Reliability and validity testing of the ASSIST functional performance index.

Reliability and validity testing of the ASSIST Functional Performance Index (AFPI) was conducted, focusing on persons with physical disabilities (PwPD). The AFPI was iteratively developed to assess persons' needs for Mainstream Smart Home Technologies (MSHT) as Assistive Technology (AT) and to measure the impact of a service delivery model for MSHT. The AFPI consists of 46 items organized by functional domains. A total of N = 22 PwPD completed the AFPI twice. The median response time between these two time points was four days. Test-retest reliability of overall scores was assessed using the Intraclass Correlation Coefficient model (ICC, 3.1). The weighted kappa coefficient was applied to conduct an item analysis, demonstrating moderate to substantial agreement in all but one of the items. During the second administration, validity was established by correlating the number of hours of assistance and total AFPI scores with the SCI-FI Self-Care and Basic Mobility Short Form Questionnaires. Results indicate that the AFPI demonstrates good to very good validity as an assessment tool and outcome measure in recommending and evaluating the impact of MSHT for PwPD. Future studies, including more participants and persons with cognitive and sensory disabilities, may further establish the clinical utility of the AFPI.

Is frequency of family meals associated with fruit and vegetable intake among preschoolers? A logistic regression analysis.

BACKGROUND: The present study aimed to examine the associations between frequency of family meals and low fruit and vegetable intake in preschool children. Promoting healthy nutrition early in life is recommended for combating childhood obesity. Frequency of family meals is associated with fruit and vegetable intake in school-age children and adolescents; the relationship in young children is less clear. METHODS: We completed a secondary analysis using data from the Early Childhood Longitudinal Study-Birth Cohort. Participants included children, born in the year 2001, to mothers who were >15 years old (n = 8 950). Data were extracted from structured parent interviews during the year prior to kindergarten. We used hierarchical logistic regression to describe the relationships between frequency of family meals and low fruit and vegetable intake. RESULTS: Frequency of family meals was associated with low fruit and vegetable intake. The odds of low fruit and vegetable intake were greater for preschoolers who shared less than three evening family meals per week (odds ratio = 1.5, ß = 0.376, P < 0.001) than preschoolers who shared the evening meal with family every night. CONCLUSIONS: Fruit and vegetable intake is related to frequency of family meals in preschool-age children. Educating parents about the potential benefits of frequent shared meals may lead to a higher fruit and vegetable consumption among preschoolers. Future studies should address other factors that likely contribute to eating patterns during the preschool years.

Movement Assessment of Children (MAC): validity, reliability, stability and sensitivity to change in typically developing children.

AIM: The purpose of this study was to establish the validity, reliability, stability and sensitivity to change of the family-centred Movement Assessment of Children (MAC) in typically developing infants/toddlers from 2 months (1 month 16 days) to 2 years (24 months 15 days) of age. BACKGROUND: Assessment of infant/toddler motor development is critical so that infants and toddlers who are at-risk for developmental delay or whose functional motor development is delayed can be monitored and receive therapy to improve their developmental outcomes. Infants/toddlers are thought to be more responsive during the MAC assessment because parents and siblings participate and elicit responses. METHODS: Two hundred seventy six children and 405 assessments contributed to the establishment of age-related parameters for typically developing infants and toddlers on the MAC. The MAC assesses three core domains of functional movement (head control, upper extremities and hands, pelvis and lower extremities), and generates a core total score. Four explanatory domains serve to alert examiners to factors that may impact atypical development (general observations, special senses, primitive reflexes/reactions, muscle tone). Construct validity of functional motor development was examined using the relationship between incremental increases in scores and increases in participants' ages. Subsamples were used to establish inter-rater reliability, test-retest reliability, stability and sensitivity to change. RESULTS: Construct validity was established and inter-rater reliability ICCs for the core items and core total ranged from 0.83 to 0.99. Percent agreement for the explanatory items ranged from 0.72 to 0.96. Stability within age grouping was consistent from baseline to 6 months post-baseline, and sensitivity to change from baseline to 6 months was significant for all core items and the total score. CONCLUSION: The MAC has proven to be a well-constructed assessment of infant and toddler functional motor development. It is a family-centred and efficient tool that can be used to assess and follow-up of infants and toddlers from 2 months to 2 years.

Does the currently accepted RADS-2 factor structure apply to LGBTIQ youth?

First-stage measures of depressive symptoms need to demonstrate accuracy in capturing depression in diverse populations of youth. The research question in this study asked, 'How is the Reynolds Adolescent Depression Scale-2nd Edition (RADS-2) factor structure expressed in a sample of lesbian, gay, bisexual, transgender, intersex or queer adolescent students?' Reliability, validity and principal components with orthogonal rotation factor analysis testing were conducted on a sample of 265 school-based adolescents in grades 7-12, including 72 girls and 193 boys, who sought guidance for sexual orientation or gender identity issues in this secondary data analysis. Four factors were identified that each demonstrates adequate internal consistency reliability. The RADS-2 effectively captures the features of depressive symptoms in sexual minority adolescents.

Predictors of hypertension following successful renal transplantation: a population-based study.

INTRODUCTION: Hypertension is common following renal transplantation. It is associated with poorer graft survival as well as reduced expectancy and quality of life among transplant recipients. This study sought to evaluate the prevalence of hypertension and its predictors among a representative sample of the population of adult kidney transplant recipients in southern Brazil. METHODS: This cross-sectional, multicenter study evaluated 272 adult kidney transplant recipients. The patients were classified as hypertensive if there was a previous diagnosis of high blood pressure and/or they were receiving antihypertensive drugs. The analysis used multivariate linear regression with the number of antihypertensive agents as a dependent variable. RESULTS: The final regression model showed that patient age (beta 0.23; 95% confidence interval [CI], 0.04-0.43; P = .02), nonwhite skin color (beta 0.32; 95% CI, 0.09-0.54; P = .005), serum creatinine reciprocal square root (beta 0.15; 95% CI, 0.0001-0.30; P = .05), steroid use (beta 0.62; 95% CI, 0.28-0.95; P < .001), and cyclosporine prescription (beta 0.39; 95% CI, 0.19-0.59; P < .001) were independent predictors of a greater number of antihypertensive drugs. CONCLUSIONS: This study analyzed high blood pressure predictors among a representative sample of a kidney transplant population. Its findings confirmed previous reports that cyclosporine and steroid use are independent predictors of high blood pressure after kidney transplantation, as are older age, nonwhite skin color, and reduced allograft function. The association of cyclosporine and steroid use with the need for a greater number of antihypertensive agents after kidney transplantation must be considered in the choice of an immunosuppressive regimen.

Study of the prophylactic effect of droperidol, alizapride, propofol and promethazine on spinal morphine-induced pruritus.

BACKGROUND: We have compared the use of alizapride, propofol, droperidol and promethazine for the prevention of spinal morphine-induced pruritus. METHODS: Three hundred ASA I or II women undergoing Caesarean section under spinal anaesthesia, in which morphine 0.2 mg was added to a local anaesthetic, were assigned randomly to receive i.v., in the operating room, just after delivery of the baby, alizapride 100 mg, propofol 20 mg, droperidol 1.25 mg, promethazine 50 mg or saline 2 ml (control group). In the postoperative period, the women were assessed for pruritus (absent, mild, moderate or severe) or other untoward symptoms by blinded observers. We used 95% confidence limits (95% CI) for the cumulative incidence of moderate and severe pruritus to compare the groups, and the NNT and 95% CI to compare droperidol, propofol and alizapride as for their effectiveness in preventing pruritus. For other untoward effects, the chi(2)-test was used, results being considered significant when P<0.05. RESULTS: The droperidol, propofol and alizapride groups had significantly lower incidences of pruritus compared with the control and promethazine groups, while the incidence of pruritus was similar among the patients assigned to the promethazine and control groups. As for the prevention of moderate and severe pruritus, droperidol had the lowest NNT (3.52; 95% CI: 3.37-3.67), followed by propofol (4.61; 95% CI: 4.45-4.77) and alizapride (5.43; 95% CI: 5.27-5.59). As for untoward effects, droperidol and promethazine increased the incidence of somnolence, which seemed more severe with promethazine. Otherwise, there were no differences between the groups. CONCLUSION: Droperidol, propofol and alizapride, in a decreasing order of effectiveness in the doses used in this study, reduced the incidence of pruritus induced by the use of morphine 0.2 mg intrathecally. On the other hand, promethazine 50 mg was shown to be ineffective.

National survey of computed tomography unit capacity: an update. Special report.

In a survey of CT scanner capacity begun in 1978, data from 521 scanners showed that only 39% had the capacity to perform 2,500 CT examinations per year (which was then the national guideline), while 64% could handle 3,000 head-equivalent CT (HECT) examinations per year. An update based on data from 913 CT scanners reveals that these figures have increased to 66% and 72%, respectively. CT units are now staffed 55.7 hours per week, up from 52.4 hours in 1978, and 77% of this time is available for patient use compared with 75% in 1978. Since 1978 the relative number of patients scanned has increased more than the number of hours of examination time, reflecting a substantial increase in the efficiency of CT systems.