Relative age effects in the Movement Assessment Battery for Children-2: age banding and scoring errors.

AIM: The Movement Assessment Battery for Children-2 (MABC-2) uses age-grouped scoring, which will result in relative motor functioning being overestimated for some children and underestimated for others. In this paper, we measure these errors and discuss their consequences. METHOD: We pool data from two validation studies to obtain a sample of 278 children assessed with the MABC-2 (mean (SD) age: 5 years, 0 months (9.6 months); 142 female). We used regression to measure the association between standard score and relative age, and used these results to estimate misclassification rates at the MABC-2's recommended thresholds. RESULTS: Movement Assessment Battery for Children-2 scores were distributed as expected (mean (SD) = 10.4 (2.8)). We estimated that the standard score varied by 2.76 units (0.92 SDs) per year of relative age. Depending on threshold and age bandwidth, this implies overall misclassification rates from 9% to 23%. INTERPRETATION: Relative age differences in MABC-2 scores led to substantial systematic error for young children. These errors can affect MABC-2 validity, longitudinal stability and agreement with other tools, which may reduce the appropriateness of care offered to children. Scoring approaches that may reduce or eliminate these errors are outlined.

Caregiving, single parents and cumulative stresses when caring for a child with cancer.

BACKGROUND: Single parents whose children have cancer are a marginalized group who report less family centred care, and therefore, less quality cancer care for their children. As such, the aims of this study were to explore how single parents of children with cancer describe their caregiving experiences and to understand their contextual life stressors. METHODS: A constructivist grounded theory method was used. Qualitative interviews with 29 single parents of children with cancer who were at least 6 months post-diagnosis were recruited between November 2009 and April 2011 from four hospitals across Canada. Line-by-line coding was used to establish codes and themes and constant comparison was used to establish relationships among emerging codes and conceptual themes. RESULTS: The first set of findings report on caregiving duties including: emotional tasks, informational tasks and physical tasks. The second set of findings report on the contextual picture of parent's lives including their living conditions, their physical and mental health and their family histories of disruption, trauma and disease. CONCLUSIONS: Single parents caring for children with cancer were found to experience several cumulative stressors in addition to the current strain of caring for a child with cancer. The synergy of these cumulative stresses with the added strain of caregiving for a child with cancer may have long-term health and financial implications for parents. Broad-based policy interventions should focus on relieving the chronic strains associated with being a single parent of a child with cancer.

The effect of sociodemographics, social stressors, health status and psychosocial resources on the age-depression relationship.

This study examines how an extensive set of covariates identified in previous research--sociodemographics, social stressors, health status and psychosocial resources--influence the age-depression relationship. The analyses were based on data collected for the 1994 National Population Health Survey (N = 16,291) by Statistics Canada. Analyses were conducted using OLS regression for generalized distress and logistic regression for major depressive episode. The relationship between age and both outcomes was linear and negative after controlling for sociodemographics. Controlling for social stress reduced levels of depression among younger cohorts while controlling for poor health status reduced levels of depression among the elderly. Controlling for psychosocial resources generally reduced the level of depression among older cohorts, however, the results were mixed across outcomes. The inclusion of all covariates appears to negate the effects of one another in that the fully adjusted relationships between age and depression across both outcomes were not significantly different from their bivariate relationships.

Socioeconomic position. Lifestyle and health among Canadians aged 18 to 64: a multi-condition approach.

Although a sizeable literature documents the link between socioeconomic position and health in Britain and the United States, much less work has been conducted in Canada. Moreover, what work has been done has been limited to single outcomes such as self-rated health or age-adjusted mortality. Very little has been conducted using multiple health outcomes, although doing so has been advocated. Using the 1991 General Social Survey on Health, we extended an earlier analysis to explore whether or not "condition-specific" relationships exist between socioeconomic position, lifestyle, and health among working age Canadians. We distinguished four patterns in terms of education and income adequacy. The effects of occupation did not fit into any simple pattern. Measures of lifestyle appear to mediate the relationship between education and morbidity, but not between income adequacy and morbidity. Findings are discussed in terms of the theoretical, methodological and policy implications of a condition-specific approach.

Reducing economic disparity to achieve better health: modelling the effect of adjustments to income adequacy on self-reported morbidity among the elderly in Canada.

Class differentials in health have been documented extensively in the sociological literature of the past two decades. Although sociologists have been concerned with analyzing the relationship between social class and health, less attention has been paid to modelling the effects of minimizing social disparities on health outcomes. From a sub-sample (N = 1,943) of elderly respondents aged 65 and over, four logistic regression equations where income adequacy was shown to be correlated with morbidity were selected. By adjusting the scores on the income adequacy variable, we were able to model the effect of shifting individuals from lower to higher income groups. The most dramatic results were obtained after all respondents were shifted into the highest income adequacy classification. A more realistic hypothetical model, the transfer of individuals from the lowest income group to the next category, produced the least attractive reduction in morbidity. Obviously, income adjustment alone is insufficient. Findings are discussed in terms of interventions to prevent economic disparity in old age.

Age and depression in a nationally representative sample of Canadians: a preliminary look at the National Population Health Survey.

There are considerable inconsistencies in the literature concerning the relationship between age and depression. Recently, however, two independent studies in the U.S. have shown that the distribution is U-shaped with the lowest reported levels of depression at ages 45-49. Three reasons for past inconsistencies are identified and addressed using the 1994 National Population Health Survey by Statistics Canada. Using both a distress scale and a diagnostic measure, a substantially different relationship was found. The prevalence of distress decreased steadily with age until about 65, with only a slight increase afterwards for both males and females. After the introduction of several sociodemographic covariates, however, this relationship was clearly negative. These findings are discussed in terms of future research questions.

Social class, health and aging: socioeconomic determinants of self-reported morbidity among the noninstitutionalized elderly in Canada.

Despite the vast amount of literature on the relationship between social class and health, little work has been done on postretirement populations. Using the 1991 General Social Survey, a sample of respondents (N = 1,943) aged 65 to 99 were selected for analysis. Three social class variables, income adequacy, education and occupation, were used along with several lifestyle variables and demographic controls to predict six different measures of health status. The findings supported a "condition-specific" approach to the study of class differences in morbidity. Income adequacy was the most consistent class predictor of these health measures in this sample. As well, 'risky' lifestyle variables were used to test the hypothesis that such factors may mediate the relationship between class and health. This hypothesis was not well supported in these data.