Reliability and validity of the Harris Infant Neuromotor Test.

OBJECTIVE: To examine the reliability and validity of the Harris Infant Neuromotor Test (HINT), a screening tool that can be administered and scored in <30 minutes, with the goal of identifying neuromotor differences in infants aged 3 to 12 months. STUDY DESIGN: Infants, aged 3 to 12 months (n = 54), were assessed in 2 high-risk infant follow-up programs in Vancouver, British Columbia. Inter-rater, test-retest, and intra-rater reliability were examined. Concurrent and predictive validity of the HINT with the Bayley Scales of Infant Development-II (BSID-II) were evaluated by using the Pearson product-moment correlation. RESULTS: Intraclass correlation coefficients for reliability for the Total HINT Score ranged from 0.98 to 0.99. Concurrent validity of the HINT with the BSID-II Mental Scale during the first year was r = -0.73 (P <.01), and with the BSID-II Motor Scale, r = -0.89 (P <.01). The predictive relationships between the HINT and the BSID-II at 17 to 22 months were r = -0.11 for the BSID-II Mental Scale and r = -0.49 (P <.01) for the BSID-II Motor Scale. CONCLUSIONS: The HINT is reliable for screening infant neuromotor performance and has strong concurrent validity with the Bayley-II Mental and Motor Scales. HINT scores during the first year accounted for 24% of the variance of Bayley-II Motor scores at 17 to 22 months.

Preparation, information and liaison: conducting successful research in palliative care.

Palliative care professionals are increasingly exposed to, and under pressure to participate in, research to promote evidence-based practice. This may pose challenges and tensions within normal working practices. This article draws on the results of a small qualitative study that explored the experiences of a group of specialist nurses at an independent hospice involved in palliative care research. By reflecting on their experiences and the difficulties they encountered, primarily with regard to obtaining informed consent from patients to take part in the research, this article explores issues relevant to practitioners and researchers when conducting palliative care research involving patients. It concludes by suggesting guidelines for conducting good quality research.

Reactions of type II restriction endonucleases with 8-base pair recognition sites.

Type II restriction endonucleases usually recognize 4-6-base pair (bp) sites on DNA and cleave each site in a separate reaction. A few type II endonucleases have 8-bp recognition sites, but these seem unsuited for restriction, since their sites are rare on most DNA. Moreover, only one endonuclease that recognizes a target containing 8 bp has been examined to date, and this enzyme, SfiI, needs two copies of this site for its DNA cleavage reaction. In this study, several endonucleases with 8-bp sites were tested on plasmids that have either one or two copies of the relevant sequence to determine if they also need two sites. SgfI, SrfI, FseI, PacI, PmeI, Sse8781I, and SdaI all acted through equal and independent reactions at each site. AscI cleaved the DNA with one site at the same rate as that with two sites but acted processively on the latter. In contrast, SgrAI showed a marked preference for the plasmid with two sites and cleaved both sites on this DNA in a concerted manner, like SfiI. Endonucleases that require two copies of an 8-bp sequence may be widespread in nature, where, despite this seemingly inappropriate requirement, they may function in DNA restriction.

Day hospice care--a review of the literature.

This paper traces the development and evaluation of day care hospice provision through analysis of the available literature. The CD-ROM was utilized to access and review the Medline, CINAHL and Healthstar databases. In addition, a hand search of Progress in Palliative Care was conducted. The literature describes the provision of a service within a day hospice, and access to day hospice services. Issues regarding the provision of a day hospice as a mechanism to meet consumer needs are explored. The literature reveals little evaluation of evidence-based practice or of the cost-effectiveness of day hospice provision. There is a dearth of research relating to day care, evaluation studies in particular. It is clearly important that future research compares outcomes with other models of service provision.

Content validity of the Harris Infant Neuromotor Test.

BACKGROUND AND PURPOSE: The purpose of this study was to assess the content validity of the Harris Infant Neuromotor Test (HINT), a new screening tool designed to detect early signs of cognitive and neuromotor delays in infants with known risk factors. SUBJECTS: A multidisciplinary panel of 26 international experts, including researchers and clinicians in physical therapy, occupational therapy, developmental pediatrics, child neurology, and psychology, was selected to assess, review, and suggest modifications to the HINT. METHODS: A validity questionnaire that was keyed to the three parts of the HINT (background information, parent questionnaire, and infant assessment) and to individual items within each part was mailed to the selected content experts. Data were analyzed using descriptive statistics. RESULTS: Twenty experts completed the validity questionnaires, and the remaining 6 experts provided written comments. The experts generally agreed that the items on the initial development edition of the HINT were clearly worded and free of cultural bias. Based on written feedback, additional background information items were added, a fifth question was added to the parent questionnaire portion, and 20 of the 22 infant assessment items were modified. CONCLUSION AND DISCUSSION: After receiving questionnaire responses and written comments from a panel of 26 experts, the original version of the HINT was modified and printed as development edition 2 in November 1993. This revised edition is currently being used to examine the reliability and validity of the HINT in assessing infants at risk.

The Miller Assessment for Preschoolers: clinical use with children with developmental delays.

In this pilot study, we investigated the clinical use of the Miller Assessment for Preschoolers (MAP) (Miller, 1982) with a sample of children with suspected or confirmed developmental delays. A retrospective chart audit was performed for 95 subjects, 30 girls and 65 boys, 34 to 68 months of age. Clinically related diagnoses were classified into six medical/developmental groups and a no-diagnosis group. When an analysis of variance was used to compare the six medical/developmental groups with the no-diagnosis group, some of the MAP score patterns differed significantly (p less than .01). These score patterns provide preliminary evidence for the MAP's effectiveness in screening children with developmental delays.

Use of videotape in occupational therapy.

The use and production of videotapes in occupational therapy are expected to increase in the future. A survey of 54 occupational therapy curricula and 59 hospital-clinics showed that 71 percent of the respondents use videotapes. Of that group, 70 percent produce videotapes for occupational therapy. Forty-six percent of the producers of occupational therapy videotapes make them available to others. Ninety-two percent of the respondents indicated a need for reviews of films and videotapes pertinent to occupational therapy, either in a directory--or a directory, with monthly reviews of new materials in the Occupational Therapy Newspaper or AJOT. A listing of subject areas most needed in a videotape format was also compiled.