Testing reliability and validity of practitioner-rated parental sensitivity: A novel tool for practice.

Improving parental sensitivity is an important objective of interventions to support families. This study examined reliability and validity of parental sensitivity ratings using a novel package of an e-learning tool and an interactive decision tree provided through a mobile application, called the OK! package. Independent raters assessed parental sensitivity using the OK! package (N = 11 raters) and the NICHD Parental Sensitivity rating scales (N = 22 raters) on the basis of videotaped mother-child interactions at 10- or 12-months-old (N = 294) and at 24-months-old (N = 204) from the Dutch longitudinal cohort study Generation2 . Mothers reported on children's externalizing and internalizing problems and social competence when children were 4 and 7 years old. Results showed excellent single interrater reliability for raters using the OK! package (mean ICC = .79), and strong evidence for convergent validity at 10- or 12-month-old (r = .57) and 24-month-old (r = .65). Prospective associations of neither parental sensitivity rated using the OK! package or the NICHD Parental Sensitivity rating scales with child developmental outcomes were statistically significant (p > .05), with overlapping 95% confidence intervals for both measures. The OK! package provides a promising direction for testing alternatives to current training and instruction modalities.

Mejorar la sensibilidad de progenitores es un objetivo importante de intervenciones para ayudar a las familias. Este estudio examinó la confiabilidad y validez de los puntajes de sensibilidad de progenitores usando un novedoso paquete de una herramienta de e-aprendizaje y un árbol interactivo de decisión, ofrecido a través de una aplicación móvil llamada ¡Paquete OK! Calificadores independientes evaluaron la sensibilidad de progenitores usando el ¡Paquete OK! (N = 11 calificadores) y las escalas de puntajes de Sensibilidad del Progenitor de NICHD (N = 22 calificadores) sobre la base de las interacciones madre-niño grabadas en video a los 10 o 12 meses de edad (N = 294) y a los 24 meses de edad (N = 204) del grupo holandés de estudio longitudinal Generación 2. Las madres reportaron sobre los problemas de externalización e internalización de los niños y la competencia social cuando los niños tenían 4 y 7 años. Los resultados muestran una excelente sola confiabilidad entre calificadores para los calificadores que usaron el ¡Paquete OK! (media ICC = .79), y una fuerte evidencia para la validez convergente a los 10 o 12 meses de edad (r = .57) y a los 24 meses de edad (r = .65). Las asociaciones probables, ni de la sensibilidad del progenitor evaluada usando el ¡Paquete OK! ni de las escalas de puntajes de Sensibilidad del Progenitor NICHD, con los resultados del desarrollo del niño, fueron estadísticamente significativas (p > .05), con intervalos de confiabilidad que coincidían 95% para ambas medidas. El ¡Paquete OK! Ofrece una prometedora directriz para examinar alternativas al entrenamiento y modalidades de instrucción actuales.

L'amélioration de la sensibilité parentale est un objectif important d'interventions pour soutenir les familles. Cette étude a examiné la fiabilité et la validité de la sensibilité parentale utilisant une nouvelle approche combinant un outil de formation en ligne et un arbre de décision interactif offert au travers d'une application mobile, appelée l'approche OK!. Des évaluateurs indépendants ont évalué la sensibilité parentale en utilisant l'approche OK! (N = 11 évaluateurs) et les échelles d'évaluation de le sensibilité parentale NICHD (N = 22 évaluateurs) sur la base d'interactions mère-enfant filmées à la vidéo à 10- ou 12 mois N = 294) et à 24 mois (N-204) de l'étude de cohorte longitudinale hollandaise Generation2. Les mères ont signalé les problèmes d'externalisation et d'internalisation des enfants et leur compétence sociale lorsque les enfants avaient 4 et 7 ans. Les résultats ont démontré une excellente fiabilité entre les évaluateurs pour les évaluateurs utilisant l'approche OK! (moyenne ICC = ,79(, et de fortes preuves d'une validité convergente à 10 ou 12 mois (r = ,57) et à 24 mois (r = ,65). Les associations prospectives d'aucune sensibilité parentale évaluée en utilisant l'approche OK! ou les échelles d'évaluation de la sensibilité parentale NICHD ave des résultats développementaux de l'enfant étaient statistiquement significatives (p . ,05) avec un chevauchement des intervalles de confiance de 95% pour les deux mesures. L'approche OK! offre une direction prometteuse d'alternatives des tests aux modalités de formation et d'instruction actuelles.

Muscle assessment in brachial plexus injury: A reliability study.

PURPOSE: Motor outcome following a brachial plexus injury is frequently measured to evaluate the success of surgical interventions. We aimed to identify whether the manual muscle testing using the Medical Research Council (MRC) method in adults with C5/6/7 motor weakness was reliable and whether its results correlated with functional recovery. METHODS: Two experienced clinicians examined 30 adults with C5/6/7 weakness following proximal nerve injury. The examination included using the modified MRC to assess motor outcome in the upper limb. Kappa statistics were calculated to evaluate inter-tester reliability. Correlation coefficients was calculated to explore the correlation between the MRC and the Disabilities of the Arm Shoulder and Hand (DASH) score and each EQ5D domain. RESULTS: We found that grades 3-5 of the modified and unmodified MRC motor rating scales have poor inter-rater reliability when assessing C5/6/7 innervated muscles in adults with a proximal nerve injury. The Deltoid Posterior and the Extensor Carpi Radialis Longus were the only muscles (using the modified MRC) to achieve a Kappa over 0.6 indicating substantial reliability. Higher combined MRC scores correlated significantly with a lower DASH and vice versa. Similarly, higher combined scores of MRC correlated significantly with a higher rating of overall health on the EQ5D VAS. CONCLUSIONS: This study demonstrates that the MRC motor rating scale has poor inter-rater reliability when assessing C5/C6/C7 innervated muscles in adults following proximal nerve injury. Other methods of assessing motor outcome following proximal nerve injury need to be considered.

Validity and reliability of a portable handheld dynamometer compared to a fixed isokinetic dynamometer to assess forearm torque strength.

To evaluate the effect of treatment on forearm rotation, torque muscle strength can be assessed using an isokinetic device (IKD) or a wrist dynamometer (WD). The aims of this study were 1) to determine concurrent validity and intra- and inter-rater reliability using the WD, and to examine correlations between WD and IKD in different positions; and 2) subsequently, to establish the intermethod reproducibility between WD as a handheld (HHD) or fixed device. We conducted a cross-sectional study in which torque strength was measured in healthy participants by two observers using an IKD and a WD. Study endpoints were concurrent validity (Pearson's r), intra- and inter-rater reliability, intermethod reproducibility (intraclass correlation coefficient: ICC) and measurement error (limits of agreement: LoA). Concurrent validity ranged, in the 2 studies assessing it, from r 0.37 to 0.52 for pronation and from r 0.50 to 0.82 for supination, with wide 95% confidence intervals. ICC for intra-rater reliability for pronation ranged from 0.85 to 0.91 and for supination from 0.91 to 0.95. ICC for inter-rater reliability for pronation ranged from 0.84 to 0.96 and for supination from 0.92 to 0.96. Despite the excellent intra- and inter-rater reliability and intermethod reproducibility for the WD-HHD and fixed WD, validity was low when compared to IKD and wide LoA indicated a high measurement error of approximately 20%. These results suggest that the WD cannot replace the IKD isometric mode for pronation and supination. LEVEL OF EVIDENCE: 2.

Confiabilidade diagnóstica e linguagem / Diagnostic reliability and language / Fiabilité diagnostique et langage / Fiabilidad diagnóstica y lenguaje

Neste artigo defendemos que a busca operacional-pragmática de uma maior confiabilidade diagnóstica deve levar em conta o papel que a linguagem desempenha na conceituação psicopatológica. Concluímos que, na conceituação dos sintomas psicopatológicos, a ênfase deve se deslocar das vivências para o relato sobre elas. Isso exige considerar de maneira explícita uma semântica, ou seja, uma teoria da significação, apenas pressuposta. Além disso, mostramos que essa mudança de ênfase tem implicações na concepção que se tem da natureza do sintoma psicopatológico. Concluímos também que a estipulação de critérios de suficiência para o diagnóstico psicopatológico favorece um aumento da confiabilidade à custa da consideração clínica dos casos limítrofes, estreitando formalmente a visada clínica da psicopatologia a partir do operacionalismo pragmático.

This article argues that the operational-pragmatic search for greater diagnostic reliability must consider the role played by language in psychopathological conceptualization. When conceptualizing psychopathological symptoms, the emphasis must shift from experience to reporting, which requires explicitly considering a semantics - that is, a theory of meaning - only presupposed. This shift in emphasis influences our understanding of the nature of the psychopathological symptom. In conclusion, stipulating sufficiency criteria for psychopathological diagnosis favors an increase in reliability in detriment of the clinical consideration of borderline cases, formally narrowing the clinical approach to psychopathology based on pragmatic operationalism.

Cet article soutien que la recherche pragmatique-opérationnelle d'une plus grande fiabilité diagnostique doit tenir compte du rôle joué par le langage dans la conceptualisation psychopathologique. Lors de la conceptualisation des symptômes psychopathologiques, l'accent doit être déplacé de l'expérience vers le rapport, ce qui nécessite de considérer explicitement une sémantique, c'est-à-dire une théorie du sens, juste présupposée. Ce changement d'accent influence notre compréhension de la nature du symptôme psychopathologique. En conclusion, la stipulation de critères de suffisance pour le diagnostic psychopathologique favorise une augmentation de la fiabilité au détriment de la considération clinique des cas limites, rétrécissant formellement l'approche clinique de la psychopathologie basée sur l'opérationnalisme pragmatique.

En este artículo argumentamos que la búsqueda pragmática operativa de una mayor fiabilidad diagnóstica debe tener en cuenta el papel que desempeña el lenguaje en la conceptualización psicopatológica. En la conceptualización de los síntomas psicopatológicos, se debe pasar el enfoque de las experiencias al de informar sobre ellas. Esto requiere considerar explícitamente una semántica, es decir, una teoría del significado, solo presupuesta. Además, mostramos que este cambio de enfoque tiene implicaciones en la comprensión de la naturaleza del síntoma psicopatológico. También concluimos que el establecimiento de criterios de suficiencia en el diagnóstico psicopatológico favorece un aumento de la fiabilidad en la observación clínica de los casos límite, que estrecha formalmente el abordaje clínico de la psicopatología desde el operacionalismo pragmático.

Examining physical literacy in young adults: psychometric properties of the PLAYself.

The PLAYself is a commonly utilized tool to assess physical literacy in child and adolescent populations. Currently, there are no measurement tools designed to examine physical literacy among adults. The purpose of this cross-sectional study was to examine the psychometric properties of PLAYself subsections in a sample of young adults. Two hundred forty-five young adults (ages 18-25) from the United States completed the PLAYself questionnaire. Multiple principal component analyses using promax rotation were utilized to assess the current factor structure of the PLAYself subsections. Each subsection was analyzed independently to explore individual summary components. PLAYself subsections were assessed for reliability using Cronbach's α, inter-item correlations, and item-total correlations. A multi-factor structure was identified for each PLAYself subsection. A 2-factor structure was identified for the Environment subsection accounting for 55.2% of the variance. A 2-factor structure was identified for the Physical Literacy Self-Description subsection accounting for 57.1% of the variance. A 3-factor structure was identified for the Relative Ranking of Literacies subsection accounting for 70.3% of the variance. The Environment, Physical Literacy Self-Description, and Relative Ranking of Literacies subsections demonstrated poor (α = 0.577), good (α = 0.89), and acceptable (α = 0.79) internal consistencies, respectively. The Physical Literacy Self-Description subsection demonstrated the best psychometric properties in our sample, and thus may be an appropriate tool to assess physical literacy in a young adult population until additional measurement tools are developed.

A systematic review of the measurement properties of the Michigan Hand Outcomes Questionnaire (MHQ).

This systematic review of the literature aimed to identify studies examining the measurement properties of the Michigan Hand Outcomes Questionnaire (MHQ) in various international populations and investigate its use in various diagnoses and health conditions. The search was conducted in MEDLINE (via PubMed), SCOPUS, CINAHL and Web of Science, with no restrictions on publication date, country or patient age. Study quality and risk of bias were assessed using the COnsensus-based Standards to select the health Measurement INstruments (COSMIN) checklist. 312 publications were identified and screened; 55 studies met the inclusion criteria and were critically reviewed. These publications comprised 16 languages and 11 pathologies and mainly investigated the internal consistency, construct validity and reliability of the MHQ. In general, all the measurement properties of the instrument showed good scores. The present review shows that the MHQ is a valid patient-reported outcome measure (PROM) and can be properly used in different clinical and rehabilitative contexts. LEVEL OF EVIDENCE: 2A.

Development and Validation of Occupation Based Practice Measure (OBPM).

Background. Occupation based practice (OBP) is the central core of occupational therapy. Therefore, measuring its usage and influencing factors seems necessary. Purpose. To develop and validate the occupation based practice measure (OBPM). Method. OBPM was developed in two phases: (I) following a qualitative study, a literature review was conducted. The item pool was revised by expert panel; (II) The face, content, construct validity, internal consistency, and test-retest reliability were assessed. Findings. The 142 items derived through the qualitative study were integrated with the 42 items derived from the literature review. The item pool was reduced by expert panel to 78 items and finalized to 37 items through face, content, and construct validity. Cronbach's alpha was greater than 0.70 and intra-class correlation coefficient showed good to excellent reliability. Implications. OBPM is a valid and reliable questionnaire that evaluates the occupational therapists' knowledge, attitudes, interest, usage, and contextual factors influencing the OBP.

Development and Validation of the Transition Readiness Assessment Instrument in Type 1 Diabetes "On TRAck".

OBJECTIVES: Transition to adult care is challenging for youth with type 1 diabetes (T1D) and their caregivers. We have developed the diabetes-specific "On TRAck" transition readiness scale, and in this study we assess its reliability and validity compared with TRANSITION-Q, a generic transition readiness questionnaire. METHODS: We systematically created 3 versions of On TRAck: adolescent, parent and health-care provider (HCP) versions (for case managers and physicians). Among adolescents 13 to 18 years of age with T1D at a single academic centre, we conducted an exploratory factor analysis and assessed interrater agreement, internal consistency and relationship with age; recent glycated hemoglobin (A1C); and recent diabetic ketoacidosis (DKA) with On TRAck and TRANSITION-Q. RESULTS: One hundred fifteen adolescents (aged 15.8±1.6 years and diabetes duration 6.7±4.1 years), their caregivers and diabetes HCPs participated. The final 24-item adolescent and parent scales (with 3 subscales: "Self-efficacy," "Autonomy" and "Support & maturity") and the 3-item HCP version had a Cronbach's alpha of 0.86 to 0.93. Adolescent scores correlated with parents (r=0.64), case managers (r=0.39) and physicians (r=0.28). Mean adolescent score was 190.3±27.1 points out of 240. Adolescent scores were 3.4 points higher per year of age (p=0.03) and 4.4 points higher for every 1% lower A1C (p=0.01), but were not associated with DKA. TRANSITION-Q was associated with age. On TRAck HCP scores were associated with adolescent's age, A1C and DKA. CONCLUSIONS: On TRAck represents a new psychometrically comprehensive diabetes-specific scale that can be used in adolescent diabetes clinics for measuring transition readiness. It is a multidimensional instrument with ease of use and high reliability scores.

Exploring the feasibility of validating early developmental screening tools for American Indian and Alaska Native children.

Screening children from birth through age 5 is critical to early identification of challenges and referral to intervention to support optimal development. Screening of American Indian and Alaska Native (AIAN) children lags behind that of other children, partly due to the lack of screening tools validated for this population. This study tested the feasibility of an online data collection strategy for use in a future study of the validity of existing screening instruments for AIAN children. Parents of AIAN children in four communities were recruited to complete screeners, provide demographic information, and provide feedback on experiences with online data collection. Participants were given the option of receiving screening results from the local early childhood program through which they were recruited. 240 participants began the process, 183 were enrolled in a partner program and reported a birthdate for at least one AIAN child, 157 had an age-eligible child, 81 began the consent process, 62 consented, and 39 fully completed data collection. Most participants were female and AIAN, the majority reported that online data collection was easy. Collecting screener validation data on a large sample of AIAN children may be able to utilize online data collection tools, with in-person support to facilitate participation.

Un examen de detección en los niños a partir del nacimiento hasta la edad de 5 años es esencial para la temprana identificación de retos y la referencia a intervenciones como apoyo a un desarrollo óptimo. El examen de detección en el caso de niños del grupo Indio Americano y Nativo de Alaska (AIAN) está muy por debajo del de otros niños, en parte debido a la falta de herramientas de detección validadas para esta población. Este estudio puso a prueba la posibilidad de una estrategia electrónica de recolección de datos para uso en un estudio futuro acerca de la validez de los existentes instrumentos de detección para niños AIAN. Se reclutaron progenitores de niños AIAN en cuatro comunidades para completar los exámenes de detección, proveer información demográfica, así como proveer información sobre las experiencias con la recolección electrónica de datos. A los participantes se les dio la opción de recibir los resultados de la detección de parte del programa local para la temprana niñez a través del cual habían sido reclutados. 240 participantes comenzaron el proceso; 183 estaban matriculados en un programa paralelo y reportaron la fecha de nacimiento de por lo menos un niño AIAN; 157 tenían un niño elegible según la edad; 81 comenzaron el proceso de consentimiento; 62 consintieron; 39 completaron en su totalidad la recolección de datos. La mayoría de los participantes eran mujeres y AIAN; la mayoría reportó que la recolección electrónica de datos fue fácil. La recolección de información de validación de la detección en un grupo muestra grande de niños AIAN pudiera ser capaz de utilizar herramientas electrónicas de recolección de datos, con un apoyo presencial para facilitar la participación.

Le dépistage des enfants de la naissance à l'âge de 5 ans est critique pour l'identification précoce des défis et problèmes et l'orientation vers l'intervention afin de soutenir le développement optimal. Le dépistage des enfants d'amérindiens des Etats-Unis et des autochtones d'Alaska est en retard par rapport à celui des autres enfants, en partie du fait du manque d'outils de dépistage validés pour cette population. Cette étude a testé la fiabilité de la stratégie de collecte de données en ligne pour son utilisation pour une étude à venir sur la validité d'instruments de dépistage existants pour les enfants AIAN. Les parents d'enfants AIAN de quatre communautés ont été recrutés afin de remplir des dépistages, d'offrir des renseignements démographiques, et d'offrir des commentaires sur les expériences de collecte de données en ligne. Les participants ont reçu l'option de recevoir les résultats de dépistage d'un programme de petite enfance local au travers duquel ils avaient été recrutés. 240 participants ont commencé le processus. 183 ont été inscrits dans un programme partenaire et ont fait état de la date de naissance d'au moins un enfant AIAN. 157 avait un enfant admissible par l'âge. 81 ont commencé le processus de consentement. 62 ont consenti. 39 ont fini la collecte de données en ligne. La collecte de données de validation du filtre de recherche sur un grand échantillon d'enfants AIAN pourrait utiliser des outils de collecte de données en ligne avec un soutien en personne afin de faciliter la participation.

Validity, reliability and test-retest study of Grip strength measurement in two positions with two dynamometers: Jamar® Plus and K-Force® Grip.

Our objective was to compare grip strength measurement in two body positions (sitting and standing) with the K-Force® Grip dynamometer and the Jamar® Plus Digital hand dynamometer, and to conduct a test-retest study of the K-Force Grip device. The study was conducted on 50 healthy young adults aged 18-25 years. Maximal grip strength was tested in sitting and standing positions with both devices. After 2 days, a re-test was conducted with the K-Force Grip. The correlation coefficient was high for grip strength measurements in sitting and standing positions with the K-Force Grip and Jamar Plus dynamometers (r > 0.9 for all). K-Force Grip values were similar in sitting and standing positions (p > 0.05). Despite this similarity, K-Force Grip measured significantly lower values than Jamar Plus (p < 0.05). Thus, the K-Force Grip device can be used as an alternative to the Jamar Plus dynamometer, regarded as the gold standard in evaluating grip strength. We believe that the same devices should be used in clinical studies, research, and patient follow-up.

Evaluation of the validity and reliability of the KFORCE Sens® electrogoniometer in evaluation of wrist proprioception.

The aim of this study was to determine the validity and reliability of the KFORCE Sens® electrogoniometer in the evaluation of wrist proprioception. Wrist position sense was assessed on a Baseline® 360° universal goniometer and a KFORCE Sens® device. The validity and reliability of the KFORCE Sens® device for wrist position sense evaluation were investigated by comparing the two data sets. Fifty-three healthy volunteers (39 female, 14 male) with a mean age of 22.83 ± 1.28 years (range, 21-27 years) were included. Joint position sense test-retest reliability (intra-class correlation coefficient) on KFORCE Sens® was "very good" for all wrist movements. There was a very strong correlation between flexion-extension movements on the dominant side (r = 0.955), and a strong correlation between ulnar-radial deviation movements (r = 0.745). There was also a very strong (r = 0.863) correlation between flexion-extension movements on the non-dominant side and a strong correlation (r = 0.690) between ulnar-radial deviation movements (p < 0.05). Our results showed that the KFORCE Sens® device was a valid and reliable evaluation means of assessing wrist position sense.

[Relevance of the theory of High Reliability Organizations in Assisted Reproductive Technology]. / Intérêt de la théorie des organisations à haute fiabilité en Assistance Médicale à la Procréation (AMP).

OBJECTIVES: The objective of this study was to assess the value of applying operating principles for High Reliability Organizations (HROs) to Assisted Reproductive Technology (ART) centres in order to optimise their operation and results. METHODS: Two exploratory qualitative case studies, in the form of ethnographic observations, were conducted in two public hospitals (Antoine-Béclère Hospital, Clamart and Nantes University Hospital). The studies analysed the structural and functional characteristics of these centres compared to HROs. Specific interviews, based on the HRO model from Roberts and Rousseau (1989), were also carried out. RESULTS: The in vitro fertilisation (IVF) procedure is comprised of a sequence of steps for which success depends on the cooperation of a range of medical staff across various specialties. Patients themselves must also play an active part in the protocol. From the different points analysed, the comparison between the characteristics of IVF activity at the ART units and those of HROs reveals structural and functional similarities, however there are also cultural differences. CONCLUSION: The study concluded that ART centres are complex healthcare organisations that face similar challenges to HROs and that they could improve their operational performance by adopting an HRO culture. To confirm the interest of this strategy, it would be useful to clarify these preliminary results by extending the exploratory study to include several public and private ART centres, and to explore the patient/couple dimension before initiating an interventional study.

Parent-Child Agreement on the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID).

OBJECTIVE: Multiple informants are often used in the assessment of child psychopathology; however, parent-child agreement is low in child psychiatry. The objective of this exploratory study was to assess informant agreement on the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) in a clinical sample of children with mental disorders and their parents, and to examine health and demographic factors associated with agreement. METHOD: MINI-KID results were analyzed for 88 parent-child dyads. Children were between 8-17 years old and were receiving in- or outpatient services for at least one mental disorder at a pediatric hospital. Kappas were calculated to assess parent-child agreement and logistic regression models were used to identify factors associated with agreement. RESULTS: Agreement was low to moderate (κ=0.19-0.41) across the MINI-KID modules. Household income was associated with agreement for major depression, generalized anxiety, and attention-deficit hyperactivity disorder. Recruitment setting and parent psychological distress were associated with agreement for generalized anxiety and separation anxiety, respectively. Age, sex, and child disability/impairment were not associated with agreement. CONCLUSIONS: Parent-child agreement on the MINI-KID was low to moderate, and few factors were associated with agreement. These initial findings reaffirm the need for multiple informants when assessing psychopathology in children and can be used by health professionals to facilitate parent-child discussions in clinical settings in child psychiatry.

OBJECTIFS: De multiples informateurs sont souvent utilisés pour évaluer la psychopathologie de l'enfant; cependant, l'entente parent-enfant est faible en psychiatrie de l'enfant. L'objectif de la présente étude exploratoire était d'évaluer l'entente des informateurs à l'égard du mini-entretien neuropsychiatrique international pour enfants et adolescents (MINI-KID) dans un échantillon clinique d'enfants souffrant de troubles mentaux et de leurs parents, et d'examiner les facteurs de santé et démographiques associés à l'entente. MÉTHODE: Le résultats du MINI-KID ont été analysés pour 88 dyades parent-enfant. Les enfants avaient entre 8 et 17 ans et recevaient des services ambulatoires ou hospitalisés pour au moins un trouble mental dans un hôpital psychiatrique. Les kappas ont été calculés pour évaluer l'entente parent-enfant et des modèles de régression logistique ont servi à identifier les facteurs associés à l'entente. RÉSULTATS: L'entente était de faible à modérée (κ = 0,19­0,41) dans tous les modules du MINI-KID. Le revenu du ménage était associé à l'entente pour la dépression majeure, l'anxiété généralisée, et le trouble de déficit de l'attention avec hyperactivité. Les paramètres du recrutement et la détresse psychologique parentale étaient associés à l'entente pour l'anxiété généralisée et l'angoisse de séparation respectivement. L'âge, le sexe et la déficience/incapacité de l'enfant n'étaient pas associés à l'entente. CONCLUSIONS: L'entente parent-enfant au MINI-KID était faible à modérée, et peu de facteurs étaient associés à l'entente. Ces premiers résultats réaffirment le besoin de multiples informateurs pour évaluer la psychopathologie des enfants et peuvent être utilisés par les professionnels de la santé pour animer les discussions parent-enfant dans les milieux cliniques de psychiatrie de l'enfant.

[Digital healthcare commons: artificial intelligence as a means of inclusion]. / Les communs numériques du soin : l'intelligence artificielle comme vecteur d'inclusion.

The progress made in the medical field thanks to artificial intelligence and its applications has developed doctors' knowledge and patients' knowledge of how to act. By giving a voice to all stakeholders in care, a commons of digital healthcare practices can be formed. Certain therapeutic support and monitoring tools, based on dialogue between health professionals, already exist. By guiding them by means of an approach of collective ethics, they, and likewise artificial intelligence, can help to foster inclusion.

[Accuracy of Optical Coherence Tomography versus Ultrasound in pachymetry]. / Fiabilité de la pachymétrie par OCT comparée à la pachymétrie par ultrasons.

PURPOSE: Measuring the central corneal thickness is an important step in the diagnosis and monitoring of glaucoma. Ultrasound pachymetry was the gold standard before the advent of OCT. The purpose of this study is to assess the reliability of OCT pachymetry compared to ultrasound pachymetry in black patients. PATIENTS AND METHODS: Pachymetry was performed as part of a glaucoma work-up. Ultrasonic pachymetry was measured using the Alcon Ocuscan by the same operator and OCT pachymetry using the Topcon 2000 OCT. The Student's t-test was used to compare means with statistical significance of 5%. The Pearson's correlation coefficient (r2) was used to measure correlations. RESULTS: One-hundred thirty-five right eyes and 135 left eyes, corresponding to 270 eyes of 135 patients, were examined. There was a female predominance (59 men/76 women), with a gender ratio of 0.78. The mean age was 42.3±17.3 [8-86] years. In the right eye, the mean OCT pachymetry was 522.4±36.8µ versus 528.2±37.9µ for ultrasonic pachymetry (P=1.00). In the left eye, the mean OCT pachymetry was 522.0±33.8µ versus 524.9±42.5µ for ultrasonic pachymetry (P=1.00). The overall mean OCT pachymetry was 522.2±35.2µ versus 526.5±40.2µ, with a non-significant difference (P=1.00). There was a strong correlation between ultrasonic pachymetry and OCT pachymetry (r2=0.83; P<0.05). On the other hand, there was a very low correlation between pachymetry and age (r2=0.09; P<0.05). Pachymetry decreased by 5µ per 10 years, corresponding to corneal thinning of 0.5µ per year. CONCLUSION: OCT pachymetry can be a reliable alternative to ultrasound pachymetry and could be performed at the same time as the OCT for glaucoma assessment.

Measuring tibial hemodynamics and metabolism at rest and after exercise using near-infrared spectroscopy.

The bone vascular system is important, yet evaluation of bone hemodynamics is difficult and expensive. This study evaluated the utility and reliability of near-infrared spectroscopy (NIRS), a portable and relatively inexpensive device, in measuring tibial hemodynamics and metabolic rate. Eleven participants were tested twice using post-occlusive reactive hyperemia technique with the NIRS probes placed on the tibia and the medial gastrocnemius (MG) muscle. Measurements were made at rest and after 2 levels of plantarflexion exercise. The difference between oxygenated and deoxygenated hemoglobin signal could be reliably measured with small coefficients of variation (CV; range 5.7-9.8%) and high intraclass correlation coefficients (ICC; range 0.73-0.91). Deoxygenated hemoglobin rate of change, a potential marker for bone metabolism, also showed good reliability (CV range 7.5-9.8%, ICC range 0.90-0.93). The tibia was characterized with a much slower metabolic rate compared with MG (p < 0.001). While exercise significantly increased MG metabolic rate in a dose-dependent manner (all p < 0.05), no changes were observed for the tibia after exercise compared with rest (all p > 0.05). NIRS is a suitable tool for monitoring hemodynamics and metabolism in the tibia. However, the local muscle exercise protocol utilized in the current study did not influence bone hemodynamics or metabolic rate. Novelty: NIRS can be used to monitor tibial hemodynamics and metabolism with good reliability. Short-duration local muscle exercise increased metabolic rate in muscle but not in bone. High level of loading and exercise volume may be needed to elicit measurable metabolic changes in bone.

A systematic review of the psychometric properties of the Jebsen-Taylor Hand Function Test (JTHFT).

This systematic review of the literature aimed to identify studies examining the psychometric properties of the Jebsen-Taylor Hand Function Test (JTHFT) in various international populations on. The search was conducted in MEDLINE, SCOPUS, CINAHL and Web Of Science, with no restrictions on publication period, the country in which the study was conducted, or the age of the patients. Eligible studies were selected on the basis of inclusion criteria and data were extracted. Study quality and the risk of bias were assessed using the COnsensus-based Standards to select the health Measurement Instruments (COSMIN) checklist. 805 articles were identified; after removing duplicates, there were 361 single studies. 338 articles did not concern the psychometric properties of JTHFT. The remaining 23 studies were selected for full text review, and all were included. They comprised 8 languages and 9 pathologies. These findings suggest the JTHFT is a useful test of manual dexterity in activities of daily living. This study provides specific information on the instrument's psychometric properties in different populations and supports clinicians in making informed decisions when choosing instruments for upper-limb evaluations.

Cross-Cultural Adaptation and Validation of the Quality of Life Questionnaire for Caregivers of Patients with Schizophrenia (S-CGQoL) in Latin America.

OBJECTIVES: The aim of this study was to adapt and validate the Schizophrenia Caregiver's Quality of Life Questionnaire (S-CGQoL) for use in the Hispanic-American population from the caregiver's perspective. METHODS: A cross-sectional instrumental model was used, with a sample of 253 caregivers of patients suffering of Schizophrenia in Bolivia, Peru and Chile. The psychometric properties of the S-CGQoL were tested through construct validity, reliability and some aspects of external validity. In addition, in order to assess the nature of the different items across the three countries, a Differential Performance Analysis (DPA) was conducted. RESULTS: A confirmatory factor analysis showed that the scale structure was well correlated to the initial structure of the QoL-MDS. The results confirmed the existence of adequate reliability indicators (α>.70 and ω>.80) and the absence of FIDs supporting the invariance of item calibrations among the three Latin American countries. CONCLUSIONS: The adaptation and validation of the S-CGQoL questionnaire demonstrate adequate psychometric properties to assess the quality of life of caregivers in samples of middle-income countries in Latin America.

Reliability of diaphragm voluntary activation measurements in healthy adults.

Voluntary activation can be used to assess central fatigue of the diaphragm after tasks such as exercise or inspiratory muscle loading. Cervical magnetic stimulation (CMS) of the phrenic nerves elicits an involuntary contraction, or twitch, of the diaphragm. This twitch is quantified based on a measure of transdiaphragmatic pressure and can be used to evaluate diaphragm contractile function and diaphragm voluntary activation (diaphragm-VA). The test-retest reliability of diaphragm-VA using CMS is currently unknown. Thirteen participants (4 male, 9 female; aged 25 ± 3 years) performed a series of interpolated twitch manoeuvres, which included a maximal inspiratory effort against a semi-occluded mouthpiece and 2 CMS-stimuli, 1 during the inspiratory manoeuvre and 1 after when the participant returned to functional residual capacity to quantify diaphragm-VA. Intraclass correlation coefficients (ICCs) and standard error of measurement (SEM) measured between-day and within-session reliability of diaphragm-VA, respectively. Maximal diaphragm-VA values were 91% (SD: 6; SEM: 3.9) and 92% (SD: 5; SEM: 2.2) during visits 1 and 2 (p = 0.68), respectively, and displayed "good" between-day reliability (ICC: 0.88; 95% confidence interval: 0.67-0.95; SEM: 2.7). Our results suggest that assessing diaphragm-VA using CMS is reliable in young healthy adults. Measuring diaphragm-VA may provide additional insight into the consequences and mechanisms of diaphragm fatigue. Novelty: Magnetic stimulation of the phrenic nerves can reliably measure voluntary activation of the diaphragm. Diaphragm voluntary activation can be used to provide additional insight into fatigability of the diaphragm.

Measurement properties of the Physical Literacy Assessment for Youth (PLAY) Tools.

The Physical Literacy Assessment for Youth (PLAY) Tools are a suite of tools to assess an individual's physical literacy. The purpose of this study is to examine the psychometric properties of the PLAY Tools, including inter-rater reliability, internal consistency, validity and the associations between the tools. In this study, 218 children and youth (aged 8.4 to 13.7 years) and a parent/guardian completed the appropriate physical literacy assessments (i.e., PLAYbasic, PLAYfun, PLAYparent and PLAYself) and the Bruiniks-Oseretsky Test of Motor Proficiency (BOT-2). Inter-rater reliability for PLAYfun was excellent (intraclass correlation coefficient = 0.94). The PLAYbasic, PLAYfun total, running and object control scores, and PLAYparent motor competence domain were higher in males than females, and PLAYfun locomotor skills were lower in males than females (p < 0.05). Age was positively correlated with PLAYbasic and PLAYfun (r = 0.14-0.32, p < 0.05). BOT-2 was positively correlated with PLAYfun and PLAYbasic (r = 0.19-0.59, p < 0.05). PLAYbasic is a significant predictor of PLAYfun (r2 = 0.742, p < 0.001). PLAYfun, PLAYparent and PLAYself were moderately correlated with one another. PLAYfun, PLAYparent and PLAYself demonstrated acceptable internal consistency (α = 0.74-0.87, ω = 0.73-0.87). The PLAY Tools demonstrated moderate associations between one another, strong inter-rater reliability and good construct and convergent validity. Continued evaluation of these tools with other populations, such as adolescents, is necessary. Novelty: In school-age children, the PLAY Tools demonstrated strong inter-rater reliability, moderate associations with one another, acceptable internal consistency and good construct and convergent validity. The results suggest that that PLAY Tools are an acceptable method of evaluation for physical literacy in school-age children.