; Fasano, Alfonso; Ricciardi, Diego; Edwards, Mark J.; Kilner, James

2017-01-01

Background and aim Parkinson’s disease (PD) patients have impairment of facial expressivity (hypomimia) and difficulties in interpreting the emotional facial expressions produced by others, especially for aversive emotions. We aimed to evaluate the ability to produce facial emotional expressions and to recognize facial emotional expressions produced by others in a group of PD patients and a group of healthy participants in order to explore the relationship between these two abilities and any differences between the two groups of participants. Methods Twenty non-demented, non-depressed PD patients and twenty healthy participants (HC) matched for demographic characteristics were studied. The ability of recognizing emotional facial expressions was assessed with the Ekman 60-faces test (Emotion recognition task). Participants were video-recorded while posing facial expressions of 6 primary emotions (happiness, sadness, surprise, disgust, fear and anger). The most expressive pictures for each emotion were derived from the videos. Ten healthy raters were asked to look at the pictures displayed on a computer-screen in pseudo-random fashion and to identify the emotional label in a six-forced-choice response format (Emotion expressivity task). Reaction time (RT) and accuracy of responses were recorded. At the end of each trial the participant was asked to rate his/her confidence in his/her perceived accuracy of response. Results For emotion recognition, PD reported lower score than HC for Ekman total score (p<0.001), and for single emotions sub-scores happiness, fear, anger, sadness (p<0.01) and surprise (p = 0.02). In the facial emotion expressivity task, PD and HC significantly differed in the total score (p = 0.05) and in the sub-scores for happiness, sadness, anger (all p<0.001). RT and the level of confidence showed significant differences between PD and HC for the same emotions. There was a significant positive correlation between the emotion facial recognition and expressivity in both groups; the correlation was even stronger when ranking emotions from the best recognized to the worst (R = 0.75, p = 0.004). Conclusions PD patients showed difficulties in recognizing emotional facial expressions produced by others and in posing facial emotional expressions compared to healthy subjects. The linear correlation between recognition and expression in both experimental groups suggests that the two mechanisms share a common system, which could be deteriorated in patients with PD. These results open new clinical and rehabilitation perspectives. PMID:28068393

Cow- and herd-level risk factors for on-farm mortality in Midwest US dairy herds.

PubMed

Shahid, M Q; Reneau, J K; Chester-Jones, H; Chebel, R C; Endres, M I

2015-07-01

The objectives of this study were to describe on-farm mortality and to investigate cow- and herd-level risk factors associated with on-farm mortality in Midwest US dairy herds using lactation survival analysis. We analyzed a total of approximately 5.9 million DHIA lactation records from 10 Midwest US states from January 2006 to December 2010. The cow-level independent variables used in the models were first test-day milk yield, milk fat percent, milk protein percent, fat-to-protein ratio, milk urea nitrogen, somatic cell score, previous dry period, previous calving interval, stillbirth, calf sex, twinning, calving difficulty, season of calving, parity, and breed. The herd-level variables included herd size, calving interval, somatic cell score, 305-d mature-equivalent milk yield, and herd stillbirth percentage. Descriptive analysis showed that overall cow-level mortality rate was 6.4 per 100 cow-years and it increased from 5.9 in 2006 to 6.8 in 2010. Mortality was the primary reason of leaving the herd (19.4% of total culls) followed by reproduction (14.6%), injuries and other (14.0%), low production (12.3%), and mastitis (10.5%). Risk factor analysis showed that increased hazard for mortality was associated with higher fat-to-protein ratio (>1.6 vs. 1 to 1.6), higher milk fat percent, lower milk protein percent, cows with male calves, cows carrying multiple calves, higher milk urea nitrogen, increasing parity, longer previous calving interval, higher first test-day somatic cell score, increased calving difficulty score, and breed (Holstein vs. others). Decreased hazard for mortality was associated with higher first test-day milk yield, higher milk protein, and shorter dry period. For herd-level factors, increased hazard for mortality was associated with increased herd size, increased percentage of stillbirths, higher somatic cell score, and increased herd calving interval. Cows in herds with higher milk yield had lower mortality hazard. Results of the study indicated that first test-day records, especially those indicative of negative energy balance in cows, could be helpful to identify animals at high risk for mortality. Higher milk yield per cow did not have a negative association with mortality. In addition, the association between herd-level factors and mortality indicated that management quality could be an important factor in lowering on-farm mortality, thereby improving cow welfare. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Links Among High EPDS Scores, State of Mind Regarding Attachment, and Symptoms of Personality Disorder.

PubMed

Smith-Nielsen, Johanne; Steele, Howard; Mehlhase, Heike; Cordes, Katharina; Steele, Miriam; Harder, Susanne; Væver, Mette Skovgaard

2015-12-01

Underlying persistent psychological difficulties have been found to moderate potential adverse effects of maternal postpartum depression (PPD) on parenting and infant development. The authors examined whether mothers presenting postpartum depressive symptoms showed higher levels of personality pathology and more insecure state of mind regarding attachment compared to nondepressed mothers. Participants (N = 85) were assessed with the Edinburgh Postnatal Depression Scale (EPDS), the Present State Examination, the Adult Attachment Interview, and the Structured Clinical Interview for DSM-IV Axis II. Mothers with high EPDS scores were more likely to have a preoccupied insecure state of mind and to have personality disorder compared with mothers scoring below clinical cutoff. Furthermore, multiple regression analysis showed that personality disorder and AAI classification were independently related to EPDS score, and that these two factors together accounted for 48% of the variance in EPDS score. Findings are discussed in terms of heterogeneity in PPD populations and underline the importance of examining potential coexisting psychological difficulties when studying PPD.

Subjective complaints after acquired brain injury: presentation of the Brain Injury Complaint Questionnaire (BICoQ).

PubMed

Vallat-Azouvi, Claire; Paillat, Cyrille; Bercovici, Stéphanie; Morin, Bénédicte; Paquereau, Julie; Charanton, James; Ghout, Idir; Azouvi, Philippe

2018-04-01

The objective of the present study was to present a new complaint questionnaire designed to assess a wide range of difficulties commonly reported by patients with acquired brain injury. Patients (n =  619) had been referred to a community re-entry service at a chronic stage after brain injury, mainly traumatic brain injury (TBI). The Brain Injury Complaint Questionnaire (BICoQ) includes 25 questions in the following domains: cognition, behavior, fatigue and sleep, mood, and somatic problems. A self and a proxy questionnaire were given. An additional question was given to the relative, about the patient's awareness of his difficulties. The questionnaires had a good internal coherence, as measured with Cronbach's alpha. The most frequent complaints were, in decreasing order, mental slowness, memory troubles, fatigue, concentration difficulties, anxiety, and dual tasking problems. Principal component analysis with varimax rotation yielded six underlying factors explaining 50.5% of total variance: somatic concerns, cognition, and lack of drive, lack of control, psycholinguistic disorders, mood, and mental fatigue/slowness. About 52% of patients reported fewer complaints than their proxy, suggesting lack of awareness. The total complaint scores were not significantly correlated with any injury severity measure, but were significantly correlated with disability and poorer quality of life (Note: only factor 2 [cognition/lack of drive] was significantly related to disability.) The BICoQ is a simple scale that can be used in addition to traditional clinical and cognitive assessment measures, and to assess awareness of everyday life problems. © 2017 Wiley Periodicals, Inc.

Lower Learning Difficulty and Fluoroscopy Reduction of Transforaminal Percutaneous Endoscopic Lumbar Discectomy with an Accurate Preoperative Location Method.

PubMed

Fan, Guoxin; Gu, Xin; Liu, Yifan; Wu, Xinbo; Zhang, Hailong; Gu, Guangfei; Guan, Xiaofei; He, Shisheng

2016-01-01

Transforaminal percutaneous endoscopic lumbar discectomy (tPELD) poses great challenges for junior surgeons. Beginners often require repeated attempts using fluoroscopy causing more punctures, which may significantly undermine their confidence and increase the radiation exposure to medical staff and patients. Moreover, the impact of an accurate location on the learning curve of tPELD has not been defined. The study aimed to investigate the impact of an accurate preoperative location method on learning difficulty and fluoroscopy time of tPELD. Retrospective evaluation. Patients receiving tPELD by one surgeon with a novel accurate preoperative location method were regarded as Group A, and those receiving tPELD by another surgeon with a conventional fluoroscopy method were regarded as Group B. From January 2012 to August 2014, we retrospectively reviewed the first 80 tPELD cases conducted by 2 junior surgeons. The operation time, fluoroscopy times, preoperative location time, and puncture-channel time were thoroughly analyzed. The operation time of the first 20 patients were 99.75 ± 10.38 minutes in Group A and 115.7 ± 16.46 minutes in Group B, while the operation time of all 80 patients was 88.36 ± 11.56 minutes in Group A and 98.26 ± 14.90 minutes in Group B. Significant differences were detected in operation time between the 2 groups, both for the first 20 patients and total 80 patients (P < 0.05). The fluoroscopy times were 26.78 ± 4.17 in Group A and 33.98 ± 2.69 in Group B (P < 0.001). The preoperative location time was 3.43 ± 0.61 minutes in Group A and 5.59 ± 1.46 minutes in Group B (P < 0.001). The puncture-channel time was 27.20 ± 4.49 minutes in Group A and 34.64 ± 8.35 minutes in Group B (P < 0.001). There was a moderate correlation between preoperative location time and puncture-channel time (r = 0.408, P < 0.001), and a moderate correlation between preoperative location time and fluoroscopy times (r = 0.441, P < 0.001). Mild correlations were also observed between preoperative location time and operation time (r = 0.270, P = 0.001). There were no significant differences in preoperative back visual analogue scale (VAS) score, postoperative back VAS, preoperative leg VAS, postoperative leg VAS, preoperative Japanese Orthopaedic Association (JOA) score, postoperative JOA, preoperative Oswestry disability score (ODI), or postoperative ODI (P > 0.05). However, significant differences were all detected between preoperative abovementioned scores and postoperative scores (P < 0.05). Moreover, there was no significant differences in Macnab satisfaction between the 2 groups (P = 0.179). There were 2 patients with recurrence in Group A and 3 patients in Group B. Twelve patients with postoperative disc remnants were identified in Group A and 9 patients in Group B. No significant difference was identified between the 2 groups (P = 0.718). The preoperative lumbar location method is just a tiny step in tPELD, junior surgeons still need to focus on their subjective feelings during punctures and accumulating their experience in endoscopic discectomy. The accurate preoperative location method lowered the learning difficulty and reduced the fluoroscopy time of tPELD, which was also associated with lower preoperative location time and puncture-channel time. Key words: Learning difficulty, fluoroscopy reduction, transforamimal percutaneous endoscopic lumbar discectomy, preoperative locationLearning difficulty, fluoroscopy reduction, transforamimal percutaneous endoscopic lumbar discectomy, preoperative location.

The HEAR-QL: Quality of Life Questionnaire for Children with Hearing Loss

PubMed Central

Umansky, Amy M.; Jeffe, Donna B.; Lieu, Judith E.C.

2012-01-01

Background Few quality of life (QOL) assessment tools are available for children with specific chronic conditions, and none have been designed specifically for children with hearing loss (HL). A validated hearing-related QOL questionnaire could help clinicians determine whether an intervention is beneficial and whether one intervention is better than another. Purpose To examine QOL in children with HL and assess the validity, reliability, and factor structure of a new measure, the Hearing Environments and Reflection on Quality of Life (HEAR-QL) questionnaire. Research Design A descriptive and correlational study of a convenience sample of children. Study Sample Participants included 35 children with unilateral HL, 45 with bilateral HL, and 35 siblings with normal hearing. Data Collection and Analysis Children 7-12 years old were recruited by mail from a tertiary-care pediatric otolaryngology practice and the local county's Special School District. With parent consent, children completed the validated Pediatric Quality of Life Inventory™ (PedsQL™) 4.0 and a 35-item HEAR-QL questionnaire. The factor structure of the HEAR-QL was determined through principal components analysis (PCA), and mean scores were computed for each subscale and the total HEAR-QL. Three weeks following return of the initial questionnaires, a second HEAR-QL questionnaire was sent to participants to assess test-retest reliability. Both PedsQL and HEAR-QL scores were compared between children with and without HL, between children with unilateral and bilateral HL, and between children who used and did not use a hearing device using analysis of variance. Sensitivity and specificity were calculated for both the HEAR-QL and PedsQL. A multivariable, hierarchical linear regression analysis was conducted with independent variables associated with HEAR-QL in unadjusted tests. Results Using exploratory PCA, the 35-item HEAR-QL was reduced to 26 items (Cronbach's α=0.97; sensitivity 91% and specificity 92% at cut-off score of 93.5) loading on 3 factors: difficulty hearing in certain environments/situations (Environments α=0.97), impact of HL on social/sports activities (Activities α=0.92), and impact of HL on child's feelings (Feelings α=0.88). Sensitivity 78.8% and specificity 30.9% at a cut-off score of 69.6 on the PedsQL ((at-risk for impaired QOL) were lower than for the HEAR-QL. Participants with HL reported significantly lower mean total HEAR-QL scores (71 [SD 18] versus 98 [SD 5]; p < 0.001), but not mean total PedsQL scores (77 [SD 14] versus 83 [SD 15]; p = 0.47), than participants with normal hearing. Among children with bilateral HL, children who used a hearing device reported lower mean total HEAR-QL scores (p = 0.01), but not mean total PedsQL scores (p = 0.55), than children who did not use a hearing device. The intraclass correlation (ICC) for test-retest reliability for the 26-item HEAR-QL total score was .83. Hearing status and use of a device were independently associated with the HEAR-QL, and the variables in the model accounted for 46% of the HEAR-QL total score variance. Conclusion The HEAR-QL appears to be a valid, reliable, and sensitive questionnaire for children with HL. The HEAR-QL was better able than the PedsQL to distinguish between children with and without HL and can help evaluate interventions for children with HL. PMID:22212764

The HEAR-QL: quality of life questionnaire for children with hearing loss.

PubMed

Umansky, Amy M; Jeffe, Donna B; Lieu, Judith E C

2011-01-01

Few quality of life (QOL) assessment tools are available for children with specific chronic conditions, and none have been designed specifically for children with hearing loss (HL). A validated hearing-related QOL questionnaire could help clinicians determine whether an intervention is beneficial and whether one intervention is better than another. To examine QOL in children with HL and assess the validity, reliability, and factor structure of a new measure, the Hearing Environments and Reflection on Quality of Life (HEAR-QL) questionnaire. A descriptive and correlational study of a convenience sample of children. Participants included 35 children with unilateral HL, 45 with bilateral HL, and 35 siblings with normal hearing. Children 7-12 yr old were recruited by mail from a tertiary-care pediatric otolaryngology practice and the local county's Special School District. With parent consent, children completed the validated Pediatric Quality of Life Inventory™ (PedsQL) 4.0 and a 35-item HEAR-QL questionnaire. The factor structure of the HEAR-QL was determined through principal components analysis (PCA), and mean scores were computed for each subscale and the total HEAR-QL. Three weeks following the return of the initial questionnaires, a second HEAR-QL questionnaire was sent to participants to assess test-retest reliability. Both PedsQL and HEAR-QL scores were compared between children with and without HL, between children with unilateral and bilateral HL, and between children who used and did not use a hearing device using analysis of variance. Sensitivity and specificity were calculated for both the HEAR-QL and the PedsQL. A multivariable, hierarchical linear regression analysis was conducted with independent variables associated with the HEAR-QL in unadjusted tests. Using exploratory PCA, the 35-item HEAR-QL was reduced to 26 items (Cronbach's α = 0.97, sensitivity of 91% and specificity of 92% at a cutoff score of 93.5) loading on three factors: difficulty hearing in certain environments/situations (Environments α = 0.97), impact of HL on social/sports activities (Activities α = 0.92), and impact of HL on child's feelings (Feelings α = 0.88). Sensitivity of 78.8% and specificity of 30.9% at a cutoff score of 69.6 on the PedsQL (at risk for impaired QOL) were lower than for the HEAR-QL. Participants with HL reported significantly lower mean total HEAR-QL scores (71 [SD 18] vs. 98 [SD 5], p < .001), but not mean total PedsQL scores (77 [SD 14] vs. 83 [SD 15], p = .47), than participants with normal hearing. Among children with bilateral HL, children who used a hearing device reported lower mean total HEAR-QL scores (p = .01), but not mean total PedsQL scores (p = .55), than children who did not use a hearing device. The intraclass correlation coefficient for test-retest reliability for the 26-item HEAR-QL total score was 0.83. Hearing status and use of a device were independently associated with the HEAR-QL, and the variables in the model accounted for 46% of the HEAR-QL total score variance. The HEAR-QL appears to be a valid, reliable, and sensitive questionnaire for children with HL. The HEAR-QL was better able than the PedsQL to distinguish between children with and without HL and can help evaluate interventions for children with HL. American Academy of Audiology.

A Nonparametric Framework for Comparing Trends and Gaps across Tests

ERIC Educational Resources Information Center

Ho, Andrew Dean

2009-01-01

Problems of scale typically arise when comparing test score trends, gaps, and gap trends across different tests. To overcome some of these difficulties, test score distributions on the same score scale can be represented by nonparametric graphs or statistics that are invariant under monotone scale transformations. This article motivates and then…

Analysis of Open-Ended Statistics Questions with Many Facet Rasch Model

ERIC Educational Resources Information Center

Güler, Nese

2014-01-01

Problem Statement: The most significant disadvantage of open-ended items that allow the valid measurement of upper level cognitive behaviours, such as synthesis and evaluation, is scoring. The difficulty associated with objectively scoring the answers to the items contributes to the reduction of the reliability of the scores. Moreover, other…

Confidence in communicating with patients with cancer mediates the relationship between rehabilitation therapists' autistic-like traits and perceived difficulty in communication.

PubMed

Hayashibara, Chinatsu; Inagaki, Masatoshi; Fujimori, Maiko; Higuchi, Yuji; Fujiwara, Masaki; Terada, Seishi; Okamura, Hitoshi; Uchitomi, Yosuke; Yamada, Norihito

2018-01-21

Recently, rehabilitation therapists have become involved in cancer rehabilitation; however, no communication skills training that increases the ability to provide emotional support for cancer patients has been developed for rehabilitation therapists. In addition, no study has examined associations between rehabilitation therapists' communication skills and their level of autistic-like traits (ALT), which are in-born characteristics including specific communication styles and difficulty communicating with patients. In this study, we aimed to investigate whether confidence in communicating with patients mitigates communication difficulties experienced by rehabilitation therapists who have high levels of ALT. Rehabilitation therapists who treat patients with cancer completed self-administered postal questionnaires anonymously. Scores were obtained on the Autism-Spectrum Quotient short form, confidence in communication, and communication difficulties. We used covariance structure analyses to test hypothetical models, and confirmed that confidence in communication mediates the relationship between ALT and perceived communication difficulties. Participants included 1,343 respondents (49.6%). Autism-Spectrum Quotient scores were positively correlated with communication difficulties (r = 0.16, p < 0.001). The correlation was mitigated by confidence in communication in the fit model. However, higher confidence in creating a supportive atmosphere was associated with more difficulty in communication (r = 0.16, p < 0.001). Significance of results Communication difficulty was linked to rehabilitation therapists' ALTs. By increasing confidence in areas of communication other than creation of a supportive atmosphere, ALT-related difficulties in communication may be ameliorated. Confidence to create supportive environments correlated positively with difficulty. Communication skills training to increase confidence in communication for rehabilitation therapists should be developed with vigilance regarding ALT levels.

Association between muscle power impairment and WHODAS 2.0 in older adults with physical disability in Taiwan.

PubMed

Chang, Kwang-Hwa; Liao, Hua-Fang; Yen, Chia-Fan; Hwang, Ai-Wen; Chi, Wen-Chou; Escorpizo, Reuben; Liou, Tsan-Hon

2015-01-01

To explore the association between muscle power impairment and each World Health Organization Disability Assessment Schedule second edition (WHODAS 2.0) domain score among subjects with physical disability. Subjects (≥ 60 years) with physical disability related to neurological diseases, including 730 subjects with brain disease (BD) and 126 subjects with non-BD, were enrolled from a data bank of persons with disabilities from 1 July 2011 to 29 February 2012. Standardized WHODAS 2.0 scores ranging from 0 (least difficulty) to 100 (greatest difficulty) points were calculated for each domain. More than 50% of subjects with physical disability had the greatest difficulty in household activities and mobility. Muscle power impairment (adjusted odds ratios range among domains, 2.75-376.42, p < 0.001), age (1.38-4.81, p < 0.05), and speech impairment (1.94-5.80, p < 0.05) were associated with BD subjects experiencing the greatest difficulty in most WHODAS 2.0 domains. But a few associated factors were identified for the non-BD group in the study. Although the patterns of difficulty in most daily activities were similar between the BD and non-BD groups, factors associated with the difficulties differed between those two groups. Muscle power impairment, age and speech impairment were important factors associated with difficulties in subjects with BD-related physical disability. Older adults with physical disability often experience difficulties in household activities and mobility. Muscle power impairment is associated with difficulties in daily life in subjects with physical disability related to brain disease. Those subjects with brain disease who had older age, a greater degree of muscle power impairment, and the presence of speech impairment were at higher risk of experiencing difficulties in most daily activities.

The effect of circumcision on young adult sexual function.

PubMed

Yang, Ming-Hsin; Tsao, Chih-Wei; Wu, Sheng-Tang; Chuang, Feng-Ping; Meng, En; Tang, Shou-Hung; Sun, Guang-Huan; Yu, Dah-Shyong; Chang, Sun-Yran; Cha, Tai-Lung

2014-06-01

Whether sexual function is affected by circumcision is a subject of considerable debate among advocate and opponent opinions. We analyzed the sexual function of young men, and the differences between those who were uncircumcised and circumcised, in Taiwan. A total of 506 patients who received circumcision between January 2009 and March 2011 at the urology department in our center were enrolled. Before circumcision, the patients' sexual performances were evaluated using the International Index of Erectile Function-5 (IIEF-5), and the Brief Male Sexual Function Inventory (BMSFI) questionnaires. They were evaluated using the questionnaires again, after a postoperative interval of 90 days. Furthermore, intravaginal ejaculation latency times (IELT) of the patients were also measured. The IELT and scores in five main domains of the BMSFI, and IIEF, before and after circumcision, were analyzed. A total of 442 patients were available for follow up. The mean age was 25.14 ± 4.46 years (range = 19-35 years). The differences in the BMSFI scores were statistically significant (p < 0.001), especially in increasing sex drive after circumcision (p < 0.001). The IIEF-5 score showed no statistically difference before and after circumcision (p = 0.141). However, after the circumcision, the participants had more erection confidence (p < 0.001), more difficulty in maintaining erections in completing intercourse (p = 0.01), and showed lower IELT scores (p = 0.06). The sexual performance, especially with regards to sex drive and mental erection confidence, seemed to have improved among the patients after circumcision. Our findings may help urologists to better counsel young men receiving circumcisions. Copyright © 2013. Published by Elsevier B.V.

Evaluation of Home Health Care Devices: Remote Usability Assessment.

PubMed

Kortum, Philip; Peres, S Camille

2015-06-05

An increasing amount of health care is now performed in a home setting, away from the hospital. While there is growing anecdotal evidence about the difficulty patients and caregivers have using increasingly complex health care devices in the home, there has been little systematic scientific study to quantify the global nature of home health care device usability in the field. Research has tended to focus on a handful of devices, making it difficult to gain a broad view of the usability of home-care devices in general. The objective of this paper is to describe a remote usability assessment method using the System Usability Scale (SUS), and to report on the usability of a broad range of health care devices using this metric. A total of 271 participants selected and rated up to 10 home health care devices of their choice using the SUS, which scores usability from 0 (unusable) to 100 (highly usable). Participants rated a total of 455 devices in their own home without an experimenter present. Usability scores ranged from 98 (oxygen masks) to 59 (home hormone test kits). An analysis conducted on devices that had at least 10 ratings showed that the effect of device on SUS scores was significant (P<.001), and that the usability of these devices was on the low end when compared with other commonly used items in the home, such as microwave ovens and telephones. A large database of usability scores for home health care devices collected using this remote methodology would be beneficial for physicians, patients, and their caregivers.

Benefit on health-related quality of life of adherence to gluten-free diet in adult patients with celiac disease.

PubMed

Casellas, Francisco; Rodrigo, Luis; Lucendo, Alfredo J; Fernández-Bañares, Fernando; Molina-Infante, Javier; Vivas, Santiago; Rosinach, Mercé; Dueñas, Carmen; López-Vivancos, Josefa

2015-04-01

Celiac disease (CD) affects health-related quality of life (HRQOL) of patients suffering it. The exclusion of gluten from the diet (GFD) improves HRQOL, but involves difficulties in following the diet that could adversely affect HRQOL. To determine the effect of adherence to the diet on HRQOL of adult CD patients. A prospective, cross-sectional, multicenter study of CD patients treated with a GFD for longer than 1 year. Adherence to the GFD was measured using the Morisky scale, and health status using the specific CD-QOL questionnaire and the generic EuroQol-5D questionnaire. 366 patients from 7 hospitals were included: 71.5% of patients reported a perfect treatment adherence, 23.5% unintentional poor adherence and 5% intentional poor adherence. Good adherence to a GFD was related to a higher mean score onthe CD-QOL (75 vs. 68, respectively, p < 0.05) and EuroQol-5D (0.9 vs. 0.8, respectively, p < 0.05). Ease of adherence to a GFD was also related to a better HRQOL (total CD-QOL score of 82 vs. 67 in patients who consider the GFD difficult to follow, p < 0.05). Good symptom control was also related to a better HRQOL (total CD-QOL score of 78 vs. 67 in asymptomatic vs. symptomatic patients, p < 0.01). The worse scored dimension of CD-QOL was related to "inadequate treatment". In CD, good adherence to a GFD and adequate symptom control result in improved HRQOL. Many patients consider that the lack of therapeutic alternatives to diet worsens their quality of life.

Structure of Enhanced Cued Recall Task in the 7 Minute Screen Test.

PubMed

Mora-Simon, Sara; Ladera-Fernandez, Valentina; Garcia-Garcia, Ricardo; Patino-Alonso, María C; Perea-Bartolome, M Victoria; Unzueta-Arce, Jaime; Perez-Arechaederra, Diana; Rodriguez-Sanchez, Emiliano

2017-01-01

Episodic memory in the 7 Minute Screen is assessed by the Enhanced Cued Recall (ECR) test. The ECR test is composed of three phases, Identification, Immediate Recall, and Free and Cued Recall. However, just the last phase is considered for the total score. We believe that collecting the performance data of the Identification and Immediate Recall phases could provide information regarding possible difficulties or impairments in the different aspects involved in the temporal mnesic process of acquisition of new information, such as in working memory or visual identification. The objective was to assess the goodness of fit for the three phases of the ECR test using a Confirmatory Factor Analysis (CFA) to show if each phase is separated from each other as a different aspect that participates in the mnesic process. A total of 311 participants greater than 65 years were included in this study. Confirmatory factor analyses were conducted for each individual phase. The analyses show that the ECR test consists of three separate phases that identify different steps of the mnesic process. Individual scores for each phase could allow for investigation of patient performance in different aspects of the memory process and could help in further neuropsychological assessment.

Development and preliminary validation of a self-report measure of psychopathic personality traits in noncriminal populations.

PubMed

Lilienfeld, S O; Andrews, B P

1996-06-01

Research on psychopathology has been hindered by persisting difficulties and controversies regarding its assessment. The primary goals of this set of studies were to (a) develop, and initiate the construct validation of, a self-report measure that assesses the major personality traits of psychopathy in noncriminal populations and (b) clarify the nature of these traits via an exploratory approach to test construction. This measure, the Psychopathic Personality Inventory (PPI), was developed by writing items to assess a large number of personality domains relevant to psychopathy and performing successive item-level factor analyses and revisions on three undergraduate samples. The PPI total score and its eight subscales were found to possess satisfactory internal consistency and test-retest reliability. In four studies with undergraduates, the PPI and its subscales exhibited a promising pattern of convergent and discriminant validity with self-report, psychiatric interview, observer rating, and family history data. In addition, the PPI total score demonstrated incremental validity relative to several commonly used self-report psychopathy-related measures. Future construct validation studies, unresolved conceptual issues regarding the assessment of psychopathy, and potential research uses of the PPI are outlined.

Alexithymia, emotion processing and social anxiety in adults with ADHD.

PubMed

Edel, M-A; Rudel, A; Hubert, C; Scheele, D; Brüne, M; Juckel, G; Assion, Hans-Jörg

2010-09-24

given sparse research on the issue, this study sought to shed light upon the interactions of alexithymia, emotion processing, and social anxiety in adults with attention-deficit hyperactivity disorder (ADHD). 73 German adults with ADHD according to DSM-IV diagnostic criteria participated. We used the Toronto Alexithymia Scale (TAS-20) to assess alexithymia, the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS) to assess different features of social anxiety, and we applied the German "Experience of Emotions Scalerdquor; (SEE) to measure emotion processing. 40% of the sample were found to meet the DSM-IV criteria of social anxiety disorder, and about 22% were highly alexithymic according to a TAS-20 total score ≥ 61; however, the mean TAS-20 total score of 50.94 ± 9.3 was not much higher than in community samples. Alexithymic traits emerged to be closely linked to emotion processing problems, particularly 'difficulty accepting own emotions', and to social anxiety features. our findings suggest interactions of alexithymia, emotion processing dysfunction, and social anxiety in adults with ADHD, which may entail the therapeutic implication to thoroughly instruct these patients to identify, accept, communicate, and regulate their emotions to aid reducing interaction anxiety.

Symptomatic efficacy of rasagiline monotherapy in early Parkinson's disease: post-hoc analyses from the ADAGIO trial.

PubMed

Jankovic, Joseph; Berkovich, Elijahu; Eyal, Eli; Tolosa, Eduardo

2014-06-01

The ADAGIO study included a large cohort of patients with early PD (baseline total-UPDRS = 20) who were initially randomized to rasagiline and placebo, thereby allowing analyses of symptomatic efficacy. Post-hoc analyses comparing the efficacy of rasagiline 1 mg/day (n = 288) versus placebo (n = 588) on key symptoms at 36 weeks, and on total-UPDRS scores over 72 weeks (completer population: rasagiline 1 mg/day n = 221, placebo n = 392) were performed. Treatment with rasagiline resulted in significantly better tremor, bradykinesia, rigidity and postural-instability-gait-difficulty scores at week 36 versus placebo. Whereas the placebo group experienced progressive deterioration from baseline (2.6 UPDRS points at week 36), patients in the rasagiline group were maintained at baseline values at week 60 (UPDRS-change of 0.3 points). At week 72, patients who had received continuous monotherapy with rasagiline experienced a worsening of only 1.6 points. Treatment with rasagiline maintained motor function to baseline values for at least a year with significant benefits observed in all key PD motor symptoms. Copyright © 2014 Elsevier Ltd. All rights reserved.

The effect of housing on the mental health of older people: the impact of lifetime housing history in Whitehall II

PubMed Central

2011-01-01

Background This study describes differences in trajectories of self-reported mental health in an ageing cohort, according to their housing, while controlling for confounders. Methods The General Health Questionnaire was measured on six occasions as part of Whitehall II cohort study of office-based British civil servants (1985-2009); 10,308 men and women aged 35-55 at baseline. Results Home-ownership was the predominant tenure at baseline and increased over the life-course, but the social gradient remained. In the bivariate analysis, by phase nine, renters had higher (poorer mental health) GHQ scores (55.48) than owner occupiers (51.98). Those who reported difficulty paying bills or problems with housing had higher GHQ scores at baseline (financial difficulties 57.70 vs 54.34; house problems 58.06 vs 53.99) and this relative difference increased by phase nine (financial difficulties 59.64 vs 51.67; house problems 56.68 vs 51.22). In multivariate models, the relative differences in GHQ scores by tenure increased with age, but were no longer significant after adjusting for confounders. Whereas GHQ scores for those with housing problems and financial difficulties were still significantly higher as participants grew older. Conclusion The social gradient in the effect of home ownership on mental health, which is evident at baseline, diminishes as people get older, whereas housing quality and financial problems become relatively more important in explaining older people's health. Inequalities in housing quality and ability to deal with household financial problems will become increasingly important mental health issues as the population ages. PMID:21884619

Ethnic differences in psychological well-being in adolescence in the context of time spent in family activities.

PubMed

Maynard, Maria J; Harding, Seeromanie

2010-01-01

In Britain and elsewhere there is ethnic variation in mental health in adulthood but less is known about adolescence. Few studies examining the role of family life in adolescent mental well-being have been based on a multi-ethnic UK sample. We explored whether family activities explain ethnic differences in mental health among adolescents in London, UK. These analyses are based on 4,349 Black Caribbean, Black African, Indian, Pakistani and Bangladeshi and White UK boys and girls aged 11-13, in 51 schools. Psychological well-being was measured as the total difficulties score from Goodman's strengths and difficulties questionnaire (increasing score represents increasing difficulties). Participation in family activities varied by ethnicity. Compared with the White UK group, all minority groups were more likely to visit friends and relatives and go other places as a family. Black Caribbeans and Nigerian/Ghanaians were less likely and South Asian groups more likely to eat a meal together as a family. In multivariate analyses all minority groups had better well-being scores compared to Whites, independent of family type and socio-economic status (SES). Although adjusting for family activities slightly attenuated the association for South Asians, the minority ethnic advantage in psychological well-being remained [regression coefficients for Black Caribbeans = -0.66 (95% CI = -1.13, -0.20); Nigerian/Ghanaians = -1.27 (-1.81, -0.74); Other Africans = -1.43 (-2.00, -0.86); Indians = -1.15 (-1.73, -0.58); Pakistani/Bangladeshis = -0.66 (-1.20, -0.12)]. In analyses based on the whole group, all activity variables were independent correlates of psychological well-being. Multivariate models, stratified by ethnicity, showed that

Racism, ethnic density and psychological well-being through adolescence: evidence from the Determinants of Adolescent Social well-being and Health longitudinal study

PubMed Central

Astell-Burt, Thomas; Maynard, Maria J.; Lenguerrand, Erik; Harding, Seeromanie

2012-01-01

Objective. To investigate the effect of racism, own-group ethnic density, diversity and deprivation on adolescent trajectories in psychological well-being. Design. Multilevel models were used in longitudinal analysis of psychological well-being (total difficulties score (TDS) from Goodman's Strengths and Difficulties Questionnaire, higher scores correspond to greater difficulties) for 4782 adolescents aged 11–16 years in 51 London (UK) schools. Individual level variables included ethnicity, racism, gender, age, migrant generation, socioeconomic circumstances, family type and indicators of family interactions (shared activities, perceived parenting). Contextual variables were per cent eligible for free school-meals, neighbourhood deprivation, per cent own-group ethnic density, and ethnic diversity. Results. Ethnic minorities were more likely to report racism than Whites. Ethnic minority boys (except Indian boys) and Indian girls reported better psychological well-being throughout adolescence compared to their White peers. Notably, lowest mean TDS scores were observed for Nigerian/Ghanaian boys, among whom the reporting of racism increased with age. Adjusted for individual characteristics, psychological well-being improved with age across all ethnic groups. Racism was associated with poorer psychological well-being trajectories for all ethnic groups (p <0.001), reducing with age. For example, mean difference in TDS (95% confidence interval) between boys who experienced racism and those who did not at age 12 years = 1.88 (+1.75 to + 2.01); at 16 years = +1.19 (+1.07 to +1.31). Less racism was generally reported in schools and neighbourhoods with high than low own-group density. Own ethnic density and diversity were not consistently associated with TDS for any ethnic group. Living in more deprived neighbourhoods was associated with poorer psychological well-being for Whites and Black Caribbeans (p <0.05). Conclusion. Racism, but not ethnic density and deprivation in schools or neighbourhoods, was an important influence on psychological well-being. However, exposure to racism did not explain the advantage in psychological well-being of ethnic minority groups over Whites. PMID:22332834

Early working memory as a racially and ethnically neutral measure of outcome in extremely preterm children at 18-22 months

PubMed Central

Lowe, Jean R.; Duncan, Andrea Freeman; Bann, Carla M.; Fuller, Janell; Hintz, Susan R.; Das, Abhik; Higgins, Rosemary D.; Watterberg, Kristi L.

2013-01-01

Background Difficulties with executive function has been found in preterm children, resulting in difficulties with learning and school performance. Aim This study evaluated the relationship of early working memory as measured by object permanence items to the cognitive and language scores on the Bayley Scales-III in a cohort of children born extremely preterm. Study Design Logistic regression models were conducted to compare object permanence scores derived from the Bayley Scales-III by race/ethnicity and maternal education, controlling for medical covariates. Subjects Extremely preterm toddlers (526), who were part of a Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network's multi-center study, were evaluated at 18-22 months corrected age. Outcome Measures Object permanence scores derived from the Bayley Developmental Scales were compared by race/ethnicity and maternal education, controlling for medical covariates. Results There were no significant differences in object permanence mastery and scores among the treatment groups after controlling for medical and social variables, including maternal education and race/ethnicity. Males and children with intraventricular hemorrhage, retinopathy of prematurity, and bronchopulmonary dysplasia were less likely to demonstrate object permanence mastery and had lower object permanence scores. Children who attained object permanence mastery had significantly higher Bayley Scales-III cognitive and language scores after controlling for medical and socio-economic factors. Conclusions Our measure of object permanence is free of influence from race, ethnic and socio-economic factors. Adding this simple task to current clinical practice could help detect early executive function difficulties in young children. PMID:23993309

Early working memory as a racially and ethnically neutral measure of outcome in extremely preterm children at 18-22 months.

PubMed

Lowe, Jean R; Duncan, Andrea Freeman; Bann, Carla M; Fuller, Janell; Hintz, Susan R; Das, Abhik; Higgins, Rosemary D; Watterberg, Kristi L

2013-12-01

Difficulties with executive function have been found in preterm children, resulting in difficulties with learning and school performance. This study evaluated the relationship of early working memory as measured by object permanence items to the cognitive and language scores on the Bayley Scales-III in a cohort of children born extremely preterm. Logistic regression models were conducted to compare object permanence scores derived from the Bayley Scales-III by race/ethnicity and maternal education, controlling for medical covariates. Extremely preterm toddlers (526), who were part of a Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network's multi-center study, were evaluated at 18-22 months corrected age. Object permanence scores derived from the Bayley Developmental Scales were compared by race/ethnicity and maternal education, controlling for medical covariates. There were no significant differences in object permanence mastery and scores among the treatment groups after controlling for medical and social variables, including maternal education and race/ethnicity. Males and children with intraventricular hemorrhage, retinopathy of prematurity, and bronchopulmonary dysplasia were less likely to demonstrate object permanence mastery and had lower object permanence scores. Children who attained object permanence mastery had significantly higher Bayley Scales-III cognitive and language scores after controlling for medical and socio-economic factors. Our measure of object permanence is free of influence from race, ethnic and socio-economic factors. Adding this simple task to current clinical practice could help detect early executive function difficulties in young children. Published by Elsevier Ireland Ltd.

The person's conception of the structures of developing intellect: early adolescence to middle age.

PubMed

Demetriou, A; Efklides, A

1989-08-01

According to experiential structuralism, thought abilities have six capacity spheres: experimental, propositional, quantitative, imaginal, qualitative, and metacognitive. The first five are applied to the environment. The metacognitive capacity is applied to the others, serving as the interface between reality and the cognitive system or between any of the other capacities. To test this postulate, 648 subjects aged 12 to 40 years, solved eight tasks that were addressed, in pairs, to the first four capacity spheres. One of the tasks in each pair tapped the first and the other the third formal level of the sphere. Having solved the tasks, the subjects were required to rate each pair of tasks in terms of similarity of operations, difficulty, and success of solution. Factor analysis of difficulty and success evaluation scores revealed the same capacity-specific factors as the analysis of performance scores. Factor analysis of similarity scores differentiated between same- and different-sphere pairs. Analysis of variance showed that difficulty and success evaluation scores preserved performance differences between the first and the third formal tasks. Cognitive level, age, socioeconomic status, and sex were related to the metacognitive measures in ways similar to their relations to performance measures. These findings were integrated into a model aimed at capturing real-time metacognitive functioning.

Psychological factors in patients with peptic ulcerand functional dyspepsia.

PubMed

Faramarzi, Mahbobeh; Kheirkhah, Farzan; Shokri-Shirvani, Javad; Mosavi, Shokofeh; Zarini, Soroush

2014-01-01

The role of psychological factors in peptic ulcer disease (PUD) and functional dyspepsia (FD) has not been clearly determined. In this study the role of conflict management styles, psychiatric symptoms, and alexithymia were assessed in patients with PUD and FD and in the healthy individuals. Ninety subjects [30 PUD (15 women, 15 men), 30 FD (15 women, 15 men), and 30 healthy individuals (15 women, 15 men)] in two endoscopy wards of Babol University of Medical Sciences were evaluated. Three groups were matched with regard to demographic variables. Conflict management styles, psychiatric symptoms, and alexithymia were evaluated by appropriate questionnaires. The patients with PUD reported less mean scores on psychiatric symptoms than the FD patients (depression 12.6±7.5 vs 28±9.5, anxiety 8.2±5.9 vs 18.7±6. obsessive-compulsive disorder 15.7±7.5 vs 21.8±8.4, interpersonal sensitivity 9.5±7.4 vs 16±7, psychoticism 8.03±4.5 vs 14.3±6.3, somatization 12.5±10.8 vs 20.7±8.1, and the total score of psychiatric symptoms 94.4±49.9 vs 160.1±46.6). The mean scores use of unconstructive conflict management styles in PUD patients were lower than FD (dominating 17.7±3.5 vs 20.2±2.7, avoiding 17.5±3 vs 23.8±4.4). Alexithymia symptoms were higher in FD patients than PUD individuals (difficulty in identifying feelings 23.5±6.3 vs 27.8±3.9, difficulty in describing feeling 16.5±4.4 vs 17.3±3.6). The PUD and FD patients had higher scores regarding these variables than the healthy subjects. The results show that both PUD and FD patients experienced more psychiatric symptoms, unconstructive conflict management styles, and alexithymia than the healthy subjects. FD patients had worse psychiatric problems than PUD.

Symptoms and impact of COPD assessed by an electronic diary in patients with moderate-to-severe COPD: psychometric results from the SHINE study.

PubMed

Kulich, Károly; Keininger, Dorothy L; Tiplady, Brian; Banerji, Donald

2015-01-01

Symptoms, particularly dyspnea, and activity limitation, have an impact on the health status and the ability to function normally in patients with chronic obstructive pulmonary disease (COPD). To develop an electronic patient diary (eDiary), qualitative patient interviews were conducted from 2009 to 2010 to identify relevant symptoms and degree of bother due to symptoms. The eDiary was completed by a subset of 209 patients with moderate-to-severe COPD in the 26-week QVA149 SHINE study. Two morning assessments (since awakening and since the last assessment) and one evening assessment were made each day. Assessments covered five symptoms ("shortness of breath," "phlegm/mucus," "chest tightness," "wheezing," and "coughing") and two impact items ("bothered by COPD" and "difficulty with activities") and were scored on a 10-point numeric scale. Patient compliance with the eDiary was 90.4% at baseline and 81.3% at week 26. Correlations between shortness of breath and impact items were >0.95. Regression analysis showed that shortness of breath was a highly significant (P<0.0001) predictor of impact items. Exploratory factor analysis gave a single factor comprising all eDiary items, including both symptoms and impact items. Shortness of breath, the total score (including five symptoms and two impact items), and the five-item symptom score from the eDiary performed well, with good consistency and reliability. The eDiary showed good sensitivity to change, with a 0.6 points reduction in the symptoms scores (on a 0-10 point scale) representing a meaningful change. The eDiary was found to be valid, reliable, and responsive. The high correlations obtained between "shortness of breath" and the ratings of "bother" and "difficulty with activities" confirmed the relevance of this symptom in patients with COPD. Future studies will be required to explore further psychometric properties and their ability to differentiate between COPD treatments.

Urinary Metabolites of Organophosphate and Pyrethroid Pesticides and Behavioral Problems in Canadian Children

PubMed Central

Oulhote, Youssef

2013-01-01

Background: Exposure to organophosphate pesticides has been associated with neurobehavioral deficits in children, although data on low levels of exposure experienced by the general population are sparse. Pyrethroids are insecticides rapidly gaining popularity, and epidemiological evidence on their potential effects is lacking. Objective: We examined the association between exposure to organophosphate and pyrethroid pesticides, indicated by urinary metabolites, and parentally reported behavioral problems in children. Methods: We used data on children 6–11 years of age from the Canadian Health Measures Survey (2007–2009). We used logistic regressions to estimate odds ratios (ORs) for high scores on the Strengths and Difficulties Questionnaire (SDQ), which may indicate behavioral problems, in association with concentrations of pyrethroid and organophosphate metabolites in the urine of 779 children, adjusting for covariates (sex, age, race/ethnicity, income, parental education, blood lead levels, maternal smoking during pregnancy, and others). Results: At least one urinary metabolite for organophosphates was detected in 91% of children, and for pyrethroids in 97% of children. Organophosphate metabolites were not significantly associated with high SDQ scores. The pyrethroid metabolite cis-DCCA [3-(2,2-dichlorovinyl)-2,2-dimethylycyclopropane carboxylic acid] was significantly associated with high scores for total difficulties on the SDQ (OR for a 10-fold increase = 2.0; 95% CI: 1.1, 3.6), and there was a nonsignificant association with trans-DCCA (OR = 1.6; 95% CI: 0.9, 3.0). Conclusion: In contrast with previous studies, we did not observe an association between exposure to organophosphate pesticides and behavioral scores in children. However, some pyrethroid urinary metabolites were associated with a high level of parent-reported behavioral problems. Longitudinal studies should be conducted on the potential risks of pyrethroids. Citation: Oulhote Y, Bouchard MF. 2013. Urinary metabolites of organophosphate and pyrethroid pesticides and behavioral problems in Canadian children. Environ Health Perspect 121:1378–1384; http://dx.doi.org/10.1289/ehp.1306667 PMID:24149046

Development and validity of a questionnaire to test the knowledge of primary care personnel regarding nutrition in obese adolescents.

PubMed

de Pinho, Lucinéia; Moura, Paulo Henrique Tolentino; Silveira, Marise Fagundes; de Botelho, Ana Cristina Carvalho; Caldeira, Antônio Prates

2013-07-18

In light of its epidemic proportions in developed and developing countries, obesity is considered a serious public health issue. In order to increase knowledge concerning the ability of health care professionals in caring for obese adolescents and adopt more efficient preventive and control measures, a questionnaire was developed and validated to assess non-dietitian health professionals regarding their Knowledge of Nutrition in Obese Adolescents (KNOA). The development and evaluation of a questionnaire to assess the knowledge of primary care practitioners with respect to nutrition in obese adolescents was carried out in five phases, as follows: 1) definition of study dimensions 2) development of 42 questions and preliminary evaluation of the questionnaire by a panel of experts; 3) characterization and selection of primary care practitioners (35 dietitians and 265 non-dietitians) and measurement of questionnaire criteria by contrasting the responses of dietitians and non-dietitians; 4) reliability assessment by question exclusion based on item difficulty (too easy and too difficult for non-dietitian practitioners), item discrimination, internal consistency and reproducibility index determination; and 5) scoring the completed questionnaires. Dietitians obtained higher scores than non-dietitians (Mann-Whitney U test, P < 0.05), confirming the validity of the questionnaire criteria. Items were discriminated by correlating the score for each item with the total score, using a minimum of 0.2 as a correlation coefficient cutoff value. Item difficulty was controlled by excluding questions answered correctly by more than 90% of the non-dietitian subjects (too easy) or by less than 10% of them (too difficult). The final questionnaire contained 26 of the original 42 questions, increasing Cronbach's α value from 0.788 to 0.807. Test-retest agreement between respondents was classified as good to very good (Kappa test, >0.60). The KNOA questionnaire developed for primary care practitioners is a valid, consistent and suitable instrument that can be applied over time, making it a promising tool for developing and guiding public health policies.

Good social skills despite poor theory of mind: exploring compensation in autism spectrum disorder.

PubMed

Livingston, Lucy Anne; Colvert, Emma; Bolton, Patrick; Happé, Francesca

2018-03-26

It is proposed that some individuals with Autism Spectrum Disorder (ASD) can 'compensate' for their underlying difficulties (e.g. in theory of mind; ToM), thus demonstrating relatively few behavioural symptoms, despite continued core cognitive deficits. The mechanisms underpinning compensation are largely unexplored, as is its potential impact on mental health. This study aimed to estimate compensation patterns in ASD, by contrasting overt social behaviour with ToM task performance, in order to compare the characteristics of 'Low' and 'High' Compensators. A total of 136 autistic adolescents, from the ongoing Social Relationships Study, completed a range of cognitive tasks, the Autistic Diagnostic Observation Schedule (ADOS) and a self-report anxiety questionnaire. Participants were assigned compensation group status; High Compensators demonstrated good ADOS scores despite poor ToM performance, while Low Compensators demonstrated similarly poor ToM, accompanied by poor ADOS scores. High Compensators demonstrated better IQ and executive function (EF), but greater self-reported anxiety, compared with Low Compensators. Such differences were not found when comparing individuals who had good versus poor ADOS scores, when ToM performance was good. Other core autistic characteristics (weak central coherence, nonsocial symptoms) did not differentiate the High and Low Compensators. IQ, EF and anxiety appear to be implicated in the processes by which certain autistic young people can compensate for their underlying ToM difficulties. This tendency to compensate does not appear to reflect the severity of 'hit' for ASD per se, suggesting that well-compensated individuals are not experiencing a milder form of ASD. The construct of compensation in ASD has implications for research and clinical practice. © 2018 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

Maternal mental quality of life mediates the associations between intimate partner abuse against mothers and their children's behaviours and quality of life in low-income Chinese families.

PubMed

Guo, Vivian Yawei; Yu, Esther Yee Tak; Wong, Rosa Sze Man; Ip, Patrick; Tiwari, Agnes Fung Yee; Wong, Carlos King Ho; Fung, Colman Siu Cheung; Wong, Wilfred Hing Sang; Lam, Cindy Lo Kuen

2017-12-01

To explore the association between maternal intimate partner abuse (IPA) and their children's health-related quality of life (HRQOL) and behavioural problem, and to establish a mediation model and investigate the mediating role of mothers' HRQOL on this association. A cross-sectional study was conducted on 197 mothers of 227 children (112 boys and 115 girls) from low-income Chinese families. The mothers were asked to complete the 5-item abuse assessment screen questionnaire for the presence of IPA, the Chinese (Hong Kong) version of 12-item Short-Form Health Survey (SF-12) for their HRQOL and a structured socio-demographics questionnaire. One of the parents completed the Child Health Questionnaire-Parent Form-50 (CHQ-PF50) and the strengths and difficulties questionnaire (SDQ) to report on their children's HRQOL and behavioural problems, respectively. The mediating effect of the maternal HRQOL on the relationship between maternal IPA status and their children's behavioural problems and HRQOL was tested using Baron and Kenney's multistage regression approach and bootstrapping method. Thirty-five of the 197 mothers reported IPA (17.8%). Children whose mothers had experienced IPA had lower scores in the CHQ-PF50 mental health, parental impact-emotional, family activities and family cohesion subscales, and the psychosocial summary score compared to children of mothers who reported no IPA; they also had more emotional, conduct and hyperactivity/inattention problems and higher total difficulties scores measured by the SDQ. Maternal mental HRQOL was a mediator on the relationship between maternal IPA status and their children's behavioural problems and psychosocial HRQOL. IPA experienced by mothers had significant negative impacts on their children's HRQOL and behaviours, which was mediated by maternal mental HRQOL.

Impact of neonatal growth on IQ and behavior at early school age.

PubMed

Smithers, Lisa G; Lynch, John W; Yang, Seungmi; Dahhou, Mourad; Kramer, Michael S

2013-07-01

The objective was to examine associations of neonatal weight gain (NWG) and head circumference gain (HCG) with IQ scores and behavior at early school age. We used data from the Promotion of Breastfeeding Intervention Trial, involving Belarusian infants born full term and weighing ≥2500 g. NWG and HCG were measured as the percentage gain in weight and head circumference over the first 4 weeks relative to birth size. IQ and behavior were measured at 6.5 years of age by using the Wechsler Abbreviated Scales of Intelligence and the Strengths and Difficulties Questionnaire (SDQ), respectively, with SDQ collected from parents and teachers. The associations between the exposures (NWG, HCG) and children's IQ and SDQ were examined by using mixed models to account for clustering of measurements, and adjustment for potentially confounding perinatal and socioeconomic factors. Mean NWG was 26% (SD 10%) of birth weight. In fully adjusted models, infants in the highest versus lowest quartile of NWG had 1.5-point (95% confidence interval [CI] 0.8 to 2.2) higher IQ scores (n = 13 840). A weak negative (protective) association between NWG and SDQ total difficulties scores was observed for the teacher-reported (β = -0.39, 95% CI -0.71 to -0.08, n = 12 016), but not the parent-reported (β = -0.12, 95% CI -0.39 to 0.15, n = 13 815), SDQ. Similar associations were observed with HCG and IQ and behavior. Faster gains in weight or head circumference in the 4 weeks after birth may contribute to children's IQ, but reverse causality (brain function affects neonatal growth) cannot be excluded.

Impact of Neonatal Growth on IQ and Behavior at Early School Age

PubMed Central

Lynch, John W.; Yang, Seungmi; Dahhou, Mourad; Kramer, Michael S.

2013-01-01

OBJECTIVES: The objective was to examine associations of neonatal weight gain (NWG) and head circumference gain (HCG) with IQ scores and behavior at early school age. METHODS: We used data from the Promotion of Breastfeeding Intervention Trial, involving Belarusian infants born full term and weighing ≥2500 g. NWG and HCG were measured as the percentage gain in weight and head circumference over the first 4 weeks relative to birth size. IQ and behavior were measured at 6.5 years of age by using the Wechsler Abbreviated Scales of Intelligence and the Strengths and Difficulties Questionnaire (SDQ), respectively, with SDQ collected from parents and teachers. The associations between the exposures (NWG, HCG) and children’s IQ and SDQ were examined by using mixed models to account for clustering of measurements, and adjustment for potentially confounding perinatal and socioeconomic factors. RESULTS: Mean NWG was 26% (SD 10%) of birth weight. In fully adjusted models, infants in the highest versus lowest quartile of NWG had 1.5-point (95% confidence interval [CI] 0.8 to 2.2) higher IQ scores (n = 13 840). A weak negative (protective) association between NWG and SDQ total difficulties scores was observed for the teacher-reported (β = −0.39, 95% CI −0.71 to −0.08, n = 12 016), but not the parent-reported (β = −0.12, 95% CI −0.39 to 0.15, n = 13 815), SDQ. Similar associations were observed with HCG and IQ and behavior. CONCLUSIONS: Faster gains in weight or head circumference in the 4 weeks after birth may contribute to children’s IQ, but reverse causality (brain function affects neonatal growth) cannot be excluded. PMID:23776123

Predictors of weight loss in early treated Parkinson's disease from the NET-PD LS-1 cohort.

PubMed

Wills, Anne-Marie; Li, Ruosha; Pérez, Adriana; Ren, Xuehan; Boyd, James

2017-08-01

Weight loss is a common symptom of Parkinson's disease and is associated with impaired quality of life. Predictors of weight loss have not been studied in large clinical cohorts. We previously observed an association between change in body mass index and change in Unified Parkinson's Disease Rating Scale (UPDRS) motor and total scores. In this study, we performed a secondary analysis of longitudinal data (1-6 years) from 1619 participants in the NINDS Exploratory Trials in PD Long-term Study-1 (NET-PD LS1) to explore predictors of weight loss in a large prospective clinical trial cohort of early treated Parkinson's disease. The NET-PD LS1 study was a double-blind randomized placebo controlled clinical trial of creatine monohydrate 10 gm/day in early treated PD (within 5 years of diagnosis and within 2 years of starting dopaminergic medications). Linear mixed models were used to estimate the effect of baseline clinical covariates on weight change over time. On average, participants lost only 0.6 kg per year. Higher age, baseline weight, female gender, higher baseline UPDRS scores, greater postural instability, difficulty eating and drinking, lower cognitive scores and baseline levodopa use (compared to dopamine agonists) were all associated with weight loss. Surprisingly baseline difficulty swallowing, dyskinesia, depression, intestinal hypomotility (constipation) and self-reported nausea/vomiting/anorexia were not significantly associated with weight loss in this cohort of early treated Parkinson's disease patients. On average, participants with Parkinson's disease experience little weight loss during the first 1-6 years after starting dopaminergic replacement therapy, however levodopa use and postural instability were both predictors of early weight loss. Trial Registration clinicaltrials.gov identifier# NCT00449865.

Trajectory of sleep disturbances in patients undergoing lung cancer surgery: a prospective study.

PubMed

Halle, Ingrid Helene; Westgaard, Therese Krystad; Wahba, Alexander; Oksholm, Trine; Rustøen, Tone; Gjeilo, Kari Hanne

2017-08-01

Patients with lung cancer report sleep difficulties to be frequent and bothersome symptoms. This study describes the trajectory of sleep from before and up to 12 months after surgery for lung cancer. Further, it investigates possible associations between sleep disturbance, demographic and clinical characteristics before surgery. This study is part of a longitudinal multicentre study. Sleep disturbance was measured by The General Sleep Disturbance Scale (GSDS) that investigates frequencies of sleep difficulties (21 items) and a total sum score ≥43 indicates a clinically meaningful level of sleep disturbance (score range 0-147). Linear mixed models were used to study changes in sleep from baseline to 1, 5, 9 and 12 months after surgery. The percentage of patients (n = 264) reporting sleep disturbances was 60.9% at baseline, 68.5% at Month 1, 55.4% at Month 5, 51.3% at Month 9 and 49.7% at Month 12. The increase to and decrease from Month 1 was the only significant alteration in the occurrence of sleep disturbance. The patients reported most problems within the subscales sleep quantity, early awakenings and sleep quality. Factors associated with sleep disturbance were lower age, use of pain medication and psychotropic medication and higher comorbidity score. Lung cancer patients sleep poorly, before as well as after surgery. There is a need to address sleeping disturbance routinely in clinical practice and screening for sleeping problems is indicated. Further studies are warranted concerning factors that contribute to sleep disturbance and how they best can be treated. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Urban Latino children's physical activity levels and performance in interactive dance video games: effects of goal difficulty and goal specificity.

PubMed

Gao, Zan; Podlog, Leslie

2012-10-01

To examine the effects of different levels of goal specificity and difficulty on Latino children's performance and physical activity (PA) levels in an after-school program incorporating an interactive dance program (Dance Dance Revolution [DDR]; Konami Corporation). Comparison study. Rose Park Elementary School, Salt Lake City, Utah. Ninety-eight Latino children in the first through sixth grades, aged 7 to 13 years. After the pretest, the participants were randomly assigned into 1 of the following 3 goal-setting conditions: (1) easy, (2) difficult, and (3) best effort (hereinafter referred to as do-your-best goal). Participants' PA levels were measured using piezoelectric pedometers, and steps per minute were used as the outcome variable. Participants' total points for their dance on television screens were retrieved as their performance scores. These outcome variables were assessed again 8 weeks later (posttest score). The multivariate analysis of covariance yielded a significant main effect for the goal-setting condition. Follow-up tests revealed that children who set specific (easy or difficult) goals had significantly greater increased PA levels (mean scores, 10.34 for easy and 22.45 for difficult) and DDR performance (0.011 for easy and 0.67 for difficult) than those in the do-your-best group (0.83 for PA and 0.17 for performance). In addition, children's increased PA levels in the difficult-goal group were significantly higher than those in the easy-goal group. The easy- and difficult-goal groups show a significant improvement on DDR performance. The difficult- goal group also displays the highest improvement on PA levels. Strategies to enhance children's DDR performance and PA levels are discussed in relation to the extant goal-setting literature.

Development and assessment of a composite score for memory in the Alzheimer's Disease Neuroimaging Initiative (ADNI).

PubMed

Crane, Paul K; Carle, Adam; Gibbons, Laura E; Insel, Philip; Mackin, R Scott; Gross, Alden; Jones, Richard N; Mukherjee, Shubhabrata; Curtis, S McKay; Harvey, Danielle; Weiner, Michael; Mungas, Dan

2012-12-01

We sought to develop and evaluate a composite memory score from the neuropsychological battery used in the Alzheimer's Disease (AD) Neuroimaging Initiative (ADNI). We used modern psychometric approaches to analyze longitudinal Rey Auditory Verbal Learning Test (RAVLT, 2 versions), AD Assessment Schedule - Cognition (ADAS-Cog, 3 versions), Mini-Mental State Examination (MMSE), and Logical Memory data to develop ADNI-Mem, a composite memory score. We compared RAVLT and ADAS-Cog versions, and compared ADNI-Mem to RAVLT recall sum scores, four ADAS-Cog-derived scores, the MMSE, and the Clinical Dementia Rating Sum of Boxes. We evaluated rates of decline in normal cognition, mild cognitive impairment (MCI), and AD, ability to predict conversion from MCI to AD, strength of association with selected imaging parameters, and ability to differentiate rates of decline between participants with and without AD cerebrospinal fluid (CSF) signatures. The second version of the RAVLT was harder than the first. The ADAS-Cog versions were of similar difficulty. ADNI-Mem was slightly better at detecting change than total RAVLT recall scores. It was as good as or better than all of the other scores at predicting conversion from MCI to AD. It was associated with all our selected imaging parameters for people with MCI and AD. Participants with MCI with an AD CSF signature had somewhat more rapid decline than did those without. This paper illustrates appropriate methods for addressing the different versions of word lists, and demonstrates the additional power to be gleaned with a psychometrically sound composite memory score.

Reading comprehension and reading related abilities in adolescents with reading disabilities and attention-deficit/hyperactivity disorder.

PubMed

Ghelani, Karen; Sidhu, Robindra; Jain, Umesh; Tannock, Rosemary

2004-11-01

Reading comprehension is a very complex task that requires different cognitive processes and reading abilities over the life span. There are fewer studies of reading comprehension relative to investigations of word reading abilities. Reading comprehension difficulties, however, have been identified in two common and frequently overlapping childhood disorders: reading disability (RD) and attention-deficit/hyperactivity disorder (ADHD). The nature of reading comprehension difficulties in these groups remains unclear. The performance of four groups of adolescents (RD, ADHD, comorbid ADHD and RD, and normal controls) was compared on reading comprehension tasks as well as on reading rate and accuracy tasks. Adolescents with RD showed difficulties across most reading tasks, although their comprehension scores were average. Adolescents with ADHD exhibited adequate single word reading abilities. Subtle difficulties were observed, however, on measures of text reading rate and accuracy as well as on silent reading comprehension, but scores remained in the average range. The comorbid group demonstrated similar difficulties to the RD group on word reading accuracy and on reading rate but experienced problems on only silent reading comprehension. Implications for reading interventions are outlined, as well as the clinical relevance for diagnosis.

[Clinico-statistical study on availability of Esterman disability score for assessment of mobility difficulty in patients with visual field loss].

PubMed

Yamagata, Yoshitaka; Terada, Yuko; Suzuki, Atsushi; Mimura, Osamu

2010-01-01

The visual efficiency scale currently adopted to determine the legal grade of visual disability associated with visual field loss in Japan is not appropriate for the evaluation of disability regarding daily living activities. We investigated whether Esterman disability score (EDS) is suitable for the assessment of mobility difficulty in patients with visual field loss. The correlation between the EDS calculated from Goldmann's kinetic visual field and the degree of subjective mobility difficulty determined by a questionnaire was investigated in 164 patients with visual field loss. The correlation between the EDS determined using a program built into the Humphrey field analyzer and that calculated from Goldmann's kinetic visual field was also investigated. The EDS based on the kinetic visual field was correlated well with the degree of subjective mobility difficulty, and the EDS measured using the Humphrey field analyzer could be estimated from the kinetic visual field-based EDS. Instead of the currently adopted visual efficiency scale, EDS should be employed for the assessment of mobility difficulty in patients with visual field loss, also to establish new judgment criteria concerning the visual field.

HoNOSCA-D As a Measure of the Severity of Diagnosed Mental Disorders in Children and Adolescents-Psychometric Properties of the German Translation.

PubMed

von Wyl, Agnes; Toggweiler, Stephan; Zollinger, Ruedi

2017-01-01

The Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), in use worldwide, is a 13-item measure assessing the biopsychosocial severity of mental health problems in children and adolescents. This article introduces the authorized German-language version of HoNOSCA, the HoNOSCA-D, and examines and discusses its psychometric properties based on a clinical sample of 1,533 children and adolescents aged 4;0 to 17;11 years. For the HoNOSCA-D total score (severity of mental health problems), internal consistency (Cronbach's alpha) was 0.63. The discriminative power of the items ranged from 0.07 to 0.44; the average interitem correlation was 0.11. Due to this stochastic independence, calculation of a total severity index is acceptable. Using factor analysis, the principal axis factoring and varimax rotation resulted in a four-factor structure, which with a Kaiser-Meyer-Olkin measure of sampling adequacy of 0.684 explained 30.62% of total variance. The convergent correlations with the German-language parent report version of the Strengths and Difficulties Questionnaire were as expected and showed a medium effect size. Gender and age differences in the HoNOSCA-D total score were small. Regarding the 13 items gender and age differences were negligible to medium. The highest severity was found for schizophrenia and psychotic disorders, followed by affective disorders and social behavior disorders. Overall, validity of HoNOSCA-D was clearly supported.

Maternal attitudinal inflexibility: longitudinal relations with mother-infant disrupted interaction and childhood hostile-aggressive behavior problems.

PubMed

Najmi, Sadia; Bureau, Jean-Francois; Chen, Diyu; Lyons-Ruth, Karlen

2009-12-01

: The Personal Attitude Scale (PAS; Hooley, 2000) is a method that is under development for identifying individuals high in Expressed Emotion based on personality traits of inflexibility, intolerance, and norm-forming. In the current study, the goal was to measure the association between this maternal attitudinal inflexibility, early hostile or disrupted mother-infant interactions, and hostile-aggressive behavior problems in the child. In a prospective longitudinal study of 76 low-income mothers and their infants, it was predicted that maternal PAS scores, assessed at child age 20, would be related to difficulties in early observed mother-infant interaction and to hostile-aggressive behavioral difficulties in the child. Results indicated that maternal difficulties in interacting with the infant in the laboratory were associated with maternal PAS scores assessed 20 years later. Hostile-aggressive behavior problems in the child at age five were also predictive of PAS scores of mothers. However, contrary to prediction, these behavior problems did not mediate the association between mother-infant interaction difficulties and maternal PAS scores, indicating that the child's hostile-aggressive behavior problems did not produce the link between quality of early interaction and later maternal attitudinal inflexibility. The current results validate the PAS against observable mother-child interactions and child hostile-aggressive behavior problems and indicate the importance of future work investigating the maternal attitudes that are associated with, and may potentially precede, parent-infant interactive difficulties. These findings regarding the inflexible attitudes of mothers whose interactions with their infants are also disrupted have important clinical implications. First, once the stability of the PAS has been established, this measure may offer a valuable screening tool for the prenatal identification of parents at risk for difficult interactions with their children. Second, it suggests routes for more cognitive interventions around helping less flexible parents shift perspectives to better take account of their child's outlooks and needs.

Associations between Acetaminophen Use during Pregnancy and ADHD Symptoms Measured at Ages 7 and 11 Years

PubMed Central

Thompson, John M. D.; Waldie, Karen E.; Wall, Clare R.; Murphy, Rinky; Mitchell, Edwin A.

2014-01-01

Objective Our aim was to replicate and extend the recently found association between acetaminophen use during pregnancy and ADHD symptoms in school-age children. Methods Participants were members of the Auckland Birthweight Collaborative Study, a longitudinal study of 871 infants of European descent sampled disproportionately for small for gestational age. Drug use during pregnancy (acetaminophen, aspirin, antacids, and antibiotics) were analysed in relation to behavioural difficulties and ADHD symptoms measured by parent report at age 7 and both parent- and child-report at 11 years of age. The analyses included multiple covariates including birthweight, socioeconomic status and antenatal maternal perceived stress. Results Acetaminophen was used by 49.8% of the study mothers during pregnancy. We found significantly higher total difficulty scores (Strengths and Difficulty Questionnaire parent report at age 7 and child report at age 11) if acetaminophen was used during pregnancy, but there were no significant differences associated with any of the other drugs. Children of mothers who used acetaminophen during pregnancy were also at increased risk of ADHD at 7 and 11 years of age (Conners’ Parent Rating Scale-Revised). Conclusions These findings strengthen the contention that acetaminophen exposure in pregnancy increases the risk of ADHD-like behaviours. Our study also supports earlier claims that findings are specific to acetaminophen. PMID:25251831

Usefulness of warm water and oil assistance in colonoscopy by trainees.

PubMed

Park, Sung Chul; Keum, Bora; Kim, Eun Sun; Jung, Eun Suk; Lee, Sehe Dong; Park, Sanghoon; Seo, Yeon Seok; Kim, Yong Sik; Jeen, Yoon Tae; Chun, Hoon Jai; Um, Soon Ho; Kim, Chang Duck; Ryu, Ho Sang

2010-10-01

Success rate of cecal intubation, endoscopist's difficulty, and procedure-related patient pain are still problems for beginners performing colonoscopy. New methods to aid colonoscopic insertion such as warm water instillation and oil lubrication have been proposed. The aim of this study is to evaluate the feasibility of using warm water or oil in colonoscopy. Colonoscopy was performed in 117 unsedated patients by three endoscopists-in-training. Patients were randomly allocated to three groups, using a conventional method with administration of antispasmodics, warm water instillation, and oil lubrication, respectively. Success rate of total intubation within time limit (15 min), cecal intubation time, degree of endoscopist's difficulty, and level of patient discomfort were compared among the three groups. Cecal intubation time was shorter in the warm water group than in the conventional and oil groups. Degree of procedural difficulty was lower in the warm water group, and patient pain score was higher in the oil lubrication group, compared with the other groups. However, there was no significant difference in success rate of intubation within time limit among the three groups. The warm water method is a simple, safe, and feasible method for beginners. Oil lubrication may not be a useful method compared with conventional and warm water method.

Learning approaches and learning difficulties: a comparison of Indian and Nepali dental science students.

PubMed

Mayya, Shreemathi S; Rao, A Krishna; Ramnarayan, K

2002-11-01

This study explored the difference in learning approaches and difficulties of Nepali and Indian undergraduate students of dental science. A locally developed inventory was used to measure learning approach and learning difficulties. Data collected from 166 Indians and 69 Nepalis were compared. The scores on various scales of the inventory indicate that Nepalis are more fearful and less confident regarding examination and course completion and have significantly less positive perception about academic capability. Indian students scored significantly higher on motivation, interest, and deep processing. The language problem was significantly greater for Nepali students. Higher percentages of Nepalis experienced various academic and nonacademic problems. The study highlights the need to consider difference in learning approach among the students of health science courses that admit students from different academic, nonacademic, and cultural backgrounds.

Aspects of Motor Performance and Preacademic Learning.

ERIC Educational Resources Information Center

Feder, Katya; Kerr, Robert

1996-01-01

The Miller Assessment for Preschoolers (MAP) and a number/counting test were given to 50 4- and 5-year-olds. Low performance on counting was related to significantly slower average response time, overshoot movement time, and reaction time, indicating perceptual-motor difficulty. Low MAP scores indicated difficulty processing visual spatial…

An Evaluation of Verbal, Spatial, and Numerical Sequencing Scores in the WISC and WISC-R, with Special Reference to Children with Reading Difficulties.

ERIC Educational Resources Information Center

Moseley, David

1980-01-01

Proposes a grouping of subtests corresponding to the three-factor pattern of the Wechsler Intelligence Scale for Children (WISC) and its revised form, WISC-R, for use with children with reading difficulties. (FL)

The associations between feeding difficulties and behaviours and dietary patterns at 2 years of age: the ALSPAC cohort.

PubMed

Northstone, Kate; Emmett, Pauline

2013-10-01

Little is known about the dietary patterns of toddlers. This period of life is important for forming good dietary habits later in life. Using dietary data collected via food frequency questionnaire (FFQ) at 2 years of age, we examined the dietary patterns of children from the Avon Longitudinal Study of Parents and Children (ALSPAC). Principal component analysis was performed for 9599 children and three patterns were extracted: 'family foods' associated with traditional British family foods such as meat, fish, puddings, potatoes and vegetables; 'sweet and easy' associated with foods high in sugar (sweets, chocolate, fizzy drinks, flavoured milks) and foods requiring little preparation (crisps, potatoes, baked beans, peas, soup); 'health conscious' associated with fruit, vegetables, eggs, nuts and juices. We found clear associations between dietary pattern scores and socio-demographic variables, with maternal education being the most important. Higher levels of education were associated with higher scores on both the 'family foods' and the 'health conscious' patterns, and decreased scores on the 'sweet and easy' pattern. Relationships were evident between dietary pattern scores and various feeding difficulties and behaviours. Notably, children who were introduced late to lumpy (chewy) solids (after 9 months) scored lower on both the 'family foods' and the 'health conscious' patterns. Further analyses are required to determine the temporal relationship between perceived feeding difficulties and behaviours, and it will be important to assess the contribution of the age of introduction to lumpy solids to these relationships. © 2012 John Wiley & Sons Ltd.

Non suicidal self-injury, emotional eating and insomnia after child sexual abuse: Are those symptoms related to emotion regulation?

PubMed

Demirci, Esra

2018-01-01

The aim of this article was to assess the effects of child sexual abuse (CSA) on emotion regulation (ER) in adolescents and to evaluate the relationships between non suicidal self-injury (NSSI), emotional eating, insomnia and emotion disregulation (ED). Fifty two adolescents, aged 10-18 years, without who weren't diagnosed a psychiatric disease before abuse and completed 6-months of follow-up after abuse included the study. Control group consisted of 33 healthy voluntary participants without any known psychiatric disorders. Patients and volunteers who participated in the study were assessed with the Inventory of Statements About Self-injury (ISAS), Dutch Eating Behavior Questionnaire (DEBQ), Pittsburgh Sleep Quality Index (PSQI), Insomnia severity index (ISI), and the Difficulties in Emotion Regulation Scale (DERS). In our study, PSQI scores, DERS total scores and DEBQ emotional eating subscores were significantly higher in the CSA victims (In orderly; p = 0,034, p < 0.001, p = 0,023). 55.7% of the CSA victims reported self-injurious behavior, while 15.5% of healthy voluntary participants reporting self-injurious behavior. The CSA victims reporting NSSI had higher DERS scores than CSA victims without NSSI. (p = 0.024). The CSA victims with post-traumatic stress disorder (PTSD) and CSA victims without PTSD had a positive correlation between DEBQ emotional eating subscores and DERS total scores (In orderly: r = 0.762, p = 0.031; r = 0.872, p < 0.001). There was a positive correlation between the PSQI scores and DERS scores in the CSA victims with PTSD (r = 0.827, p = 0.023). Further studies are needed to assess the relationship between self-injury, emotional eating, insomnia and ED, and to determine how sexual abuse effect the ER in a clinical sample of CSA. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Usefulness of tenderness to characterise fibromyalgia severity in women.

PubMed

Aparicio, V A; Carbonell-Baeza, A; Ortega, F B; Estevez, F; Ruiz, J R; Delgado-Fernández, M

2011-01-01

To investigate the usefulness of tenderness (tender points count (TPC) and algometer score) to characterise fibromyalgia (FM) severity and symptomatology in women. The study sample comprised 174 women aged 51±7 years. We ossesse tenderness using pressure algometry; quality of life by means of the Short-Form 36 Health Survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS). We used the FM impact questionnaire (FIQ) to assess FM severity and symptomatology. Patients were categorised according to three FIQ-derived categories: FIQ<70 vs. ≥70; FIQ<59 vs. ≥59; and FM-type I and II. TPC was significantly higher in the group of patients with FIQ≥59 (16.9±2 vs. 15.6±4, p=0.02), whereas no differences between groups were observed according to FIQ≥70 (17.0±2 vs. 16.2±3, p=0.12) or FM type (16.8±3 for type II vs. 15.9±4 for type I, p=0.13). We observed a significant association between TPC and FIQ-job difficulty, pain, morning tiredness and stiffness dimensions (all p<0.05), yet it was not correlated with total score of FIQ, FIQ-anxiety, fatigue and depression dimensions (all p>0.05). Algometer score was lower in the FIQ≥70 (45.7±12 vs. 51.1±14, p=0.05) and FIQ≥59 (46.7±13 vs. 52.7±14, p=0.05) groups, and there were no difference between FM types (48.7±13 vs. 49.5±14 for type II and I respectively, p=0.81). Algometer score was not associated with total score of FIQ or FIQ dimensions (all p≥0.1). Widespread pain and pain hypersensitivity, as measured by TPC and algometer score, do not seem to be useful to characterise FM severity and symptomatology (measured by FIQ) in women.

Psychopathic traits and offender characteristics – a nationwide consecutive sample of homicidal male adolescents

PubMed Central

Lindberg, Nina; Laajasalo, Taina; Holi, Matti; Putkonen, Hanna; Weizmann-Henelius, Ghitta; Häkkänen-Nyholm, Helinä

2009-01-01

Background The aim of the study was to evaluate psychopathy-like personality traits in a nationwide consecutive sample of adolescent male homicide offenders and to compare the findings with those of a randomly sampled adult male homicide offender group. A further aim was to investigate associations between psychopathic traits and offender and offence characteristics in adolescent homicides. Methods Forensic psychiatric examination reports and crime reports of all 15 to19- year- old male Finnish offenders who had been subjected to a forensic psychiatric examination and convicted for a homicide during 1995–2004 were collected (n = 57). A random sample of 57 adult male homicide offenders was selected as a comparison group. Offence and offender characteristics were collected from the files and a file-based assessment of psychopathic traits was performed using the Hare Psychopathy Checklist-Revised (PCL-R) by trained raters. Results No significant differences existed between the adolescents and adults in PCL-R total scores, factor 2 (social deviance) scores, or in facets 3 (lifestyle) and 4 (antisocial). Adults scored significantly higher on factor 1 (interpersonal/affective) and facets 1 (interpersonal) and 2 (affective). The adolescent group was divided into two subgroups according to PCL-R total scores. One in five homicidal male adolescents met criteria for psychopathic personality using a PCL-R total score of 26 or higher. These boys significantly more often had a crime history before the index homicide, more frequently used excessive violence during the index homicide, more rarely lived with both parents until 16 years of age, had more institutional or foster home placements in childhood, had more school difficulties, more often had received special education, and, more often had contact with mental health services prior to age 18 years than boys scoring low on the PCL-R. They also more often had parental criminal history as well as homicide history of parents or near relatives than the group scoring low on the PCL-R. Conclusion Homicidal boys behaved as antisocially as the homicidal adults. The adults, however, showed more both affective and interpersonal features of psychopathy. Homicidal adolescents with psychopathy-like personality character form a special subgroup among other homicidal youngsters. Recognizing their characteristics, especially in life course development, would facilitate effective prevention and intervention efforts. PMID:19419577

Psychopathic traits and offender characteristics - a nationwide consecutive sample of homicidal male adolescents.

PubMed

Lindberg, Nina; Laajasalo, Taina; Holi, Matti; Putkonen, Hanna; Weizmann-Henelius, Ghitta; Häkkänen-Nyholm, Helinä

2009-05-06

The aim of the study was to evaluate psychopathy-like personality traits in a nationwide consecutive sample of adolescent male homicide offenders and to compare the findings with those of a randomly sampled adult male homicide offender group. A further aim was to investigate associations between psychopathic traits and offender and offence characteristics in adolescent homicides. Forensic psychiatric examination reports and crime reports of all 15 to 19- year- old male Finnish offenders who had been subjected to a forensic psychiatric examination and convicted for a homicide during 1995-2004 were collected (n = 57). A random sample of 57 adult male homicide offenders was selected as a comparison group. Offence and offender characteristics were collected from the files and a file-based assessment of psychopathic traits was performed using the Hare Psychopathy Checklist-Revised (PCL-R) by trained raters. No significant differences existed between the adolescents and adults in PCL-R total scores, factor 2 (social deviance) scores, or in facets 3 (lifestyle) and 4 (antisocial). Adults scored significantly higher on factor 1 (interpersonal/affective) and facets 1 (interpersonal) and 2 (affective). The adolescent group was divided into two subgroups according to PCL-R total scores. One in five homicidal male adolescents met criteria for psychopathic personality using a PCL-R total score of 26 or higher. These boys significantly more often had a crime history before the index homicide, more frequently used excessive violence during the index homicide, more rarely lived with both parents until 16 years of age, had more institutional or foster home placements in childhood, had more school difficulties, more often had received special education, and, more often had contact with mental health services prior to age 18 years than boys scoring low on the PCL-R. They also more often had parental criminal history as well as homicide history of parents or near relatives than the group scoring low on the PCL-R. Homicidal boys behaved as antisocially as the homicidal adults. The adults, however, showed more both affective and interpersonal features of psychopathy. Homicidal adolescents with psychopathy-like personality character form a special subgroup among other homicidal youngsters. Recognizing their characteristics, especially in life course development, would facilitate effective prevention and intervention efforts.

Testing a Novel 3D Printed Radiographic Imaging Device for Use in Forensic Odontology.

PubMed

Newcomb, Tara L; Bruhn, Ann M; Giles, Bridget; Garcia, Hector M; Diawara, Norou

2017-01-01

There are specific challenges related to forensic dental radiology and difficulties in aligning X-ray equipment to teeth of interest. Researchers used 3D printing to create a new device, the combined holding and aiming device (CHAD), to address the positioning limitations of current dental X-ray devices. Participants (N = 24) used the CHAD, soft dental wax, and a modified external aiming device (MEAD) to determine device preference, radiographer's efficiency, and technique errors. Each participant exposed six X-rays per device for a total of 432 X-rays scored. A significant difference was found at the 0.05 level between the three devices (p = 0.0015), with the MEAD having the least amount of total errors and soft dental wax taking the least amount of time. Total errors were highest when participants used soft dental wax-both the MEAD and the CHAD performed best overall. Further research in forensic dental radiology and use of holding devices is needed. © 2016 American Academy of Forensic Sciences.

Factors Predicting Cybersex Use and Difficulties in Forming Intimate Relationships among Male and Female Users of Cybersex

PubMed Central

Weinstein, Aviv M.; Zolek, Rinat; Babkin, Anna; Cohen, Koby; Lejoyeux, Michel

2015-01-01

Sexual addiction otherwise known as compulsive sexual behavior is associated with serious psychosocial problems and risk-taking behavior. This study used the Cybersex addiction test, Craving for pornography questionnaire, and a Questionnaire on intimacy among 267 participants (192 males and 75 females) mean age for males 28.16 (SD = 6.8) and for females 25.5 (SD = 5.13) who were recruited from special sites that are dedicated to pornography and cybersex on the Internet. Results of regression analysis indicated that pornography, gender, and cybersex significantly predicted difficulties in intimacy and it accounted for 66.1% of the variance of rating on the intimacy questionnaire. Second, regression analysis also indicated that craving for pornography, gender, and difficulties in forming intimate relationships significantly predicted frequency of cybersex use and it accounted for 83.7% of the variance in ratings of cybersex use. Third, men had higher scores of frequency of using cybersex than women [t(2,224) = 1.97, p < 0.05] and higher scores of craving for pornography than women [t(2,265) = 3.26, p < 0.01] and no higher scores on the questionnaire measuring difficulties in forming intimate relationship than women [t(2,224) = 1, p = 0.32]. These findings support previous evidence for sex differences in compulsive sexual behavior. PMID:25941496

Mapping area variability in social and behavioural difficulties among Glasgow pre-schoolers: linkage of a survey of pre-school staff with routine monitoring data

PubMed Central

Barry, S.J.E.; Marryat, L.; Thompson, L.; Ellaway, A.; White, J.; McClung, M.; Wilson, P.

2016-01-01

Background Social, emotional and behavioural development in early to middle childhood impact upon many outcomes in future life and are influenced by home, neighbourhood and school environments. We used linked data to investigate differences between areas in Glasgow City in level of difficulties in pre-school age children, after consideration of demographics, including area level deprivation. Methods Pre-school education staff completed Strengths and Difficulties Questionnaires (SDQ) on all children progressing to school from a local authority or partnership (local authority funded private) pre-school in Glasgow City between 2010 and 2012. These data were linked to individual (age, gender) and area level (deprivation) demographics from the City Council Education Services Department. Statistical models were fitted to the SDQ scores, adjusting for age, gender, area deprivation, year of school entry, pre-school establishment attended and electoral ward of residence. Correlation between neighbouring wards was incorporated to allow for clustering of scores. Results Boys and those living in more deprived areas had higher levels of difficulties. Children aged 5-5.5 years had fewest difficulties, while the oldest and youngest children had similar levels of difficulties. There were no significant secular trends by year of school entry. There remained differences between areas after adjusting for these variables, with children living in some areas having fewer difficulties than would be expected based on their socio-demographic characteristics. Conclusions There remained differences in children’s levels of difficulties between areas after adjusting for age, gender, area deprivation and year of school entry. Children in some very deprived areas had fewer difficulties than might be expected, while those in relatively affluent areas had more difficulties than expected based on their deprivation level. There may be other, unmeasured, individual and area level reasons for children’s level of difficulties and these require further exploration. PMID:25707313

Mapping area variability in social and behavioural difficulties among Glasgow pre-schoolers: linkage of a survey of pre-school staff with routine monitoring data.

PubMed

Barry, S J E; Marryat, L; Thompson, L; Ellaway, A; White, J; McClung, M; Wilson, P

2015-11-01

Social, emotional and behavioural development in early to middle childhood impact upon many outcomes in future life and are influenced by home, neighbourhood and school environments. We used linked data to investigate differences between areas in Glasgow City in level of difficulties in pre-school age children, after consideration of demographics, including area-level deprivation. Pre-school education staff completed Strengths and Difficulties Questionnaires (SDQ) on all children progressing to school from a local authority or partnership (local authority-funded private) pre-school in Glasgow City between 2010 and 2012. These data were linked to individual (age, gender) and area-level (deprivation) demographics from the City Council Education Services Department. Statistical models were fitted to the SDQ scores, adjusting for age, gender, area deprivation, year of school entry, pre-school establishment attended and electoral ward of residence. Correlation between neighbouring wards was incorporated to allow for clustering of scores. Boys and those living in more deprived areas had higher levels of difficulties. Children aged 5.0-5.5 years had fewest difficulties, while the oldest and youngest children had similar levels of difficulties. There were no significant secular trends by year of school entry. There remained differences among areas after adjusting for these variables, with children living in some areas having fewer difficulties than would be expected based on their socio-demographic characteristics. There remained differences in children's levels of difficulties between areas after adjusting for age, gender, area deprivation and year of school entry. Children in some very deprived areas had fewer difficulties than might be expected, while those in relatively affluent areas had more difficulties than expected based on their deprivation level. There may be other, unmeasured, individual- and area-level reasons for children's level of difficulties, and these require further exploration. © 2015 John Wiley & Sons Ltd.

Support group programme for siblings of children with special needs: predictors of improved emotional and behavioural functioning.

PubMed

Roberts, Rachel M; Ejova, Anastasia; Giallo, Rebecca; Strohm, Kate; Lillie, Meredith E

2016-10-01

A pilot study to identify the predictors of improvement in emotional and behavioural functioning of siblings of children with special needs following participation in SibworkS, a six-week manual-based, cognitive-behavioural group programme. Data from 36 participants from a recent evaluation of the SibworkS programme was used. Measures were administered pre-intervention, immediately post-intervention and three months post-intervention. Treatment effects were measured using change scores for siblings on the Strengths and Difficulties Questionnaire - Parent Version (SDQ). Seven predictors were analysed: symptom severity of the child with special needs, participant age and gender, sibling birth order, family socio-economic status, participant baseline SDQ score and participant use of additional support services. The overall model significantly predicted change in SDQ scores at post-intervention and follow-up (adjusted R(2) = 0.41 and 0.40). At both evaluation points, SDQ change scores were significantly predicted by baseline SDQ score. Furthermore, symptom severity of the child with special needs was a significant predictor at three months post-intervention. Poorer emotional and behavioural functioning among participants and symptom severity of the child with special needs were associated with greater intervention effects. These results indicate that SibworkS is likely to be beneficial for siblings who have difficulties adjusting, and siblings of children with more severe special needs. Implications for Rehabilitation Siblings of children with disability are at increased risk of emotional and behavioural difficulties. Sibworks is a manualised group-based intervention for the siblings of children with a disability. Poorer emotional and behavioural functioning among participants and symptom severity of the child with special needs were associated with greater intervention effects. SibworkS is likely to be beneficial for siblings who have difficulties adjusting and siblings of children with more severe disabilities.

Problem and pro-social behavior among Nigerian children with intellectual disability: the implication for developing policy for school based mental health programs

PubMed Central

2010-01-01

Background School based mental health programs are absent in most educational institutions for intellectually disabled children and adolescents in Nigeria and co-morbid behavioral problems often complicate intellectual disability in children and adolescents receiving special education instructions. Little is known about prevalence and pattern of behavioral problems existing co-morbidly among sub-Saharan African children with intellectual disability. This study assessed the prevalence and pattern of behavioral problems among Nigerian children with intellectual disability and also the associated factors. Method Teachers' rated Strengths and Difficulties Questionnaire (SDQ) was used to screen for behavioral problems among children with intellectual disability in a special education facility in south eastern Nigeria. Socio-demographic questionnaire was used to obtain socio-demographic information of the children. Results A total of forty four (44) children with intellectual disability were involved in the study. Twenty one (47.7%) of the children were classified as having behavioral problems in the borderline and abnormal categories on total difficulties clinical scale of SDQ using the cut-off point recommended by Goodman. Mild mental retardation as compared to moderate, severe and profound retardation was associated with highest total difficulties mean score. Males were more likely to exhibit conduct and hyperactivity behavioral problems compared to the females. The inter-clinical scales correlations of teachers' rated SDQ in the studied population also showed good internal consistency (Cronbach Alpha = 0.63). Conclusion Significant behavioral problems occur co-morbidly among Nigerian children with intellectual disability receiving special education instructions and this could impact negatively on educational learning and other areas of functioning. There is an urgent need for establishing school-based mental health program and appropriate screening measure in this environment. These would afford early identification of intellectually disabled children with behavioral problems and appropriate referral for clinical evaluation and interventions. The need to focus policy making attention on hidden burden of intellectual disability in sub-Saharan African children is essential. PMID:20465841

Communication of mechanically ventilated patients in intensive care units

PubMed Central

Martinho, Carina Isabel Ferreira; Rodrigues, Inês Tello Rato Milheiras

2016-01-01

Objective The aim of this study was to translate and culturally and linguistically adapt the Ease of Communication Scale and to assess the level of communication difficulties for patients undergoing mechanical ventilation with orotracheal intubation, relating these difficulties to clinical and sociodemographic variables. Methods This study had three stages: (1) cultural and linguistic adaptation of the Ease of Communication Scale; (2) preliminary assessment of its psychometric properties; and (3) observational, descriptive-correlational and cross-sectional study, conducted from March to August 2015, based on the Ease of Communication Scale - after extubation answers and clinical and sociodemographic variables of 31 adult patients who were extubated, clinically stable and admitted to five Portuguese intensive care units. Results Expert analysis showed high agreement on content (100%) and relevance (75%). The pretest scores showed a high acceptability regarding the completion of the instrument and its usefulness. The Ease of Communication Scale showed excellent internal consistency (0.951 Cronbach's alpha). The factor analysis explained approximately 81% of the total variance with two scale components. On average, the patients considered the communication experiences during intubation to be "quite hard" (2.99). No significant correlation was observed between the communication difficulties reported and the studied sociodemographic and clinical variables, except for the clinical variable "number of hours after extubation" (p < 0.05). Conclusion This study translated and adapted the first assessment instrument of communication difficulties for mechanically ventilated patients in intensive care units into European Portuguese. The preliminary scale validation suggested high reliability. Patients undergoing mechanical ventilation reported that communication during intubation was "quite hard", and these communication difficulties apparently existed regardless of the presence of other clinical and/or sociodemographic variables. PMID:27410408

The multiple sclerosis work difficulties questionnaire: translation and cross-cultural adaptation to Turkish and assessment of validity and reliability.

PubMed

Kahraman, Turhan; Özdoğar, Asiye Tuba; Honan, Cynthia Alison; Ertekin, Özge; Özakbaş, Serkan

2018-05-09

To linguistically and culturally adapt the Multiple Sclerosis Work Difficulties Questionnaire-23 (MSWDQ-23) for use in Turkey, and to examine its reliability and validity. Following standard forward-back translation of the MSWDQ-23, it was administered to 124 people with multiple sclerosis (MS). Validity was evaluated using related outcome measures including those related to employment status and expectations, disability level, fatigue, walking, and quality of life. Randomly selected participants were asked to complete the MSWDQ-23 again to assess test-retest reliability. Confirmatory factor analysis on the MSWDQ-23 demonstrated a good fit for the data, and the internal consistency of each subscale was excellent. The test-retest reliability for the total score, psychological/cognitive barriers, physical barriers, and external barriers subscales were high. The MSWDQ-23 and its subscales were positively correlated with the employment, disability level, walking, and fatigue outcome measures. This study suggests that the Turkish version of MSWDQ-23 has high reliability and adequate validity, and it can be used to determine the difficulties faced by people with multiple sclerosis in workplace. Moreover, the study provides evidence about the test-retest reliability of the questionnaire. Implications for rehabilitation Multiple sclerosis affects young people of working age. Understanding work-related problems is crucial to enhance people with multiple sclerosis likelihood of maintaining their job. The Multiple Sclerosis Work Difficulties Questionnaire-23 (MSWDQ-23) is a valid and reliable measure of perceived workplace difficulties in people with multiple sclerosis: we presented its validation to Turkish. Professionals working in the field of vocational rehabilitation may benefit from using the MSWDQ-23 to predict the current work outcomes and future employment expectations.

Form cues and content difficulty as determinants of children's cognitive processing of televised educational messages.

PubMed

Campbell, T A; Wright, J C; Huston, A C

1987-06-01

An experiment was designed to assess the effects of formal production features and content difficulty on children's processing of televised messages about nutrition. Messages with identical content (the same script and visual shot sequence) were made in two forms: child program forms (animated film, second-person address, and character voice narration with sprightly music) and adult program forms (live photography, third-person address, and adult male narration with sedate background music). For each form, messages were made at three levels of content difficulty. Easier versions were longer, more redundant, and used simpler language; difficult versions presented information more quickly with less redundancy and more abstract language. Regardless of form or difficulty level, each set of bits presented the same basic information. Kindergarten children (N = 120) were assigned to view three different bits of the same form type and difficulty embedded in a miniprogram. Visual attention to child forms was significantly greater than to adult forms; free and cued recall scores were also higher for child than for adult forms. Although all recall and recognition scores were best for easy versions and worst for difficult versions, attention showed only minor variation as a function of content difficulty. Results are interpreted to indicate that formal production features, independently of content, influence the effort and level of processing that children use to understand televised educational messages.

Internet-based survey of factors associated with subjective feeling of insomnia, depression, and low health-related quality of life among Japanese adults with sleep difficulty.

PubMed

Aritake, Sayaka; Asaoka, Shoichi; Kagimura, Tatsuo; Shimura, Akiyoshi; Futenma, Kunihiro; Komada, Yoko; Inoue, Yuichi

2015-04-01

This study was conducted to determine what symptom components or conditions of insomnia are related to subjective feelings of insomnia, low health-related quality of life (HRQOL), or depression. Data from 7,027 Japanese adults obtained using an Internet-based questionnaire survey was analyzed to examine associations between demographic variables and each sleep difficulty symptom item on the Pittsburgh Sleep Quality Index (PSQI) with the presence/absence of subjective insomnia and scores on the Short Form-8 (SF-8) and Center for Epidemiologic Studies Depression Scale (CES-D). Prevalence of subjective insomnia was 12.2% (n = 860). Discriminant function analysis revealed that item scores for sleep quality, sleep latency, and sleep medication use on the PSQI and CES-D showed relatively high discriminant function coefficients for identifying positivity for the subjective feeling of insomnia. Among respondents with subjective insomnia, a low SF-8 physical component summary score was associated with higher age, depressive state, and PSQI items for sleep difficulty and daytime dysfunction, whereas a low SF-8 mental component summary score was associated with depressive state, PSQI sleep latency, sleeping medication use, and daytime dysfunction. Depressive state was significantly associated with sleep latency, sleeping medication use, and daytime dysfunction. Among insomnia symptom components, disturbed sleep quality and sleep onset insomnia may be specifically associated with subjective feelings of the disorder. The existence of a depressive state could be significantly associated with not only subjective insomnia but also mental and physical QOL. Our results also suggest that different components of sleep difficulty, as measured by the PSQI, might be associated with mental and physical QOL and depressive status.

Clinical utility of calf front hoof circumference and maternal intrapelvic area in predicting dystocia in 103 late gestation Holstein-Friesian heifers and cows.

PubMed

Hiew, Mark W H; Megahed, Ameer A; Townsend, Jonathan R; Singleton, Wayne L; Constable, Peter D

2016-02-01

The objective of this study was to determine the clinical utility of measuring calf front hoof circumference, maternal intrapelvic area, and selected morphometric values in predicting dystocia in dairy cattle. An observational study using a convenience sample of 103 late-gestation Holstein-Friesian heifers and cows was performed. Intrapelvic height and width of the dam were measured using a pelvimeter, and the intrapelvic area was calculated. Calf front hoof circumference and birth weight were also measured. Data were analyzed using Spearman's correlation coefficient (rs), Mann-Whitney U test, and binary or ordered logistic regression; P < 0.05 was significant. The calving difficulty score (1-5) was greater in heifers (median, 3.0) than in cows (median, 1.0). Median intrapelvic area immediately before parturition was smaller in heifers (268 cm(2)) than in cows (332 cm(2)), whereas front hoof circumference and birth weight of the calf were similar in both groups. The calving difficulty score was positively associated with calf birth weight in heifers (rs = 0.39) and cows (rs = 0.24). Binary logistic regression using both dam and calf data indicated that the ratio of front hoof circumference of the calf to the maternal intrapelvic area provided the best predictor of dystocia (calving difficulty score = 4 or 5), with sensitivity = 0.50 and specificity = 0.93 at the optimal cutpoint for the ratio (>0.068 cm/cm(2)). Determining the ratio of calf front hoof circumference to maternal intrapelvic area has clinical utility in predicting the calving difficulty score in Holstein-Friesian cattle. Copyright © 2016 Elsevier Inc. All rights reserved.

Determinants of footwear difficulties in people with plantar heel pain.

PubMed

Sullivan, Justin; Pappas, Evangelos; Adams, Roger; Crosbie, Jack; Burns, Joshua

2015-01-01

Plantar heel pain is a common foot disorder aggravated by weight-bearing activity. Despite considerable focus on therapeutic interventions such as orthoses, there has been limited investigation of footwear-related issues in people with plantar heel pain. The aim of this study was to investigate whether people with plantar heel pain experience footwear-related difficulties compared to asymptomatic individuals, as well as identifying factors associated with footwear comfort, fit and choice. The footwear domain of the Foot Health Status Questionnaire (FHSQ) was assessed in 192 people with plantar heel pain and 69 asymptomatic controls. The plantar heel pain group was also assessed on a variety of measures including: foot posture, foot strength and flexibility, pedobarography and pain level. A univariate analysis of covariance, with age as the covariate, was used to compare the heel pain and control groups on the FHSQ footwear domain score. A multiple regression model was then constructed to investigate factors associated with footwear scores among participants with plantar heel pain. When compared to asymptomatic participants, people with plantar heel pain reported lower FHSQ footwear domain scores (mean difference -24.4; p < 0.001; 95 % CI: -32.0 to -17.0). In the participants with heel pain, footwear scores were associated with maximum force beneath the postero-lateral heel during barefoot walking, toe flexor strength and gender. People with plantar heel pain experience difficulty with footwear comfort, fit and choice. Reduced heel loading during barefoot walking, toe flexor weakness and female gender are all independently associated with reports of footwear difficulties in people with heel pain. Increased focus, in both clinical and research settings, is needed to address footwear-related issues in people with plantar heel pain.

Canine ovariectomy by hybrid or total natural orifice transluminal endoscopic surgery: technical feasibility study and pain assessment.

PubMed

Linhares, Marcella Teixeira; Feranti, João Pedro Scussel; Coradini, Gabriela Pesamosca; Martins, Letícia Reginato; Martins, Arthur Rodrigues; Sarturi, Vanessa Zanchi; Gavioli, Felipe Baldissarella; Machado Silva, Marco Augusto; de Ataíde, Michelli Westphal; Teixeira, Luciana Gonçalves; Brun, Maurício Veloso

2018-06-13

To compare technical feasibility, surgical time, surgical complications, and postoperative pain in ovariectomy (OVE) by hybrid and total natural orifice transluminal endoscopic surgery (NOTES). Prospective randomized clinical trial. Sixteen healthy and sexually intact bitches. Dogs were randomly assigned to the hybrid NOTES group (HNG; n = 8) and the total NOTES group (TNG; n = 8) to compare surgical time, pain scores and complications. Pain was assessed by using the visual analog scale (VAS) and the Melbourne pain scale (MPS). Surgical time did not differ between the experimental groups (HNG = 46.3 ± 18.5 minutes, TNG = 54.6 ± 31.1 minutes). Exteriorization of the ovaries through the vaginal wound was the major difficulty. Complications were minor in both groups and occurred intraoperatively only in the HNG, and in both groups post operatively. No dogs required rescue analgesia in the intraoperative or postoperative period. There were no differences in VAS or MPS scores between the groups for any surgical times except for the VAS assessment at 72 hours after extubation (HNG = 1.1 ± 0.3, TNG = 0.7 ± 0.4, P = .0221). Both NOTES techniques were comparable for canine OVE, with no requirement for additional analgesia in the postoperative periods. It was not possible to determine whether there was a clear advantage of one technique rather than the other. The minimally invasive techniques proposed for laparoscopic OVE are feasible for dogs with low pain scores and low rates of complications for both groups. © 2018 The American College of Veterinary Surgeons.

Predicting Motor Skills from Strengths and Difficulties Questionnaire Scores, Language Ability, and Other Features of New Zealand Children Entering Primary School

ERIC Educational Resources Information Center

Sargisson, Rebecca J.; Powell, Cheniel; Stanley, Peter; de Candole, Rosalind

2014-01-01

The motor and language skills, emotional and behavioural problems of 245 children were measured at school entry. Fine motor scores were significantly predicted by hyperactivity, phonetic awareness, prosocial behaviour, and the presence of medical problems. Gross motor scores were significantly predicted by the presence of medical problems. The…

A Comparison of Methods to Screen Middle School Students for Reading and Math Difficulties

ERIC Educational Resources Information Center

Nelson, Peter M.; Van Norman, Ethan R.; Lackner, Stacey K.

2016-01-01

The current study explored multiple ways in which middle schools can use and integrate data sources to predict proficiency on future high-stakes state achievement tests. The diagnostic accuracy of (a) prior achievement data, (b) teacher rating scale scores, (c) a composite score combining state test scores and rating scale responses, and (d) two…

Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Improving Sexual Function in Women: A Pilot Study

PubMed Central

Dongre, Swati

2015-01-01

Background. Many women experience sexual dysfunction where there are orgasm disorders and sexual difficulties. Ashwagandha (Withania somnifera) is a herb known to improve the body's physical and psychological condition. Objective. The purpose of the study was to determine the efficacy and safety of a high-concentration ashwagandha root extract (HCARE) supplementation for improving sexual function in healthy females. Methods. In this pilot study, 50 study subjects were randomized to either (i) HCARE-treated group or (ii) placebo- (starch-) treated group. The subjects consumed either HCARE or placebo capsules of 300mg twice daily for 8 weeks. Sexual function was assessed using two psychometric scales, the Female Sexual Function Index (FSFI) Questionnaire and the Female Sexual Distress Scale (FSDS), and by the number of total and successful sexual encounters. Results. The analysis indicates that treatment with HCARE leads to significantly higher improvement, relative to placebo, in the FSFI Total score (p < 0.001), FSFI domain score for “arousal” (p < 0.001), “lubrication” (p < 0.001), “orgasm” (p = 0.004), and “satisfaction” (p < 0.001), and also FSDS score (p < 0.001) and the number of successful sexual encounters (p < 0.001) at the end of the treatment. Conclusions. This study demonstrated that oral administration of HCARE may improve sexual function in healthy women. The present study is registered in the Clinical Trial Registry, Government of India, with a number CTRI/2015/07/006045. PMID:26504795

Interpretation of the Rasch Ability and Difficulty Scales for Educational Purposes.

ERIC Educational Resources Information Center

Woodcock, Richard W.

Though many test developers have utilized item response theory in their work, few have taken advantage of the potential of item response theory for providing new interpretation procedures that accentuate the educational implications to be drawn from test scores. This paper describes several features, based upon the Rasch difficulty and ability…

The Impact of Task Difficulty and Performance Scores on Student Engagement and Progression

ERIC Educational Resources Information Center

Lynch, Raymond; Patten, James Vincent; Hennessy, Jennifer

2013-01-01

Background: This article considers the impact of differential task difficulty on student engagement and progression within an Irish primary school context. Gaining and maintaining student engagement during learning tasks such as homework is a significant and understandable on-going challenge for teachers. The findings of this study hold the…

Comparing Students with and without Reading Difficulties on Reading Comprehension Assessments: A Meta-Analysis

ERIC Educational Resources Information Center

Collins, Alyson A.; Lindström, Esther R.; Compton, Donald L.

2018-01-01

Researchers have increasingly investigated sources of variance in reading comprehension test scores, particularly with students with reading difficulties (RD). The purpose of this meta-analysis was to determine if the achievement gap between students with RD and typically developing (TD) students varies as a function of different reading…

Functional and morphological differences following Monarc and TVT-O procedures.

PubMed

Huang, W-C; Yang, S-H; Yang, J-M; Tzeng, C-R

2012-12-01

To explore function of the lower urinary tract and morphology of tape and urethra following Monarc or TVT-O suburethral tape placement for urodynamic stress incontinence (USI). We recruited prospectively women undergoing either Monarc or TVT-O placement for USI. Before and 3 months after the procedure, participants were evaluated by a question-directed interview, the measures of Sandvik Incontinence Severity Index (SISI), Incontinence Bother Scale (IBS), Ingelman-Sundberg Score (ISS) and short forms of Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7), physical examination, a cough stress test and 4D ultrasound investigation. The primary outcome was participants' responses to clinical assessments and the secondary outcome was ultrasound findings. A total of 67 women with Monarc procedures and 60 women with TVT-O procedures completed the survey both preoperatively and 3 months postoperatively. There were significant improvements in scores of SISI, IBS, ISS, UDI-6 and IIQ-7 after both Monarc and TVT-O procedures. At the 3-month follow-up, both procedures had similar success rates, SISI scores, IBS scores, ISS scores, UDI-6 scores and IIQ-7 scores, and similar incidences of postoperative voiding difficulty and overactive bladder symptoms. After Bonferroni correction, all ultrasound parameters representing tape location, tape tension and urethral mobility were similar between the two procedures. At short-term follow-up, Monarc and TVT-O procedures are comparable in both functional outcome of the lower urinary tract and morphology on ultrasound as assessed by parameters representing tape location, tape tension and urethral mobility. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.

Comorbidity of PTSD and depression among refugee children during war conflict.

PubMed

Thabet, Abdel Aziz Mousa; Abed, Yehia; Vostanis, Panos

2004-03-01

We examined the prevalence and nature of comorbid post-traumatic stress reactions and depressive symptoms, and the impact of exposure to traumatic events on both types of psychopathology, among Palestinian children during war conflict in the region. The 403 children aged 9-15 years, who lived in four refugee camps, were assessed by completing the Gaza Traumatic Events Checklist, the Child Post Traumatic Stress Reaction Index (CPTSD-RI), and the Short Mood and Feelings Questionnaire (MFQ). Children reported experiencing a wide range of traumatic events, both direct experience of violence and through the media. CPTSD-RI and MFQ scores were significantly correlated. Both CPTSD-RI and MFQ scores were independently predicted by the number of experienced traumatic events, and this association remained after adjusting for socioeconomic variables. Exposure to traumatic events strongly predicted MFQ scores while controlling for CPTSD-RI scores. In contrast, the association between traumatic events and CPTSD-RI scores, while controlling for MFQ scores, was weak. The CPTSD-RI items whose frequency was significantly associated with total MFQ scores were: sleep disturbance, somatic complaints, constricted affect, impulse control, and difficulties in concentration. However, not all remaining CPTSD-RI items were significantly associated with exposure to traumatic events, thus raising the possibility that the association between depression and PTSD was due in part to symptom overlap. Children living in war zones are at high risk of suffering from PTSD and depressive disorders. Exposure to trauma was not found to have a unique association with PTSD. The relationship between PTSD and depressive symptomatology requires further investigation.

Infant-onset eczema in relation to mental health problems at age 10 years: results from a prospective birth cohort study (German Infant Nutrition Intervention plus).

PubMed

Schmitt, Jochen; Apfelbacher, Christian; Chen, Chih-Mei; Romanos, Marcel; Sausenthaler, Stefanie; Koletzko, Sibylle; Bauer, Carl-Peter; Hoffmann, Ute; Krämer, Ursula; Berdel, Dietrich; von Berg, Andrea; Wichmann, H-Erich; Heinrich, Joachim

2010-02-01

Cross-sectional studies suggest an association between eczema and mental health problems, but the temporal relationship is unclear. To assess the association between infant-onset eczema and mental health problems in a prospective study. Between 1995 and 1998, a birth cohort study was recruited and followed until age 10 years. Physician-diagnosed eczema, comorbidities, and a broad set of environmental exposures were assessed at age 1, 2, 3, 4, 6, and 10 years. First, we investigated the association between infant-onset eczema (age 1-2 years) and mental health problems at age 10 years according to the Strengths and Difficulties Questionnaire. Second, we analyzed the likelihood of mental health problems at age 10 years in relation to the course of eczema. A total of 2916 infants were eligible for analysis. Compared with participants never diagnosed as having eczema, children with infant-onset eczema had a significantly increased risk for possible/probable mental health problems (Strengths and Difficulties Questionnaire total score) at age 10 years (odds ratio, 1.49; 95% CI, 1.13-1.96) and for emotional symptoms (odds ratio, 1.62; 95% CI, 1.25-2.09). Eczema limited to infancy predicted a significantly higher risk for conduct problems at age 10 years. The strength of the association between eczema and emotional problems at age 10 years increased with increasing eczema persistence. Infants with eczema are at increased risk for mental health problems at age 10 years. Even if cleared afterward, eczema at age 1 to 2 years may cause persistent emotional and behavioral difficulties. Copyright 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Perceived stress and reported cognitive symptoms among Georgia patients with systemic lupus erythematosus.

PubMed

Plantinga, L; Lim, S S; Bowling, C B; Drenkard, C

2017-09-01

Objective To examine associations of perceived stress with cognitive symptoms among adults with systemic lupus erythematosus (SLE). Methods Among 777 adult (≥18 years) SLE patients, the association of Perceived Stress Scale (PSS) scores with two self-reported cognitive symptoms was examined: forgetfulness (severe/moderate vs. mild/none; from the Systemic Lupus Activity Questionnaire) and difficulty concentrating (all/most vs. some/little/none of the time; from the Lupus Impact Tracker). The study used multivariable logistic regression to estimate the odds ratios (ORs) per minimal important difference (MID = 0.5*SD) of PSS score and cognitive symptoms. Results Forgetfulness and difficulty concentrating were reported by 41.7% and 29.5%, respectively. Women and those with less education and high disease activity had higher PSS scores and were more likely to report cognitive symptoms than their counterparts. With adjustment for age, race, sex, education, and disease activity, each MID increase in PSS score was associated with higher prevalence of forgetfulness (OR = 1.43, 95% CI 1.29-1.47) and difficulty concentrating (OR = 2.19, 95% CI 1.90-2.52). No substantial differences in this association by age, race, sex, or disease activity were noted. Conclusions SLE patients, particularly those with high disease activity, report a high burden of cognitive symptoms, for which stress may be a modifiable risk factor.

Diagnosis of subclinical mastitis in Santa Inês and Morada Nova sheep in southeastern Brazil.

PubMed

Zafalon, Luiz Francisco; Santana, Raul Costa Mascarenhas; Pilon, Lucas Eduardo; Júnior, Guilherme Aparecido Fim

2016-06-01

The objective of this study was to evaluate different screening limits for the California mastitis test (CMT) and the somatic cell count (SCC) in previous diagnoses of subclinical mastitis in Santa Inês and Morada Nova ewes, which were reared under the same management conditions. Additionally, cutoff points were defined for SCC in accordance with the sensitivity and specificity of the test. A total of 907 mammary halves were subjected to CMT and SCC. The disease was confirmed by means of microbiological identification. Coagulase-negative staphylococci (CNS) were the microorganisms with highest occurrence. The CMT score of 1+ provided adequate sensitivity and specificity at all periods of lactation investigated. This score showed good agreement with SCC, >400,000 cells mL(-1). Higher cell counts favored higher diagnostic specificity. They can be used when producers have financial difficulties relating to treatment or culling of sheep with subclinical mastitis. However, producers should be warned about the risk of false-negative results in the flock.

[Ambulatory laparoscopic cholecystectomy by minilaparoscopy versus traditional multiport ambulatory laparoscopic cholecystectomy. Prospective randomized trial].

PubMed

Planells Roig, Manuel; Arnal Bertomeu, Consuelo; Garcia Espinosa, Rafael; Cervera Delgado, Maria; Carrau Giner, Miguel

2016-02-01

Difference analysis of ambulatorization rate, pain, analgesic requirements and daily activities recovery in patients undergoing laparoscopic cholecystectomy with standard multiport access (CLMP) versus a minilaparoscopic, 3mm size, technique. Prospective randomized trial of 40 consecutive patients undergoing laparoscopic cholecystectomy. Comparison criteria included predictive ultrasound factors of difficult cholecystectomy, previous history of complicated biliary disease and demographics. Results are analyzed in terms of ambulatorization rate, pain, analgesic requirements, postoperative recovery, technical difficulty, hemorrhage intensity, overnight stay, readmission rate and total or partial conversion. Both procedures were similar in surgery time, technical score and hemorrhage score. MLC was associated with similar ambulatorization rate, 85%, and over-night stay 15%, with only 15% partial conversion rate. MLC showed less postoperative pain (P=.026), less analgesic consumption (P=.006) and similar DAR (P=.879). MLC is similar to CLMP in terms of ambulatorization with less postoperative pain and analgesic requirements without differences in postoperative recovery. Copyright © 2014 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

The strengths and weaknesses in verbal short-term memory and visual working memory in children with hearing impairment and additional language learning difficulties.

PubMed

Willis, Suzi; Goldbart, Juliet; Stansfield, Jois

2014-07-01

To compare verbal short-term memory and visual working memory abilities of six children with congenital hearing-impairment identified as having significant language learning difficulties with normative data from typically hearing children using standardized memory assessments. Six children with hearing loss aged 8-15 years were assessed on measures of verbal short-term memory (Non-word and word recall) and visual working memory annually over a two year period. All children had cognitive abilities within normal limits and used spoken language as the primary mode of communication. The language assessment scores at the beginning of the study revealed that all six participants exhibited delays of two years or more on standardized assessments of receptive and expressive vocabulary and spoken language. The children with hearing-impairment scores were significantly higher on the non-word recall task than the "real" word recall task. They also exhibited significantly higher scores on visual working memory than those of the age-matched sample from the standardized memory assessment. Each of the six participants in this study displayed the same pattern of strengths and weaknesses in verbal short-term memory and visual working memory despite their very different chronological ages. The children's poor ability to recall single syllable words in relation to non-words is a clinical indicator of their difficulties in verbal short-term memory. However, the children with hearing-impairment do not display generalized processing difficulties and indeed demonstrate strengths in visual working memory. The poor ability to recall words, in combination with difficulties with early word learning may be indicators of children with hearing-impairment who will struggle to develop spoken language equal to that of their normally hearing peers. This early identification has the potential to allow for target specific intervention that may remediate their difficulties. Copyright © 2014. Published by Elsevier Ireland Ltd.

Racial and sex differences in associations between activities of daily living and cognition in community-dwelling older adults.

PubMed

Garrett, Stephanie L; Sawyer, Patricia; Kennedy, Richard E; McGuire, Dawn; Simon, Roger P; Strothers, Harry S; Allman, Richard M

2013-12-01

To examine the association between function measured according to activities of daily living (ADLs), instrumental activ1ities of daily living (IADLs), and cognition assessed according to Mini-Mental State Examination (MMSE) scores of older African-American and non-Hispanic white community-dwelling men and women. Cross-sectional study assessing associations between self-reported ADL and IADL difficulty and MMSE scores for race- and sex-specific groups. Homes of community-dwelling older adults. A random sample of 974 African-American and non-Hispanic white Medicare beneficiaries aged 65 and older living in west-central Alabama and participating in the University of Alabama at Birmingham Study of Aging, excluding those with reported diagnoses of dementia or with missing data. Function, based on self-reported difficulty in performing ADLs and IADLs, and cognition, using the MMSE. Multivariable linear regression models were used to test the association between function and cognition in race- and sex-specific groups after adjusting for covariates. Mini-Mental State Examination scores were modestly correlated with ADL and IADL difficulty in all four race- and sex-specific groups, with Pearson correlation coefficients ranging from −0.189 for non-Hispanic white women to −0.429 for African-American men. Correlations between MMSE and ADL or IADL difficulty in any of the race- and sex-specific groups were no longer significant after controlling for sociodemographic factors and comorbidities. Mini-Mental State Examination was not significantly associated with functional difficulty in older African-American and non-Hispanic white men and women after adjusting for sociodemographic factors and comorbidities, suggesting a mediating role in the relationship between cognition and function. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

Screening for oral health literacy in an urban dental clinic

PubMed Central

Atchison, Kathryn A.; Gironda, Melanie W.; Messadi, Diana; Der-Martirosian, Claudia

2013-01-01

Objective Studies show that the average person fails to understand and use health care related materials to their full potential. The goal of this study was to evaluate a health literacy instrument based on the Rapid Estimate of Adult Literacy in Medicine (REALM) that incorporates dental and medical terms into one 84-item Rapid Estimate of Adult Literacy in Medicine and Dentistry (REALM-D) measure and determine its association with patient characteristics of a culturally diverse dental clinic population. Methods An 84-item dental/medical health literacy word list and a 48-item health beliefs and attitudes survey was provided to a sample of 200 adult patients seeking treatment for the first time at an oral diagnosis clinic located in a large urban medical center in Los Angeles, California. Results Of the total sample, 154 participants read all of list 1 correctly, 141 read list 2 correctly, and only 38 read list 3 correctly. Nonwhite participants had significantly lower REALM-D scores at each level of difficulty as well as the total scale score compared to white participants. Participants who reported English as not their main language had significantly lower REALM-D scores. REALM-D scores also varied significantly by level of education among participants where as level of education increased, oral health literacy increased. At a bivariate level, race, education, and English as a main language remain predictive of health literacy in a regression model. An interaction between education and English as a main language was significant. Conclusions The REALM-D is an effective instrument for use by medical and dental clinicians in detecting differences among people of different backgrounds and for whom English was not their primary language. PMID:20545829

Social communication deficits: Specific associations with Social Anxiety Disorder.

PubMed

Halls, Georgia; Cooper, Peter J; Creswell, Cathy

2015-02-01

Social communication deficits are prevalent amongst children with anxiety disorders; however whether they are over-represented specifically among children with Social Anxiety Disorder has not been examined. This study set out to examine social communication deficits among children with Social Anxiety Disorder in comparison to children with other forms of anxiety disorder. Parents of 404 children with a diagnosed anxiety disorder completed the Social Communication Questionnaire (SCQ; Rutter, M., Bailey, A., Lord, C., 2003. The Social Communication Questionnaire - Manual. Western Psychological Services, Los Angeles, CA). Children with a diagnosis of Social Anxiety Disorder (n=262) and anxious children without Social Anxiety Disorder (n=142) were compared on SCQ total and subscale scores and the frequency of participants scoring above clinical cut-offs. Children with Social Anxiety Disorder scored significantly higher than anxious children without Social Anxiety Disorder on the SCQ total (t(352)=4.85, p<.001, d=.55, r=.27), Reciprocal Social Interaction (t(351)=4.73, p<.001, d=.55, r=.27), communication (t(344)=3.62, p<.001, d=.43, r=.21) and repetitive, restrictive and stereotyped behaviors subscales (t(353)=3.15, p=.002, d=.37, r=.18). Furthermore, children with Social Anxiety Disorder were three times more likely to score above clinical cut-offs. The participants were a relatively affluent group of predominantly non-minority status. The social communication difficulties measure relied on parental report which could be influenced by extraneous factors. Treatments for Social Anxiety Disorder may benefit from a specific focus on developing social communication skills. Future research using objective assessments of underlying social communication skills is required. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

Social communication deficits: Specific associations with Social Anxiety Disorder

PubMed Central

Halls, Georgia; Cooper, Peter J.; Creswell, Cathy

2015-01-01

Background Social communication deficits are prevalent amongst children with anxiety disorders; however whether they are over-represented specifically among children with Social Anxiety Disorder has not been examined. This study set out to examine social communication deficits among children with Social Anxiety Disorder in comparison to children with other forms of anxiety disorder. Methods Parents of 404 children with a diagnosed anxiety disorder completed the Social Communication Questionnaire (SCQ; Rutter, M., Bailey, A., Lord, C., 2003. The Social Communication Questionnaire – Manual. Western Psychological Services, Los Angeles, CA). Children with a diagnosis of Social Anxiety Disorder (n=262) and anxious children without Social Anxiety Disorder (n=142) were compared on SCQ total and subscale scores and the frequency of participants scoring above clinical cut-offs. Results Children with Social Anxiety Disorder scored significantly higher than anxious children without Social Anxiety Disorder on the SCQ total (t(352)=4.85, p<.001, d=.55, r=.27), Reciprocal Social Interaction (t(351)=4.73, p<.001, d=.55, r=.27), communication (t(344)=3.62, p<.001, d=.43, r=.21) and repetitive, restrictive and stereotyped behaviors subscales (t(353)=3.15, p=.002, d=.37, r=.18). Furthermore, children with Social Anxiety Disorder were three times more likely to score above clinical cut-offs. Limitations The participants were a relatively affluent group of predominantly non-minority status. The social communication difficulties measure relied on parental report which could be influenced by extraneous factors. Conclusions Treatments for Social Anxiety Disorder may benefit from a specific focus on developing social communication skills. Future research using objective assessments of underlying social communication skills is required. PMID:25451393

Thirteen-year prospective study between fish consumption, long-chain n-3 fatty acids intakes and cognitive function.

PubMed

Kesse-Guyot, E; Péneau, S; Ferry, M; Jeandel, C; Hercberg, S; Galan, P

2011-02-01

Because of their structural, anti-inflammatory and antithrombic properties, long-chain n-3 fatty acids may be key factors in the aging process. We sought to elucidate the association between intake of long-chain n-3 fatty acids and/or fish and cognitive function evaluated 13 years after dietary assessment. Prospective population-based study. 3,294 adults from the SU.VI.MAX study (Supplementation with Antioxidant Vitamins and Minerals study). MEASUREMENTS/STATISTICAL ANALYSIS: Subjects underwent a standardized clinical examination which included cognitive tests and self-reported cognitive difficulties scale (2007-2009). Poor scores were defined using percentiles as cut-off. Dietary data were assessed through repeated 24-h dietary records. Odd ratio (OR), comparing the fourth (Q4) to the first quartile (Q1), of having a poor score were calculated using adjusted logistic regression. Self-reported cognitive difficulties were less frequent among subjects with higher intakes of total n-3 long chain fatty acids (OR = 0.72, CI 95%=0.56-0.92) and eicosapentaenoic acid (OR Q4 versus Q1 = 0.74, CI 95%=0.58-0.95), even after adjustment for depressive symptoms. A borderline significant association was also found with high fish consumption (OR Q4 versus Q1 = 0.80, CI 95%=0.63-1.01). Cognitive complaints, which may be an early indicator of cognitive decline, are less frequent among the elderly who have a high long-chain n-3 acids intake, as assessed 13 years earlier.

Cross-cultural comparisons of the Mini-mental State Examination between Japanese and U.S. cohorts

PubMed Central

Meguro, Kenichi; Ishii, Hiroshi; Yamaguchi, Satoshi; Saxton, Judith A.; Ganguli, Mary

2009-01-01

Background The Mini-mental State Examination (MMSE) is widely used in Japan and the U.S.A. for cognitive screening in the clinical setting and in epidemiological studies. A previous Japanese community study reported distributions of the MMSE total score very similar to that of the U.S.A. Methods Data were obtained from the Monongahela Valley Independent Elder's Study (MoVIES), a representative sample of community-dwelling elderly people aged 65 and older living near Pittsburgh, U.S.A., and from the Tajiri Project, with similar aims in Tajiri, Japan. We examined item-by-item distributions of the MMSE between two cohorts, comparing (1) percentage of correct answers for each item within each cohort, and (2) relative difficulty of each item measured by Item Characteristic Curve analysis (ICC), which estimates log odds of obtaining a correct answer adjusted for the remaining MMSE items, demographic variables (age, gender, education) and interactions of demographic variables and cohort. Results Median MMSE scores were very similar between the two samples within the same education groups. However, the relative difficulty of each item differed substantially between the two cohorts. Specifically, recall and auditory comprehension were easier for the Tajiri group, but reading comprehension and sentence construction were easier for the MoVIES group. Conclusions Our results reaffirm the importance of validation and examination of thresholds in each cohort to be studied when a common instrument is used as a dementia screening tool or for defining cognitive impairment. PMID:18925977

Comparison of patients with and without intellectual disability under general anesthesia: A retrospective study.

PubMed

Sitilci, T; Demirgan, S; Akcay, C; Kahraman, N; Koseoglu, B G; Erdem, M A; Cankaya, A B

2017-04-01

We analyzed and retrospectively compared patients with and without intellectual disability (ID) who underwent oral surgery under general anesthesia at Istanbul University, Faculty of Dentistry, Department of General Anesthesia, between October 2012 and June 2013 with regard to the following categories: Demographic features, American Society of Anesthesiologists (ASA) classification, Mallampati score, type of anesthetic drug used during the operation, type of intubation used, any difficulties with tracheal intubation, presence of systemic diseases, and recovery times after ending general anesthesia. A total of 348 patients were selected from the Department of Maxillofacial Surgery and the Department of Pedodontics who underwent surgery with general anesthesia. Medical histories of all patients were taken, and their electrocardiography, chest X-rays, complete blood count, and blood clotting tests were checked during a preoperative assessment. Mallampati evaluations were also performed. Patients were grouped into ASA I, II, or III according to the ASA classification and were treated under general anesthesia. There was no significant difference between normal and intellectually disabled patients in terms of gender, Mallampati scores, intubation difficulties, mean anesthetic period, time to discharge, or postoperative nausea and vomiting. Epilepsy and genetic diseases in intellectually disabled patients were significantly more common than in non-ID (NID) patients. However, the frequency of diabetes and chronic obstructive pulmonary disease in NID patients was significantly higher than in the intellectually disabled patients. Dental treatment of intellectually disabled patients under general anesthesia can be performed just as safely as that with NID patients.

On the development of a computer-based handwriting assessment tool to objectively quantify handwriting proficiency in children.

PubMed

Falk, Tiago H; Tam, Cynthia; Schellnus, Heidi; Chau, Tom

2011-12-01

Standardized writing assessments such as the Minnesota Handwriting Assessment (MHA) can inform interventions for handwriting difficulties, which are prevalent among school-aged children. However, these tests usually involve the laborious task of subjectively rating the legibility of the written product, precluding their practical use in some clinical and educational settings. This study describes a portable computer-based handwriting assessment tool to objectively measure MHA quality scores and to detect handwriting difficulties in children. Several measures are proposed based on spatial, temporal, and grip force measurements obtained from a custom-built handwriting instrument. Thirty-five first and second grade students participated in the study, nine of whom exhibited handwriting difficulties. Students performed the MHA test and were subjectively scored based on speed and handwriting quality using five primitives: legibility, form, alignment, size, and space. Several spatial parameters are shown to correlate significantly (p<0.001) with subjective scores obtained for alignment, size, space, and form. Grip force and temporal measures, in turn, serve as useful indicators of handwriting legibility and speed, respectively. Using only size and space parameters, promising discrimination between proficient and non-proficient handwriting can be achieved. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

The Effect Of Different Corrective Feedback Methods on the Outcome and Self Confidence of Young Athletes

PubMed Central

Tzetzis, George; Votsis, Evandros; Kourtessis, Thomas

2008-01-01

This experiment investigated the effects of three corrective feedback methods, using different combinations of correction, or error cues and positive feedback for learning two badminton skills with different difficulty (forehand clear - low difficulty, backhand clear - high difficulty). Outcome and self-confidence scores were used as dependent variables. The 48 participants were randomly assigned into four groups. Group A received correction cues and positive feedback. Group B received cues on errors of execution. Group C received positive feedback, correction cues and error cues. Group D was the control group. A pre, post and a retention test was conducted. A three way analysis of variance ANOVA (4 groups X 2 task difficulty X 3 measures) with repeated measures on the last factor revealed significant interactions for each depended variable. All the corrective feedback methods groups, increased their outcome scores over time for the easy skill, but only groups A and C for the difficult skill. Groups A and B had significantly better outcome scores than group C and the control group for the easy skill on the retention test. However, for the difficult skill, group C was better than groups A, B and D. The self confidence scores of groups A and C improved over time for the easy skill but not for group B and D. Again, for the difficult skill, only group C improved over time. Finally a regression analysis depicted that the improvement in performance predicted a proportion of the improvement in self confidence for both the easy and the difficult skill. It was concluded that when young athletes are taught skills of different difficulty, different type of instruction, might be more appropriate in order to improve outcome and self confidence. A more integrated approach on teaching will assist coaches or physical education teachers to be more efficient and effective. Key pointsThe type of the skill is a critical factor in determining the effectiveness of the feedback types.Different instructional methods of corrective feedback could have beneficial effects in the outcome and self-confidence of young athletesInstructions focusing on the correct cues or errors increase performance of easy skills.Positive feedback or correction cues increase self-confidence of easy skills but only the combination of error and correction cues increase self confidence and outcome scores of difficult skills. PMID:24149905

Measuring stigma among abortion providers: assessing the Abortion Provider Stigma Survey instrument.

PubMed

Martin, Lisa A; Debbink, Michelle; Hassinger, Jane; Youatt, Emily; Eagen-Torkko, Meghan; Harris, Lisa H

2014-01-01

We explored the psychometric properties of 15 survey questions that assessed abortion providers' perceptions of stigma and its impact on providers' professional and personal lives referred to as the Abortion Provider Stigma Survey (APSS). We administered the survey to a sample of abortion providers recruited for the Providers' Share Workshop (N = 55). We then completed analyses using Stata SE/12.0. Exploratory factor analysis, which resulted in 13 retained items and identified three subscales: disclosure management, resistance and resilience, and discrimination. Stigma was salient in abortion provider's lives: they identified difficulties surrounding disclosure (66%) and felt unappreciated by society (89%). Simultaneously, workers felt they made a positive contribution to society (92%) and took pride in their work (98%). Paired t-test analyses of the pre- and post-Workshop APSS scores showed no changes in the total score. However, the Disclosure Management subscale scores were significantly lower (indicating decreased stigma) for two subgroups of participants: those over the age of 30 and those with children. This analysis is a promising first step in the development of a quantitative tool for capturing abortion providers' experiences of and responses to pervasive abortion stigma.

Assessing implementation difficulties in tobacco use prevention and cessation counselling among dental providers.

PubMed

Amemori, Masamitsu; Michie, Susan; Korhonen, Tellervo; Murtomaa, Heikki; Kinnunen, Taru H

2011-05-26

Tobacco use adversely affects oral health. Clinical guidelines recommend that dental providers promote tobacco abstinence and provide patients who use tobacco with brief tobacco use cessation counselling. Research shows that these guidelines are seldom implemented, however. To improve guideline adherence and to develop effective interventions, it is essential to understand provider behaviour and challenges to implementation. This study aimed to develop a theoretically informed measure for assessing among dental providers implementation difficulties related to tobacco use prevention and cessation (TUPAC) counselling guidelines, to evaluate those difficulties among a sample of dental providers, and to investigate a possible underlying structure of applied theoretical domains. A 35-item questionnaire was developed based on key theoretical domains relevant to the implementation behaviours of healthcare providers. Specific items were drawn mostly from the literature on TUPAC counselling studies of healthcare providers. The data were collected from dentists (n = 73) and dental hygienists (n = 22) in 36 dental clinics in Finland using a web-based survey. Of 95 providers, 73 participated (76.8%). We used Cronbach's alpha to ascertain the internal consistency of the questionnaire. Mean domain scores were calculated to assess different aspects of implementation difficulties and exploratory factor analysis to assess the theoretical domain structure. The authors agreed on the labels assigned to the factors on the basis of their component domains and the broader behavioural and theoretical literature. Internal consistency values for theoretical domains varied from 0.50 ('emotion') to 0.71 ('environmental context and resources'). The domain environmental context and resources had the lowest mean score (21.3%; 95% confidence interval [CI], 17.2 to 25.4) and was identified as a potential implementation difficulty. The domain emotion provided the highest mean score (60%; 95% CI, 55.0 to 65.0). Three factors were extracted that explain 70.8% of the variance: motivation (47.6% of variance, α = 0.86), capability (13.3% of variance, α = 0.83), and opportunity (10.0% of variance, α = 0.71). This study demonstrated a theoretically informed approach to identifying possible implementation difficulties in TUPAC counselling among dental providers. This approach provides a method for moving from diagnosing implementation difficulties to designing and evaluating interventions.

Evaluating the Effects of Differences in Group Abilities on the Tucker and the Levine Observed-Score Methods for Common-Item Nonequivalent Groups Equating. ACT Research Report Series 2010-1

ERIC Educational Resources Information Center

Chen, Hanwei; Cui, Zhongmin; Zhu, Rongchun; Gao, Xiaohong

2010-01-01

The most critical feature of a common-item nonequivalent groups equating design is that the average score difference between the new and old groups can be accurately decomposed into a group ability difference and a form difficulty difference. Two widely used observed-score linear equating methods, the Tucker and the Levine observed-score methods,…

RADAR: A novel fast-screening method for reading difficulties with special focus on dyslexia.

PubMed

Smyrnakis, Ioannis; Andreadakis, Vassilios; Selimis, Vassilios; Kalaitzakis, Michail; Bachourou, Theodora; Kaloutsakis, Georgios; Kymionis, George D; Smirnakis, Stelios; Aslanides, Ioannis M

2017-01-01

Dyslexia is a developmental learning disorder of single word reading accuracy and/or fluency, with compelling research directed towards understanding the contributions of the visual system. While dyslexia is not an oculomotor disease, readers with dyslexia have shown different eye movements than typically developing students during text reading. Readers with dyslexia exhibit longer and more frequent fixations, shorter saccade lengths, more backward refixations than typical readers. Furthermore, readers with dyslexia are known to have difficulty in reading long words, lower skipping rate of short words, and high gaze duration on many words. It is an open question whether it is possible to harness these distinctive oculomotor scanning patterns observed during reading in order to develop a screening tool that can reliably identify struggling readers, who may be candidates for dyslexia. Here, we introduce a novel, fast, objective, non-invasive method, named Rapid Assessment of Difficulties and Abnormalities in Reading (RADAR) that screens for features associated with the aberrant visual scanning of reading text seen in dyslexia. Eye tracking parameter measurements that are stable under retest and have high discriminative power, as indicated by their ROC (receiver operating characteristic) curves, were obtained during silent text reading. These parameters were combined to derive a total reading score (TRS) that can reliably separate readers with dyslexia from typical readers. We tested TRS in a group of school-age children ranging from 8.5 to 12.5 years of age. TRS achieved 94.2% correct classification of children tested. Specifically, 35 out of 37 control (specificity 94.6%) and 30 out of 32 readers with dyslexia (sensitivity 93.8%) were classified correctly using RADAR, under a circular validation condition (see section Results/Total Reading Score) where the individual evaluated was not included in the test construction group. In conclusion, RADAR is a novel, automated, fast and reliable way to identify children at high risk of dyslexia that is amenable to large-scale screening. Moreover, analysis of eye movement parameters obtained with RADAR during reading will likely be useful for implementing individualized treatment strategies and for monitoring objectively the success of chosen interventions. We envision that it will be possible to use RADAR as a sensitive, objective, and quantitative first pass screen to identify individuals with reading disorders that manifest with abnormal oculomotor reading strategies, like dyslexia.

RADAR: A novel fast-screening method for reading difficulties with special focus on dyslexia

PubMed Central

Smyrnakis, Ioannis; Andreadakis, Vassilios; Selimis, Vassilios; Kalaitzakis, Michail; Bachourou, Theodora; Kaloutsakis, Georgios; Kymionis, George D.; Smirnakis, Stelios; Aslanides, Ioannis M.

2017-01-01

Dyslexia is a developmental learning disorder of single word reading accuracy and/or fluency, with compelling research directed towards understanding the contributions of the visual system. While dyslexia is not an oculomotor disease, readers with dyslexia have shown different eye movements than typically developing students during text reading. Readers with dyslexia exhibit longer and more frequent fixations, shorter saccade lengths, more backward refixations than typical readers. Furthermore, readers with dyslexia are known to have difficulty in reading long words, lower skipping rate of short words, and high gaze duration on many words. It is an open question whether it is possible to harness these distinctive oculomotor scanning patterns observed during reading in order to develop a screening tool that can reliably identify struggling readers, who may be candidates for dyslexia. Here, we introduce a novel, fast, objective, non-invasive method, named Rapid Assessment of Difficulties and Abnormalities in Reading (RADAR) that screens for features associated with the aberrant visual scanning of reading text seen in dyslexia. Eye tracking parameter measurements that are stable under retest and have high discriminative power, as indicated by their ROC (receiver operating characteristic) curves, were obtained during silent text reading. These parameters were combined to derive a total reading score (TRS) that can reliably separate readers with dyslexia from typical readers. We tested TRS in a group of school-age children ranging from 8.5 to 12.5 years of age. TRS achieved 94.2% correct classification of children tested. Specifically, 35 out of 37 control (specificity 94.6%) and 30 out of 32 readers with dyslexia (sensitivity 93.8%) were classified correctly using RADAR, under a circular validation condition (see section Results/Total Reading Score) where the individual evaluated was not included in the test construction group. In conclusion, RADAR is a novel, automated, fast and reliable way to identify children at high risk of dyslexia that is amenable to large-scale screening. Moreover, analysis of eye movement parameters obtained with RADAR during reading will likely be useful for implementing individualized treatment strategies and for monitoring objectively the success of chosen interventions. We envision that it will be possible to use RADAR as a sensitive, objective, and quantitative first pass screen to identify individuals with reading disorders that manifest with abnormal oculomotor reading strategies, like dyslexia. PMID:28800632

Predictive factors for the placebo effect in clinical trials for dry eye: a pooled analysis of three clinical trials.

PubMed

Imanaka, Takahiro; Sato, Izumi; Tanaka, Shiro; Kawakami, Koji

2017-11-01

Placebo effect is one of the methodological difficulties in dry eye clinical trials. If we could elucidate the tendencies of the placebo response and find predictors, we could reduce the placebo response in clinical trials for dry eye. In this study, we investigated the predictive factors for the placebo effect in dry eye clinical trials. A total of 205 patients with dry eye assigned to the placebo arms of three placebo-controlled randomised clinical trials were analysed by simple and multivariable regression analysis. The corneal fluorescein (FL) staining score and dry eye symptoms were studied at week 4. The variables of interest included gender, age, complications of Sjögren's syndrome, Schirmer's test I value, tear break-up time and conjunctival hyperaemia score. We also conducted a stratified analysis according to the patients' age. Among all the studied endpoints, the baseline scores were significantly related to the corresponding placebo response. In addition, for the FL score and the dryness score, age was a significant predictor of the placebo response (p=0.04 and p<0.0001, respectively). Stratified analysis by age showed that patients more than 40 years of age are more likely to have a stronger placebo response in the FL and dryness scores. The baseline scores and age were predictive factors of the placebo response in frequently used endpoints, such as FL score or dryness symptoms. These patient characteristics can be controlled by study design, and our findings enable the design of more efficient placebo-controlled studies with good statistical power. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Early Identification of Children at Risk for Academic Difficulties Using Standardized Assessment: Stability and Predictive Validity of Preschool Math and Language Scores

ERIC Educational Resources Information Center

Frans, Niek; Post, Wendy J.; Huisman, Mark; Oenema-Mostert, Ineke C. E.; Keegstra, Anne L.; Minnaert, Alexander E. M. G.

2017-01-01

Despite the claim by several researchers that variability in performance may complicate the identification of "at-risk" children, variability in the academic performance of young children remains an undervalued area of research. The goal of this study is to examine the predictive validity for future scores and the score stability of two…

Development and Application of a Scoring Rubric for Evaluating Students' Experimental Skills in Organic Chemistry: An Instructional Guide for Teaching Assistants

ERIC Educational Resources Information Center

Chen, Hui-Jung; She, Jui-Lin; Chou, Chin-Cheng; Tsai, Yeun-Min; Chiu, Mei-Hung

2013-01-01

The purpose of this study was to develop a scoring rubric to assess students' manipulation skills and identify students' learning difficulties in conducting organic chemistry experiments. In constructing the scoring rubric, we first analyzed the skills needed in the experiment, then divided the skills into subskills, and finally…

Stability and Change of Behavioral and Emotional Screening Scores

ERIC Educational Resources Information Center

Dever, Bridget V.; Dowdy, Erin; Raines, Tara C.; Carnazzo, Katherine

2015-01-01

Universal screening for behavioral and emotional difficulties is integral to the identification of students needing early intervention and prevention efforts. However, unanswered questions regarding the stability of screening scores impede the ability to determine optimal strategies for subsequent screening. This study examined the 2-year…

The relationship between body mass index and gross motor development in children aged 3 to 5 years.

PubMed

Nervik, Deborah; Martin, Kathy; Rundquist, Peter; Cleland, Joshua

2011-01-01

To investigate the relationship between obesity and gross motor development in children who are developing typically and determine whether body mass index (BMI) predicts difficulty in gross motor skills. BMIs were calculated and gross motor skills examined in 50 children who were healthy aged 3 to 5 years using the Peabody Developmental Motor Scales, 2nd edition (PDMS-2). Pearson chi-square statistic and stepwise linear hierarchical regression were used for analysis. A total of 24% of the children were overweight/obese, whereas 76% were found not to be overweight/obese. Fifty-eight percent of the overweight/obese group scored below average on the PDMS-2 compared to 15% of the nonoverweight group. Association between BMI and gross motor quotients was identified with significance of less than 0.002. Regression results were nonsignificant with all 50 subjects, yet showed significance (P = 0.018) when an outlier was excluded. Children aged 3 to 5 years with high BMIs may have difficulty with their gross motor skills. Further research is needed.

The relationship between patients' perception of the effects of neurofibromatosis type 2 and the domains of the Short Form-36.

PubMed

Neary, W J; Hillier, V F; Flute, T; Stephens, S D G; Ramsden, R T; Evans, D G R

2010-08-01

To investigate the relationship between those issues concerning quality of life in patients with neurofibromatosis type 2 (NF2) as identified by the closed set NF2 questionnaire and the eight norm-based measures and the physical component summary (PCS) and mental component summary (MCS) scores of the Short Form-36 (SF-36) Questionnaire. Postal questionnaire study. Questionnaires sent to subjects' home addresses. Eighty-seven adult subjects under the care of the Manchester Multidisciplinary NF2 Clinic were invited to participate. Sixty-two (71%) completed sets of closed set NF2 questionnaires and SF-36 questionnaires were returned. Subjects with NF2 scored less than the norm of 50 on both the physical component summary and mental component summary scores and the eight individual norm-based measures of the Short Form-36 questionnaire. Correlations (using Kendall's tau) were examined between patients' perceptions of their severity of difficulty with the following activities and the eight norm-based measures and the physical component summary and mental component summary scores of the Short Form-36 questionnaire: Communicating with spouse/significant other (N = 61). The correlation coefficients were significant at the 0.01 level for the mental component summary score, together with three of the norm-based scores [vitality (VT), social functioning and role emotional]. Social communication (N = 62). All 10 correlations were significant at the 0.01 or 0.001 level. Balance (N = 59). All 10 correlations were highly significant at the P < 0.001 level. Hearing difficulties (N = 61). All correlations were significant at either the 0.01 level or less apart from the mental component summary score and three of the norm-based scores (role physical, VT and mental health). Mood change (N = 61). All correlations were significant at the 0.01 level or less, apart from one norm-based score (role physical). The Short Form-36 questionnaire has allowed us to relate patients' perceptions of their difficulties, as identified by the closed set NF2 questionnaire, to the physical and mental domains measured by this validated and widely used scale, and has provided further insight into areas of functioning affected by NF2.

Item response theory-based validation of a short form of the Eating Behavior Scale for Japanese adults

PubMed Central

Tayama, Jun; Ogawa, Sayaka; Takeoka, Atsushi; Kobayashi, Masakazu; Shirabe, Susumu

2017-01-01

Abstract Obesity has become a serious social problem in industrialized countries in recent years. Clinically, although the evaluation of dietary behavior abnormalities is as important as any method of risk assessment for obesity, almost all the existing scales with many items may have numerous practical clinical difficulties. In this study, we aimed to prepare a short questionnaire to assess the dietary behavior abnormalities related to obesity. A total of 1032 individuals aged 20 to 59 years participated in the present study. Using item response theory (IRT), we selected the items for a short version from among 30 items of Sakata Eating Behavior Scale (EBS), which is widely used in Japan. As a result of the IRT-based analysis on the original 30-item version, 7 items were adopted as the short version. The correlation between the total score of the original EBS and the EBS short form was extremely high (r = 0.93, P = .001). In examining the criterion validity, for all participants (n = 1032), male (n = 516), and female (n = 516), the correlation coefficients between the total score of the EBS short form and body mass index (BMI) were r = 0.26, r = 0.28, and r = 0.28, respectively. The results of the receiver operating characteristic analysis was performed with obesity BMI > 25 kg/m2 as a dependent variable, the value of the area under the curve in the ROC was significantly higher in the 7-item version than in the total score of the original items (P = .0005). In conclusion, the 7-item EBS short form was created. Furthermore, it was found that the EBS short form is a reliable and valid measure that can be used as an indicator of obesity in both clinical and research settings. PMID:29049248

Education on electrical phenomena involved in electroporation-based therapies and treatments: a blended learning approach.

PubMed

Čorović, Selma; Mahnič-Kalamiza, Samo; Miklavčič, Damijan

2016-04-07

Electroporation-based applications require multidisciplinary expertise and collaboration of experts with different professional backgrounds in engineering and science. Beginning in 2003, an international scientific workshop and postgraduate course electroporation based technologies and treatments (EBTT) has been organized at the University of Ljubljana to facilitate transfer of knowledge from leading experts to researches, students and newcomers in the field of electroporation. In this paper we present one of the integral parts of EBTT: an e-learning practical work we developed to complement delivery of knowledge via lectures and laboratory work, thus providing a blended learning approach on electrical phenomena involved in electroporation-based therapies and treatments. The learning effect was assessed via a pre- and post e-learning examination test composed of 10 multiple choice questions (i.e. items). The e-learning practical work session and both of the e-learning examination tests were carried out after the live EBTT lectures and other laboratory work. Statistical analysis was performed to compare and evaluate the learning effect measured in two groups of students: (1) electrical engineers and (2) natural scientists (i.e. medical doctors, biologists and chemists) undergoing the e-learning practical work in 2011-2014 academic years. Item analysis was performed to assess the difficulty of each item of the examination test. The results of our study show that the total score on the post examination test significantly improved and the item difficulty in both experimental groups decreased. The natural scientists reached the same level of knowledge (no statistical difference in total post-examination test score) on the post-course test take, as do electrical engineers, although the engineers started with statistically higher total pre-test examination score, as expected. The main objective of this study was to investigate whether the educational content the e-learning practical work presented to the students with different professional backgrounds enhanced their knowledge acquired via lectures during EBTT. We compared the learning effect assessed in two experimental groups undergoing the e-learning practical work: electrical engineers and natural scientists. The same level of knowledge on the post-course examination was reached in both groups. The results indicate that our e-learning platform supported by blended learning approach provides an effective learning tool for populations with mixed professional backgrounds and thus plays an important role in bridging the gap between scientific domains involved in electroporation-based technologies and treatments.

Comparison of Scores on Two Visual-Motor Tests for Children Referred for Learning or Adjustment Difficulties.

ERIC Educational Resources Information Center

DeMers, Stephen T.; And Others

1981-01-01

This study compared the performance of school-aged children referred for learning or adjustment difficulties on Beery's Developmental Test of Visual-Motor Integration and Koppitz's version of the Bender-Gestalt test. Results indicated that the tests are related but not equivalent when administered to referred populations. (Author/AL)

Difficulties First-Year University Mathematics Students Have in Reading Their Mathematics Textbook. Technical Report. No. 2009-1

ERIC Educational Resources Information Center

Shepherd, Mary D.; Selden, Annie; Selden, John

2009-01-01

This exploratory study examined the experiences and difficulties certain first-year university students displayed in reading new passages from their mathematics textbooks. We interviewed eleven precalculus and calculus students who were considered to be good at mathematics, as indicated by high ACT mathematics scores. These students were also …

HoNOSCA-D As a Measure of the Severity of Diagnosed Mental Disorders in Children and Adolescents—Psychometric Properties of the German Translation

PubMed Central

von Wyl, Agnes; Toggweiler, Stephan; Zollinger, Ruedi

2017-01-01

The Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), in use worldwide, is a 13-item measure assessing the biopsychosocial severity of mental health problems in children and adolescents. This article introduces the authorized German-language version of HoNOSCA, the HoNOSCA-D, and examines and discusses its psychometric properties based on a clinical sample of 1,533 children and adolescents aged 4;0 to 17;11 years. For the HoNOSCA-D total score (severity of mental health problems), internal consistency (Cronbach’s alpha) was 0.63. The discriminative power of the items ranged from 0.07 to 0.44; the average interitem correlation was 0.11. Due to this stochastic independence, calculation of a total severity index is acceptable. Using factor analysis, the principal axis factoring and varimax rotation resulted in a four-factor structure, which with a Kaiser–Meyer–Olkin measure of sampling adequacy of 0.684 explained 30.62% of total variance. The convergent correlations with the German-language parent report version of the Strengths and Difficulties Questionnaire were as expected and showed a medium effect size. Gender and age differences in the HoNOSCA-D total score were small. Regarding the 13 items gender and age differences were negligible to medium. The highest severity was found for schizophrenia and psychotic disorders, followed by affective disorders and social behavior disorders. Overall, validity of HoNOSCA-D was clearly supported. PMID:29033858

Alexithymia, emotion processing and social anxiety in adults with ADHD

PubMed Central

2010-01-01

Objective Given sparse research on the issue, this study sought to shed light upon the interactions of alexithymia, emotion processing, and social anxiety in adults with attention-deficit hyperactivity disorder (ADHD). Subjects and methods 73 German adults with ADHD according to DSM-IV diagnostic criteria participated. We used the Toronto Alexithymia Scale (TAS-20) to assess alexithymia, the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS) to assess different features of social anxiety, and we applied the German 'Experience of Emotions Scale' (SEE) to measure emotion processing. Results 40% of the sample were found to meet the DSM-IV criteria of social anxiety disorder, and about 22% were highly alexithymic according to a TAS-20 total score ≥ 61; however, the mean TAS-20 total score of 50.94 ± 9.3 was not much higher than in community samples. Alexithymic traits emerged to be closely linked to emotion processing problems, particularly 'difficulty accepting own emotions', and to social anxiety features. Discussion/conclusion Our findings suggest interactions of alexithymia, emotion processing dysfunction, and social anxiety in adults with ADHD, which may entail the therapeutic implication to thoroughly instruct these patients to identify, accept, communicate, and regulate their emotions to aid reducing interaction anxiety. PMID:20952350

The maternal childbirth experience more than a decade after delivery.

PubMed

Bossano, Carla M; Townsend, Kelly M; Walton, Alexandra C; Blomquist, Joan L; Handa, Victoria L

2017-09-01

Maternal satisfaction with the birth experience is multidimensional and influenced by many factors, including mode of delivery. To date, few studies have investigated maternal satisfaction outside of the immediate postpartum period. This study investigated whether differences in satisfaction based on mode of delivery are observed more than a decade after delivery. This was a planned, supplementary analysis of data collected for the Mothers' Outcomes after Delivery study, a longitudinal cohort study of pelvic floor disorders in parous women and their association with mode of delivery. Obstetric and demographic data were obtained through patient surveys and obstetrical chart review. Maternal satisfaction with childbirth experience was assessed via the Salmon questionnaire, administered to Mothers' Outcomes after Delivery study participants >10 years from their first delivery. This validated questionnaire yields 3 scores: fulfillment, distress, and difficulty. These 3 scores were compared by mode of delivery (cesarean prior to labor, cesarean during labor, spontaneous vaginal delivery, and operative vaginal delivery). In addition, the impact of race, age, education level, parity, episiotomy, labor induction, and duration of second stage of labor on maternal satisfaction were examined. Among 576 women, 10.1-17.5 years from delivery, significant differences in satisfaction scores were noted by delivery mode. Salmon scale scores differed between women delivering by cesarean and those delivering vaginally: women delivering vaginally reported greater fulfillment (0.40 [-0.37 to 0.92] vs 0.15 [-0.88 to 0.66], P < .001) and less distress (-0.34 [-0.88 to 0.38] vs 0.20 [-0.70 to 0.93], P < .001) than those who delivered by cesarean. Women who delivered by cesarean prior to labor reported the greatest median fulfillment scores and the lowest median difficulty scores. Median distress scores were lowest among those who delivered by spontaneous vaginal birth. Among women who underwent cesarean delivery, labor induction and prolonged second stage were associated with higher difficulty scores. These factors did not affect satisfaction scores among women who delivered vaginally. Among women who delivered vaginally, operative vaginal delivery was associated with less favorable scores across all 3 scores. Maternal satisfaction with childbirth is influenced by mode of delivery. The birth experience leaves an impression on women more than a decade after delivery. Copyright © 2017 Elsevier Inc. All rights reserved.

[An investigation on self-harm episodes and their relationship with suicidal psychology and behaviors in 2713 college students].

PubMed

Su, Pu-Yu; Hao, Jia-Hu; Huang, Zhao-Hui; Tao, Fang-Biao

2010-11-01

To investigate the episodes and influencing factors on self-harm and to explore the relationship between self-harm episodes and suicidal psychology and behaviors in college students. Four universities were selected using cluster sampling method in Anqing city and Chaohu city. Totally, 2713 college students completed this survey. Data were analyzed by Pearson Chi-square and logistic regression. In the last six months, rates of highly lethal self-harm, less lethal self-harm with visible tissue damage, self-injury without visible tissue damage, self-harmful behaviors with latency damage, other self-harmful behaviors with menticide were 1.9%, 5.5%, 15.3%, 21.2% and 17.0% respectively. The total rate of self-harm was 31.3%. 73.1% of the students with self harmful experiences had the above mentioned behaviors more than 3 times in the last six months. The top 3 reasons for taking self-harm actions were: having learning problems (43.1%), failed love affairs (25.0%) and having conflicts with others (23.9%). There were different influencing factors among different kinds of self-harm episodes. Depression was the risk factor of self-harm. The higher score of having high self-esteem was the protective factor of all kinds of self-harm actions except highly lethal ones. Higher score of difficulties in identifying feelings was one of the risk factors. The rates of suicidal psychology and behaviors in students with self-harm were significantly higher than those in students without those behaviors. Result from linear χ(2) test indicated that the graveness of tissue damage of self-harm was higher along with the rates of suicidal psychology and behaviors (P < 0.01). Among 2713 college students, about 1/3 adolescents having experienced self-harm in the last 6 months, many with repeated ones. Depression and difficulties in identifying feelings were the two risk factors while self-esteem was the protective factor related to most of the self-harm cases.

Prevalence of sleep disorders and their relationship with core symptoms of inattention and hyperactivity in children with attention-deficit/hyperactivity disorder.

PubMed

Vélez-Galarraga, Rosario; Guillén-Grima, Francisco; Crespo-Eguílaz, Nerea; Sánchez-Carpintero, Rocío

2016-11-01

To determine the prevalence of sleep disorders in children with attention-deficit/hyperactivity disorder (ADHD) and in a control population. To examine the relationship between sleep disorders and symptoms of inattention, hyperactivity/impulsiveness and executive dysfunction. We studied 126 children with ADHD and 1036 control children aged between 5 and 18 years old. Caregivers completed the Pediatric Sleep Questionnaire and the ADHD Rating Scale (ADHD-RS). Children with ADHD were subsequently assessed for executive function with the Conner's Continuous Performance Test (CPT) or with AULA Nesplora. Children with ADHD slept less at night and were more likely to display sleep-related rhythmic movements. Children in the ADHD group who were under 12 years old and who had total ADHD-RS scores over the 90th percentile had more difficulty falling asleep than other children; there was also a relationship between total ADHD-RS scores over the 90th percentile and certain parasomnias in the control population. There was a correlation between shorter duration of night-time sleep and omission errors in children who were 12 or older and who were under pharmacological treatment for ADHD. Bedtime resistance and difficulty falling sleep were more frequent in children with ADHD whose symptoms were not treated pharmacologically, than in children receiving treatment. Symptoms of inattention and hyperactivity are correlated with impaired sleep duration and quality; specifically, there is an association between ADHD symptoms and problems falling asleep and parasomnias, however, the current study does not address the nature and direction of causality. Children with ADHD and receiving methylphenidate had fewer sleep disorders, suggesting that, at least in some children, stimulant treatment is associated with improvement of some aspects of sleep. Shorter sleep duration in adolescents under pharmacological treatment for ADHD tended to result in more errors of omission, suggesting that it is important to promote good sleep habits in this population. Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

ANALYSIS OF FOOD TOLERANCE IN PATIENTS SUBMITTED TO BARIATRIC SURGERY USING THE QUESTIONNAIRE QUALITY OF ALIMENTATION.

PubMed

Stumpf, Matheo Augusto Morandi; Rodrigues, Marcos Ricardo da Silva; Kluthcovsky, Ana Claudia Garabeli Cavalli; Travalini, Fabiana; Milléo, Fábio Quirillo

2015-01-01

Due to the increased prevalence of obesity in many countries, the number of bariatric surgeries is increasing. They are considered the most effective treatment for obesity. In the postoperative there may be difficulties with the quality of alimentation, tolerance to various types of food, as well as vomiting and regurgitation. Few surveys are available to assess these difficulties in the postoperative. To perform a systematic literature review about food tolerance in patients undergoing bariatric surgery using the questionnaire "Quality of Alimentation", and compare the results between different techniques. A descriptive-exploratory study where the portals Medline and Scielo were used. The following headings were used in english, spanish and portuguese: quality of alimentation, bariatric surgery and food tolerance. A total of 88 references were found, 14 used the questionnaire "Quality of Alimentation" and were selected. In total, 2745 patients were interviewed of which 371 underwent to gastric banding, 1006 to sleeve gastrectomy, 1113 to Roux-en-Y gastric bypass, 14 to biliopancreatic diversion associated with duodenal switch, 83 were non-operated obese, and 158 non-obese patients. The questionnaire showed good acceptability. The biliopancreatic diversion with duodenal switch had the best food tolerance in the postoperative when compared to other techniques, but it was evaluated in a single article with a small sample. The longer the time after the operation, the better is the food tolerance. Comparing the sleeve gastrectomy and the Roux-en-Y gastric bypass, there are still controversial results in the literature. The gastric banding had the worst score of food tolerance among all the techniques evaluated. The questionnaire is easy and fast to assess the food tolerance in patients after bariatric surgery. Biliopancreatic diversion with duodenal switch had the best food tolerance in the postoperative when compared to sleeve gastrectomy and the Roux-en-Y gastric bypass. Gastric banding still remains in controversy, due it presented the worst score.

The relationship between motor performance and parent-rated executive functioning in 3- to 5-year-old children: What is the role of confounding variables?

PubMed

Houwen, Suzanne; van der Veer, Gerda; Visser, Jan; Cantell, Marja

2017-06-01

It is generally agreed that motor performance and executive functioning (EF) are intertwined. As the literature on this issue concerning preschool children is scarce, we examined the relationship between motor performance and parent-rated EF in a sample of 3- to 5-year-old children with different levels of motor skill proficiency, while controlling for age, gender, socio-economic status (SES), and attention-deficit-hyperactivity disorder (ADHD) symptomatology. EF was reported by parents of 153 children (mean age 4years 1months, SD 8months; 75 male) by means of the Behaviour Rating Inventory of Executive Function-Preschool version (BRIEF-P). Parent-reported ADHD symptoms were assessed using the Hyperactivity-Inattention subscale of the Strengths and Difficulties Questionnaire3-4. In addition, the children performed the Movement Assessment Battery for Children-2 (MABC-2). Several weak to moderate relationships were found between the MABC-2 Total Score and the EF subscales. Once other variables such as age, gender, SES, and ADHD symptomatology were taken into account, the only BRIEF-P subscale that was associated with the MABC-2 Total Score was the Working Memory subscale. Compared to their typically developing peers, children who are at risk for motor coordination difficulties (⩽the 16th percentile on the MABC-2) performed poorly on the Working Memory subscale, which confirms the results of the regression analyses. The at risk group also performed significantly worse on the Planning/Organize subscale, however. This is one of the first studies investigating the relationship between motor performance and parent-rated EF in such a young age group. It shows that the relationship between motor performance and EF in young children is complex and may be influenced by the presence of confounding variables such as ADHD symptomatology. Copyright © 2017 Elsevier B.V. All rights reserved.

Relationship Between Leaving Children at Home Alone and Their Mental Health: Results From the A-CHILD Study in Japan.

PubMed

Doi, Satomi; Fujiwara, Takeo; Isumi, Aya; Ochi, Manami; Kato, Tsuguhiko

2018-01-01

Leaving children at home alone is considered a form of "neglect" in most developed countries. In Japan, this practice is not prohibited, probably because this country is considered to have relatively safe communities for children. The impact of leaving children at home alone on their mental health is a controversial issue, and few studies have examined it to date. The aim of this study was to examine the impact of leaving children aged 6 or 7 years at home alone on their mental health, focusing on both the positive and negative aspects; that is, resilience, difficult behavior, and prosocial behavior. Data from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study were used. The caregivers of all children in the first grade in Adachi City, Tokyo, were targeted, of whom 80% completed the questionnaire ( n = 4,291). Among the analytical sample which comprises those who completed both exposure and outcome variables ( n = 4,195), 2,190 (52.2%) children had never been left at home alone, 1,581 (37.7%) children were left at home alone less than once a week, and 424 (10.1%) children were left at home alone once a week or more. Child resilience was measured using the Children's Resilient Coping Scale, and difficult behavior (emotional symptoms, conduct problems, hyperactivity/inattention, and peer relationship problems) and prosocial behavior using the Strength and Difficulty Questionnaire. Multivariate regression analyses were performed to examine the dose-response association between leaving children at home alone and child mental health, followed by propensity-score matching as a pseudo-randomized controlled trial to reduce potential confounding. The results showed that leaving children at home alone once a week or more, but not less than once a week, was associated with total difficulties scores, especially conduct problems, hyperactivity/inattention, and peer relationship problems. These findings indicate that leaving children at home alone should be avoided in Japan, as is recommended in North America.

How Do Students Experience Testing on the University Computer?

ERIC Educational Resources Information Center

Whittington, Dale; And Others

1995-01-01

Reports a study of the administration mode, scores, and testing experiences of students taking the PreProfessional Skills Test (PPST) under differing conditions (computer based and paper and pencil). PPST scores and surveys of the students revealed varied test-taking strategies and computer-related alterations in test difficulty, construct,…

Evaluation of Dermatology Practice Online Reviews: Lessons From Qualitative Analysis.

PubMed

Smith, Robert J; Lipoff, Jules B

2016-02-01

Patient satisfaction is an increasingly important component of health care quality measures. Online reviews of physicians represent a promising platform for capturing patient perspectives of care. To identify qualitative themes associated with patient reviews of dermatologic care on consumer reporting websites. A qualitative analysis was conducted of patient-generated reviews of dermatology practices on 2 consumer review platforms. Yelp is an online consumer portal for users to review their experience with local businesses; ZocDoc is an online patient-scheduling portal that provides opportunity for patients to write reviews of physician practices. A total of 518 reviews from 45 dermatology practices on Yelp and 4921 reviews from 45 dermatology providers on ZocDoc were collected from 3 geographically diverse cities: Philadelphia, Pennsylvania; Houston, Texas; and Seattle, Washington. The study was conducted from January 15 to July 15, 2015. Reviews were separated into high-scoring and low-scoring groups. An inductive qualitative method was used to code and identify key themes associated with positive and negative patient experiences. Analysis was completed upon reaching thematic saturation. Reported as mean (95% CI), the overall Yelp score for the 45 selected practices was 3.46 of 5 stars (3.17-3.75) and overall ZocDoc score for the 45 selected practices was 4.72 of 5 stars (4.47-4.80). The proportion of individual reviews giving a score of 5.0 was significantly higher on ZocDoc (3986 [81.0%]) than on Yelp (229 [44.2%]) (P < .001). Qualitative themes centered on characteristics of the physician and the practice. Themes that emerged from the high-scoring and low-scoring reviews were similar in content but opposite in valence. Physician-specific themes included temperament, knowledge and competency, physical examination, communication abilities, and mindfulness of cost. Practice-specific themes included scheduling, staff temperament, office cleanliness, waiting room, and insurance. Patients appreciated physicians who are kind, respectful, and thorough with the physical examination; empathetic about the emotional difficulty of skin disease; and cognizant of cost. Negative experiences were frequently affected by considerations outside of the physician-patient interaction, such as curt interactions with staff, difficulty with scheduling, practice cleanliness, and insurance problems. Patients reported relying on consumer websites to identify dermatology providers. Online consumer review websites are designed to facilitate instantaneous and public communication among patients. These platforms provide elaborate and timely data for dermatologists to garner insight into their patients' experiences. The themes identified in this study are consistent with past satisfaction studies and may aid dermatologists in optimizing the patient care experience.

Minimizing Interrater Variability in Staging Sleep by Use of Computer-Derived Features

PubMed Central

Younes, Magdy; Hanly, Patrick J.

2016-01-01

Study Objectives: Inter-scorer variability in sleep staging of polysomnograms (PSGs) results primarily from difficulty in determining whether: (1) an electroencephalogram pattern of wakefulness spans > 15 sec in transitional epochs, (2) spindles or K complexes are present, and (3) duration of delta waves exceeds 6 sec in a 30-sec epoch. We hypothesized that providing digitally derived information about these variables to PSG scorers may reduce inter-scorer variability. Methods: Fifty-six PSGs were scored (five-stage) by two experienced technologists, (first manual, M1). Months later, the technologists edited their own scoring (second manual, M2). PSGs were then scored with an automatic system and the same two technologists and an additional experienced technologist edited them, epoch-by-epoch (Edited-Auto). This resulted in seven manual scores for each PSG. The two M2 scores were then independently modified using digitally obtained values for sleep depth and delta duration and digitally identified spindles and K complexes. Results: Percent agreement between scorers in M2 was 78.9 ± 9.0% before modification and 96.5 ± 2.6% after. Errors of this approach were defined as a change in a manual score to a stage that was not assigned by any scorer during the seven manual scoring sessions. Total errors averaged 7.1 ± 3.7% and 6.9 ± 3.8% of epochs for scorers 1 and 2, respectively, and there was excellent agreement between the modified score and the initial manual score of each technologist. Conclusions: Providing digitally obtained information about sleep depth, delta duration, spindles and K complexes during manual scoring can greatly reduce interrater variability in sleep staging by eliminating the guesswork in scoring epochs with equivocal features. Citation: Younes M, Hanly PJ. Minimizing interrater variability in staging sleep by use of computer-derived features. J Clin Sleep Med 2016;12(10):1347–1356. PMID:27448418

Physiological scoring: an aid to emergency medical services transport decisions?

PubMed

Challen, Kirsty; Walter, Darren

2010-01-01

Attendance at UK emergency departments is rising steadily despite the proliferation of alternative unscheduled care providers. Evidence is mixed on the willingness of emergency medical services (EMS) providers to decline to transport patients and the safety of incorporating such an option into EMS provision. Physiologically based Early Warning Scores are in use in many hospitals and emergency departments, but not yet have been proven to be of benefit in the prehospital arena. The use of a physiological-social scoring system could safely identify patients calling EMS who might be diverted from the emergency department to an alternative, unscheduled, care provider. This was a retrospective, cohort study of patients with a presenting complaint of "shortness of breath" or "difficulty breathing" transported to the emergency department by EMS. Retrospective calculation of a physiological social score (PMEWS) based on first recorded data from EMS records was performed. Outcome measures of hospital admission and need for physiologically stabilizing treatment in the emergency department also were performed. A total of 215 records were analyzed. One hundred thirty-nine (65%) patients were admitted from the emergency department or received physiologically stabilizing treatment in the emergency department. Area Under the Receiver Operating Characteristic Curve (AUROC) for hospital admission was 0.697 and for admission or physiologically stabilizing treatment was 0.710. No patient scoring<2 was admitted or received stabilizing treatment. Despite significant over-triage, this system could have diverted 79 patients safely from the emergency department to alternative, unscheduled, care providers.

Test battery for measuring the perception and recognition of facial expressions of emotion

PubMed Central

Wilhelm, Oliver; Hildebrandt, Andrea; Manske, Karsten; Schacht, Annekathrin; Sommer, Werner

2014-01-01

Despite the importance of perceiving and recognizing facial expressions in everyday life, there is no comprehensive test battery for the multivariate assessment of these abilities. As a first step toward such a compilation, we present 16 tasks that measure the perception and recognition of facial emotion expressions, and data illustrating each task's difficulty and reliability. The scoring of these tasks focuses on either the speed or accuracy of performance. A sample of 269 healthy young adults completed all tasks. In general, accuracy and reaction time measures for emotion-general scores showed acceptable and high estimates of internal consistency and factor reliability. Emotion-specific scores yielded lower reliabilities, yet high enough to encourage further studies with such measures. Analyses of task difficulty revealed that all tasks are suitable for measuring emotion perception and emotion recognition related abilities in normal populations. PMID:24860528

Developmental trajectories in siblings of children with autism: cognition and language from 4 months to 7 years.

PubMed

Gamliel, Ifat; Yirmiya, Nurit; Jaffe, Dena H; Manor, Orly; Sigman, Marian

2009-08-01

We compared the cognitive and language development at 4, 14, 24, 36, 54 months, and 7 years of siblings of children with autism (SIBS-A) to that of siblings of children with typical development (SIBS-TD) using growth curve analyses. At 7 years, 40% of the SIBS-A, compared to 16% of SIBS-TD, were identified with cognitive, language and/or academic difficulties, identified using direct tests and/or parental reports. This sub-group was identified as SIBS-A-broad phenotype (BP). Results indicated that early language scores (14-54 months), but not cognitive scores of SIBS-A-BP and SIBS-A-nonBP were significantly lower compared to the language scores of SIBS-TD, and that the rate of development was also significantly different, thus pinpointing language as a major area of difficulty for SIBS-A during the preschool years.

Family relationships and depressive symptoms preceding induced abortion.

PubMed

Bluestein, D; Rutledge, C M

1993-06-01

This study examines the association between depressive symptoms preceding induced abortion and dissatisfaction with family relationships. In a cross-sectional survey, 304 women undergoing a first-trimester abortion completed a short version of the Center for Epidemiologic Studies Depression Scale, the Family APGAR, and a researcher-designed questionnaire. Bivariate analyses revealed that depressive symptoms decreased as measures of age, educational attainment, Family APGAR scores, marriage, and subjective health increased. Depressive symptoms increased as measures of denial, difficulties communicating with male partners, pregnancy symptoms, contraceptive use, and dissatisfaction with choosing abortion increased. Controlling for the effects of these significant bivariate associations, increased depressive symptoms were independently predicted by Family APGAR scores, age, communications difficulties, pregnancy symptoms, contraceptive use, and denial. Low Family APGAR scores exhibited the strongest overall effect. Clinicians who encounter women experiencing depressive symptoms preceding abortion may wish to explore family relationships and the possibility of underlying family dysfunction.

Behaviour in children with cerebral palsy with and without epilepsy.

PubMed

Carlsson, Malin; Olsson, Ingrid; Hagberg, Gudrun; Beckung, Eva

2008-10-01

The aim of the study was to describe behavioural problems in children with cerebral palsy (CP) with and without epilepsy. The children were sampled from the Western Sweden CP register and were part of a European Union project. The Strength and Difficulties Questionnaire and questions on epilepsy were answered by one parent of each child. Medical records were reviewed. Parents of 83 children (44 males, 39 females) age range participated: 30 at Gross Motor Function Classification System levels I and II, and 53 at levels III to V; 60 had spastic age range 8 to 12 years (bilateral 42, unilateral 18) and 23 dyskinetic CP; 34 children had active epilepsy. The proportion of children with normal behaviour on the total difficulties score (TDS) of the Strength and Difficulties Questionnaire was significantly lower than normative data (57% vs 80%, p<0.001). Parents of 21 children (25%) considered their child's behaviour to be abnormal. Children with CP and epilepsy had a significantly higher median TDS (p=0.03) than seizure-free children. In children with aided or no walking ability, the TDS was significantly higher in those with epilepsy (p=0.04). Parents of 32 children (39%) considered their children's behaviour to have an impact on themselves and others. We conclude that behavioural problems are common in children with CP, and even more when epilepsy is present. Parents identify these problems, and professionals need to address them.

Prosody Perception and Production in Children with Hearing Loss and Age- and Gender-Matched Controls.

PubMed

Kalathottukaren, Rose Thomas; Purdy, Suzanne C; Ballard, Elaine

2017-04-01

Auditory development in children with hearing loss, including the perception of prosody, depends on having adequate input from cochlear implants and/or hearing aids. Lack of adequate auditory stimulation can lead to delayed speech and language development. Nevertheless, prosody perception and production in people with hearing loss have received less attention than other aspects of language. The perception of auditory information conveyed through prosody using variations in the pitch, amplitude, and duration of speech is not usually evaluated clinically. This study (1) compared prosody perception and production abilities in children with hearing loss and children with normal hearing; and (2) investigated the effect of age, hearing level, and musicality on prosody perception. Participants were 16 children with hearing loss and 16 typically developing controls matched for age and gender. Fifteen of the children with hearing loss were tested while using amplification (n = 9 hearing aids, n = 6 cochlear implants). Six receptive subtests of the Profiling Elements of Prosody in Speech-Communication (PEPS-C), the Child Paralanguage subtest of Diagnostic Analysis of Nonverbal Accuracy 2 (DANVA 2), and Contour and Interval subtests of the Montreal Battery of Evaluation of Amusia (MBEA) were used. Audio recordings of the children's reading samples were rated using a perceptual prosody rating scale by nine experienced listeners who were blinded to the children's hearing status. Thirty two children, 16 with hearing loss (mean age = 8.71 yr) and 16 age- and gender-matched typically developing children with normal hearing (mean age = 8.87 yr). Assessments were completed in one session lasting 1-2 hours in a quiet room. Test items were presented using a laptop computer through loudspeaker at a comfortable listening level. For children with hearing loss using hearing instruments, all tests were completed with hearing devices set at their everyday listening setting. All PEPS-C subtests and total scores were significantly lower for children with hearing loss compared to controls (p < 0.05). The hearing loss group performed more poorly than the control group in recognizing happy, sad, and fearful emotions in the DANVA 2 subtest. Musicality (composite MBEA scores and musical experience) was significantly correlated with prosody perception scores, but this link was not evident in the regression analyses. Regression modeling showed that age and hearing level (better ear pure-tone average) accounted for 55.4% and 56.7% of the variance in PEPS-C and DANVA 2 total scores, respectively. There was greater variability for the ratings of pitch, pitch variation, and overall impression of prosody in the hearing loss group compared to control group. Prosody perception (PEPS-C and DANVA 2 total scores) and ratings of prosody production were not correlated. Children with hearing loss aged 7-12 yr had significant difficulties in understanding different aspects of prosody and were rated as having more atypical prosody overall than controls. These findings suggest that clinical assessment and speech-language therapy services for children with hearing loss should be expanded to target prosodic difficulties. Future studies should investigate whether musical training is beneficial for improving receptive prosody skills. American Academy of Audiology

Alexithymia and emotional regulation: A cluster analytical approach.

PubMed

Chen, Jie; Xu, Ting; Jing, Jin; Chan, Raymond C K

2011-02-23

Alexithymia has been a familiar conception of psychosomatic phenomenon. The aim of this study was to investigate whether there were subtypes of alexithymia associating with different traits of emotional expression and regulation among a group of healthy college students. 1788 healthy college students were administered with the Chinese version of the 20-item Toronto Alexithymia Scale (TAS-20) and another set of questionnaires assessing emotion status and regulation. A hierarchical cluster analysis was conducted on the three factor scores of the TAS-20. The cluster solution was cross-validated by the corresponding emotional regulation. The results indicated there were four subtypes of alexithymia, namely extrovert-high alexithymia (EHA), general-high alexithymia (GHA), introvert-high alexithymia (IHA) and non-alexithymia (NA). The GHA was characterized by general high scores on all three factors, the IHA was characterized by high scores on difficulty identifying feelings and difficulty describing feelings but low score on externally oriented cognitive style of thinking, the EHA was characterized by high score on externally oriented cognitive style of thinking but normal score on the others, and the NA got low score on all factors. The GHA and IHA were dominant by suppressive character of emotional regulation and expression with worse emotion status as compared to the EHA and NA. The current findings suggest there were four subtypes of alexithymia characterized by different emotional regulation manifestations.

Alexithymia and emotional regulation: A cluster analytical approach

PubMed Central

2011-01-01

Background Alexithymia has been a familiar conception of psychosomatic phenomenon. The aim of this study was to investigate whether there were subtypes of alexithymia associating with different traits of emotional expression and regulation among a group of healthy college students. Methods 1788 healthy college students were administered with the Chinese version of the 20-item Toronto Alexithymia Scale (TAS-20) and another set of questionnaires assessing emotion status and regulation. A hierarchical cluster analysis was conducted on the three factor scores of the TAS-20. The cluster solution was cross-validated by the corresponding emotional regulation. Results The results indicated there were four subtypes of alexithymia, namely extrovert-high alexithymia (EHA), general-high alexithymia (GHA), introvert-high alexithymia (IHA) and non-alexithymia (NA). The GHA was characterized by general high scores on all three factors, the IHA was characterized by high scores on difficulty identifying feelings and difficulty describing feelings but low score on externally oriented cognitive style of thinking, the EHA was characterized by high score on externally oriented cognitive style of thinking but normal score on the others, and the NA got low score on all factors. The GHA and IHA were dominant by suppressive character of emotional regulation and expression with worse emotion status as compared to the EHA and NA. Conclusions The current findings suggest there were four subtypes of alexithymia characterized by different emotional regulation manifestations. PMID:21345180

Emotion dysregulation and negative affect: Laboratory and EMA investigations in smokers.

PubMed

MacIntyre, Jessica M; Ruscio, Aimee C; Brede, Emily; Waters, Andrew J

2018-06-01

Difficulties in emotion regulation are associated with addictive behaviors, including smoking. Difficulties in emotion regulation may underlie large, rapid changes in negative affect that can increase likelihood of relapse. We investigated the association between emotion regulation ability and negative affect in smokers assessed both in the laboratory and in the field using Ecological Momentary Assessment. Adult community smokers ( N  = 44) carried a personal digital assistant (PDA) for two weeks and were instructed to complete assessments of negative affect multiple times per day. Participants were instructed that they could smoke as much or as little as they liked. The Difficulties in Emotion Regulation Scale (DERS) and the Positive and Negative Affect Schedule (PANAS) were completed at three lab visits. Participants with higher average DERS scores reported greater negative affect at lab visits. When a participant reported a DERS score at a lab visit higher than their individual average, they also reported higher negative affect at that lab visit. Participants with higher baseline DERS scores reported more labile negative affect during EMA than those with lower baseline DERS scores, and they also reported a higher maximum level of negative affect during EMA. Overall, the findings suggest that changes in emotion regulation are associated with negative affect and that emotion regulation ability is related to both the intensity and lability of negative affect. A better understanding of momentary changes in emotion regulation and negative affect may lead to improved interventions for preventing substance use relapse.

The Effects of Judgment-Based Stratum Classifications on the Efficiency of Stratum Scored CATs.

ERIC Educational Resources Information Center

Finney, Sara J.; Smith, Russell W.; Wise, Steven L.

Two operational item pools were used to investigate the performance of stratum computerized adaptive tests (CATs) when items were assigned to strata based on empirical estimates of item difficulty or human judgments of item difficulty. Items from the first data set consisted of 54 5-option multiple choice items from a form of the ACT mathematics…

Comparability of Self-Concept among Normal Achievers and Children with Learning Difficulties within a Greek Context.

ERIC Educational Resources Information Center

Leonadari, Angeliki

1994-01-01

Assessed Greek third through sixth graders on the Perceived Competence Scale for Children (PCSC). Subjects were normally achieving (NA) and low achieving students and a special class (SC) of students identified as at risk for learning difficulties. The SC students scored lower than the NA students on the PCSC global self-worth, competence affect,…

Do subjective measures of attention and memory predict actual performance? Metacognition in older couples.

PubMed

Volz-Sidiropoulou, Eftychia; Gauggel, Siegfried

2012-06-01

Older individuals who recognize their cognitive difficulties are more likely to adjust their everyday life to their actual cognitive functioning, particularly when they are able to estimate their abilities accurately. We assessed self- and spouse-ratings of memory and attention difficulties in everyday life of healthy, older individuals and compared them with the respective test performance. Eighty-four older individuals (women's age, M = 67.4 years, SD = 5.2; men's age, M = 68.5 years, SD = 4.9) completed both the self and the spouse versions of the Attention Deficit Questionnaire and the Everyday Memory Questionnaire and completed two neuropsychological tests. Using the residual score approach, subjective metacognitive measures of memory and attention were created and compared with actual test performance. Significant associations between subjective and objective scores were found only for men and only for episodic memory measures. Men who underreported memory difficulties performed more poorly; men who overreported memory difficulties performed better. Men's recognition performance was best predicted by subjective measures (R² = .25), followed by delayed recall (R² = .14) and forgetting rate (R² = .13). The results indicate gender-specific differences in metacognitive accuracy and predictive validity of subjective ratings. PsycINFO Database Record (c) 2012 APA, all rights reserved

[Effects of auditory integrative training on autistic children].

PubMed

Zhang, Gai-qiao; Gong, Qun; Zhang, Feng-ling; Chen, Sun-min; Hu, Li-qun; Liu, Feng; Cui, Rui-hua; He, Lin

2009-08-18

To explore the short-term treatment effect of the auditory integrative training on autistic children and provide them with clinical support for rehabilitative treatment. A total of 81 cases of autistic children were selected through the standard of DSM-4 and clinical case study was used. They were divided randomly into experimental group and control one, and respectively received auditory integrative training and no training based on the multiple therapies. The patients were investigated using clinical manifestation and Autism Behavior Checklist (ABC) and intelligence quotient (IQ) before and after six months of treatment. The effect was evaluated through the changes of clinical manifestations and scores of ABC and IQ. The changes of scores of IQ were determined with Gesell and WPPSI or WISC-R. Compared with 40 patients of the control group after the six months of the auditory integrative training, 41 of the experimental group had greatly improved in many aspects, such as the disorders of their language, social interactions and typical behavior symptoms while they had not changed in their abnormal behaviors. The scores of IQ or DQ had increased and scores of ABC had dropped. The differences between the two groups were greatly significant in statistics (P < 0.01). The decreasing level of both ABC scores and the increasing level of the IQ scores were negatively correlated with age, and the decreasing level of ABC scores was in line regression(positive correlation) with base IQ. The treatment of auditory integrative training (AIT) could greatly improve on language disorders, the difficulties of social interactions, typical behavior symptoms and developmental levels,therefore it is positive to the autistic children in its short-term treatment effect.

Dyslexia and psycho-social functioning: an exploratory study of the role of self-esteem and understanding.

PubMed

Terras, Melody M; Thompson, Lucy C; Minnis, Helen

2009-11-01

Individuals with dyslexia may have lower self-esteem and exhibit more emotional and behavioural difficulties than those without reading problems. However, the nature of any relationship between self-esteem and psychopathology remains unknown. This exploratory study assessed levels of self-esteem using the Self-Perception Profile for Children (Manual for the Self-Perception Profile for Children. University of Denver, CO: Denver; 1985) and psycho-social adjustment using the Strengths and Difficulties Questionnaire (J. Child Psychol. Psychiatry, 1997; 38: 581-586) and examined child and parent understanding, attitudes and the perceived impact of reading difficulties on daily life. Sixty-eight children assessed as dyslexic on the basis of discrepancy scores (mean age 11.2 years; 44 male), and their parents, participated. No global self-esteem deficit was found, but the mean score for both child and parent-rated scholastic competence was significantly lower than that of the general population. Rates of social, emotional and behavioural difficulties were significantly higher than in the general population and were correlated with self-esteem. For children who had high global self-worth, both children and their parents had more positive attitudes towards their reading difficulties and were less likely to perceive a negative impact on relationships. The association between academic self-esteem and emotional symptoms is consistent with the proposed link between dyslexia and internalizing difficulties. Good self-esteem and a good understanding of dyslexia may help children avoid some of these difficulties. Further research with larger more representative samples is necessary as understanding the factors that promote successful psycho-social adjustment is essential to the development of effective prevention and intervention strategies.

Pain scores for intravenous cannulation and arterial blood gas test among emergency department patients.

PubMed

Ballesteros-Peña, Sendoa; Vallejo-De la Hoz, Gorka; Fernández-Aedo, Irrintzi

2017-12-23

To analyse vein catheterisation and blood gas test-related pain among adult patients in the emergency department and to explore pain score-related factors. An observational and multicentre research study was performed. Patients undergoing vein catheterisation or arterial puncture for gas test were included consecutively. After each procedure, patients scored the pain experienced using the NRS-11. 780 vein catheterisations and 101 blood gas tests were analysed. Venipuncture was scored with an average score of 2.8 (95% CI: 2.6-3), and arterial puncture with 3.6 (95%CI 3.1-4). Iatrogenic pain scores were associated with moderate - high difficulty procedures (P<.001); with the choice of the humeral rather than the radial artery (P=.02) in the gas test and correlated to baseline pain in venipunctures (P<.001). Pain scores related to other variables such as sex, place of origin or needle gauge did not present statistically significant differences. Vein catheterisation and blood gas test-related pain can be considered mild to moderately and moderately painful procedures, respectively. The pain score is associated with certain variables such as the difficulty of the procedure, the anatomic area of the puncture or baseline pain. A better understanding of painful effects related to emergency nursing procedures and the factors associated with pain self-perception could help to determine when and how to act to mitigate this undesired effect. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Quality of life in Parkinson's disease: the relative importance of the symptoms.

PubMed

Rahman, Shibley; Griffin, Harry J; Quinn, Niall P; Jahanshahi, Marjan

2008-07-30

A body of literature now exists, which demonstrates that idiopathic Parkinson's disease (PD) has a major negative impact on quality of life (QoL), and that depression and cognitive impairment are among the main predictors of poor QoL in this disorder. Relatively little work has been done to assess the differential contribution of the specific symptoms of PD to QoL, which was the aim of this study. One hundred thirty patients with PD completed a booklet of questionnaires, which included the PDQ39 as a disease-specific measure of QoL, a symptom checklist, a mobility checklist, as well as patient ratings of disease stage and disability. The results indicated that the contribution of physical, medication-related, and cognitive/psychiatric symptoms to QoL can be significant. Sudden unpredictable on/off states, difficulty in dressing, difficulty in walking, falls, depression, and confusion were PD symptoms, which significantly influenced QoL scores. Among the mobility problems associated with PD, start hesitation, shuffling gait, freezing, festination, propulsion, and difficulty in turning had a significant effect on QoL scores. In addition to depression and anxiety, the major predictors of QoL were shuffling, difficulty turning, falls, difficulty in dressing, fatigue, confusion, autonomic disturbance particularly urinary incontinence, unpredictable on/off fluctuations, and sensory symptoms such as pain. The implications of these results for the medical management of PD are discussed. Copyright 2007 Movement Disorder Society.

Experiential Awareness of the Effects of Test Score Reports.

ERIC Educational Resources Information Center

Bender, Robert C.

Because most counselors have experienced a significant amount of success, they often have difficulty understanding the impact of test scores on persons who do not perform well. Counselor educators must develop experiential awareness in an area normally outside the realm of their students. To provide such an experience, 25 counselor trainees took…

Effects of Selected Nonmusical Characteristics and Band Festival Participation, Scores, and Literature Difficulty

ERIC Educational Resources Information Center

Perrine, William M.

2016-01-01

The purpose of this study was to examine potential validity concerns regarding the use of music festival scores as an element of value-added assessment practices mandated by federal education policy. Nonmusical school and band characteristics of band size, school enrollment, school percentage of minority enrollment, and school percentage of…

Developing and Evaluating a Machine-Scorable, Constrained Constructed-Response Item.

ERIC Educational Resources Information Center

Braun, Henry I.; And Others

The use of constructed response items in large scale standardized testing has been hampered by the costs and difficulties associated with obtaining reliable scores. The advent of expert systems may signal the eventual removal of this impediment. This study investigated the accuracy with which expert systems could score a new, non-multiple choice…

Students' Geographic Knowledge and Skills in Different Kinds of Tests: Multiple-Choice versus Performance Assessment.

ERIC Educational Resources Information Center

Kon, Jane Heckley; Martin-Kniep, Giselle O.

1992-01-01

Describes a case study to determine whether performance tests are a feasible alternative to multiple-choice tests. Examines the difficulties of administering and scoring performance assessments. Explains that the study employed three performance tests and one multiple-choice test. Concludes that performance test administration and scoring was no…

Investigating Prompt Difficulty in an Automatically Scored Speaking Performance Assessment

ERIC Educational Resources Information Center

Cox, Troy L.

2013-01-01

Speaking assessments for second language learners have traditionally been expensive to administer because of the cost of rating the speech samples. To reduce the cost, many researchers are investigating the potential of using automatic speech recognition (ASR) as a means to score examinee responses to open-ended prompts. This study examined the…

Duly noted: Lessons from a two-site intervention to assess and improve the quality of clinical documentation in the electronic health record.

PubMed

Fanucchi, Laura; Yan, Donglin; Conigliaro, Rosemarie L

2016-07-06

Communication errors are identified as a root cause contributing to a majority of sentinel events. The clinical note is a cornerstone of physician communication, yet there are few published interventions on teaching note writing in the electronic health record (EHR). This is a prospective, two-site, quality improvement project to assess and improve the quality of clinical documentation in the EHR using a validated assessment tool. Internal Medicine (IM) residents at the University of Kentucky College of Medicine (UK) and Montefiore Medical Center/Albert Einstein College of Medicine (MMC) received one of two interventions during an inpatient ward month: either a lecture, or a lecture and individual feedback on progress notes. A third group of residents in each program served as control. Notes were evaluated with the Physician Documentation Quality Instrument 9 (PDQI-9). Due to a significant difference in baseline PDQI-9 scores at MMC, the sites were not combined. Of 75 residents at the UK site, 22 were eligible, 20 (91%) enrolled, 76 notes in total were scored. Of 156 residents at MMC, 22 were eligible, 18 (82%) enrolled, 40 notes in total were scored. Note quality did not improve as measured by the PDQI-9. This educational quality improvement project did not improve the quality of clinical documentation as measured by the PDQI-9. This project underscores the difficulty in improving note quality. Further efforts should explore more effective educational tools to improve the quality of clinical documentation in the EHR.

Psychometric properties and Dutch norm values of the Children's Sleep Habits Questionnaire in toddlers.

PubMed

Steur, Lindsay Martina Helena; Visser, Eva Henriëtte; Grootenhuis, Martha Alexandra; Terwee, Caroline Barbara; Kaspers, Gerardus Johannes Laurentius; van Litsenburg, Raphaële Reine Lydie

2017-06-01

The Children's Sleep Habits Questionnaire (CSHQ) was developed in the USA for children aged 4-10 years. The Dutch CSHQ has been validated for this age group, but not yet for toddlers. Furthermore, Dutch norm values for toddlers are unavailable. This study aimed to investigate the psychometric properties and collect norm values of the Dutch CSHQ in toddlers. Data collection was conducted by Taylor Nelson Sofres Netherlands Institute for Public Opinion (TNS-NIPO), a Dutch market research agency. The TNS-NIPO provided access to the TNS-NIPO base, which comprises a panel of respondents who have indicated that they are willing to regularly participate in research. Parents of children aged 2-3 years were invited to complete the CSHQ. The CSHQ is a multidimensional questionnaire to detect sleep problems in children. It is a 33-item, one-week retrospective (parent-)proxy survey. A higher score indicates more sleep problems. The response rate was 61% (n = 201). The original eight-factor structure did not fit well in this population and a more appropriate structure could not be achieved with explorative factor analyses. The mean total score was 41.9 (SD 5.6), and was higher (indicating more sleep problems) compared to Dutch school-aged children. The one-dimensionality of the subscales of the CSHQ could not be confirmed in Dutch toddlers. Clinicians and researcher should be aware of the difficulty of reliably measuring sleep in this age group when using the CSHQ. For research purposes, it is therefore recommended to only use the total score. Copyright © 2017 Elsevier B.V. All rights reserved.

Psychological assessment in children and adolescents with Benign Paroxysmal Vertigo.

PubMed

Reale, Laura; Guarnera, Manuela; Grillo, Caterina; Maiolino, Luigi; Ruta, Liliana; Mazzone, Luigi

2011-02-01

Migraine in childhood and adolescence has been associated with the presence of behavioural and emotional difficulties, but only few data are available with respect to unusual types of headache syndromes such as Benign Paroxysmal Vertigo of Childhood (BPVC). Aim of the present study was to evaluate the behavioural and emotional profiles of clinically referred children and adolescents suffering from BPVC and migraine, as compared to normal controls. According to the revised International Classification of Headache Disorders (ICHD-2) the BPVC belongs to the category of "primary headache", as a migraine equivalent, in a subset that is called "periodic syndromes of childhood". A total of 60 clinically referred children and adolescents (4-15 years) 21 suffering from BPVC and 20 from migraine, according to the diagnostic criteria of the ICHD-2, and 19 normal control (NC) were recruited in this study. Psychological assessment were performed using the Child Behaviour Checklist (CBCL), the Children's Depression Inventory (CDI) and the Multidimensional Anxiety Scale for Children (MASC). Although most of the patients suffering from headache had scores within the normative non-pathological range, both BPVC and migraine patients had significantly higher CBCL total, internalizing, and externalizing scores, as compared to NC. Furthermore, both BPVC and migraine groups displayed significantly higher CDI and MASC scores than NC group. No differences were found between the two types of headache. In conclusion, clinically referred children and adolescents with BPVC and migraine showed higher indices of behavioural and emotional symptoms, both internalizing and externalizing, as compared to normal peers. Copyright © 2010 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Psychological factors in patients with peptic ulcerand functional dyspepsia

PubMed Central

Faramarzi, Mahbobeh; Kheirkhah, Farzan; Shokri-Shirvani, Javad; Mosavi, Shokofeh; Zarini, Soroush

2014-01-01

Background: The role of psychological factors in peptic ulcer disease (PUD) and functional dyspepsia (FD) has not been clearly determined. In this study the role of conflict management styles, psychiatric symptoms, and alexithymia were assessed in patients with PUD and FD and in the healthy individuals. Methods: Ninety subjects [30 PUD (15 women, 15 men), 30 FD (15 women, 15 men), and 30 healthy individuals (15 women, 15 men)] in two endoscopy wards of Babol University of Medical Sciences were evaluated. Three groups were matched with regard to demographic variables. Conflict management styles, psychiatric symptoms, and alexithymia were evaluated by appropriate questionnaires. Results: The patients with PUD reported less mean scores on psychiatric symptoms than the FD patients (depression 12.6±7.5 vs 28±9.5, anxiety 8.2±5.9 vs 18.7±6. obsessive-compulsive disorder 15.7±7.5 vs 21.8±8.4, interpersonal sensitivity 9.5±7.4 vs 16±7, psychoticism 8.03±4.5 vs 14.3±6.3, somatization 12.5±10.8 vs 20.7±8.1, and the total score of psychiatric symptoms 94.4±49.9 vs 160.1±46.6). The mean scores use of unconstructive conflict management styles in PUD patients were lower than FD (dominating 17.7±3.5 vs 20.2±2.7, avoiding 17.5±3 vs 23.8±4.4). Alexithymia symptoms were higher in FD patients than PUD individuals (difficulty in identifying feelings 23.5±6.3 vs 27.8±3.9, difficulty in describing feeling 16.5±4.4 vs 17.3±3.6). The PUD and FD patients had higher scores regarding these variables than the healthy subjects. Conclusion: The results show that both PUD and FD patients experienced more psychiatric symptoms, unconstructive conflict management styles, and alexithymia than the healthy subjects. FD patients had worse psychiatric problems than PUD. PMID:24778780

Development and validity of a questionnaire to test the knowledge of primary care personnel regarding nutrition in obese adolescents

PubMed Central

2013-01-01

Background In light of its epidemic proportions in developed and developing countries, obesity is considered a serious public health issue. In order to increase knowledge concerning the ability of health care professionals in caring for obese adolescents and adopt more efficient preventive and control measures, a questionnaire was developed and validated to assess non-dietitian health professionals regarding their Knowledge of Nutrition in Obese Adolescents (KNOA). Methods The development and evaluation of a questionnaire to assess the knowledge of primary care practitioners with respect to nutrition in obese adolescents was carried out in five phases, as follows: 1) definition of study dimensions 2) development of 42 questions and preliminary evaluation of the questionnaire by a panel of experts; 3) characterization and selection of primary care practitioners (35 dietitians and 265 non-dietitians) and measurement of questionnaire criteria by contrasting the responses of dietitians and non-dietitians; 4) reliability assessment by question exclusion based on item difficulty (too easy and too difficult for non-dietitian practitioners), item discrimination, internal consistency and reproducibility index determination; and 5) scoring the completed questionnaires. Results Dietitians obtained higher scores than non-dietitians (Mann–Whitney U test, P < 0.05), confirming the validity of the questionnaire criteria. Items were discriminated by correlating the score for each item with the total score, using a minimum of 0.2 as a correlation coefficient cutoff value. Item difficulty was controlled by excluding questions answered correctly by more than 90% of the non-dietitian subjects (too easy) or by less than 10% of them (too difficult). The final questionnaire contained 26 of the original 42 questions, increasing Cronbach’s α value from 0.788 to 0.807. Test-retest agreement between respondents was classified as good to very good (Kappa test, >0.60). Conclusion The KNOA questionnaire developed for primary care practitioners is a valid, consistent and suitable instrument that can be applied over time, making it a promising tool for developing and guiding public health policies. PMID:23865564

Usefulness of a clinical scoring system to anticipate difficulty of Norplant removal.

PubMed

Blumenthal, P D; Remsburg, R E; Glew, G; McGrath, J A; Gaffikin, L

1995-12-01

Removal of contraceptive implants (e.g. Norplant) is an issue affecting its worldwide acceptability. Reports of difficult, painful removals have resulted in lawsuits and reduced demand. To improve quality of care, we developed a scoring system to anticipate difficult removals. We report on the usefulness of such a system and present client perspectives about the removal experience. A 9-point scoring system based on the visibility, arrangement, and position (VAP) of Norplant capsules was used to assess the anticipated difficulty of removal in 53 consecutive patients. The VAP score was then correlated with removal time and related parameters. Mean removal time was 14.74 min (range 4.75-47). In 20% of patients, the VAP score indicated a potentially difficult removal and the VAP score correlated significantly with removal time (r = 0.3, p = 0.05). Patients expected removal to be moderately difficult (mean visual analog score 4.7 out of a possible 10), but after removal they rated the actual removal experience as relatively easy (mean score 2.6/10). Before the removal, only 48% of patients said they would recommend Norplant to a friend but after removal, 70% said they would do so. A scoring system such as the VAP score can help identify potentially difficult removals so that an experienced remover can be present at the time of removal or an appropriate referral made. However, the VAP score cannot predict variables such as the density of the subcutaneous fibrous tissue "envelope". Although patient anxiety concerning removal may be high, the presence of a competent remover and an easy removal experience reduces this anxiety and encourages patients to be more positive about this method. The value of having properly trained, competent personnel available to perform removals cannot be over-emphasized.

Malnutrition among Cognitively Intact, non-Critically Ill Older Adults in the Emergency Department

PubMed Central

Pereira, Greg F.; Bulik, Cynthia M.; Weaver, Mark A.; Holland, Wesley C.; Platts-Mills, Timothy F.

2014-01-01

Objectives We estimate the prevalence of malnutrition among older patients presenting to an emergency department (ED) in the southeastern United States and identify subgroups at increased risk. Methods We conducted a cross-sectional study with random time block sampling of cognitively intact patients aged 65 years and older. Nutrition was assessed using the Mini Nutritional Assessment Short-Form (0–14 scale) with malnutrition defined as a score of 7 or less and at-risk for malnutrition defined as a score of 8–11. The presence of depressive symptoms was defined as a Center for Epidemiological Studies Depression-10 score of 4 or more (0–10 scale). Results Among 138 older adults, 16% (95% Confidence Interval [CI], 10%–22%) were malnourished and 60% (95% CI, 52%–69%) were either malnourished or at-risk for malnutrition. Seventeen of the 22 malnourished patients (77%) denied previously being diagnosed with malnutrition. The prevalence of malnutrition was not appreciably different between males and females, across levels of patient education, or between those living in urban and rural areas. However, the prevalence of malnutrition was higher among patients with depressive symptoms 52%, those residing in assisted living 50%, those with difficulty eating 38%, and those reporting difficulty buying groceries 33%. Conclusion Among a random sample of cognitively intact older ED patients, more than half were malnourished or at-risk for malnutrition, and the majority of malnourished patients had not previously been diagnosed. Higher rates of malnutrition among those with depression, difficulty eating, and difficulty buying groceries suggest the need to explore multifaceted interventions. PMID:25129819

Association of Velopharyngeal Insufficiency With Quality of Life and Patient-Reported Outcomes After Speech Surgery.

PubMed

Bhuskute, Aditi; Skirko, Jonathan R; Roth, Christina; Bayoumi, Ahmed; Durbin-Johnson, Blythe; Tollefson, Travis T

2017-09-01

Patients with cleft palate and other causes of velopharyngeal insufficiency (VPI) suffer adverse effects on social interactions and communication. Measurement of these patient-reported outcomes is needed to help guide surgical and nonsurgical care. To further validate the VPI Effects on Life Outcomes (VELO) instrument, measure the change in quality of life (QOL) after speech surgery, and test the association of change in speech with change in QOL. Prospective descriptive cohort including children and young adults undergoing speech surgery for VPI in a tertiary academic center. Participants completed the validated VELO instrument before and after surgical treatment. The main outcome measures were preoperative and postoperative VELO scores and the perceptual speech assessment of speech intelligibility. The VELO scores are divided into subscale domains. Changes in VELO after surgery were analyzed using linear regression models. VELO scores were analyzed as a function of speech intelligibility adjusting for age and cleft type. The correlation between speech intelligibility rating and VELO scores was estimated using the polyserial correlation. Twenty-nine patients (13 males and 16 females) were included. Mean (SD) age was 7.9 (4.1) years (range, 4-20 years). Pharyngeal flap was used in 14 (48%) cases, Furlow palatoplasty in 12 (41%), and sphincter pharyngoplasty in 1 (3%). The mean (SD) preoperative speech intelligibility rating was 1.71 (1.08), which decreased postoperatively to 0.79 (0.93) in 24 patients who completed protocol (P < .01). The VELO scores improved after surgery (P<.001) as did most subscale scores. Caregiver impact did not change after surgery (P = .36). Speech Intelligibility was correlated with preoperative and postoperative total VELO score (P < .01) and to preoperative subscale domains (situational difficulty [VELO-SiD, P = .005] and perception by others [VELO-PO, P = .05]) and postoperative subscale domains (VELO-SiD [P = .03], VELO-PO [P = .003]). Neither the VELO total nor subscale score change after surgery was correlated with change in speech intelligibility. Speech surgery improves VPI-specific quality of life. We confirmed validation in a population of untreated patients with VPI and included pharyngeal flap surgery, which had not previously been included in validation studies. The VELO instrument provides patient-specific outcomes, which allows a broader understanding of the social, emotional, and physical effects of VPI. 2.

Prenatal and Childhood Traffic-Related Air Pollution Exposure and Childhood Executive Function and Behavior

PubMed Central

Harris, Maria H.; Gold, Diane R.; Rifas-Shiman, Sheryl L.; Melly, Steven J.; Zanobetti, Antonella; Coull, Brent A.; Schwartz, Joel D.; Gryparis, Alexandros; Kloog, Itai; Koutrakis, Petros; Bellinger, David C.; Belfort, Mandy B.; Webster, Thomas F.; White, Roberta F.; Sagiv, Sharon K.; Oken, Emily

2016-01-01

Background Traffic-related air pollution exposure may influence brain development and function and thus be related to neurobehavioral problems in children, but little is known about windows of susceptibility. Aims Examine associations of gestational and childhood exposure to traffic-related pollution with executive function and behavior problems in children. Methods We studied associations of pre- and postnatal pollution exposures with neurobehavioral outcomes in 1,212 children in the Project Viva pre-birth cohort followed to mid-childhood (median age 7.7 years). Parents and classroom teachers completed the Behavior Rating Inventory of Executive Function (BRIEF), and the Strengths and Difficulties Questionnaire (SDQ). Using validated spatiotemporal models, we estimated exposure to black carbon (BC) and fine particulate matter (PM2.5) in the third trimester of pregnancy, from birth to 3 years, from birth to 6 years, and in the year before behavioral ratings. We also measured residential distance to major roadways and near-residence traffic density at birth and in mid-childhood. We estimated associations of BC, PM2.5, and other traffic exposure measures with BRIEF and SDQ scores, adjusted for potential confounders. Results Higher childhood BC exposure was associated with higher teacher-rated BRIEF Behavioral Regulation Index (BRI) scores, indicating greater problems: 1.0 points (95% confidence interval (CI): 0.0, 2.1) per interquartile range (IQR) increase in birth-age 6 BC, and 1.7 points (95% CI: 0.6, 2.8) for BC in the year prior to behavioral ratings. Mid-childhood residential traffic density was also associated with BRI score (0.6, 95% CI: 0.1, 1.1). Birth-age 3 BC was not associated with BRIEF or SDQ scores. Third trimester BC exposure was not associated with teacher-rated BRI scores (−0.2, 95% CI: −1.1, 0.8), and predicted lower scores (fewer problems) on the BRIEF Metacognition Index (−1.2, 95% CI: −2.2, −0.2) and SDQ total difficulties (−0.9, 95% CI: −1.4, −0.4). PM2.5 exposure was associated with teacher-rated BRIEF and SDQ scores in minimally adjusted models but associations attenuated with covariate adjustment. None of the parent-rated outcomes suggested adverse effects of greater pollution exposure at any time point. Conclusions Children with higher mid-childhood exposure to BC and greater near-residence traffic density in mid-childhood had greater problems with behavioral regulation as assessed by classroom teachers, but not as assessed by parents. Prenatal and early childhood exposure to traffic-related pollution did not predict greater executive function or behavior problems; third trimester BC was associated with lower scores (representing fewer problems) on measures of metacognition and behavioral problems. PMID:27350569

Prenatal and childhood traffic-related air pollution exposure and childhood executive function and behavior.

PubMed

Harris, Maria H; Gold, Diane R; Rifas-Shiman, Sheryl L; Melly, Steven J; Zanobetti, Antonella; Coull, Brent A; Schwartz, Joel D; Gryparis, Alexandros; Kloog, Itai; Koutrakis, Petros; Bellinger, David C; Belfort, Mandy B; Webster, Thomas F; White, Roberta F; Sagiv, Sharon K; Oken, Emily

Traffic-related air pollution exposure may influence brain development and function and thus be related to neurobehavioral problems in children, but little is known about windows of susceptibility. Examine associations of gestational and childhood exposure to traffic-related pollution with executive function and behavior problems in children. We studied associations of pre- and postnatal pollution exposures with neurobehavioral outcomes in 1212 children in the Project Viva pre-birth cohort followed to mid-childhood (median age 7.7years). Parents and classroom teachers completed the Behavior Rating Inventory of Executive Function (BRIEF) and the Strengths and Difficulties Questionnaire (SDQ). Using validated spatiotemporal models, we estimated exposure to black carbon (BC) and fine particulate matter (PM 2.5 ) in the third trimester of pregnancy, from birth to 3years, from birth to 6years, and in the year before behavioral ratings. We also measured residential distance to major roadways and near-residence traffic density at birth and in mid-childhood. We estimated associations of BC, PM 2.5 , and other traffic exposure measures with BRIEF and SDQ scores, adjusted for potential confounders. Higher childhood BC exposure was associated with higher teacher-rated BRIEF Behavioral Regulation Index (BRI) scores, indicating greater problems: 1.0 points (95% confidence interval (CI): 0.0, 2.1) per interquartile range (IQR) increase in birth-age 6BC, and 1.7 points (95% CI: 0.6, 2.8) for BC in the year prior to behavioral ratings. Mid-childhood residential traffic density was also associated with BRI score (0.6, 95% CI: 0.1, 1.1). Birth-age 3BC was not associated with BRIEF or SDQ scores. Third trimester BC exposure was not associated with teacher-rated BRI scores (-0.2, 95% CI: -1.1, 0.8), and predicted lower scores (fewer problems) on the BRIEF Metacognition Index (-1.2, 95% CI: -2.2, -0.2) and SDQ total difficulties (-0.9, 95% CI: -1.4, -0.4). PM 2.5 exposure was associated with teacher-rated BRIEF and SDQ scores in minimally adjusted models but associations attenuated with covariate adjustment. None of the parent-rated outcomes suggested adverse effects of greater pollution exposure at any time point. Children with higher mid-childhood exposure to BC and greater near-residence traffic density in mid-childhood had greater problems with behavioral regulation as assessed by classroom teachers, but not as assessed by parents. Prenatal and early childhood exposure to traffic-related pollution did not predict greater executive function or behavior problems; third trimester BC was associated with lower scores (representing fewer problems) on measures of metacognition and behavioral problems. Copyright © 2016 Elsevier Inc. All rights reserved.

Symptoms of depression, anxiety, and stress in parents of young children with epilepsy: A case controlled population-based study.

PubMed

Reilly, Colin; Atkinson, Patricia; Memon, Ayesha; Jones, Chloe; Dabydeen, Lyvia; Das, Krishna B; Gillberg, Christopher; Neville, Brian G R; Scott, Rod C

2018-03-01

The objective was to provide population-based data on depression, anxiety, and stress in parents of young children with epilepsy and to compare findings with those of parents of developmental-, age-, and gender-matched children with nonepilepsy-related neurodisability (neurological and/or neurodevelopmental concerns). The parents (mothers and fathers) of 47 (89% ascertainment) young children (1-7years) with epilepsy in a defined geographical area of the UK completed the Depression Anxiety Stress Scales - Short Form (DASS-21), a screening measure for depression, anxiety, and stress. The responses of parents of children with epilepsy were compared with parents of developmental-, age-, and gender-matched children with nonepilepsy-related neurodisability (n=48). Factors associated with parental symptoms were analyzed using regression. In the group with epilepsy, 47 mothers and 39 fathers completed the DASS-21. Seventy-two percent of mothers scored in the at-risk range on at least one DASS-21 subscale (Fathers 49%). Mothers of children with epilepsy were significantly more likely to score in the at risk range than fathers on depression (55% vs. 33%), anxiety (47% vs. 26%), and stress (55% vs. 31%) subscales (all p<0.05). Mothers of children with epilepsy were also significantly more likely to score in the at-risk range than mothers of children with neurodisability on measures of depression (p=0.005) and stress (p=0.03). There was not a significant difference between fathers in both groups on any measures. In the group with epilepsy, increased child emotional-behavioral difficulties were associated with increased DASS-21 scores on multivariable analysis (p=0.04). Mothers of young children with epilepsy are at high risk for mental health difficulties, and all should be screened for such difficulties. There is a need to explore what parent and/or child focused interventions might be useful to reduce the mental health difficulties reported by mothers of young children with epilepsy. Copyright © 2017 Elsevier Inc. All rights reserved.

Adolescent behavior and PTSD 6-7 years after the World Trade Center terrorist attacks of September 11, 2001.

PubMed

Mann, Mana; Li, Jiehui; Farfel, Mark R; Maslow, Carey B; Osahan, Sukhminder; Stellman, Steven D

2014-01-01

Behavioral problems and psychopathologies were reported in children exposed to the World Trade Center (WTC) attacks in New York City within 2-3 y post-disaster. Little is known of subsequent 9/11 related behavioral and emotional problems. We assessed risk factors for behavioral difficulties and probable posttraumatic stress disorder (PTSD) in 489 adolescent enrollees ages 11-18 y of age in the World Trade Center Health Registry cohort using the Strengths and Difficulties Questionnaire (SDQ) and DISC Predictive Scales (DPS), respectively, as reported by the adolescents. Associations between parental PTSD and adolescent PTSD and behavioral problems were studied in a subset of 166 adolescent-parent pairs in which the parent was also a Registry enrollee. Nearly one-fifth (17.4%) of the adolescents, all of whom were 5-12 y old at the time of the attacks, scored in the abnormal (5.7%) or borderline (11.7%) range of total SDQ. Problems were more frequent in minority, low-income, and single-parent adolescents. Abnormal and borderline SDQ scores were significantly associated with direct WTC exposures and with WTC-related injury or death of a family member. Adolescent PTSD was significantly associated with WTC exposure and with fear of one's own injury or death, and with PTSD in the parent (OR = 5.6; 95% CI 1.1-28.4). This adolescent population should be monitored for persistence or worsening of these problems. Co-occurrence of parent and child mental health symptoms following a disaster may have implications for healthcare practitioners and for disaster response planners.

Continuously Adaptive vs. Discrete Changes of Task Difficulty in the Training of a Complex Perceptual-Motor Task.

ERIC Educational Resources Information Center

Wood, Milton E.

The purpose of the effort was to determine the benefits to be derived from the adaptive training technique of automatically adjusting task difficulty as a function of a student skill during early learning of a complex perceptual motor task. A digital computer provided the task dynamics, scoring, and adaptive control of a second-order, two-axis,…

Moderating effect of communication difficulty on the relationship between depression and pain: a study on community-dwelling older adults in Hong Kong.

PubMed

Chan, Wallace Chi Ho; Kwan, Chi Wai; Chi, Iris

2015-01-01

This study examined the relationship between depression and pain, and the moderating effect of communication difficulty on this relationship, among community-dwelling older adults in Hong Kong. We used logistic regression to analyze secondary data regarding 12,402 Chinese older adults applying for long-term care service in Hong Kong in 2012. Approximately 30% of participants were depressed and 37% experienced communication difficulty. Depression was associated with increased pain. Communication difficulty was found to moderate the relationship between depression and pain. Pain scores increased more when individuals who experienced communication difficulty reported being depressed, compared to those who did not experience communication difficulty. The moderating effect of communication difficulty may be explained by the interaction between depression and communication difficulty. Participants who were depressed and concurrently experienced communication difficulty may be more likely to catastrophize their pain and may tend to report or experience more pain. Health care professionals need to be aware of the different effects of communication difficulty on the pain experiences of older adults. Psychosocial intervention may be provided to minimize older adults' communication barriers to pain management.

A cluster randomized-controlled trial of a classroom-based drama workshop program to improve mental health outcomes among immigrant and refugee youth in special classes.

PubMed

Rousseau, Cécile; Beauregard, Caroline; Daignault, Katherine; Petrakos, Harriet; Thombs, Brett D; Steele, Russell; Vasiliadis, Helen-Maria; Hechtman, Lily

2014-01-01

The aim of this cluster randomized trial was to evaluate the effectiveness of a school-based theatre intervention program for immigrant and refugee youth in special classes for improving mental health and academic outcomes. The primary hypothesis was that students in the theatre intervention group would report a greater reduction in impairment from symptoms compared to students in the control and tutoring groups. Special classrooms in five multiethnic high schools were randomly assigned to theater intervention (n = 10), tutoring (n = 10) or control status (n = 9), for a total of 477 participants. Students and teachers were non-blinded to group assignment. The primary outcome was impairment from emotional and behavioural symptoms assessed by the Impact Supplement of the Strengths and Difficulties Questionnaire (SDQ) completed by the adolescents. The secondary outcomes were the SDQ global scores (teacher and youth reports), impairment assessed by teachers and school performance. The effect of the interventions was assessed through linear mixed effect models which incorporate the correlation between students in the same class, due to the nature of the randomization of the interventions by classroom. The theatre intervention was not associated with a greater reduction in self-reported impairment and symptoms in youth placed in special class because of learning, emotional and behavioural difficulties than a tutoring intervention or a non-active control group. The estimates of the different models show a non-significant decrease in both self-reported and impairment scores in the theatre intervention group for the overall group, but the impairment score decreased significantly for first generation adolescents while it increased for second generation adolescents. The difference between the population of immigrant and refugee youth newcomers studied previously and the sample of this trial may explain some of the differences in the observed impact of the theatre intervention. ClinicalTrials.gov NCT01426451.

A Cluster Randomized-Controlled Trial of a Classroom-Based Drama Workshop Program to Improve Mental Health Outcomes among Immigrant and Refugee Youth in Special Classes

PubMed Central

Rousseau, Cécile; Beauregard, Caroline; Daignault, Katherine; Petrakos, Harriet; Thombs, Brett D.; Steele, Russell; Vasiliadis, Helen-Maria; Hechtman, Lily

2014-01-01

Objectives The aim of this cluster randomized trial was to evaluate the effectiveness of a school-based theatre intervention program for immigrant and refugee youth in special classes for improving mental health and academic outcomes. The primary hypothesis was that students in the theatre intervention group would report a greater reduction in impairment from symptoms compared to students in the control and tutoring groups. Methods Special classrooms in five multiethnic high schools were randomly assigned to theater intervention (n = 10), tutoring (n = 10) or control status (n = 9), for a total of 477 participants. Students and teachers were non-blinded to group assignment. The primary outcome was impairment from emotional and behavioural symptoms assessed by the Impact Supplement of the Strengths and Difficulties Questionnaire (SDQ) completed by the adolescents. The secondary outcomes were the SDQ global scores (teacher and youth reports), impairment assessed by teachers and school performance. The effect of the interventions was assessed through linear mixed effect models which incorporate the correlation between students in the same class, due to the nature of the randomization of the interventions by classroom. Results The theatre intervention was not associated with a greater reduction in self-reported impairment and symptoms in youth placed in special class because of learning, emotional and behavioural difficulties than a tutoring intervention or a non-active control group. The estimates of the different models show a non-significant decrease in both self-reported and impairment scores in the theatre intervention group for the overall group, but the impairment score decreased significantly for first generation adolescents while it increased for second generation adolescents. Conclusion The difference between the population of immigrant and refugee youth newcomers studied previously and the sample of this trial may explain some of the differences in the observed impact of the theatre intervention. Trial Registration ClinicalTrials.gov NCT01426451 PMID:25127251

Traffic-Related Air Pollution, Noise at School, and Behavioral Problems in Barcelona Schoolchildren: A Cross-Sectional Study.

PubMed

Forns, Joan; Dadvand, Payam; Foraster, Maria; Alvarez-Pedrerol, Mar; Rivas, Ioar; López-Vicente, Mònica; Suades-Gonzalez, Elisabet; Garcia-Esteban, Raquel; Esnaola, Mikel; Cirach, Marta; Grellier, James; Basagaña, Xavier; Querol, Xavier; Guxens, Mònica; Nieuwenhuijsen, Mark J; Sunyer, Jordi

2016-04-01

The available evidence of the effects of air pollution and noise on behavioral development is limited, and it overlooks exposure at schools, where children spend a considerable amount of time. We aimed to investigate the associations of exposure to traffic-related air pollutants (TRAPs) and noise at school on behavioral development of schoolchildren. We evaluated children 7-11 years of age in Barcelona (Catalonia, Spain) during 2012-2013 within the BREATHE project. Indoor and outdoor concentrations of elemental carbon (EC), black carbon (BC), and nitrogen dioxide (NO2) were measured at schools in two separate 1-week campaigns. In one campaign we also measured noise levels inside classrooms. Parents filled out the strengths and difficulties questionnaire (SDQ) to assess child behavioral development, while teachers completed the attention deficit/hyperactivity disorder criteria of the DSM-IV (ADHD-DSM-IV) list to assess specific ADHD symptomatology. Negative binomial mixed-effects models were used to estimate associations between the exposures and behavioral development scores. Interquartile range (IQR) increases in indoor and outdoor EC, BC, and NO2 concentrations were positively associated with SDQ total difficulties scores (suggesting more frequent behavioral problems) in adjusted multivariate models, whereas noise was significantly associated with ADHD-DSM-IV scores. In our study population of 7- to 11-year-old children residing in Barcelona, exposure to TRAPs at school was associated with increased behavioral problems in schoolchildren. Noise exposure at school was associated with more ADHD symptoms. Forns J, Dadvand P, Foraster M, Alvarez-Pedrerol M, Rivas I, López-Vicente M, Suades-Gonzalez E, Garcia-Esteban R, Esnaola M, Cirach M, Grellier J, Basagaña X, Querol X, Guxens M, Nieuwenhuijsen MJ, Sunyer J. 2016. Traffic-related air pollution, noise at school, and behavioral problems in Barcelona schoolchildren: a cross-sectional study. Environ Health Perspect 124:529-535; http://dx.doi.org/10.1289/ehp.1409449.

Traffic-Related Air Pollution, Noise at School, and Behavioral Problems in Barcelona Schoolchildren: A Cross-Sectional Study

PubMed Central

Forns, Joan; Dadvand, Payam; Foraster, Maria; Alvarez-Pedrerol, Mar; Rivas, Ioar; López-Vicente, Mònica; Suades-Gonzalez, Elisabet; Garcia-Esteban, Raquel; Esnaola, Mikel; Cirach, Marta; Grellier, James; Basagaña, Xavier; Querol, Xavier; Guxens, Mònica; Nieuwenhuijsen, Mark J.; Sunyer, Jordi

2015-01-01

Background: The available evidence of the effects of air pollution and noise on behavioral development is limited, and it overlooks exposure at schools, where children spend a considerable amount of time. Objective: We aimed to investigate the associations of exposure to traffic-related air pollutants (TRAPs) and noise at school on behavioral development of schoolchildren. Methods: We evaluated children 7–11 years of age in Barcelona (Catalonia, Spain) during 2012–2013 within the BREATHE project. Indoor and outdoor concentrations of elemental carbon (EC), black carbon (BC), and nitrogen dioxide (NO2) were measured at schools in two separate 1-week campaigns. In one campaign we also measured noise levels inside classrooms. Parents filled out the strengths and difficulties questionnaire (SDQ) to assess child behavioral development, while teachers completed the attention deficit/hyperactivity disorder criteria of the DSM-IV (ADHD-DSM-IV) list to assess specific ADHD symptomatology. Negative binomial mixed-effects models were used to estimate associations between the exposures and behavioral development scores. Results: Interquartile range (IQR) increases in indoor and outdoor EC, BC, and NO2 concentrations were positively associated with SDQ total difficulties scores (suggesting more frequent behavioral problems) in adjusted multivariate models, whereas noise was significantly associated with ADHD-DSM-IV scores. Conclusion: In our study population of 7- to 11-year-old children residing in Barcelona, exposure to TRAPs at school was associated with increased behavioral problems in schoolchildren. Noise exposure at school was associated with more ADHD symptoms. Citation: Forns J, Dadvand P, Foraster M, Alvarez-Pedrerol M, Rivas I, López-Vicente M, Suades-Gonzalez E, Garcia-Esteban R, Esnaola M, Cirach M, Grellier J, Basagaña X, Querol X, Guxens M, Nieuwenhuijsen MJ, Sunyer J. 2016. Traffic-related air pollution, noise at school, and behavioral problems in Barcelona schoolchildren: a cross-sectional study. Environ Health Perspect 124:529–535; http://dx.doi.org/10.1289/ehp.1409449 PMID:26241036

Assessing implementation difficulties in tobacco use prevention and cessation counselling among dental providers

PubMed Central

2011-01-01

Background Tobacco use adversely affects oral health. Clinical guidelines recommend that dental providers promote tobacco abstinence and provide patients who use tobacco with brief tobacco use cessation counselling. Research shows that these guidelines are seldom implemented, however. To improve guideline adherence and to develop effective interventions, it is essential to understand provider behaviour and challenges to implementation. This study aimed to develop a theoretically informed measure for assessing among dental providers implementation difficulties related to tobacco use prevention and cessation (TUPAC) counselling guidelines, to evaluate those difficulties among a sample of dental providers, and to investigate a possible underlying structure of applied theoretical domains. Methods A 35-item questionnaire was developed based on key theoretical domains relevant to the implementation behaviours of healthcare providers. Specific items were drawn mostly from the literature on TUPAC counselling studies of healthcare providers. The data were collected from dentists (n = 73) and dental hygienists (n = 22) in 36 dental clinics in Finland using a web-based survey. Of 95 providers, 73 participated (76.8%). We used Cronbach's alpha to ascertain the internal consistency of the questionnaire. Mean domain scores were calculated to assess different aspects of implementation difficulties and exploratory factor analysis to assess the theoretical domain structure. The authors agreed on the labels assigned to the factors on the basis of their component domains and the broader behavioural and theoretical literature. Results Internal consistency values for theoretical domains varied from 0.50 ('emotion') to 0.71 ('environmental context and resources'). The domain environmental context and resources had the lowest mean score (21.3%; 95% confidence interval [CI], 17.2 to 25.4) and was identified as a potential implementation difficulty. The domain emotion provided the highest mean score (60%; 95% CI, 55.0 to 65.0). Three factors were extracted that explain 70.8% of the variance: motivation (47.6% of variance, α = 0.86), capability (13.3% of variance, α = 0.83), and opportunity (10.0% of variance, α = 0.71). Conclusions This study demonstrated a theoretically informed approach to identifying possible implementation difficulties in TUPAC counselling among dental providers. This approach provides a method for moving from diagnosing implementation difficulties to designing and evaluating interventions. PMID:21615948

The relationship between phonological short-term memory, receptive vocabulary, and fast mapping in children with specific language impairment.

PubMed

Jackson, Emily; Leitao, Suze; Claessen, Mary

2016-01-01

Children with specific language impairment (SLI) often experience word-learning difficulties, which are suggested to originate in the early stage of word learning: fast mapping. Some previous research indicates significantly poorer fast mapping capabilities in children with SLI compared with typically developing (TD) counterparts, with a range of methodological factors impacting on the consistency of this finding. Research has explored key issues that might underlie fast mapping difficulties in children with SLI, with strong theoretical support but little empirical evidence for the role of phonological short-term memory (STM). Additionally, further research is required to explore the influence of receptive vocabulary on fast mapping capabilities. Understanding the factors associated with fast mapping difficulties that are experienced by children with SLI may lead to greater theoretically driven word-learning intervention. To investigate whether children with SLI demonstrate significant difficulties with fast mapping, and to explore the related factors. It was hypothesized that children with SLI would score significantly lower on a fast mapping production task compared with TD children, and that phonological STM and receptive vocabulary would significantly predict fast mapping production scores in both groups of children. Twenty-three children with SLI (mean = 64.39 months, SD = 4.10 months) and 26 TD children (mean = 65.92 months, SD = 2.98) were recruited from specialist language and mainstream schools. All participants took part in a unique, interactive fast-mapping task whereby nine novel objects with non-word labels were presented and production accuracy was assessed. A non-word repetition test and the Peabody Picture Vocabulary Test-Fourth Edition (PPVT-IV) were also administered as measures of phonological STM capacity and receptive vocabulary, respectively. Results of the fast-mapping task indicated that children with SLI had significantly poorer fast mapping production scores than TD children. Scores from the non-word repetition task were also significantly lower for the SLI group, revealing reduced phonological STM capacity. Phonological STM capacity and receptive vocabulary emerged as significant predictors of fast mapping performance when the group data were combined in a multiple regression analysis. These results suggest that the word-learning difficulties experienced by children with SLI may originate at the fast mapping stage, and that phonological STM and receptive vocabulary significantly predict fast mapping ability. These findings contribute to the theoretical understanding of word-learning difficulties in children with SLI and may inform lexical learning intervention. © 2015 Royal College of Speech and Language Therapists.

Nocturnal sleep, daytime sleepiness, and quality of life in stable patients on hemodialysis

PubMed Central

Parker, Kathy P; Kutner, Nancy G; Bliwise, Donald L; Bailey, James L; Rye, David B

2003-01-01

Background Although considerable progress has been made in the treatment of chronic kidney disease, compromised quality of life continues to be a significant problem for patients receiving hemodialysis (HD). However, in spite of the high prevalence of sleep complaints and disorders in this population, the relationship between these problems and quality of life remains to be well characterized. Thus, we studied a sample of stable HD patients to explore relationships between quality of life and both subjective and objective measures of nocturnal sleep and daytime sleepiness Methods The sample included forty-six HD patients, 24 men and 22 women, with a mean age of 51.6 (10.8) years. Subjects underwent one night of polysomnography followed the next morning by a Multiple Sleep Latency Test (MSLT), an objective measure of daytime sleepiness. Subjects also completed: 1) a brief nocturnal sleep questionnaire; 2) the Epworth Sleepiness Scale; and, 3) the Quality of Life Index (QLI, Dialysis Version) which provides an overall QLI score and four subscale scores for Health & Functioning (H&F), Social & Economic (S&E), Psychological & Spiritual (P&S), and Family (F). (The range of scores is 0 to 30 with higher scores indicating better quality of life.) Results The mean (standard deviation; SD) of the overall QLI was 22.8 (4.0). The mean (SD) of the four subscales were as follows: H&F – 21.1 (4.7); S&E – 22.0 (4.8); P&S – 24.5 (4.4); and, F – 26.8 (3.5). H&F (rs = -0.326, p = 0.013) and F (rs = -0.248, p = 0.048) subscale scores were negatively correlated with periodic limb movement index but not other polysomnographic measures. The H&F subscale score were positively correlated with nocturnal sleep latency (rs = 0.248, p = 0.048) while the H&F (rs = 0.278, p = 0.030) and total QLI (rs = 0.263, p = 0.038) scores were positively associated with MSLT scores. Both of these latter findings indicate that higher life quality is associated with lower sleepiness levels. ESS scores were unrelated to overall QLI scores or the subscale scores. Subjective reports of difficulty falling asleep and waking up too early were significantly correlated with all four subscale scores and overall QLI. Feeling rested in the morning was positively associated with S&E, P&S, and Total QLI scores. Conclusion Selected measures of both poor nocturnal sleep and increased daytime sleepiness are associated with decreased quality of life in HD patients, underscoring the importance of recognizing and treating these patients' sleep problems. PMID:14633280

Longitudinal analysis of the strengths and difficulties questionnaire scores of the Millennium Cohort Study children in England using M-quantile random-effects regression.

PubMed

Tzavidis, Nikos; Salvati, Nicola; Schmid, Timo; Flouri, Eirini; Midouhas, Emily

2016-02-01

Multilevel modelling is a popular approach for longitudinal data analysis. Statistical models conventionally target a parameter at the centre of a distribution. However, when the distribution of the data is asymmetric, modelling other location parameters, e.g. percentiles, may be more informative. We present a new approach, M -quantile random-effects regression, for modelling multilevel data. The proposed method is used for modelling location parameters of the distribution of the strengths and difficulties questionnaire scores of children in England who participate in the Millennium Cohort Study. Quantile mixed models are also considered. The analyses offer insights to child psychologists about the differential effects of risk factors on children's outcomes.

Self-esteem and its relationship to mental health and quality of life in adults with cystic fibrosis.

PubMed

Platten, Melanie Jane; Newman, Emily; Quayle, Ethel

2013-09-01

Research from the general population indicates an important role for self-esteem in mental health, but limited research in this area exists in the cystic fibrosis (CF) literature. This study aimed to explore the predictive value of self-esteem and health-related quality of life (HRQoL) in mental health symptoms in adults with CF. Seventy-four participants, recruited online, completed the Clinical Outcomes in Routine Evaluation-Outcome Measure 34 (CORE-OM), Rosenberg Self-esteem Scale and Cystic Fibrosis Questionnaire-Revised (CFQ-R). Comparably high levels of self-esteem were found, but HRQoL was lower than previous research. Thirty percent of participants scored within the clinical range for mental health difficulty. Hierarchical regression, controlling for gender, explored the value of four CFQ-R subscales (physical, social, emotional and role functioning) and self-esteem in predicting CORE-OM total score. Gender accounted for 8.2% of the variance in mental health scores while the five independent variables accounted for a further 73.0% of variance. Of the five variables, CFQ-R emotional functioning and self-esteem were significant predictors of mental health symptoms. Results are discussed in relation to clinical implications and potential uses for internet technologies to promote socialisation.

Symptoms of depression as reported by Norwegian adolescents on the Short Mood and Feelings Questionnaire

PubMed Central

Lundervold, Astri J.; Breivik, Kyrre; Posserud, Maj-Britt; Stormark, Kjell Morten; Hysing, Mari

2013-01-01

The present study investigated sex-differences in reports of depressive symptoms on a Norwegian translation of the short version of the Mood and Feelings Questionnaire (SMFQ). The sample comprised 9702 Norwegian adolescents (born 1993–1995, 54.9% girls), mainly attending highschool. A set of statistical analyses were run to investigate the dimensionality of the SMFQ. Girls scored significantly higher than boys on the SMFQ and used the most severe response-category far more frequently. Overall, the statistical analyses supported the essential unidimensionality of SMFQ. However, the items with the highest loadings according to the bifactor analysis, reflecting problems related to tiredness, restlessness and concentration difficulties, indicated that some of the symptoms may both be independent of and part of the symptomatology of depression. Measurement invariance analysis showed that girls scored slightly higher on some items when taking the latent variable into account; girls had a lower threshold for reporting mood problems and problems related to tiredness than boys, who showed a marginally lower threshold for reporting that no-one loved them. However, the effect on the total SMFQ score was marginal, supporting the use of the Norwegian translation of SMFQ as a continuous variable in further studies of adolescents. PMID:24062708

Factors that Influence Functional Outcome after Total or Subtotal Scapulectomy: Japanese Musculoskeletal Oncology Group (JMOG) Study

PubMed Central

Hayashi, Katsuhiro; Iwata, Shintaro; Ogose, Akira; Kawai, Akira; Ueda, Takafumi; Otsuka, Takanobu; Tsuchiya, Hiroyuki

2014-01-01

Background Scapulectomy requires not only joint resection but also wide resection of the shoulder girdle muscles. Even the significance of reconstruction has not yet been determined because of the difficulties in comparing the different conditions. The purpose of this study was to investigate factors that influence functional outcomes after scapulectomy in a multicenter study. Methods This retrospective study comprised 48 patients who underwent total or subtotal scapulectomy and were followed for at least one year after surgery. Patients were registered at the Japanese Musculoskeletal Oncology Group affiliated hospitals. Soft tissue reconstruction for joint stabilization was performed when there was enough remaining tissue for reconstruction of the rotator cuff and tendons. In 23 cases, humeral suspension was performed. The average follow-up period was 61.9 months. Multivariate analysis was performed using the patient’s background to determine which factors influence the Enneking functional score or active range of motion. Results The average functional score was 21.1 out of 30. Active shoulder range of motion was 42.7 degree in flexion, 39.7 degree in abduction, 49.6 degree of internal rotation and 16.8 degree of external rotation. The amount of remaining bone influenced functional outcome, which means that preserving the glenoid or the acromion lead to better function compared to total scapulectomy (p<0.01). Factors that influenced each functional measure include the amount of remaining bone, soft tissue reconstruction, the length of the resected humerus and nerve resection (p<0.05). Conclusion Although shoulder function was almost eliminated following total or subtotal scapulectomy, minimal resection of bone, and soft tissue reconstruction should lead to better function. PMID:24937254

Are the GFRUP's recommendations for withholding or withdrawing treatments in critically ill children applicable? Results of a two‐year survey

PubMed Central

Cremer, R; Binoche, A; Noizet, O; Fourier, C; Leteurtre, S; Moutel, G; Leclerc, F

2007-01-01

Objective To evaluate feasibility of the guidelines of the Groupe Francophone de Réanimation et Urgence Pédiatriques (French‐speaking group of paediatric intensive and emergency care; GFRUP) for limitation of treatments in the paediatric intensive care unit (PICU). Design A 2‐year prospective survey. Setting A 12‐bed PICU at the Hôpital Jeanne de Flandre, Lille, France. Patients Were included when limitation of treatments was expected. Results Of 967 children admitted, 55 were included with a 2‐day median delay. They were younger than others (24 v 60 months), had a higher paediatric risk of mortality (PRISM) score (14 v 4), and a higher paediatric overall performance category (POPC) score at admission (2 v 1); all p<0.002. 34 (50% of total deaths) children died. A limitation decision was made without meeting for 7 children who died: 6 received do‐not‐resuscitate orders (DNROs) and 1 received withholding decision. Decision‐making meetings were organised for 31 children, and the following decisions were made: 12 DNROs (6 deaths and 6 survivals), 4 withholding (1 death and 3 survivals), with 14 withdrawing (14 deaths) and 1 continuing treatment (survival). After limitation, 21 (31% of total deaths) children died and 10 survived (POPC score 4). 13 procedures were interrupted because of death and 11 because of clinical improvement (POPC score 4). Parents' opinions were obtained after 4 family conferences (for a total of 110 min), 3 days after inclusion. The first meeting was planned for 6 days after inclusion and held on the 7th day after inclusion; 80% of parents were immediately informed of the decision, which was implemented after half a day. Conclusions GFRUPs procedure was applicable in most cases. The main difficulties were anticipating the correct date for the meeting and involving nurses in the procedure. Children for whom the procedure was interrupted because of clinical improvement and who survived in poor condition without a formal decision pointed out the need for medical criteria for questioning, which should systematically lead to a formal decision‐making process. PMID:17329379

Impact of Accumulated Error on Item Response Theory Pre-Equating with Mixed Format Tests

ERIC Educational Resources Information Center

Keller, Lisa A.; Keller, Robert; Cook, Robert J.; Colvin, Kimberly F.

2016-01-01

The equating of tests is an essential process in high-stakes, large-scale testing conducted over multiple forms or administrations. By adjusting for differences in difficulty and placing scores from different administrations of a test on a common scale, equating allows scores from these different forms and administrations to be directly compared…

Sources of L2 Writing Apprehension: A Study of Egyptian University Students

ERIC Educational Resources Information Center

Abdel Latif, Muhammad M.

2015-01-01

High levels of apprehension cause students to have writing difficulties. This study attempted to identify the sources of Egyptian university students' English writing apprehension. The study made use of both quantitative and qualitative data. The scores of 57 students on a writing apprehension scale were compared to their scores on another scale…

Are There Adverse Consequences to Being a Sibling of a Person with a Disability? A Propensity Score Analysis

ERIC Educational Resources Information Center

Neely-Barnes, Susan L.; Graff, J. Carolyn

2011-01-01

This study examined whether siblings of children with disabilities have increased mental health problems, behavioral difficulties, or greater mental health service use as compared to siblings of children without disabilities. Data come from the 2006 National Health Interview Survey. Propensity score matching was used to complete the analysis.…

Sensitivity of Equated Aggregate Scores to the Treatment of Misbehaving Common Items

ERIC Educational Resources Information Center

Michaelides, Michalis P.

2010-01-01

The delta-plot method (Angoff, 1972) is a graphical technique used in the context of test equating for identifying common items with aberrant changes in their item difficulties across administrations or alternate forms. This brief research report explores the effects on equated aggregate scores when delta-plot outliers are either retained in or…

EMS Response to Mass Casualty Incidents: The Critical Importance of Automatic Statewide Mutual Aid and MCI Training

DTIC Science & Technology

2008-09-01

difficulty in implementation for each case study. After an overview, each case study is given a score against each of the criteria of “meets” or “exceeds...While expectations may be different for different individuals, the narrative section provides supporting information for the assigned score , with...decrease in response time will improve patient outcome? The narrative discussing the score will give information from the case study on the specific

Perceived difficulty of various steps of manual small incision cataract surgery among trainees in rural China.

PubMed

Huang, Wenyong; Ye, Ronghua; Huang, Shengsong; Wang, Decai; Wang, Lanhua; Liu, Bin; Friedman, David S; He, Mingguang; Liu, Yizhi; Congdon, Nathan G

2013-01-01

The perceived difficulty of steps of manual small incision cataract surgery among trainees in rural China was assessed. Cohort study. Fifty-two trainees at the end of a manual small incision cataract surgery training programme. Participants rated the difficulty of 14 surgical steps using a 5-point scale, 1 (very easy) to 5 (very difficult). Demographic and professional information was recorded for trainees. Mean ratings for surgical steps. Questionnaires were completed by 49 trainees (94.2%, median age 38 years, 8 [16.3%] women). Twenty six (53.1%) had performed ≤50 independent cataract surgeries prior to training. Trainees rated cortical aspiration (mean score ± standard deviation = 3.10 ± 1.14) the most difficult step, followed by wound construction (2.76 ± 1.08), nuclear prolapse into the anterior chamber (2.74 ± 1.23) and lens delivery (2.51 ± 1.08). Draping the surgical field (1.06 ± 0.242), anaesthetic block administration (1.14 ± 0.354) and thermal coagulation (1.18 ± 0.441) were rated easiest. In regression models, the score for cortical aspiration was significantly inversely associated with performing >50 independent manual small incision cataract surgery surgeries during training (P = 0.01), but not with age, gender, years of experience in an eye department or total number of cataract surgeries performed prior to training. Cortical aspiration, wound construction and nuclear prolapse pose the greatest challenge for trainees learning manual small incision cataract surgery, and should receive emphasis during training. Number of cases performed is the strongest predictor of perceived difficulty of key steps. © 2013 The Authors. Clinical and Experimental Ophthalmology © 2013 Royal Australian and New Zealand College of Ophthalmologists.

Outcome evaluation of the Palliative care Emphasis program on symptom management and Assessment for Continuous Medical Education: nationwide physician education project for primary palliative care in Japan.

PubMed

Yamamoto, Ryo; Kizawa, Yoshiyuki; Nakazawa, Yoko; Ohde, Sachiko; Tetsumi, Sato; Miyashita, Mitsunori

2015-01-01

Palliative care is an essential part of medicine, but most physicians have had no formal opportunity to acquire basic skills in palliative care. In Japan, the Palliative care Emphasis program on symptom management and Assessment for Continuous Medical Education (PEACE) was launched to provide formal primary palliative care education for all physicians engaged in cancer care. This study sought to determine whether PEACE could improve physicians' knowledge of, practices in, and difficulties with palliative care. In 2011, we conducted questionnaire-based surveys before, just after, and 2 months after completion of the PEACE program in physicians participating in the program at each of 15 designated cancer hospitals in Japan. Knowledge was measured using the palliative care knowledge questionnaire for PEACE (PEACE-Q). Practices and difficulties were evaluated using the Palliative Care self-reported Practice Scale (PCPS) and the Palliative Care Difficulties Scale (PCDS), respectively. Among 223 physicians participating in the program, 85 (38%) answered the follow-up survey. Significant improvements were noted on the PEACE-Q compared with baseline immediately after completion of the program, and this progress was maintained at 2 months (21.7 ± 5.56 versus 29.5 ± 2.10 versus 28.7 ± 3.28, respectively; p < 0.0001). Similarly, significant improvements were noted for total scores on both the PCPS and the PCDS at 2 months after completion of the program (62.1 ± 13.9 versus 69.6 ± 9.94 [p < 0.0001] for the PCPS; 44.4 ± 9.96 versus 39.4 ± 10.7 [p < 0.0001] for the PCDS). The PEACE education program improved physicians' knowledge of, practices in, and difficulties with palliative care.

Feasibility of the adaptive and automatic presentation of tasks (ADAPT) system for rehabilitation of upper extremity function post-stroke.

PubMed

Choi, Younggeun; Gordon, James; Park, Hyeshin; Schweighofer, Nicolas

2011-08-03

Current guidelines for rehabilitation of arm and hand function after stroke recommend that motor training focus on realistic tasks that require reaching and manipulation and engage the patient intensively, actively, and adaptively. Here, we investigated the feasibility of a novel robotic task-practice system, ADAPT, designed in accordance with such guidelines. At each trial, ADAPT selects a functional task according to a training schedule and with difficulty based on previous performance. Once the task is selected, the robot picks up and presents the corresponding tool, simulates the dynamics of the tasks, and the patient interacts with the tool to perform the task. Five participants with chronic stroke with mild to moderate impairments (> 9 months post-stroke; Fugl-Meyer arm score 49.2 ± 5.6) practiced four functional tasks (selected out of six in a pre-test) with ADAPT for about one and half hour and 144 trials in a pseudo-random schedule of 3-trial blocks per task. No adverse events occurred and ADAPT successfully presented the six functional tasks without human intervention for a total of 900 trials. Qualitative analysis of trajectories showed that ADAPT simulated the desired task dynamics adequately, and participants reported good, although not excellent, task fidelity. During training, the adaptive difficulty algorithm progressively increased task difficulty leading towards an optimal challenge point based on performance; difficulty was then continuously adjusted to keep performance around the challenge point. Furthermore, the time to complete all trained tasks decreased significantly from pretest to one-hour post-test. Finally, post-training questionnaires demonstrated positive patient acceptance of ADAPT. ADAPT successfully provided adaptive progressive training for multiple functional tasks based on participant's performance. Our encouraging results establish the feasibility of ADAPT; its efficacy will next be tested in a clinical trial.

Availability, use of, and satisfaction with green space, and children's mental wellbeing at age 4 years in a multicultural, deprived, urban area: results from the Born in Bradford cohort study.

PubMed

McEachan, Rosemary R C; Yang, Tiffany C; Roberts, Hannah; Pickett, Kate E; Arseneau-Powell, Diana; Gidlow, Christopher J; Wright, John; Nieuwenhuijsen, Mark

2018-06-01

It is unknown whether the quantity or quality of green space is more important for mental wellbeing. We aimed to explore associations between availability of, satisfaction with, and use of green space and mental wellbeing among children aged 4 years in a multi-ethnic sample. We did a 4-year follow-up assessment of participants in the Born in Bradford longitudinal cohort study, which recruited children and mothers at the city's main maternity unit from 2007 to 2011. The primary outcome was parent-reported mental wellbeing for children aged 4 years, assessed with the standardised Strengths and Difficulties Questionnaire. Total, internalising, and externalising behavioural difficulties and prosocial behaviour scales were computed (with higher scores indicating greater difficulties or more prosocial behaviour). Residential green space around participants' home addresses and distance to major green spaces were computed with the normalised difference vegetation index (NDVI). A subsample of participants completed additional questionnaires on measures of satisfaction with, and use of, local green spaces. Multiple regressions examined associations between green space and children's mental wellbeing and explored moderation by ethnicity (white British vs south Asian) and socioeconomic status. Between Oct 1, 2012, and June 30, 2015, 2594 mothers attended a follow-up appointment during which they completed a detailed questionnaire assessing the health of their child. 1519 (58%) participants were of south Asian origin, 740 (29%) of white British origin, and 333 (13%) of another ethnicity. Data on ethnicity were missing for two participants. 832 (32%) of 2594 participants completed additional questionnaires. Ethnicity moderated associations between residential green space and mental wellbeing (p<0·05 for total and internalising difficulties). After adjusting for all relevant variables, more green space was associated with fewer internalising behavioural difficulties (mean NDVI 100 m: β -2·35 [95% CI -4·20 to -0·50]; 300 m: -3·15 [-5·18 to -1·13]; 500 m: -2·85 [-4·91 to -0·80]) and with fewer total behavioural difficulties (100 m: -4·27 [-7·65 to -0·90]; 300 m: -5·22 [-8·91 to -1·54]; 500 m: -4·82 [-8·57 to -1·07]) only for south Asian children across all three buffer zones. In the subsample of participants, the effect of NDVI on wellbeing was rendered non-significant after controlling for satisfaction with, and use of, green space. Among south Asian children, satisfaction with green space was significantly associated with fewer total behavioural difficulties across all three buffer zones (β -0·59 [95% CI -1·11 to -0·07]), fewer internalising behavioural difficulties within 100 m (-0·28 [95% CI -0·56 to -0·003]) and 300 m buffer zones (-0·28 [-0·56 to -0·002]), and greater prosocial behaviour across all three buffer zones (0·20 [0·02 to 0·38]); no such associations were observed among white British children. Positive effects of green space on wellbeing differ by ethnicity. Satisfaction with the quality of green space appears to be a more important predictor of wellbeing than does quantity of green space. Public health professionals and urban planners need to focus on both quality and quantity of urban green spaces to promote health, particularly among ethnic minority groups. European Community's Seventh Framework Programme. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

[Dental loss and prosthetic replacement expectation: qualitative study].

PubMed

Silva, Maria Elisa de Souza E; Magalhães, Cláudia Silami de; Ferreira, Efigênia Ferreira E

2010-05-01

This qualitative research analyses the repercussions of total dental loss on people's quality of life. The Oral Health Impact Profile short-form (OHIP14) was applied to 50 volunteers, and after analyzing the results, 13 out of those 50, were selected to be individually interviewed in an opened questions script. The criteria to select these 13 people were: perception of the impact of mouth condition on quality of life measured by the score reached on OHIP. We tried to comprise the sample with a good variety, according to the profile of the initial sample. After analyzing people's statements, it was possible to verify that dental loss had strong negative consequences on people's life, like shame, difficulty to eat, impact on social relationship and feeling of not being complete. The possibility of having their teeth replaced generates some anxiety. Although being aware that wearing total prosthesis represents some sacrifices, people considered it worthwhile because the possibility of regaining the social pattern and the self-image is renewed.

A model-based cluster analysis of social experiences in clinically anxious youth: links to emotional functioning.

PubMed

Suveg, Cynthia; Jacob, Marni L; Whitehead, Monica; Jones, Anna; Kingery, Julie Newman

2014-01-01

Social difficulties are commonly associated with anxiety disorders in youth, yet are not well specified in the literature. The aim of this study was to identify patterns of social experiences in clinically anxious children and examine the associations with indices of emotional functioning. A model-based cluster analysis was conducted on parent-, teacher-, and child-reports of social experiences with 64 children, ages 7-12 years (M = 8.86 years, SD = 1.59 years; 60.3% boys; 85.7% Caucasian) with a primary diagnosis of separation anxiety disorder, social phobia, and/or generalized anxiety disorder. Follow-up analyses examined cluster differences on indices of emotional functioning. Findings yielded three clusters of social experiences that were unrelated to diagnosis: (1) Unaware Children (elevated scores on parent- and teacher-reports of social difficulties but relatively low scores on child-reports, n = 12), (2) Average Functioning (relatively average scores across all informants, n = 44), and (3) Victimized and Lonely (elevated child-reports of overt and relational victimization and loneliness and relatively low scores on parent- and teacher-reports of social difficulties, n = 8). Youth in the Unaware Children cluster were rated as more emotionally dysregulated by teachers and had a greater number of diagnoses than youth in the Average Functioning group. In contrast, the Victimized and Lonely group self-reported greater frequency of negative affect and reluctance to share emotional experiences than the Average Functioning cluster. Overall, this study demonstrates that social maladjustment in clinically anxious children can manifest in a variety of ways and assessment should include multiple informants and methods.

Postpartum fatigue, baby-care activities, and maternal-infant attachment of vaginal and cesarean births following rooming-in.

PubMed

Lai, Ya-Ling; Hung, Chich-Hsiu; Stocker, Joel; Chan, Te-Fu; Liu, Yi

2015-05-01

This study compares women's postpartum fatigue, baby-care activities, and maternal-infant attachment following vaginal and cesarean births in rooming-in settings. Postpartum women admitted to baby-friendly hospitals are asked to stay with their babies 24 hours a day and to breastfeed on demand regardless of the type of childbirth. The study used a descriptive cross-sectional study design. A total of 120 postpartum women were recruited from two accredited baby-friendly hospitals in southern Taiwan. Three structured questionnaires were used to collect data, on which an analysis of covariance was conducted. Women who experienced a cesarean birth had higher postpartum fatigue scores than women who had given birth vaginally. Higher postpartum fatigue scores were correlated with greater difficulty in baby-care activities, which in turn resulted in weaker maternal-infant attachment as measured in the first 2 to 3 days postpartum. Hospitals should implement rooming-in in a more flexible way by taking women's postpartum fatigue and physical functioning into consideration. Copyright © 2014 Elsevier Inc. All rights reserved.

[Behaviour problems of children with Down syndrome in preschool-age - Results from the Heidelberg Down syndrome study].

PubMed

Sarimski, Klaus

2018-05-01

We report on the frequency and the correlations of behaviour problems among children with Down syndrome in preschool-age. As part of a longitudinal study 48 mothers of children with Down syndrome completed the German version of the “Strengths and Difficulties Questionnaire” (SDQ-D) and the Parenting Stress Inventory (PSI). The mothers were asked to fill out the questionnaires when the children had a mean age of five years. The results were compared to norms from children with typical development. Thirty per cent of the children with Down syndrome were rated as abnormal. Specifically, mean scores indicating problems with children of the same age and hyperactivity were elevated. A regression analysis predicting the total problem score of the SDQ-D revealed maternal educational level, optimistic attitude, and subjective parental stress at the age of one year and the degree of behavioural abnormalities at the age of three years as significant influential factors. Early intervention for Down syndrome children should include supporting parenting competence and coping skills in order to prevent behaviour problems.

Understanding planning ability measured by the Tower of London: an evaluation of its internal structure by latent variable modeling.

PubMed

Koppenol-Gonzalez, Gabriela V; Bouwmeester, Samantha; Boonstra, A Marije

2010-12-01

The Tower of London (TOL) is a widely used instrument for assessing planning ability. Inhibition and (spatial) working memory are assumed to contribute to performance on the TOL, but findings about the relationship between these cognitive processes are often inconsistent. Moreover, the influence of specific properties of TOL problems on cognitive processes and difficulty level is often not taken into account. Furthermore, it may be expected that several planning strategies can be distinguished that cannot be extracted from the total score. In this study, a factor analysis and a latent class regression analysis were performed to address these issues. The results showed that 4 strategy groups that differed with respect to preplanning time could be distinguished. The effect of problem properties also differed for the 4 groups. Additional analyses showed that the groups differed on average planning performance but that there were no significant differences between inhibition and spatial working memory performance. Finally, it seemed that multiple factors influence performance on the TOL, the most important ones being the score measurements, the problem properties, and strategy use.

The fitness of apps: a theory-based examination of mobile fitness app usage over 5 months

PubMed Central

Kim, Jinsook

2017-01-01

Background There are thousands of fitness-related smartphone applications (“apps”) available for free and purchase, but there is uncertainty if these apps help individuals achieve and maintain personal fitness. Technology usage attrition is also a concern among research studies on health technologies. Methods Usage of three fitness apps was examined over 5 months to assess adherence and effectiveness. Initially, 64 participants downloaded three free apps available on Android and iOS and 47 remained in the study until posttest. With a one group pre-posttest design and checkpoints at months 1, 3, and 5, exercise and exercise with fitness apps were examined in the framework of the Theory of Planned Behavior (TPB) using a validated survey. Apps were selected based on their function from the Functional Triad. Perceived fitness was also measured. T-tests, sign tests, Fisher’s exact tests, and linear and logistic regression were used to compare pre to posttests and users to non-users of the apps. Results Forty-seven participants completed both pre and posttests. Individual item scores indicated no significant change pre to posttest except for decreases observed in usefulness of using apps for exercise (attitude) (−0.78, P<0.01), peer influence on exercise (subjective norm) (−0.51, P<0.05), peer influence on exercise with apps (subjective norm) (−1.02, P<0.01), perceived difficulties in exercising with apps (perceived behavioral control) (−1.29, P<0.001), and the expected frequency of exercise with apps over the next 2 weeks (behavioral intention) (P<0.0001 in a sign test). Subscale total scores indicated significant decreases in subjective norm regarding exercise (−0.72, P<0.05), subjective norm regarding exercise with apps (−1.72, P<0.01), and perceived behavioral control over exercising with apps (−2.56, P<0.01) between pre and posttest. When comparing app users (n=32) to non-users (n=15), there was only a significant difference in subscale total scores at posttest for attitude toward exercising using apps, which was significantly more favorable among users than non-users (32.3 vs. 27.6, P<0.05). Fitness perception did not change over 5 months regarding cardiovascular fitness, strength, endurance, flexibility, or body composition. Technology usage attrition was desirable at 31.9%. Conclusions App usage and effectiveness appears to have a connection to usefulness (attitude) and to perceived difficulties of exercising using apps (perceived behavioral control). Exercise and exercise using apps are not influenced by peer influence (subjective norm). Intention to exercise using these particular apps decreased (behavioral intention). Those who utilized the apps were more likely to have a positive attitude about the apps. Usefulness and perceived difficulties in particular should be considered with future app development. App usefulness and ease of use may be facilitated by using health behavior theories to guide development. PMID:28293619

The fitness of apps: a theory-based examination of mobile fitness app usage over 5 months.

PubMed

Herrmann, Lynn Katherine; Kim, Jinsook

2017-01-01

There are thousands of fitness-related smartphone applications ("apps") available for free and purchase, but there is uncertainty if these apps help individuals achieve and maintain personal fitness. Technology usage attrition is also a concern among research studies on health technologies. Usage of three fitness apps was examined over 5 months to assess adherence and effectiveness. Initially, 64 participants downloaded three free apps available on Android and iOS and 47 remained in the study until posttest. With a one group pre-posttest design and checkpoints at months 1, 3, and 5, exercise and exercise with fitness apps were examined in the framework of the Theory of Planned Behavior (TPB) using a validated survey. Apps were selected based on their function from the Functional Triad. Perceived fitness was also measured. T -tests, sign tests, Fisher's exact tests, and linear and logistic regression were used to compare pre to posttests and users to non-users of the apps. Forty-seven participants completed both pre and posttests. Individual item scores indicated no significant change pre to posttest except for decreases observed in usefulness of using apps for exercise (attitude) (-0.78, P<0.01), peer influence on exercise (subjective norm) (-0.51, P<0.05), peer influence on exercise with apps (subjective norm) (-1.02, P<0.01), perceived difficulties in exercising with apps (perceived behavioral control) (-1.29, P<0.001), and the expected frequency of exercise with apps over the next 2 weeks (behavioral intention) (P<0.0001 in a sign test). Subscale total scores indicated significant decreases in subjective norm regarding exercise (-0.72, P<0.05), subjective norm regarding exercise with apps (-1.72, P<0.01), and perceived behavioral control over exercising with apps (-2.56, P<0.01) between pre and posttest. When comparing app users (n=32) to non-users (n=15), there was only a significant difference in subscale total scores at posttest for attitude toward exercising using apps, which was significantly more favorable among users than non-users (32.3 vs . 27.6, P<0.05). Fitness perception did not change over 5 months regarding cardiovascular fitness, strength, endurance, flexibility, or body composition. Technology usage attrition was desirable at 31.9%. App usage and effectiveness appears to have a connection to usefulness (attitude) and to perceived difficulties of exercising using apps (perceived behavioral control). Exercise and exercise using apps are not influenced by peer influence (subjective norm). Intention to exercise using these particular apps decreased (behavioral intention). Those who utilized the apps were more likely to have a positive attitude about the apps. Usefulness and perceived difficulties in particular should be considered with future app development. App usefulness and ease of use may be facilitated by using health behavior theories to guide development.

Examining and comparing social perception abilities across childhood-onset neurodevelopmental disorders.

PubMed

Baribeau, Danielle A; Doyle-Thomas, Krissy A R; Dupuis, Annie; Iaboni, Alana; Crosbie, Jennifer; McGinn, Holly; Arnold, Paul D; Brian, Jessica; Kushki, Azadeh; Nicolson, Rob; Schachar, Russell J; Soreni, Noam; Szatmari, Peter; Anagnostou, Evdokia

2015-06-01

Several neurodevelopmental disorders are associated with social processing deficits. The objective of this study was to compare patterns of social perception abilities across obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and control participants. A total of 265 children completed the Reading the Mind in the Eyes Test-Child Version (RMET). Parents or caregivers completed established trait/symptom scales. The predicted percentage of accuracy on the RMET was compared across disorders and by item difficulty and item valence (i.e., positive/negative/neutral mental states), then analyzed for associations with trait/symptom scores. The percentage of correct RMET scores varied significantly between diagnostic groups (p < .0001). On pairwise group comparisons controlling for age and sex, children with ADHD and ASD scored lower than the other groups (p < .0001). When IQ was also controlled for in the model, participants with OCD performed better than controls (p < .001), although differences between other groups were less pronounced. Participants with ASD scored lowest on easy items. Those with ASD and ADHD scored significantly lower than other groups on items with positive valence (p < .01). Greater social communication impairment and hyperactivity/impulsivity, but not OCD traits/symptoms, were associated with lower scores on the RMET, irrespective of diagnosis. Social perception abilities in neurodevelopmental disorders exist along a continuum. Children with ASD have the greatest deficits, whereas children with OCD may be hypersensitive to social information. Social communication deficits and hyperactive/impulsive traits are associated with impaired social perception abilities; these findings highlight overlapping cognitive and behavioral manifestations across disorders. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

A New Adaptive Home-based Exercise Technology among Older Adults Living in Nursing Home: A Pilot Study on Feasibility, Acceptability and Physical Performance.

PubMed

Valiani, V; Lauzé, M; Martel, D; Pahor, M; Manini, T M; Anton, S; Aubertin-Leheudre, M

2017-01-01

To explore the feasibility and acceptability of a new home-based exercise technology among older adults and to evaluate its efficacy on physical performance measures. Longitudinal clinical trial. Oak Hammock at the University of Florida, a nursing home located in Gainesville, Florida. Twelve pre-disabled older adults (≥75 years) living in a nursing home with a Short Physical Performance Battery (SPPB) score between 6 and 9 and no diagnosis of dementia. Thirty minutes of light intensity exercise (aerobic, strength and balance) two times per week for four weeks using a home-based physical activity technology called Jintronix. Feasibility and acceptability were assessed through a 9-item self-administered questionnaire and by exploring the percentage of quality of movements and time performing exercise which was calculated automatically by Jintronix technology. Physical performance measures were assessed through the SPPB score at baseline, after 4 weeks of intervention and after 3 months from the completion of the intervention. Twelve older adults (80.5±4.2 years old) performed light intensity exercise with Jintronix for a total of 51.9±7.9 minutes per week. Participants reached 87% score of quality of movements in strength and balance exercises, a global appreciation score of 91.7% and a global difficulty score of 36%. Compared to baseline, there was a significant improvement in SPPB score at the end of the intervention and at 3 months following the completion of the exercise program (0.67±0.98 and 1.08±0.99 respectively, p-value <0.05). Jintronix technology is feasible and acceptable among pre-disabled older adults without dementia living in nursing home and is beneficial in improving their physical performance.

Improved understanding of human anatomy through self-guided radiological anatomy modules.

PubMed

Phillips, Andrew W; Smith, Sandy G; Ross, Callum F; Straus, Christopher M

2012-07-01

To quantifiably measure the impact of self-instructed radiological anatomy modules on anatomy comprehension, demonstrated by radiology, gross, and written exams. Study guides for independent use that emphasized structural relationships were created for use with two online radiology atlases. A guide was created for each module of the first year medical anatomy course and incorporated as an optional course component. A total of 93 of 96 eligible students participated. All exams were normalized to control for variances in exam difficulty and body region tested. An independent t-test was used to compare overall exam scores with respect to guide completion or incompletion. To account for aptitude differences between students, a paired t-test of each student's exam scores with and without completion of the associated guide was performed, thus allowing students to serve as their own controls. Twenty-one students completed no study guides; 22 completed all six guides; and 50 students completed between one and five guides. Aggregate comparisons of all students' exam scores showed significantly improved mean performance when guides were used (radiology, 57.8% [percentile] vs. 45.1%, P < .001; gross, 56.9% vs. 46.5%, P = .001; written, 57.8% vs. 50.2%, P = .011). Paired comparisons among students who completed between one and five guides demonstrated significantly higher mean practical exam scores when guides were used (radiology, 49.3% [percentile] vs. 36.0%, P = .001; gross, 51.5% vs. 40.4%, P = .005), but not higher written scores. Radiological anatomy study guides significantly improved anatomy comprehension on radiology, gross, and written exams. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

Influence of body habitus on feasibility and outcome of laparoscopic liver resections: a prospective study.

PubMed

Ratti, Francesca; D'Alessandro, Valentina; Cipriani, Federica; Giannone, Fabio; Catena, Marco; Aldrighetti, Luca

2016-06-01

The aim of the present study was to prospectively investigate whether the anthropometric measures of A Body Shape Index (ABSI, taking into account waist circumference adjusted for height and weight) affects feasibility and outcome of laparoscopic liver resections. One hundred patients undergoing laparoscopic liver resection were prospectively included in the study (2014-2015). Preoperative clinical parameters, including body mass index (BMI) and ABSI were evaluated for associations with intraoperative outcome and postoperative results (morbidity, mortality and functional recovery). Twenty-two and 78 patients underwent major and minor hepatectomies, respectively. Conversion rate was 9%, mean blood loss was 210 ± 115 ml. Postoperative morbidity was 15% and mortality was nil. Mean length of stay was 4 days. When considering the entire series, ABSI was not associated with intra and postoperative outcome. After stratification of patients according to difficulty score, Pearson's correlation demonstrated an association between ABSI and intraoperative blood loss (P = 0.03) and time for functional recovery (P = 0.05) in patients undergoing resections with high score of difficulty. Body habitus has an influence on outcome of laparoscopic liver resections with high degree of difficulty, while feasibility and outcome of low difficulty resections seem not to be affected by anthropometric measures. © 2016 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

Results of a SNP genome screen in a large Costa Rican pedigree segregating for severe bipolar disorder.

PubMed

Service, Susan; Molina, Julio; Deyoung, Joseph; Jawaheer, Damini; Aldana, Ileana; Vu, Thuy; Araya, Carmen; Araya, Xinia; Bejarano, Julio; Fournier, Eduardo; Ramirez, Magui; Mathews, Carol A; Davanzo, Pablo; Macaya, Gabriel; Sandkuijl, Lodewijk; Sabatti, Chiara; Reus, Victor; Freimer, Nelson

2006-06-05

We have ascertained in the Central Valley of Costa Rica a new kindred (CR201) segregating for severe bipolar disorder (BP-I). The family was identified by tracing genealogical connections among eight persons initially independently ascertained for a genome wide association study of BP-I. For the genome screen in CR201, we trimmed the family down to 168 persons (82 of whom are genotyped), containing 25 individuals with a best-estimate diagnosis of BP-I. A total of 4,690 SNP markers were genotyped. Analysis of the data was hampered by the size and complexity of the pedigree, which prohibited using exact multipoint methods on the entire kindred. Two-point parametric linkage analysis, using a conservative model of transmission, produced a maximum LOD score of 2.78 on chromosome 6, and a total of 39 loci with LOD scores >1.0. Multipoint parametric and non-parametric linkage analysis was performed separately on four sections of CR201, and interesting (nominal P-value from either analysis <0.01), although not statistically significant, regions were highlighted on chromosomes 1, 2, 3, 12, 16, 19, and 22, in at least one section of the pedigree, or when considering all sections together. The difficulties of analyzing genome wide SNP data for complex disorders in large, potentially informative, kindreds are discussed.

Function in job seekers with mental illness and drug and alcohol problems who access community based disability employment services.

PubMed

Matthews, Lynda R; Harris, Lynne M; Jaworski, Alison; Alam, Ashraful; Bozdag, Gokcen

2013-03-01

This study identified functioning, health, and social needs in jobseekers with mental disorders independently assessed as having capacity to work and referred to disability employment services. Differences in function between jobseekers with mental illness alone and with additional drug and alcohol problems were examined with view to identifying interventions for vocational rehabilitation. A convenience sample of 116 jobseekers completed BASIS-32, CANSAS, AUDIT, DAST-10 and 6 items from the EXIT interview and were divided into two groups: mental illness only, and additional drug and alcohol issues (AUDIT total score >8 and/or DAST total score >3). Analysis of variance was used to determine group differences. Jobseekers reported low-moderate problems with function. Over 40% of the sample reported unresolved psychological distress, physical health needs, and social/daytime activity needs. Thirty-five jobseekers (30%) had additional drug and alcohol problems and reported significantly greater difficulty with impulsive/addictive behavior and poorer memory and executive function than the mental illness only group. No significant differences were identified in past work functioning. Screening all job seekers for psychological, physical, and social needs to identify suitable treatment and rehabilitation strategies and providing interventions that improve emotional regulation and executive function for job seekers with additional drug and alcohol problems may improve employability of job seekers accessing disability employment services.

Strength training for a child with suspected developmental coordination disorder.

PubMed

Menz, Stacy M; Hatten, Kristin; Grant-Beuttler, Marybeth

2013-01-01

Children with developmental coordination disorder (DCD) demonstrate difficulty with feedforward motor control and use varied compensatory strategies. To examine gross motor function changes following strength training in a child with motor control difficulties. A girl aged 6 years 11 months, with apraxia and hypotonia, and demonstrating motor delays consistent with DCD. Twenty-four strength training sessions were completed using a universal exercise unit. Postintervention scores significantly improved on the Bruininks-Oseretsky test of motor proficiency, second edition, and the Canadian occupational performance measure scores and raised the developmental coordination disorder questionnaire, revised 2007, scores above the range where DCD is suspected. Nonsignificant changes in strength were observed. Improved function and significant gains in manual coordination were observed following blocked practice of isolated, simple joint movements during strength training. Improved motor skills may be because of effective use of feedforward control and improved stabilization. Strength training does not rehearse skills using momentum, explaining nonsignificant changes in locomotor or locomotion areas.

Caregiver burden, productivity loss, and indirect costs associated with caring for patients with poststroke spasticity

PubMed Central

Ganapathy, Vaidyanathan; Graham, Glenn D; DiBonaventura, Marco D; Gillard, Patrick J; Goren, Amir; Zorowitz, Richard D

2015-01-01

Objective Many stroke survivors experience poststroke spasticity and the related inability to perform basic activities, which necessitates patient management and treatment, and exerts a considerable burden on the informal caregiver. The current study aims to estimate burden, productivity loss, and indirect costs for caregivers of stroke survivors with spasticity. Methods Internet survey data were collected from 153 caregivers of stroke survivors with spasticity including caregiving time and difficulty (Oberst Caregiver Burden Scale), Work Productivity and Activity Impairment measures, and caregiver and patient characteristics. Fractional logit models examined predictors of work-related restriction, and work losses were monetized (2012 median US wages). Results Mean Oberst Caregiver Burden Scale time and difficulty scores were 46.1 and 32.4, respectively. Employed caregivers (n=71) had overall work restriction (32%), absenteeism (9%), and presenteeism (27%). Caregiver characteristics, lack of nursing home coverage, and stroke survivors’ disability predicted all work restriction outcomes. The mean total lost-productivity cost per employed caregiver was US$835 per month (>$10,000 per year; 72% attributable to presenteeism). Conclusion These findings demonstrate the substantial burden of caring for stroke survivors with spasticity illustrating the societal and economic impact of stroke that extends beyond the stroke survivor. PMID:26609225

Building Knowledge Structures by Testing Helps Children With Mathematical Learning Difficulty.

PubMed

Zhang, Yiyun; Zhou, Xinlin

2016-01-01

Mathematical learning difficulty (MLD) is prevalent in the development of mathematical abilities. Previous interventions for children with MLD have focused on number sense or basic mathematical skills. This study investigated whether mathematical performance of fifth grade children with MLD could be improved by developing knowledge structures by testing using a web-based curriculum learning system. A total of 142 children with MLD were recruited; half of the children were in the experimental group (using the system), and the other half were in the control group (not using the system). The children were encouraged to use the web-based learning system at home for at least a 15-min session, at least once a week, for one and a half months. The mean accumulated time of testing on the system for children in the experimental group was 56.2 min. Children in the experimental group had significantly higher scores on their final mathematical examination compared to the control group. The results suggest that web-based curriculum learning through testing that promotes the building of knowledge structures for a mathematical course was helpful for children with MLD. © Hammill Institute on Disabilities 2014.

Impact of Psychosocial Environment on Young Children's Emotional and Behavioral Difficulties.

PubMed

Grazuleviciene, Regina; Andrusaityte, Sandra; Petraviciene, Inga; Balseviciene, Birute

2017-10-24

Objective: The impact of maternal psychosocial stress on young children's mental difficulties is unclear. This study investigated the joint effects of the socioeconomic status and parent-child relationships on emotional and behavioral difficulties in preschool children. Methods: The case-control study included 1416 mothers and their 4-6 year-old children pairs, living in Kaunas city, Lithuania. The parent-child relationships were measured using the Parent-Child Dysfunctional Interaction subscale. Children's mental health difficulties were assessed by the Strengths and Difficulties Questionnaire. We used logistic regression models to indicate the strength of the associations. Results: Lower socioeconomic status women more often than higher ones reported pathological mother-child relations. Low education level was associated with statistically significant increase adjusted odds ratios for emotional symptoms and total behavioral difficulties. With reference to the group of better-educated mothers and normal mother-child relations, low education and pathological mother-child relations statistically significantly increased the risk of total difficulties in 4-6 year-old children; the adjusted odds ratios were 2.45; 95% CI 1.51-3.99. Conclusions: Pathological mother-child relations strengthened the effect of lower education on the increased risk of emotional and behavioral difficulties in preschool-age children. Measures oriented towards health behavior and psychosocial difficulties management may decrease children's emotional and behavioral difficulties.

The development and validation of a health-related quality of life questionnaire for pre-school children with a chronic heart disease.

PubMed

Niemitz, M; Seitz, D C M; Oebels, M; Schranz, D; Hövels-Gürich, H; Hofbeck, M; Kaulitz, R; Galm, C; Berger, F; Nagdymann, N; Stiller, B; Borth-Bruhns, T; Konzag, I; Balmer, C; Goldbeck, L

2013-12-01

Heart diseases are often associated with residual injuries, persisting functional restrictions, and long-term sequelae for psychosocial development. Currently, there are no disease-specific instruments to assess the health-related quality of life (HrQoL) of pre-school children. The aims of this study were to develop a parent proxy instrument to measure the HrQoL of children aged 3-7 years with a heart disease and to confirm its validity and reliability. Items from the Preschool Pediatric Cardiac Quality of Life Inventory (P-PCQLI) were generated through focus groups of caregivers. In a pilot study, comprehensibility and feasibility were tested. Five subdimensions were defined theoretically. Psychometric properties were analysed within a multicentre study with 167 parental caregivers. The final 52-item instrument contains a total score covering five moderately inter-correlated dimensions. The total score of the questionnaire showed a very high internal consistency (Cronbachs' α = 0.95). Test-retest correlation was at r tt = 0.96. External validity was indicated by higher correlations (r = 0.24-0.68) with a generic paediatric quality of life questionnaire (KINDL) compared to the Strengths and Difficulties Questionnaire (r = 0.17 to 0.59). Low P-PCQLI total scores were significantly associated with inpatient as opposed to outpatient treatment (t = 6.04, p < .001), with at least moderate disease severity ((t = 5.05, p < .001) NYHA classification) and with poorer prognosis (t = 5.53, p < .001) as estimated by the physician. The P-PCQLI is reliable and valid for pre-school children with a heart disease. It could be used as a screening instrument in routine care, and for evaluation of HrQoL outcomes in clinical trials and intervention research.

Sleep disturbances and teacher ratings of school achievement and temperament in children.

PubMed

Bruni, Oliviero; Ferini-Strambi, Luigi; Russo, Paolo M; Antignani, Massimo; Innocenzi, Margherita; Ottaviano, Paola; Valente, Donatella; Ottaviano, Salvatore

2006-01-01

The current study examined the relationships between academic achievement, sleep, temperament and demographic-historical data in school-age children. Teachers were asked to fill out the teacher temperament questionnaire and a form for school achievement, while mothers filled out a demographic-historical form and the sleep disturbance scale for children (SDSC), a 26-item questionnaire that consisted of six factors: difficulty in initiating and maintaining sleep (DIMS), sleep breathing disorders (SBD), arousal disorders (DA), sleep-wake transition disorders (SWTD), disorders of excessive somnolence (DOES), sleep hyperhydrosis (SHY). From a sample of 380 school children, 264 (70%) were suitable for the analyses (141 M and 123 F aged 8-11 years, mean 9.6 years). A school achievement index (SAI) was derived, summing up four items (reading ability, reading comprehension, mathematics, executive ability) of the teacher form for school achievement. SAI mean for the total sample was 11.1 (SD=2.8). A significant gender difference was found: females have higher SAI than males. The analysis of the demographic-historical form showed that only two factors appeared to affect SAI score: enuresis and the low educational level of the mother. The pattern of correlations showed that (a) the SAI was negatively related to the SDSC total score, in particular to DIMS and DOES sub-factors, and (b) the SAI was significantly and positively correlated with the temperamental traits of task-orientation and personal-social flexibility. A multiple stepwise regression analysis showed that the temperamental traits task-orientation and personal-social flexibility are the most predictive factors for SAI while the mother's educational level and the SDSC total score, although they contributed significantly to the prediction of SAI, accounted for only a small portion of variance. Temperament and sleep are important factors influencing school achievement, and their assessment could help to identify children at risk regarding school achievement.

Development and preliminary evaluation of a practice-based learning and improvement tool for assessing resident competence and guiding curriculum development.

PubMed

Lawrence, Renée H; Tomolo, Anne M

2011-03-01

Although practice-based learning and improvement (PBLI) is now recognized as a fundamental and necessary skill set, we are still in need of tools that yield specific information about gaps in knowledge and application to help nurture the development of quality improvement (QI) skills in physicians in a proficient and proactive manner. We developed a questionnaire and coding system as an assessment tool to evaluate and provide feedback regarding PBLI self-efficacy, knowledge, and application skills for residency programs and related professional requirements. Five nationally recognized QI experts/leaders reviewed and completed our questionnaire. Through an iterative process, a coding system based on identifying key variables needed for ideal responses was developed to score project proposals. The coding system comprised 14 variables related to the QI projects, and an additional 30 variables related to the core knowledge concepts related to PBLI. A total of 86 residents completed the questionnaire, and 2 raters coded their open-ended responses. Interrater reliability was assessed by percentage agreement and Cohen κ for individual variables and Lin concordance correlation for total scores for knowledge and application. Discriminative validity (t test to compare known groups) and coefficient of reproducibility as an indicator of construct validity (item difficulty hierarchy) were also assessed. Interrater reliability estimates were good (percentage of agreements, above 90%; κ, above 0.4 for most variables; concordances for total scores were R  =  .88 for knowledge and R  =  .98 for application). Despite the residents' limited range of experiences in the group with prior PBLI exposure, our tool met our goal of differentiating between the 2 groups in our preliminary analyses. Correcting for chance agreement identified some variables that are potentially problematic. Although additional evaluation is needed, our tool may prove helpful and provide detailed information about trainees' progress and the curriculum.

Development and Preliminary Evaluation of a Practice-Based Learning and Improvement Tool for Assessing Resident Competence and Guiding Curriculum Development

PubMed Central

Lawrence, Renée H; Tomolo, Anne M

2011-01-01

Background Although practice-based learning and improvement (PBLI) is now recognized as a fundamental and necessary skill set, we are still in need of tools that yield specific information about gaps in knowledge and application to help nurture the development of quality improvement (QI) skills in physicians in a proficient and proactive manner. We developed a questionnaire and coding system as an assessment tool to evaluate and provide feedback regarding PBLI self-efficacy, knowledge, and application skills for residency programs and related professional requirements. Methods Five nationally recognized QI experts/leaders reviewed and completed our questionnaire. Through an iterative process, a coding system based on identifying key variables needed for ideal responses was developed to score project proposals. The coding system comprised 14 variables related to the QI projects, and an additional 30 variables related to the core knowledge concepts related to PBLI. A total of 86 residents completed the questionnaire, and 2 raters coded their open-ended responses. Interrater reliability was assessed by percentage agreement and Cohen κ for individual variables and Lin concordance correlation for total scores for knowledge and application. Discriminative validity (t test to compare known groups) and coefficient of reproducibility as an indicator of construct validity (item difficulty hierarchy) were also assessed. Results Interrater reliability estimates were good (percentage of agreements, above 90%; κ, above 0.4 for most variables; concordances for total scores were R  =  .88 for knowledge and R  =  .98 for application). Conclusion Despite the residents' limited range of experiences in the group with prior PBLI exposure, our tool met our goal of differentiating between the 2 groups in our preliminary analyses. Correcting for chance agreement identified some variables that are potentially problematic. Although additional evaluation is needed, our tool may prove helpful and provide detailed information about trainees' progress and the curriculum. PMID:22379522

Readability Formulas and User Perceptions of Electronic Health Records Difficulty: A Corpus Study

PubMed Central

Yu, Hong

2017-01-01

Background Electronic health records (EHRs) are a rich resource for developing applications to engage patients and foster patient activation, thus holding a strong potential to enhance patient-centered care. Studies have shown that providing patients with access to their own EHR notes may improve the understanding of their own clinical conditions and treatments, leading to improved health care outcomes. However, the highly technical language in EHR notes impedes patients’ comprehension. Numerous studies have evaluated the difficulty of health-related text using readability formulas such as Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Gunning-Fog Index (GFI). They conclude that the materials are often written at a grade level higher than common recommendations. Objective The objective of our study was to explore the relationship between the aforementioned readability formulas and the laypeople’s perceived difficulty on 2 genres of text: general health information and EHR notes. We also validated the formulas’ appropriateness and generalizability on predicting difficulty levels of highly complex technical documents. Methods We collected 140 Wikipedia articles on diabetes and 242 EHR notes with diabetes International Classification of Diseases, Ninth Revision code. We recruited 15 Amazon Mechanical Turk (AMT) users to rate difficulty levels of the documents. Correlations between laypeople’s perceived difficulty levels and readability formula scores were measured, and their difference was tested. We also compared word usage and the impact of medical concepts of the 2 genres of text. Results The distributions of both readability formulas’ scores (P<.001) and laypeople’s perceptions (P=.002) on the 2 genres were different. Correlations of readability predictions and laypeople’s perceptions were weak. Furthermore, despite being graded at similar levels, documents of different genres were still perceived with different difficulty (P<.001). Word usage in the 2 related genres still differed significantly (P<.001). Conclusions Our findings suggested that the readability formulas’ predictions did not align with perceived difficulty in either text genre. The widely used readability formulas were highly correlated with each other but did not show adequate correlation with readers’ perceived difficulty. Therefore, they were not appropriate to assess the readability of EHR notes. PMID:28254738

Motion perception tasks as potential correlates to driving difficulty in the elderly

NASA Astrophysics Data System (ADS)

Raghuram, A.; Lakshminarayanan, V.

2006-09-01

Changes in the demographics indicates that the population older than 65 is on the rise because of the aging of the ‘baby boom’ generation. This aging trend and driving related accident statistics reveal the need for procedures and tests that would assess the driving ability of older adults and predict whether they would be safe or unsafe drivers. Literature shows that an attention based test called the useful field of view (UFOV) was a significant predictor of accident rates compared to any other visual function tests. The present study evaluates a qualitative trend on using motion perception tasks as a potential visual perceptual correlates in screening elderly drivers who might have difficulty in driving. Data was collected from 15 older subjects with a mean age of 71. Motion perception tasks included—speed discrimination with radial and lamellar motion, time to collision using prediction motion and estimating direction of heading. A motion index score was calculated which was indicative of performance on all of the above-mentioned motion tasks. Scores on visual attention was assessed using UFOV. A driving habit questionnaire was also administered for a self report on the driving difficulties and accident rates. A qualitative trend based on frequency distributions show that thresholds on the motion perception tasks are successful in identifying subjects who reported to have had difficulty in certain aspects of driving and had accidents. Correlation between UFOV and motion index scores was not significant indicating that probably different aspects of visual information processing that are crucial to driving behaviour are being tapped by these two paradigms. UFOV and motion perception tasks together can be a better predictor for identifying at risk or safe drivers than just using either one of them.

Development and evaluation of a simulation-based continuing medical education course: beyond lectures and credit hours.

PubMed

Pugh, Carla M; Arafat, Fahd O; Kwan, Calvin; Cohen, Elaine R; Kurashima, Yo; Vassiliou, Melina C; Fried, Gerald M

2015-10-01

The aim of our study was to modify our previously developed laparoscopic ventral hernia (LVH) simulator to increase difficulty and then reassess validity and feasibility for using the simulator in a newly developed simulation-based continuing medical education course. Participants (N = 30) were practicing surgeons who signed up for a hands-on postgraduate laparoscopic hernia course. An LVH simulator, with prior validity evidence, was modified for the course to increase difficulty. Participants completed 1 of the 3 variations in hernia anatomy: incarcerated omentum, incarcerated bowel, and diffuse adhesions. During the procedure, course faculty and peer observers rated surgeon performance using Global Operative Assessment of Laparoscopic Skills-Incisional Hernia and Global Operative Assessment of Laparoscopic Skills rating scales with prior validity evidence. Rating scale reliability was reassessed for internal consistency. Peer and faculty raters' scores were compared. In addition, quality and completeness of the hernia repairs were rated. Internal consistency on the general skills performance (peer α = .96, faculty α = .94) and procedure-specific performance (peer α = .91, faculty α = .88) scores were high. Peers were more lenient than faculty raters on all LVH items in both the procedure-specific skills and general skills ratings. Overall, participants scored poorly on the quality and completeness of their hernia repairs (mean = 3.90/16, standard deviation = 2.72), suggesting a mismatch between course attendees and hernia difficulty and identifying a learning need. Simulation-based continuing medical education courses provide hands-on experiences that can positively affect clinical practice. Although our data appear to show a significant mismatch between clinical skill and simulator difficulty, these findings also underscore significant learning needs in the surgical community. Copyright © 2015 Elsevier Inc. All rights reserved.

Gender differences in irritable bowel syndrome: the interpersonal connection.

PubMed

Thakur, E R; Gurtman, M B; Keefer, L; Brenner, D M; Lackner, J M

2015-10-01

While irritable bowel syndrome (IBS) affects women more than men, the reasons are unclear. Research on the female preponderance of IBS has focused on gender differences in sex-linked biological processes; much less attention has been paid to the role of psychosocial factors. Interpersonal difficulties may be one source of stress that may significantly impact on women with IBS. Because of the importance that women attach to relationships, we suspected they would be more reactive to interpersonal stress. A total of 283 (M age = 41 years, F = 80%), Rome III-diagnosed IBS patients completed a test battery that included the IBS Symptom Severity Scale, McGill Pain Questionnaire, Inventory of Interpersonal Problems (IIP), interpersonal support evaluation list (social support), Negative Interactions Scale, Brief Symptom Inventory (distress), Beck Depression Inventory, Anxiety Sensitivity Inventory, and IBS-Quality of Life as part of baseline assessment of an NIH trial. Males scored higher on two IIP scales reflecting a hostile-dominant interpersonal pattern, and reported less social support. The quality of relationship problems (more interpersonal difficulties, lower support) correlated with IBS symptom severity as measured mainly by gastroenterologists. Male, not female, IBS patients reported more interpersonal difficulties. Male patients-a population for whom little is known-are characterized by hostile-dominant interpersonal problems. This finding has clinical importance, given that relationship problems may influence MDs' estimation of IBS symptom severity and undermine the physician-patient relationship. © 2015 John Wiley & Sons Ltd.

[Depression associated with movement disorders].

PubMed

Mao, Cheng-jie; Chen, Ju-ping; Hu, Wei-dong; Liu, Chun-feng

2013-01-01

To explore the incidence of depression in movement disorders and associated factors. A total of 121 Parkinson's disease (PD) patients from August 2010 to June 2011 and 62 ET patients from July 2009 to June 2010 were recruited. All of them were outpatients of our hospital. PD patients received the unified Parkinson's disease rating scale (UPDRS) -motor examination and a modified Hoehn and Yahr scale to stage the severity of their disorders while 62 essential tremor (ET) patients were evaluated with tremor rating scale for tremor-motor examination (items 1 - 15 of rating scale). All participants completed Hamilton depression rating scale (24 items) to measure the presence and degree of symptoms of depression. It was found that 56.2% of PD patients and 53.2% of ET patients were depressed (HAMD score of 8 or higher). Among them, the rates of mild depression were 38.9% and 35.5%, moderate depression 15.7% and 17.7% and severe depression 1.7% and 0% in PD and ET patients respectively. No significant differences existed between each group. The factor scores of cognitive impairment were 1.81 ± 1.86 and 1.04 ± 1.07 in PD and ET patients while those of sense of despair were 2.95 ± 1.97 and 4.09 ± 2.08 in each group. The differences had statistical significance in two factor scores of two groups (P < 0.05). No differences in anxiety/somatization, lose weight, day-and-night changes, block and sleep disorders between two groups. For PD patients, the motor score of UPDRS-III was positively correlated with total HAMD score (r = 0.511, P < 0.01). Similarly, for ET patients, tremor rating scale for tremor-motor subscale score and HAMD score were positively correlated (r = 0.828, P < 0.01). As two common movement disorders, PD and ET have a high incidence of depression. The severity of depression is similar in two groups. There is no significant intra-group difference in severity and frequency of depression. The most common symptoms are anxiety somatization, anhedonia, working difficulty, slowness and sleep disturbance. The depression and motor symptoms are positively correlated. Like the non-motor symptoms in PD, we should also pay attention to the non-motor symptoms in ET.

The development of a new questionnaire for cognitive complaints in vertigo: the Neuropsychological Vertigo Inventory (NVI).

PubMed

Lacroix, Emilie; Deggouj, Naima; Salvaggio, Samuel; Wiener, Valérie; Debue, Michel; Edwards, Martin Gareth

2016-12-01

Vertigo patients frequently complain of emotional and associated cognitive problems, yet currently, there is no satisfactory questionnaire to measure these associated problems. In the present paper, we propose a new internet-based Neuropsychological Vertigo Inventory (NVI; French) that evaluates attention, memory, emotion, space perception, time perception, vision, and motor abilities. The questionnaire was created using four steps: (1) open interviews with patients suffering from vertigo; (2) semi-structured interviews with an analysis grid to quantify and define the various cognitive and emotional problems reported by the patients; (3) a first version of an internet questionnaire tested on 108 vertigo participants; and (4) the selection of subscale items using principal component analyses (PCA). From the development phase, the revised NVI was composed of seven subscales, each with four items (28 items). In the validation phase, Cronbach's alphas were performed on the revised NVI for total and each subscale score, and to test extreme groups validity, the analyses of covariance (ANCOVAs) taking into account age were performed between 108 vertigo and 104 non-vertigo participants. The Cronbach's alphas showed good to satisfactory coefficients for the total and for all subscale scores, demonstrating acceptable reliability. The extreme groups validity analyses (ANCOVAs) were reliable for the total scale and for four subscales. Supplementary analyses showed no effect of hearing difficulties and an inverse age effect for attention and emotion subscales, with reduced problems with increased age in the vertigo participants. The NVI provides a useful new questionnaire to determine cognitive and emotional neuropsychological complaints that are associated with vertigo.

Psychological profile of Turkish rock climbers: an examination of climbing experience and route difficulty.

PubMed

Aşçi, F Hülya; Demirhan, Giyasettin; Dinç, S Cem

2007-06-01

The purpose of this study was to examine sensation seeking, physical self-perception, and intrinsic and extrinsic motives of rock climbers and to compare these psychological constructs with respect to their years of climbing experience and the difficulty of their climbing routes. 64 climbers (M age=29.1 yr., SD=6.4) voluntarily participated in this study. The Arnett Inventory of Sensation Seeking (AISS), Physical Self-Description Questionnaire (PSDQ), and Sport Motivation Scale (SMS) were administered to the rock climbers. Analysis indicated that the mean score of rock climbers on the Novelty subscale of the Sensation Seeking Scale was 33.9 (SD= 3.6) and mean value on the Intensity subscale was 29.2 (SD=5.2). The mean scores of rock climbers on the PSDQ ranged between 3.9 (SD= 1.0, Physical Activity) and 5.1 (SD= 1.1, Body Fat). Descriptive analysis indicated that the highest mean score of rock climbers on the SMS was obtained in Intrinsic motivation to Experience Stimulation (5.7, SD= 0.9). The independent sample t test showed no significant differences in sensation seeking, physical self-perception, and sport motivation with regard to years of climbing experience and route difficulty (p>.05). It may be concluded that sensation seeking in climbers is high, and they have internal motivational orientation and positive physical self-perception; their competence in climbing has no obvious relationship to these variables.

Subjective Word-Finding Difficulty Reduces Engagement in Social Leisure Activities in Alzheimer’s Disease

PubMed Central

Farrell, Meagan T.; Zahodne, Laura B.; Stern, Yaakov; Dorrejo, Jhedy; Yeung, Philip; Cosentino, Stephanie

2014-01-01

Objectives To assess the influence of subjective word-finding difficulty on Alzheimer’s disease (AD) patients’ likelihood of engaging in social leisure activities. Design Analysis of data collected from the second cohort of the Multicenter Study of Predictors of Disease Course in Alzheimer’s disease. Setting Four study sites in the U.S. and France. Participants Individuals diagnosed with mild to moderate AD (N = 236) Measurements On separate questionnaires, patients were asked to 1) report whether had trouble finding the right word when speaking (subjective word-finding difficulty), and 2) rate their frequency and enjoyment of both social and nonsocial leisure activities. Objective language measures included object naming and verbal fluency. Measures of dependence, depression, cognitive status, age, sex, and education were also included as covariates in regression analyses. Results Over half (52%) of the sample reported word-finding difficulty, and subjective complaints were correlated with poorer verbal fluency scores. Subjective word-finding difficulty was uniquely related to social activity measures. Endorsers of word-finding difficulty reported reduced frequency and enjoyment of social leisure activities, controlling for covariates. In contrast, engagement in nonsocial activities was associated with higher age and depression scores, but was not related to word-finding complaints. These results were corroborated by the caregivers’ reports, and occurred above and beyond the effect of objective word-finding ability. Conclusion AD patients who are aware of increasing word-finding failures are less likely to participate in and enjoy socially-oriented leisure activities. This finding may have significant implications for clinical and health outcomes in AD. A failure to evaluate subjective language complaints could result in social withdrawal symptoms, thereby threatening the patient’s quality of life as well as increasing caregiver burden. Importantly, reduced social interaction may ultimately exacerbate language symptoms over time. PMID:24890186

Structural Complexity in Linguistic Systems Research Topic 3: Mathematical Sciences

DTIC Science & Technology

2015-04-01

understanding of structure (pattern, correlation, memory , semantics , ...) observed in linguistic systems and process? On this score we believe the...on our understanding of structure (pattern, correlation, memory , semantics , ...) observed in linguistic systems and process? On this score we believe...promised to overcome these difficulties, since it gives a clear and constructive view of structure in memoryful stochastic processes. In principle, this

easyCBM[R] Slope Reliability: Letter Names, Word Reading Fluency, and Passage Reading Fluency. Technical Report #1111

ERIC Educational Resources Information Center

Patarapichayatham, Chalie; Anderson, Daniel; Irvin, P. Shawn; Kamata, Akhito; Alonzo, Julie; Tindal, Gerald

2011-01-01

Within a response to intervention (RTI) framework, students are administered multiple tests of equivalent difficulty. Changes in students' scores over time are then attributed to changes in learning. In the current study, we evaluated the reliability of score changes (i.e., slope) for the easyCBM[R] letter names, word reading fluency, and passage…

Evaluation of Verbal, Spatial and Numerical Sequencing Scores in the WISC-R, with Special Reference to Children with Reading Difficulties.

ERIC Educational Resources Information Center

Moseley, David

The paper reviews factor analytic studies concerning the Wechsler Intelligence Scale for Children-Revised (WISC-R) profiles of children with learning disabilities (LD). Considered are the following topics: subtest profiles of backward readers, a sex difference in coding, and derivation and use of grouped subtest scores in profile analysis. The…

Student perception and post-exam analysis of one best MCQs and one correct MCQs: A comparative study.

PubMed

Adhi, Mohammad Idrees; Aly, Syed Moyn

2018-04-01

To find differences between One-Correct and One-Best multiple-choice questions with relation to student scores, post-exam item analyses results and student perception. This comparative cross-sectional study was conducted at the Dow University of Health Sciences, Karachi, from November 2010 to April 2011, and comprised medical students. Data was analysed using SPSS 18. Of the 207 participants, 16(7.7%) were boys and 191(92.3%) were girls. The mean score in Paper I was 18.62±4.7, while in Paper II it was 19.58±6.1. One-Best multiple-choice questions performed better than One-Correct. There was no statistically significant difference in the mean scores of the two papers or in the difficulty indices. Difficulty and discrimination indices correlated well in both papers. Cronbach's alpha of paper I was 0.584 and that of paper II was 0.696. Point-biserial values were better for paper II than for paper I. Most students expressed dissatisfaction with paper II. One-Best multiple-choice questions showed better scores, higher reliability, better item performance and correlation values.

Examination of the Triarchic Assessment Procedure for Inconsistent Responding in six non-English language samples.

PubMed

Kelley, Shannon E; van Dongen, Josanne D M; Donnellan, M Brent; Edens, John F; Eisenbarth, Hedwig; Fossati, Andrea; Howner, Katarina; Somma, Antonella; Sörman, Karolina

2018-05-01

The Triarchic Assessment Procedure for Inconsistent Responding (TAPIR; Mowle et al., 2016) was recently developed to identify inattentiveness or comprehension difficulties that may compromise the validity of responses on the Triarchic Psychopathy Measure (TriPM; Patrick, 2010). The TAPIR initially was constructed and cross-validated using exclusively English-speaking participants from the United States; however, research using the TriPM has been increasingly conducted internationally, with numerous foreign language translations of the measure emerging. The present study examined the cross-language utility of the TAPIR in German, Dutch, Swedish, and Italian translations of the TriPM using 6 archival samples of community members, university students, forensic psychiatric inpatients, forensic detainees, and adolescents residing outside the United States (combined N = 5,404). Findings suggest that the TAPIR effectively detects careless responding across these 4 translated versions of the TriPM without the need for language-specific modifications. The TAPIR total score meaningfully discriminated genuine participant responses from both fully and partially randomly generated data in every sample, and demonstrated further utility in detecting fixed "all true" or "all false" response patterns. In addition, TAPIR scores were reliably associated with inconsistent responding scores from another psychopathy inventory. Specificity for a range of tentative cut scores for assessing profile validity was modestly reduced among our samples relative to rates previously obtained with the English version of the TriPM; however, overall the TAPIR appears to demonstrate satisfactory cross-language generalizability. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Behavioural Difficulties That Co‐occur With Specific Word Reading Difficulties: A UK Population‐ Based Cohort Study

PubMed Central

Ryder, Denise; Norwich, Brahm; Ford, Tamsin

2015-01-01

This study aimed to examine the association between specific word reading difficulties (SWRD) identified at age 7 years using a discrepancy approach and subsequent dimensional measures of behavioural difficulties reported by teachers and parents at age 11 years. Behavioural problems were assessed using the Strengths and Difficulties Questionnaire. Secondary analysis of a UK representative population‐based sample of children (n = 12 631) was conducted using linear regression models. There were 284 children (2.2%) identified with SWRD at age 7 years. Children with SWRD had significantly higher scores on all measures of behavioural difficulties in unadjusted analysis. SWRD was associated with elevated behavioural difficulties at age 11 years according to parent report, and with greater emotional problems, hyperactivity and conduct issues according to teachers, even after having controlled for baseline difficulties. These results were replicated for children with low reading attainment, but no cognitive ability discrepancy. Categories of special educational need into which children with SWRD were classed at school were varied. Given high rates of co‐occurring behavioural difficulties, assessment that identifies each individual child's specific functional, rather than categorical, difficulties is likely to be the most effective way of providing classroom support. © 2015 The Authors. Dyslexia published by John Wiley & Sons Ltd. PMID:25693052

Evaluation of Relationship between Obsessive-compulsive Disorder and Dissociative Experiences.

PubMed

Tatlı, Mustafa; Cetinkaya, Ozlem; Maner, Fulya

2018-05-31

The aim of the study is to evaluate the relationship between obsessive-compulsive disorder (OCD) symptoms and dissociative experiences and the effect of childhood traumatic experiences on this relationship in OCD patients. Fifty consecutive OCD patients and 50 healthy controls are enrolled for this study. Sociodemographic and Clinical Data Form, Dissociative Experiences Scale (DES), Padua Inventory (PI) and Childhood Trauma Questionnaire (CTQ) are applied to participants. Average DES total score in the patient group is 20.58 and in the control group it is 4.87. In the patient group, when we evaluate the relation strengths of DES total and subscale scores with PI total score, we found out that amnesia subscale has r=0.361 ( p <0.01), absorption subscale has r=0.611 ( p <0.01), depersonalization/derealization subscale has r=0.574 ( p <0.01), and DES total score has r=0.55 ( p <0.01) relation strengths with PI total score. In patient group both DES total score and CTQ total score have influence on PI total score independently from each other. In addition to this, the level of the influence of DES total scores on PI total scores is, R²=0.399 ( p <0.01) and the level of the influence of CTQ total scores on PI total scores is R²=0.343 ( p <0.01). Dissociative experiences are seen more frequently in OCD patients than healthy controls. Among dissociative experiences, absorption has stronger relation with OCD symptoms. The relation between OCD and dissociation is independent from and stronger than the relation between childhood traumatic experiences and OCD.

Return to Sports and Physical Activities After Primary Partial Arthrodesis for Lisfranc Injuries in Young Patients.

PubMed

MacMahon, Aoife; Kim, Paul; Levine, David S; Burket, Jayme; Roberts, Matthew M; Drakos, Mark C; Deland, Jonathan T; Elliott, Andrew J; Ellis, Scott J

2016-04-01

Research regarding outcomes in sports and physical activities after primary partial arthrodesis for Lisfranc injuries has been sparse. The purposes of this study were to assess various sports and physical activities in young patients following primary partial arthrodesis for Lisfranc injuries and to compare these with clinical outcomes. Patients who underwent primary partial arthrodesis for a Lisfranc injury were identified by a retrospective registry review. Thirty-eight of 46 eligible patients (83%) responded for follow-up at a mean of 5.2 (range, 1.0 to 9.3) years with a mean age at surgery of 31.8 (range, 16.8 to 50.3) years. Physical activity participation was assessed with a new sports-specific, patient-administered questionnaire. Clinical outcomes were assessed with the Foot and Ankle Outcome Score (FAOS). Patients participated in 29 different and 155 total physical activities preoperatively, and 27 different and 145 total physical activities postoperatively. Preoperatively, 47.1% were high impact, and postoperatively, 44.8% were high impact. The most common activities were walking, bicycling, running, and weightlifting. Compared to preoperatively, difficulty was the same in 66% and increased in 34% of physical activities. Participation levels were improved in 11%, the same in 64%, and impaired in 25% of physical activities. Patients spent on average 4.2 (range, 0.0 to 19.8) hours per week exercising postoperatively. In regard to return to physical activity, 97% of respondents were satisfied with their operative outcome. Mean postoperative FAOS subscores were significantly worse for patients who had increased physical activity difficulty. Most patients were able to return to their previous physical activities following primary partial arthrodesis for a Lisfranc injury, many of which were high-impact. However, the decreased participation or increase in difficulty of some activities suggests that some patients experienced postoperative limitations in exercise. Future studies could compare sports outcomes between primary partial arthrodesis and open reduction internal fixation for Lisfranc injuries. Level IV, retrospective case series. © The Author(s) 2015.

Associations between gender, disease features and symptom burden in patients with myeloproliferative neoplasms: an analysis by the MPN QOL International Working Group

PubMed Central

Geyer, Holly L.; Kosiorek, Heidi; Dueck, Amylou C.; Scherber, Robyn; Slot, Stefanie; Zweegman, Sonja; te Boekhorst, Peter AW; Senyak, Zhenya; Schouten, Harry C.; Sackmann, Federico; Fuentes, Ana Kerguelen; Hernández-Maraver, Dolores; Pahl, Heike L.; Griesshammer, Martin; Stegelmann, Frank; Döhner, Konstanze; Lehmann, Thomas; Bonatz, Karin; Reiter, Andreas; Boyer, Francoise; Etienne, Gabriel; Ianotto, Jean-Christophe; Ranta, Dana; Roy, Lydia; Cahn, Jean-Yves; Harrison, Claire N.; Radia, Deepti; Muxi, Pablo; Maldonado, Norman; Besses, Carlos; Cervantes, Francisco; Johansson, Peter L.; Barbui, Tiziano; Barosi, Giovanni; Vannucchi, Alessandro M.; Paoli, Chiara; Passamonti, Francesco; Andreasson, Bjorn; Ferrari, Maria L; Rambaldi, Alessandro; Samuelsson, Jan; Cannon, Keith; Birgegard, Gunnar; Xiao, Zhijian; Xu, Zefeng; Zhang, Yue; Sun, Xiujuan; Xu, Junqing; Kiladjian, Jean-Jacques; Zhang, Peihong; Gale, Robert Peter; Mesa, Ruben A.

2017-01-01

The myeloproliferative neoplasms, including polycythemia vera, essential thrombocythemia and myelofibrosis, are distinguished by their debilitating symptom profiles, life-threatening complications and profound impact on quality of life. The role gender plays in the symptomatology of myeloproliferative neoplasms remains under-investigated. In this study we evaluated how gender relates to patients’ characteristics, disease complications and overall symptom expression. A total of 2,006 patients (polycythemia vera=711, essential thrombocythemia=830, myelofibrosis=460, unknown=5) were prospectively evaluated, with patients completing the Myeloproliferative Neoplasm-Symptom Assessment Form and Brief Fatigue Inventory Patient Reported Outcome tools. Information on the individual patients’ characteristics, disease complications and laboratory data was collected. Consistent with known literature, most female patients were more likely to have essential thrombocythemia (48.6% versus 33.0%; P<0.001) and most male patients were more likely to have polycythemia vera (41.8% versus 30.3%; P<0.001). The rate of thrombocytopenia was higher among males than females (13.9% versus 8.2%; P<0.001) and males also had greater red-blood cell transfusion requirements (7.3% versus 4.9%; P=0.02) with shorter mean disease duration (6.4 versus 7.2 years, P=0.03). Despite there being no statistical differences in risk scores, receipt of most therapies or prior complications (hemorrhage, thrombosis), females had more severe and more frequent symptoms for most individual symptoms, along with overall total symptom score (22.8 versus 20.3; P<0.001). Females had particularly high scores for abdominal-related symptoms (abdominal pain/discomfort) and microvascular symptoms (headache, fatigue, insomnia, concentration difficulties, dizziness; all P<0.01). Despite complaining of more severe symptom burden, females had similar quality of life scores to those of males. The results of this study suggest that gender contributes to the heterogeneity of myeloproliferative neoplasms by influencing phenotypic profiles and symptom expression. PMID:27540137

Do healthy preterm children need neuropsychological follow-up? Preschool outcomes compared with term peers.

PubMed

Dall'oglio, Anna M; Rossiello, Barbara; Coletti, Maria F; Bultrini, Massimiliano; DE Marchis, Chiara; Ravà, Lucilla; Caselli, Cristina; Paris, Silvana; Cuttini, Marina

2010-10-01

the aim of this study was to determine neuropsychological performance (possibly predictive of academic difficulties) and its relationship with cognitive development and maternal education in healthy preterm children of preschool age and age-matched comparison children born at term. a total of 35 infants who were born at less than 33 weeks' gestational age and who were free from major neurosensory disability (16 males, 19 females; mean gestational age 29.4wk, SD 2.2wk; mean birthweight 1257g, SD 327g) and 50 term-born comparison children (25 males, 25 females; mean birthweight 3459g, SD 585g) were assessed at 4 years of age. Cognition was measured using the Griffiths Mental Development scales while neuropsychological abilities (language, short-term memory, visual-motor and constructive spatial abilities, and visual processing) were assessed using standardized tests. Multivariable regression analysis was used to explore the effects of preterm birth and sociodemographic factors on cognition, and to adjust neuropsychological scores for cognitive level and maternal education. the mean total Griffiths score was significantly lower in preterm than in term children (97.4 vs 103.4; p<0.001). Factors associated with higher Griffiths score were maternal university education (β=6.2; 95% confidence interval [CI] 0.7-11.7) and having older siblings or a twin (β=4.0; 95% CI 0.5-7.6). At neuropsychological assessment, preterm children scored significantly lower than term comparison children in all tests except lexical production (Boston Naming Test) and visual-processing accuracy. After adjustment for cognitive level and maternal education, differences remained statistically significant for verbal fluency (p<0.05) and comprehension, short-term memory, and spatial abilities (p<0.01). neuropsychological follow-up is also recommended for healthy very preterm children to identify strengths and challenges before school entry, and to plan interventions aimed at maximizing academic success.