Relationship between the Vineland Adaptive Behaviour Scales and the Wechsler Adult Intelligence Scale IV in adults with intellectual disabilities.

BACKGROUND: Diagnoses of intellectual disability (ID) are based on three criteria: significant impairments in intellectual functioning, concurrent deficits in adaptive behaviour, and both being acquired in the developmental period. Adaptive behaviour was formally incorporated into the diagnosis in 1959; the rationale being that IQ and adaptive behaviour were different constructs that independently contribute to the diagnosis. However, there are limited data on the relationship between IQ and adaptive behaviour and especially so for adults who have ID. The aim of this study was to investigate this relationship on two widely used assessment tools: the Wechsler Adult Intelligence Scale - fourth edition (WAIS-IV) and the Vineland Adaptive Behaviour Scales (VABS). METHOD: Data were extracted from the case files of 147 adults who had a formal diagnosis of ID based on the WAIS-IV and VABS. Internal consistency was computed and compared to general population data. Correlations between the WAIS-IV and the VABS were computed. RESULTS: Internal consistencies for the tests when used with adults who have ID were generally good. The correlations between the WAIS-IV and VABS composite and subdomain scores were all low and similar to those reported for the general population. CONCLUSION: These results suggest that the WAIS-IV and VABS are measuring different constructs that contribute to the diagnosis of ID. Unfortunately, by the time such data have been collected, tests are being revised. The Vineland has now been revised and is in its third edition, but no data on the relationship between IQ and the VABS were collected during test development. The WAIS-V is now in development, and so it is recommended that such work be incorporated into this process or shortly thereafter to ensure that the tools continue to access independent constructs.

Legal priorities for prevention of non-communicable diseases: innovations from WHO's Eastern Mediterranean region.

OBJECTIVES: Non-communicable diseases (NCDs) are the leading cause of death globally and in the World Health Organization's (WHO) Eastern Mediterranean region (EMR). This paper reports on a research collaboration between the WHO's Eastern Mediterranean Office (EMRO) and the O'Neill Institute for National and Global Health Law at Georgetown University that aims to identify (1) regionally relevant, cost-effective and affordable legal interventions to prevent NCDs, and (2) methods to strengthen implementation and enforcement. STUDY DESIGN: Comparative analysis of >200 international, regional and domestic interventions addressing key NCD risk factors, including tobacco, alcohol, diet and physical inactivity. METHODS: Researchers searched legal and policy databases including the WHO Nutrition, Obesity and Physical Activity Database and drew upon academic commentary and 'grey' literature. Measures included evidence of impact; evidence of cost-effectiveness; and monitoring and enforcement mechanisms. RESULTS: Researchers identified many examples of legal interventions effectively reducing NCD risk factors. Key enabling factors for effective NCD-related laws include regulatory capacity; governance mechanisms promoting multisectoral collaboration and accountability; and tailoring interventions to local legal, economic and social contexts. CONCLUSIONS: In the EMR, and globally, law can be a cost-effective and affordable means of curbing underlying drivers of the NCD pandemic, such as rampant junk food marketing. Building upon this research, together with international and regional experts, EMRO has identified 10 priority interventions in the areas of tobacco control, unhealthy diets and NCD governance. The EMRO/O'Neill Institute partnership will develop guidance tools and capacity building initiatives to support Member States to harness the power of law to achieve population health improvements.

The control of hypertension by use of coconut water and mauby: two tropical food drinks.

In this study, the authors investigated the effect of regular consumption of two tropical food drinks, coconut (Cocos nucifera) water and mauby (Colubrina arborescens), on the control of hypertension. Twenty-eight hypertensive subjects were assigned to four equal groups and their systolic and diastolic blood pressures recorded for two weeks before and then for another two weeks while receiving one of four interventions. One group (the control) received bottled drinking water, the second group received coconut water, the third received mauby and the fourth group, a mixture of coconut water and mauby. Significant decreases in the mean systolic blood pressure were observed for 71%, 40% and 43% respectively of the groups receiving the coconut water, mauby and the mixture (p < or = 0.05). For these groups, the respective proportions showing significant decreases in the mean diastolic pressure were 29%, 40% and 57%. For the group receiving the mixture, the largest decreases in mean systolic and mean diastolic pressure were 24 mmHg and 15 mmHg respectively; these were approximately double the largest values seen with the single interventions.

The control of hypertension by use of coconut water and mauby: two tropical food drinks / El Control de la Hipertensión Mediante el uso del Agua de Coco y el Mauby: Dos Bedidas Tropicales Naturales

In this study, the authors investigated the effect of regular consumption of two tropical food drinks, coconut (Cocos nucifera) water and mauby (Colubrina arborescens), on the control of hypertension. Twenty-eight hypertensive subjects were assigned to four equal groups and their systolic and diastolic blood pressures recorded for two weeks before and then for another two weeks while receiving one of four interventions. One group (the control) received bottled drinking water, the second group received coconut water, the third received mauby and the fourth group, a mixture of coconut water and mauby. Significant decreases in the mean systolic blood pressure were observed for 71, 40 and 43 respectively of the groups receiving the coconut water, mauby and the mixture (p < or = 0.05). For these groups, the respective proportions showing significant decreases in the mean diastolic pressure were 29, 40 and 57. For the group receiving the mixture, the largest decreases in mean systolic and mean diastolic pressure were 24 mmHg and 15 mmHg respectively; these were approximately double the largest values seen with the single interventions

En el presente estudio, los autores investigaron el efecto del consume regular de dos bebidas tropicales naturales: el agua de coco (Cocos nucifera) y el mauby (Colubrina arborescens) sobre el control de la hipertensión. A veintiocho sujetos hipertensos asignados a cuatro grupos iguales, se les hizo un registro de su presión sanguínea sistólica y diastólica por espacio de dos semanas antes, y luego otras dos semanas mientras que recibían una de cuatro intervenciones. Un grupo (de control) recibió agua mineral embotellada; un segundo grupo recibió agua de coco; un tercer grupo recibió mauby; y finalmente el cuarto grupo recibió una bebida mixta de agua de coco y mauby. Se observaron disminuciones significativas de la presión sistólica media en el 71%, el 40% y el 43% respectivamente, de los grupos que recibieron el agua de coco, el mauby, y la bebida combinada (p ≤ 0.05). Para estos grupos, las proporciones respectivas que mostraron disminuciones significativas de la presión diastólica media fueron 29%, 40% y 57%. Para el grupo que recibió la bebida mixta, las disminuciones mayores en las presiones medias sistólica y diastólica fueron 24 mmHg y 15 mmHg respectivamente - aproximadamente el doble de los valores observados en cada una de las intervenciones.

The physician-based sentinel surveillance project - a pilot programme for internet-based sentinel surveillance - Poster abstract

OBJECTIVE: To establish and evaluate an internet-based pilot programme for sentinel surveillance of emerging health problems among the private sector physicians in three Caribbean countries. DESIGN AND METHODS: Participating physicians were identified in cooperation with local chapters of the Caribbean College of Family Physicians in Jamaica, Trinidad andTobago and St Lucia. A menu-driven Epi Info programme was used for reporting as well as on-site analysis of individual site data. Hardware was installed,participants were trained and surveillance data entry began in September-October, 1999. Three disease entities were chosen by consensus as the initial targets for surveillance - diarrhoeal disease, fever/rash syndrome, and sexually transmitted diseases. Evaluation criteria for the programme included the achievement of timely data entry and reporting, the establishment of regular feedback, and the regular use of internet-based data transfer for reporting and communication. RESULTS: The practices of twenty-one physicians were chosen as initial pilot sites. All Ministries valued the enhancement of their existing surveillance through the project and cited improved public-private partnership as a positive impact. Reduced cost of communication through use of theinternet was partially offset by the high initial cost of computer hardware, and the relatively high cost of local internet connections. Other limitations included a constrained communication infrastructure, limited baseline computer skills administrative barriers, and cost. CONCLUSION: The strengths of the programme were simplicity; potential for improved data quality; and improved competency in computer skills and surveillance among participating physicians. Proposed changes in the next phase include improvement in the software programme and development of a more extended network and e-mail forum. (Au)