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PubMed1997

A case-comparison of intermittent exotropia and quality of life measurements.

A Vision Quality of Life Questionnaire that combines the SF-20 and a Vision Quality Scale developed by the authors was pilot tested in a case-comparison of extreme groups, patients with intermittent exotropia (IXT) and those with no vision problems (Non-IXT), at the University of Houston (UH) Optometry Clinic. The purposes of the study were to measure the internal consistency reliability and examine the validity-related evidence of vision function associated with the instrument. The pilot study involved mailing the instrument to 52 patients in each group (IXT and Non-IXT patients). IXT patients were then frequency-matched by age and separately by sex, to control for confounding variables, to Non-IXT group patients. The Cronbach's Alpha internal consistency reliability of both scales was acceptable at > 0.70 for both the IXT and Non-IXT groups. The Wilcoxon signed ranks test was used to determine validity-related evidence. The differences between groups on the SF-20 (p = 0.0276) and Vision Function Scale (VFS) (p = 0.0385) confirm that the scales discriminate between IXT and Non-IXT populations. Two conclusions can be drawn from the pretesting and pilot testing of the SF-20 and the VFS: (1) both have acceptable internal consistency reliability scores, and (2) both show validity-related evidence that they can discriminate vision function between IXT and Non-IXT patient populations.

Adolescent↗

PubMed2006

Eye-hand co-ordination skills in very preterm infants <29 weeks gestation at 3 years: Effects of preterm birth and retinopathy of prematurity.

INTRODUCTION: Preterm infants are known to have low gross motor and fine motor skills. We questioned whether poor eye-hand coordination skills are associated with moderate to severe stages of Retinopathy of Prematurity (ROP). AIMS: The aim of this study was to examine development, with specific reference to eye-hand coordination skills, among preterm infants <29 weeks gestation with different stages of ROP at 3 years of age. METHODS AND MATERIALS: Fifteen preterm infants (<29 weeks gestation) who developed Stage 3 ROP were matched for gestation, birthweight and gender with infants who developed Stage 2 and Stage 1/no ROP. Developmental (Griffiths Mental Development Scales and Peabody Developmental Motor Scales) and ophthalmic assessments in the 3 matched groups of 15 were performed at 3 years of age. RESULTS: 1) Whilst the eye-hand coordination scores and Peabody fine motor scores were lower in the Stage 3 ROP group, they were not significantly lower than the other ROP groups. 2) Locomotor, Peabody gross motor skills and hearing and speech were significantly lower in the infants with Stage 3 ROP. The other developmental domains were not significantly different to the severe ROP group. 3) All 3 groups (of preterm infants) had lower eye-hand coordination and Peabody fine motor scores compared to test norms. 4) There were 8 of 15 infants with Stage 3 ROP who developed moderate visual problems by 3 years of age. CONCLUSION: In preterm infants, low eye-hand coordination/fine motor scores are likely to be due to their extreme prematurity.

Child, Preschool↗

PubMed1989

[Validation of an instrument to measure Exercise of Self Care Agency and its predictors].

The aim of this investigation was to delineate concepts contributing to the Exercise of Self-Care Agency (E.S.C.A.) Scale developed by Kearney & Fleischer (1979) and to test its construct validity and its predictors. The results are summarized as follows: 1. By means of principal factor analysis and maximal likelihood factor analysis upon data generated from 280 undergraduate students, the factors of Concern about Health Knowledge, Self-Concept, Information-Seeking Behavior, Decision-making and Responsibility, Self-esteem, and Passivity emerged. The total percent of variance explained by the 6 factors was 75.1%. 2. To assess factor independence and instrument homogeneity, correlations among the 6 factors were computed. The correlations ranged from .24 to .46 indicating that the factors and the items were not too similar or redundant. 3. Test-retest reliability of the total scale is r = .70. Cronbach's alpha coefficient for internal consistency of the total scale is .86 and that of the factors ranged from .750 to .661 (only factor 6 .497). 4. In additional analysis of the Exercise of Self-Care Agency Scale in relationship to Multiple Health Locus of Control, Family Environmental Scale, and Cornell Medical Index using stepwise multiple regression, the Internal Health Locus of Control Score predicted 21.8%(F = 53.34, P = .0001), Family Environmental Score 8.3%(F = 22.59, P = .0001), Modified Cornell Medical Index Score 5.4%(F = 15.74, P = .0001) of the score of the E.S.C.A.

Family↗

PubMed2003

The influence of extrinsic and intrinsic risk factors on the probability of sustaining an injury.

This study was designed to quantify the relative contributions of extrinsic and intrinsic risk factors to the probability of an injury event. A case-control design was used with data collected from injured patients at an emergency department (n=797) and a community sample matched on area of residence and time of injury (n=797). Principal components analysis was used to develop scales for the measurement of 'intrinsic' risk taking tendencies that were slightly modified versions of previously published measures. Two principal components were identified: 'health risk taking' (HRT) and 'adventurous risk taking' (ART). Logistic regression analysis identified variables that significantly predicted membership of the group of injured cases. The main hypothesis was supported by the results: that 'extrinsic' factors such as location, activity, drug and alcohol use and the type of people present at the time of the injury were related to a greater risk of injury than 'intrinsic' variables (health and adventurous risk taking tendencies). The results suggest that injury research and prevention efforts should continue to focus on the identification and modification of situational risk factors for injury rather developing programs that focus on high-risk individuals. High-risk alcohol use, use of prescribed drugs and aspects of work and recreational environments were identified as warranting particular attention.

Alcohol Drinking↗

PubMedDate not supplied

The practice characterization model: the importance of organizational life cycles and targeted interventions in general medical practice.

In response to a climate of constant change and increasing demand for services, general practice in the UK has undergone significant modification over the last 10 years. It has become a multi-disciplinary organisation encouraged by funding bodies to plan for service delivery using a more structured team based approach. In Tayside in 1996, practices were charged with producing formal Practice Development Plans (PDPs) which would focus on priority areas aligned with the Health Boards own strategic plan--those were teamwork, information management and technology, and clinical service delivery. The University of Dundee's Department of General Practice successfully applied for funding to develop ways of facilitating practices so that they could a) identify their own development priorities, and b) plan and implement action and learning to see these priorities through. Using action research methodology, the project attempted to create a climate for change, provide support and training to see the changes implemented, and ensure commitment to the changes from all members of the practice team. The Facilitator adopted a flexible style varying her role between expert, guide and support. Analysis of progress made by different practices, coupled with the Facilitator's in depth knowledge of them, suggested the importance of certain key aspects of practice organisation and culture. A practice characterisation model identified practices which were stable, currently coping, proactive and ready to face the challenge of change as best placed to engage in a full scale development programme. Other profiles suggested a range of alternative interventions as more likely to be acceptable and productive.

Data Collection↗

PubMed1986

The influence of prolonged pregnancy on infant development at one and two years of age: a prospective controlled study.

Isolated reports of developmental disturbances following prolonged pregnancy led us to compare, prospectively, at 1 and 2 years of age, infants born after normal term gestations with those born after prolonged pregnancies (exceeding 294 days). The infants were subgrouped according to their physical condition at birth, that is, normal or dysmature (mild or advanced dysmaturity). Infant assessments included: (1) height and weight, (2) hospitalizations, and (3) mental development by the Griffiths Mental Development Scales. Follow-up testing was obtained on 130 term control infants and 89 infants of prolonged pregnancies at 1 year of age and 111 term control infants and 76 infants of prolonged pregnancies at 2 years of age. At 1 and 2 years the general intelligence quotient, physical milestones, and intercurrent illnesses for normal infants and those of prolonged pregnancies were not significantly different.

Body Height↗

PubMed2006

[Validation of the Home Care Quality Assessment Index (HCQAI)].

AIM: To confirm the convergent validity of the Home Care Quality Assessment Index (HCQAI), developed by Dr. Arai et al., which is used for overall assessment of home care in three areas: 1) conditions of the disabled elderly (outcome); 2) caregiver and caregiving situation (process); and 3) the home care environment (input), based on professional staff observation. METHODS: We surveyed 102 pairs of disabled elderly and their family caregivers who used the visiting nurse station of the Okazaki Medical Association were surveyed. The validity of HCQAI was investigated by computing the Spearman rank correlation coefficient between the subscales of the HCQAI and the variables measuring "outcome", "process" and "input", respectively. "Yokaigodo" (Government-Certified Disability Index), the Activities of Daily Living (ADL) of the disabled elderly, severity of dementia, the Short-Memory Questionnaire (SMQ) and Troublesome Behavior Scale (TBS) were used for the "outcome" variables."The impression of home care", a new scale developed for this study, was used as a variable to evaluate "process and input". RESULTS: The HCQAI subscales for "outcome" indicators were significantly correlated with the other above-described variables measuring "outcome", but not with "the impression of home care", the variable evaluating "process and input". All 5 HCQAI subscales for "process" and "input" were significantly correlated with "the impression of home care", but 4 out of 5 HCQAI subscales were not significantly correlated with the variables measuring "outcome". CONCLUSION: These findings indicate that each subscale of the HCQAI has the expected properties. Therefore, the convergent validity of the HCQAI is confirmed.

Aged↗

PubMed1989

Illness coping strategies and hypochondriacal traits among medical inpatients.

The Illness Coping Strategies scale (ICS) is an 18-Likert-item scale developed to examine illness appraisal and coping by medical patients more comprehensively than instruments which screen for hypochondriacal traits in this population. This study has examined the association of hypochondriacal traits with illness coping strategies addressed by the ICS among 101 randomly selected inpatients drawn from a general medicine unit of a teaching general hospital. Despite the exclusion of patients with substance abuse or organic mental disorder, or referral for psychiatric consultations, hypochondriacal traits were prevalent in this inpatient sample. Five factor-derived subscales of the ICS (disease vigilance, limit activity, overresponsiveness, self-treatment and obsessive worry) were extracted, and internal consistency and test-retest reliabilities were determined. Multiple regression analysis on a composite measure of hypochondriasis revealed that the five ICS factor scales accounted for 26 percent of the variance. Patients with a high hypochondriacal index had associated high scores on symptom vigilance, limit activity and obsessive worry subscales, suggesting that these illness coping strategies may represent an important aspect of hypochondriacal illness presentation. The self-treatment subscale appeared to act as a suppressor variable, contributing to the prediction of the hypochondriacal index by extracting self treatment aspects from the other illness coping factors. Illness coping responses found to be associated with hypochondriacal traits in this study were rather passive strategies which promoted increased vigilance and concern about symptoms while providing few opportunities to reduce uncertainty regarding health status.

Adaptation, Psychological↗

PubMed1995

Concerns about aging and a drive for thinness: a factor in the biopsychosocial model of eating disorders?

OBJECTIVE: Examine the association between concerns about aging and a drive for thinness. METHOD: Two groups were studied: (1) randomly selected nonclinical subjects (77 men, M +/- SD age: 44.4 +/- 18.3 years; 140 women, M +/- SD age: 41.9 +/- 15.3 years) from Ann Arbor, Michigan (replication of an earlier shopping mall-based survey); and (2) women (N = 54) who were concerned about their aging appearance (18 women with mild to moderate skin aging, M +/- SD age: 41 +/- 4 years; 36 women with moderate to severe skin aging, M +/- SD age: 62 +/- 6 years) and had volunteered for 24-week, prospective, controlled studies evaluating the efficacy of topical retinoic acid versus placebo for the treatment of aging skin. All subjects rated their aging-related concerns on previously developed scales, and completed the Drive for Thinness (DT) and Body Dissatisfaction (BD) subscales of the Eating Disorder Inventory (EDI). RESULT: In the random community survey there was a direct correlation between both concerns about the effect of aging on the appearance (men: r = .28, p < .05; women: r = .32, p < .01) and concerns about the cutaneous stigmata of aging (men: r = .38, p < .01; women: r = .28, p < .01) and DT (EDI). In the aging skin study both DT (EDI) and BD (EDI) were lower (p < .01) at 24 weeks posttherapy, in the retinoic acid (n = 32) but not the placebo (n = 22) group. DISCUSSION: Concerns about an aging appearance can be associated with a drive for thinness and excessive dieting, factors that are important in the development of eating disorders.

Administration, Topical↗

PubMed2006

Neonatal neurodevelopmental outcomes following tocolysis with glycerol trinitrate patches.

OBJECTIVE: The object of this study was to determine the effects of maternal tocolysis with glycerol trinitrate (GTN) patches on the neurodevelopment of infants. STUDY DESIGN: This was a randomized, multicenter, controlled trial comparing the efficacy of GTN patches with standard beta2 agonist as tocolytic therapy. The previously reported outcomes of this study indicated no difference in neonatal mortality or morbidity to hospital discharge. One hundred fifty-six surviving infants from 2 Australian centers were psychometrically assessed using the Griffiths Mental development Scales (revised) at 18 months of age. RESULTS: There was no difference in psychometric performance between those infants enrolled in either the GTN (81 infants) or beta2 agonist (75 infants) arm of the study. CONCLUSION: This randomized trial supports no significant difference between GTN patches in comparison with standard beta2 agonist for tocolytic therapy. The results underscore the association between premature labor and adverse infant outcomes.

Adrenergic beta-Agonists↗

PubMed1988

Useful parameters to predict the eventual mental outcome of hypothyroid children.

The Quebec Network for Genetic Medicine has followed the development of some 100 hypothyroid children treated by 1 month of age and evaluated at 18 months, 3 and 5 yr and the Griffiths Mental Development Scales, then at 7 and 9 yr with the Wechsler Intelligence Scale for Children Revised. Results show that the children as a group reach scores within the normal range of the tests. However, a few patients have low scores at each evaluation. Previously, we showed a correlation between a low serum thyroxine concentration, or a relatively retarded bone maturation before treatment, and low mental scores. To better characterize the significance of this relationship we correlated these pretreatment factors and the Wechsler Intelligence Scale for Children Revised results of 43 subjects reaching the age of 7 yr. Again, the same correlation was observed. Calculating a predictive factor (low thyroxine, less than 2 micrograms/dl and retarded bone surface, less than 0.05 cm2) from data recorded before therapy initiation, 10 of 13 children were correctly predicted to have I.Q. values less than 90. The use of these parameters might permit early intervention, and allow specific guidance of the more affected subjects.

Bone Development↗

PubMed2002

Early developmental outcomes after newborn encephalopathy.

OBJECTIVE: The aim of this study was to ascertain the early developmental status of children who have a history of newborn encephalopathy. METHODS: A longitudinal follow-up was conducted of a population-based, case-control study of children born in Western Australia between June 1993 and December 1996. The study included 276 term children (>/=37 weeks' gestation) with moderate or severe newborn encephalopathy and 564 unmatched term control subjects. The Griffiths Mental Development Scales was used to ascertain developmental status and a General Quotient (GQ) score. Outcome measures were the Griffiths developmental subscales, GQ, diagnosis of cerebral palsy, and mortality. RESULTS: Thirty-four patients and 1 control subject died before reaching assessment. Between June 1994 and December 1999, 195 (81%) eligible patients and 445 (79%) eligible control subjects were assessed. Statistically significant differences were found between patients and control subjects for GQ and all developmental subscales. Overall, 39% of patients had a poor outcome as defined by death, cerebral palsy, or a significant degree of developmental delay, compared with 2.7% of control subjects. Furthermore, 62% of those with severe encephalopathy had a poor outcome compared with 25% of those with moderate encephalopathy. Patients with a history of seizures were 3 times more likely to develop cerebral palsy than patients without. Overall, 28 (10.1%) of patients have cerebral palsy. CONCLUSIONS: These data provide important prognostic information regarding survival and serious disability and indicate that newborn encephalopathy places children at significant risk of developmental delay by their second year. These findings also suggest that comprehensive clinical and educational assessments are required to enable appropriate educational provisions as these infants approach school entry.

Australia↗

PubMed2000

A high-yielding, generic fed-batch cell culture process for production of recombinant antibodies.

A fed-batch cell culture process was developed that has general applicability to all evaluated Sp2/0 (n = 8) and NS0 (n = 1) antibody-producing cell lines. The two key elements of this generic process were a protein-free concentrated feed medium, and a robust, metabolically responsive feeding strategy based on the off-line measurement of glucose. The fed-batch process was shown to perform equivalently at the 15 L development scale and 750 L manufacturing scale. Compared to batch cultures, the fed-batch process yielded a 4. 3 fold increase in the average integral of viable cell concentration and a 1.7 fold increase in average specific antibody production rate, equivalent to a 7.6 fold increase in average final antibody concentration. The highest producing cell line reached a peak viable cell concentration of 1.0 x 10(7) cell mL(-1) and a final antibody concentration of 750 mg L(-1) in a 10 day process. For all lines evaluated, reducing bioreactor pH set point from 7.2 to 7.0 resulted in an additional 2.4 fold increase in average final antibody concentration. The optimized fed-batch process consistently yielded a volumetric productivity exceeding 50 mg L(-1) day(-1). This generic, high-yielding fed-batch process significantly decreased development time, and increased manufacturing efficiency, thereby facilitating the clinical evaluation of numerous recombinant antibodies.

Animals↗

PubMed1995

Aggressive family communication, weight gain, and improved eating attitudes during systemic family therapy for anorexia nervosa.

During systemic family therapy with 15 hospitalized anorexics, family communication was evaluated, using a Family Aggression Scale developed by one of the authors. Initially members communicated aggression covertly. This finding may partially explain the common clinical observation that the families of anorexics present a strong facade of togetherness and avoid overt conflict. During therapy members shifted from covert communication of aggression to covert communication of aggression. This shift correlated with improvement in subjects' eating attitudes reflected by their EAT-26 scores. All subjects gained weight. Greater weight gain occurred in subjects whose families had low levels of covert or indirect aggression. A regression analysis showed that 86% of the variance in weight gain was predicted by two leading indicators in the middle phase of treatment. Two other factors accounted for 64% of the variance in EAT scores. The findings of this study suggest that family aggression as measured by the Family Aggression Scale is a significant index of pathology in anorexics' families and is also a clinically meaningful measure of improved conflict resolution during systemic family therapy.

Adolescent↗

PubMed2005

Cognitive competence at the onset of West syndrome: correlation with EEG patterns and visual function.

The aim of this study was to evaluate cognitive development at the onset of West syndrome (WS) with regard to electroencephalogram (EEG) patterns and visual function. Twenty-five patients (14 males, 11 females) at the onset of spasms (T0) in WS and 2 months later (T1) underwent a full clinical evaluation, including neuroimaging, cognitive assessment, video-EEG, and visual function. Mean age of the patients at spasm onset was 5.9 months (SD 2.5; range 2 to 13mo). Cognitive development, assessed with Griffiths Mental Development Scales (GMDS), was generally impaired at T0 and was significantly related to visual function (p<0.001) at both T0 and T1. In general, there was a specific major impairment in the eye-hand coordination scale of the GMDS which tended to disappear after 2 months in less severe cases. At the onset of spasms, sleep EEG organization seemed to be better related to cognitive abilities than awake hypsarrhythmia. These results support a close link between visual function and cognitive competence in WS and provide additional information to improve the understanding of possible mechanisms underlying cognitive impairment.

Child Development↗

PubMed1992

The Toddler-Preschooler Postoperative Pain Scale: an observational scale for measuring postoperative pain in children aged 1-5. Preliminary report.

This study evaluates the reliability and validity of the Toddler-Preschooler Postoperative Pain Scale (TPPPS), an observational scale developed to be a clinically useful measure of postoperative pain in children aged 1-5 years. The TPPPS consists of 7 items divided among 3 pain behavior categories: (1) Vocal pain expression; (2) Facial pain expression; and (3) Bodily pain expression. These items were derived from preliminary studies by the authors and from other observational studies of children's pain behavior. Seventy-four children between the ages of 12 and 64 months seen for inguinal hernia or hydrocele repair were the subjects of the study. Subjects were observed postoperatively for six 5-min intervals, commencing with their awakening from anesthesia, using the TPPPS. Two raters independently observed 28 of the children to assess inter-rater reliability. Validity was assessed by relating TPPPS scores to the timing and type of analgesics used, visual analog and numerical scale pain ratings made by parents and nurses, and perioperative vital signs. The TPPPS was found to possess satisfactory internal reliability (Cronbach's alpha = 0.88). Inter-rater reliability was good, with kappas for the pain behavior items ranging from 0.53 to 0.78. Preliminary evidence of the scale's validity is provided by the sensitivity of the scale to analgesic regimen, the convergence between TPPPS scores and nurse and parent ratings of postoperative pain, and the associations found between TPPPS scores and perioperative vital signs.

Analgesia↗

PubMed2003

Correlates of children's cognitive skills in an Agrarian community with mixed crop-livestock production systems, Ghinchi, central Ethiopia.

A cross-sectional survey was carried out in Ghinchi farming community, central Ethiopia during October and November 2001 to assess the level of association between children's nutritional status, families' socio-economic gradient, and degree of maternal attention and cognitive development. Ninety children were enrolled in the study, and assessment for cognitive performance was carried out using Bailey Infant Development Scale II. A pilot tested questionnaire was used to collect data on socio-economic status, mothers' care behavior, sanitary conditions of households and feeding pattern, and anthropometry of children. Chronic malnutrition expressed as height for age < -2Z-score of standard was prevalent beginning from the second birthday. Poor cognitive performance was comparatively common in the age group where chronic malnutrition is proportionately prevalent. Logistic regression analysis for variables that demonstrated significant association in correlation study revealed height for age, household possession of consumable durables, maternal care time, type and frequency of feeding and birth order of the child to be significant determinants for cognitive performance of children. Findings implicate a need for comprehensive approach, which incorporates, programs in nutrition, environmental sanitation, family planning, and strategies to reduce maternal workload, to ensure adequate physical and mental development of children.

Agriculture↗

PubMed1987

Development of severely malnourished children who received psychosocial stimulation: six-year follow-up.

The development of 16 children who were hospitalized for severe malnutrition and participated in a home-visiting program of psychosocial stimulation was compared with that of two other groups who were also hospitalized but received standard medical care only: severely malnourished group (n = 18) and an adequately nourished one (n = 20). All groups were assessed regularly on the Griffiths Mental Development Scales and the Stanford-Binet test. Both groups of malnourished children were markedly behind the adequately nourished group on admission to the hospital and the group that received no intervention showed little sign of catching up. The intervention group caught up to the adequately nourished group in 2 years. This report covers the third year of home-visiting and the 3 years following its cessation. The intervention group showed a decline in three of the five Griffiths subscales. However, they retained a marked advantage over the nonintervention group of malnourished children on the Stanford-Binet test until the end of follow-up, showing no further decline in the last year. For height, both malnourished groups failed to catch up to the adequately nourished group. It was concluded that a relatively simple intervention can benefit the development of severely malnourished children.

Child Development↗