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PubMed1993

First-grade classroom behavior: its short- and long-term consequences for school performance.

Effects of children's classroom behavior on school performance over a 4-year period are examined for a large, representative panel of beginning first graders. Scales developed from homeroom teachers' ratings of children in the spring of their first, second, and fourth years of school are used to predict spring marks in reading and math and spring scores on verbal and quantitative subtests from the CAT battery. The teachers' ratings cluster in three domains: Interest-Participation (I-P), Cooperation-Compliance (C-C), and Attention Span-Restlessness (A-R). The I-P and A-R ratings, but not C-C ratings, affect test score gains in first grade and marks in all 3 years. Behavior ratings from Year 1 also affect Year 2 and Year 4 performance, with indications that effects are understated over single-year periods. The importance of assessing classroom behavior in a longitudinal framework that allows for lagged and cumulative effects is discussed.

Achievement↗
PubMed1993

Attitudes of medical students towards IAP Pediatric Quiz.

Attitudes of medical students towards IAP Pediatrics Quiz were assessed, using a 5 point pre-tested, standardized Likert type scale, developed in our own department. Students had a favorable attitude towards the Quiz and felt that it helps them in the study of Pediatrics, but they are not able to devote sufficient time for preparations because of their preoccupation with other major subjects. The attitudes demonstrated a decline towards unfavorableness when comparison was made between the scores of third year and final year medical students. The difference was statistically significant (p < 0.05). It is suggested that the timing of the Quiz should be changed, so that it doesn't coincide with final professional examinations. This will make it more popular besides generating interest of medical students in Pediatric. Giving more weightage to Pediatrics in university examinations is also re-emphasized as a means of making students more interested in pediatrics.

Attitude↗
PubMed1993

Declining blood lead levels and cognitive changes in moderately lead-poisoned children.

OBJECTIVE: To determine whether chelation therapy or biochemical changes during a lead-lowering intervention was associated with changes in cognitive functioning of moderately lead-poisoned children. It was hypothesized that cognitive performance would improve as blood lead level declined over time. DESIGN: Short-term intervention study with measures obtained before and after intervention. SETTING: Hospital specialty clinic and university research center. PATIENTS: A total of 154 previously untreated children referred to clinic with blood lead levels between 1.21 and 2.66 mumol/L (25 and 55 micrograms/dL) at time of enrollment. Ages ranged from 13 to 87 months. INTERVENTION: Enrolled children were treated with edetate calcium disodium (EDTA) if eligible and/or with orally administered iron supplement if iron deficient. For all children, housing inspections and abatement procedures were performed as necessary. MAIN OUTCOME MEASURES: Score on Bayley Mental Development Scale or Stanford-Binet Intelligence Scale (4th edition). RESULTS: There was no effect of edetate calcium disodium treatment per se. In the short term (7 weeks), changes in blood lead levels were not related to changes in cognitive scores. In the long term (6 months), however, changes in performance were significantly related to changes in blood lead level, even after controlling for confounding variables. The standardized score increased 1 point for every decrease of 0.14 mumol/L (3 micrograms/dL) in blood lead level. CONCLUSION: The results suggest an association between decreases in blood lead level and cognitive improvements in moderately lead-poisoned children.

Chelation Therapy↗
PubMed1993

Medical students' attitudes toward providing care for the underserved. Are we training socially responsible physicians?

OBJECTIVE: To investigate the association between attitudes toward caring for the medically indigent and years of medical training. DESIGN: Questionnaire comparing attitudes of first-year medical students (MS-Is) and fourth-year medical students (MS-IVs). SETTING: Southwest medical school. PARTICIPANTS: A total of 83 (67%) male and 41 (33%) female MS-I and 65 (73%) male and 24 (27%) female MS-IV volunteers. MAIN OUTCOME MEASURE: Self-report, attitudinal scale developed for this study that provided a measure of overall attitudes, perceived societal expectations, physician/student responsibility, personal efficacy, and provision of basic services and expensive procedures. RESULTS: Overall attitudes were significantly less favorable for MS-IVs (95% confidence interval [CI], 99.6 to 106.2) than MS-Is (95% CI, 109.5 to 114.3, P < .0001). Except for basic services (P = .46), MS-IVs had worse attitudes on all attitudes subscales. Male MS-IVs reported significantly less favorable attitudes than male MS-Is in the areas of general attitudes (P = .03) and physician/student responsibility (P = .01). Female medical students showed no significant differences across classes (P > .05). Except for physician/student responsibility, female medical students' attitudes were more favorable than those of males, regardless of class. CONCLUSIONS: The MS-IVs are less favorably inclined toward caring for the medically indigent than MS-Is, though these differences are apparent only for males. Further research is needed to explore why females appear to be more resistant to attitude changes, and what educational interventions are necessary to better train physicians to respond to national health care issues.

Attitude of Health Personnel↗
PubMed1995

The impact of IAIMS on the work of information experts. Integrated Advanced Information Management Systems.

Integrated Advanced Information Management Systems (IAIMS) programs differ but have certain characteristics in common. Technological and organizational integration are universal goals. As integration takes place, what happens to those implementing the vision? A survey of 125 staff members, or information experts, involved in information or informatics at an IAIMS-funded institution was conducted during the last year of the implementation phase. The purpose was to measure the impact of IAIMS on the jobs of those in the library and related service units, and the computing, telecommunications, and health informatics divisions. The researchers used newly developed scales measuring levels of integration (knowledge of and involvement with other departments), customer orientation (focus on the user), and informatedness (changes in the nature of work beyond automation of former routines). Ninety-four percent of respondents indicated that their jobs had changed a great deal; the changes were similar regardless of division. To further investigate the impact of IAIMS on librarians in particular, a separate skills survey was conducted. The IAIMS librarians indicated that technology and training skills are especially needed in the new, integrated environment.

Analysis of Variance↗
PubMed1995

GMHC volunteers and the challenges and hopes for the second decade of AIDS.

A documentation of the impact of AIDS on New York City during the first decade of the epidemic must highlight the extraordinary responses of the Gay Men's Health Crisis (GMHC) and other community-based organizations. Data collected from volunteers (n = 587) at the close of this decade are presented to address concerns about how successfully an organization such as GMHC will be able to confront the challenging future of the epidemic. Questionnaire data on demographics and prior AIDS experiences and responses to a GMHC Reasons for Volunteering Scale, developed for this study through exploratory and confirmatory factor analysis strategies, are brought to bear on questions about the (1) diversity of the volunteer community, (2) the extent to which volunteers are burdened by potentially debilitating AIDS-related experiences, and (3) the promise for the continued effective and inspirational functioning of GMHC suggested by volunteers' reasons for choosing to volunteer at this time. Volunteers, 62% of whom are gay men and 28% are heterosexual women, represent a wide age range but little diversity in race/ethnicity and educational background. They arrive at GMHC 8 years after its founding with a slight majority having had significant prior experience with HIV-related events. There are six basic kinds of reasons for their volunteering, in order of importance: Joining the AIDS Cause, Personal Growth, Social Contact, Helping the Gay Family, Coping with AIDS, and Career Enhancement.

Acquired Immunodeficiency Syndrome↗
PubMed1977

Evoked brain potentials and disability in brain-damaged patients.

Various measures of evoked brain potential abnormality (EPA) were correlated with disability ratings (DR) for 35 brain-damaged patients. EPA data consisted of judgements of abnormality of ipsilateral, contralateral and bilateral responses to auditory and visual stimuli reflecting activity in the brain stem, subcortex and cortex. DR data were obtained from a scale developed for this study to quantize and categorize patients with a wide range of disabilities from coma to normal functioning. EPA scores based on visual and auditory cortical responses showed significantly positive correlations with degree of disability. Visual response correlation was .49, auditory .38 and combined visual and auditory .51. It was concluded that EPA measures can reflect disability independently of clinical information. They are useful in assessing brain function in general and, specifically, in assessing impairment of sensory function. The evoked potential technique was particularly useful in patients who were not able to participate fully in their own examination. There were indications that the technique may also be valuable in monitoring progress and in predicting clinical outcome in brain-damaged patients.

Adult↗
PubMed1997

[Toxic complications of high-dose polychemotherapy in the transplantation of bone marrow and of peripheral blood stem cells].

The authors propose their own system of assessment of high-dose polychemotherapy toxicity. The system was applied to toxic complications of high-dose polychemotherapy in 31 patients with hematological malignancies subjected to allogenic, autologous bone marrow transplantation and transplantation of stem cells from peripheral blood within the scope of different protocols of high-dose polychemotherapy in conditioning regimen. A special scale developed in the Belarus Center for Bone Marrow Transplantation basing on the above system provides prediction of survival in early post-transplantation period.

Adolescent↗
PubMed1998

Some psychosocial aspects of nonlethal chondrodysplasias: IV. Dyadic scale of marital adjustment.

This article examines marital adjustment of couples who have had a child with dwarfism due to a skeletal dysplasia, and of couples where one or both members are dwarfs. The instrument used was the Dyadic Adjustment Scale developed by Spanier [1976: Marriage Family 38:15-38]. The reasons for examining this psychosocial aspect of dwarfism were that the birth of a dwarfed child to average-size parents might be expected to cause stress in the relationship, and because several authors had raised concerns about the nature and/or quality of marriages involving dwarfs. This study provides evidence of a decrease in the level of marital adjustment for the average-size parents of affected children, gives tentative reassurance about marriages where both individuals are dwarfs, but raises some concerns about couples where only one member is a dwarf.

Adult↗
PubMedDate not supplied

Single case research in mental health.

In the drive to evidence-based practice, mental health nurses may be doubly disadvantaged. They lack both a strong research culture and the political power to influence large-scale developments. One approach to overcoming this hurdle is the evaluation of innovative treatments through the experimental evaluation of single cases and case series. This article explores the rationale and requirements for single case experimental designs and gives an example of the use of the approach in service development.

Evidence-Based Medicine↗
PubMed2004

Assessing medication adherence self-efficacy among low-literacy patients: development of a pictographic visual analogue scale.

Health behavior interventions are often grounded in Social Cognitive Theory, but instruments used to assess self-efficacy rely on verbal skills and yield scores that are highly positively skewed. Based on a review of the research literature and qualitative research with key informants, a pictographic medication adherence self-efficacy scale was developed. Two studies were conducted to test the pictographic and color visual analogue scale for assessing self-efficacy for medication adherence. Study 1 (N = 81) demonstrated that the pictographic self-efficacy scale was internally consistent (alpha = 0.68), time stable (2-week test-re-test r = 0.63), and showed evidence for convergent and divergent construct validity. Study 2 (N = 64) further supported the reliability of the pictographic self-efficacy scale with additional data supporting its convergent, divergent and criterion-related validity, including associations with medication adherence and HIV viral load. Distributions of self-efficacy scores approximated normal. This newly developed pictographic scale may be useful in assessing medication adherence self-efficacy in lower-literacy populations.

Adult↗
PubMed1996

Development of the scale of quality of life for diseases with visual impairment.

PURPOSE: To describe the development of the of scale quality of life which can measure the quality of life of Chinese patients with visual impairment. METHODS: Based on a thorough literature search and consultation with ophthalmologists and public health professionals, 20 items were selected to create a scale. Fifty-seven cataract patients with vision impairment and 60 glaucoma patients with vision impairment and visual field loss were measured by the scale to evaluate the validity, reliability and responsiveness of the scale. RESULTS: The scale covered four domains of the quality of life (QOL). The criterion related validity of the scale: r = 0.6865 (P = 0.001). The test-retest reliability of the scale: r = 0.8959 (P = 0.001). Coronback's alpha was 0.9359. The variance ratio (VR) of intra-individual variance to inter-individual variance was 0.0551 for overall scores. The correlation coefficient of split-half method was 0.9553. The responsiveness: T-test, T = 5.95 (P = 0.001), effect size statistic was 1.533. CONCLUSIONS: The result demonstrates that the scale has a satisfactory validity, reliability and responsiveness. It suggests that the scale can be applied to clinical trials.

Cataract↗
PubMed2006

Development and validation of a muscular dystrophy-specific functional rating scale.

OBJECTIVE: To develop a reliable and valid new rating scale for measuring the functional impact of muscular dystrophy. DESIGN: Prospective and longitudinal investigation. SETTING: Three academic medical centres in Taiwan and the Muscular Dystrophy Association of Taiwan. MEASURES: The Brooke Scale, the Vignos Scale, the Barthel Index, muscular strength, contracture severity, and predicted forced vital capacity (FVC%). METHODS: Scale development was in three stages. In stage I, a preliminary pool of 53 items was generated from patient interviews (n = 25), literature review, existing functional rating scales and expert opinion. In stage II, these items were administered to 85 patients with muscular dystrophy. The resulting data were analysed to construct a rating scale (the Muscular Dystrophy Functional Rating Scale, MDFRS) that encompassed four unidimensional constructs: mobility, basic activities of daily living, arm function and impairment. In stage III, the measurement properties of this rating scale were assessed in 121 muscular dystrophy patients different from those examined with the preliminary instrument. RESULTS: Internal consistency reliability was excellent for all domains of the final 33-item scale, with values of Cronbach's alpha ranging from 0.84 to 0.97. Intraclass correlation coefficients for test-retest and inter-rater reliability were 0.99 for all domains of the MDFRS. The MDFRS showed moderate to high correlations with a range of functional rating scales measuring similar aspects and impairment parameters (Spearman's rho = 0.65-0.91; P < 0.001, each). Confirmatory factor analysis supported a unitary construct of the four-dimensional MDFRS. The MDFRS had small floor and ceiling effects in the study samples. Sensitivity to change was confirmed by large standardized response means for the MDFRS total score. CONCLUSIONS: The MDFRS is a reliable and valid disease-specific measure of functional status for patients with muscular dystrophy.

Activities of Daily Living↗
PubMed1993

Development of a scale to measure gender-role attitudes toward breast-feeding among primiparas.

Women's roles have undergone rapid transformation in recent decades and appear to affect the decision to breast-feed. Research in this area has been hampered by the lack of valid instruments to measure the relevant domains of gender-role related considerations. This study developed a scale to measure gender-role attitudes toward breast-feeding in primiparous women. Ninety-one married women, recruited during childbirth education classes in the Chicago metropolitan area, were surveyed by mail at eight weeks postpartum regarding their experiences as new mothers. Questionnaire items measuring infant feeding method (breast-feeding, bottle feeding) and attitudes toward breast-feeding were developed specifically for this investigation. Validity and reliability were assessed by structural equations analysis using LISREL. The LISREL fit statistics supported a one factor measurement model and combining the six items into a scale. Reliability analysis yielded a standardized alpha coefficient of .74. If results of future research are promising, the scale could be used to target new mothers with multiple roles for education and support and to evaluate interventions designed to promote positive breast-feeding attitudes and behavior.

Adult↗
PubMed2002

The development of a scale to measure medical students' attitudes towards communication skills learning: the Communication Skills Attitude Scale (CSAS).

INTRODUCTION: There is little research identifying medical students' attitudes towards communication skills learning. This pilot study outlines the development of a new scale to measure attitudes towards communication skills learning. METHODS: First- and second-year medical students (n = 490) completed the 26-item Communication Skills Attitude Scale (CSAS) and 39 students completed the CSAS on a second occasion. Factor analysis was conducted to determine the factors underpinning the scale. The internal consistency of the subscales was determined using alpha coefficients. The test-retest reliability of the individual scale items were determined using weighted kappa coefficients and the test-retest reliability of the subscales were established using intraclass correlation coefficients. RESULTS: Maximum likelihood extraction with direct oblimin rotation resulted in a 2-factor scale with 13 items on each subscale. Factor I represented positive attitudes towards communication skills learning and factor II represented negative attitudes. Subscale I had an internal consistency of alpha=0.873 and an intraclass correlation of 0.646 (P < 0.001). Subscale II had an internal consistency of alpha=0.805 and an intraclass correlation of 0.771 (P < 0.001). The majority of items on the positive (n=9, 69.2%) and the negative attitude subscales (n=8, 61.5%) possessed moderate test-retest reliability. DISCUSSION: The development of a new and reliable scale to identify medical students' attitudes towards communication skills learning will enable researchers to explore the relationships between medical students' attitudes and their demographic and education-related characteristics. Further work is needed to validate this scale among a broader population of medical students.

Adolescent↗
PubMed2006

The development of a scale to discover outpatients' perceptions of the relative desirability of different elements of doctors' communication behaviours.

OBJECTIVE: The objective of the study was to discover which aspects of doctor communication behaviours are more or less desirable to patients who are attending medical outpatients clinics. METHODS: Two hundred and twenty patients took part in the study, which was undertaken in four phases. In phase one, patients completed a 10-item questionnaire where they indicated, by means of a five-point scale, their preferences for doctor communication behaviours. In phases two and three patients qualitatively expressed the meaning that they ascribed to terminology that is used by some researchers to define doctor communication behaviours. In the final phase of the study a 12-item questionnaire was developed by integrating the phase one questionnaire and patients' report from phases two and three. Patients indicated, by means of a five-point scale, their preferences for different communication behaviours that might be used by doctors. Patient's preferences were ranked in terms of the most to the least preferred behaviours. RESULTS: The findings suggest that patients most prefer consultations where doctors give information spontaneously and display affective behaviours. They least preferred consultations where medical matters are discussed and where information is not forthcoming. Furthermore, the finding suggests that the use of blanket terms by researches in defining doctor communication can lead to differences in interpretation by patients. CONCLUSIONS: The methods developed in the study appear to provide a useful tool to discover patients' desires in terms of doctor communication. PRACTICE IMPLICATIONS: The rank scale developed in the study could prove useful to medical practice. It could, for example, provide a straightforward method whereby doctors could readily access researcher's recommendations about communication. Furthermore, the scale could be used in various healthcare settings in order to discover if different patient groups vary in terms of the doctor communication they desire.

Adolescent↗
PubMed1977

The development of a scale for the assessment of sexual behaviour in Australian women.

The aim of this study was to develop a simple method of assessing female sexual response, suitable for use in clinical investigations. Following a review of interview, physiological and psychological methods, a Scale of Sexual Response was developed. Sexually dysfunctional women and women who stated they had no sexual problems completed the Scale. The results demonstrated that 11 of the 15 subscales had concurrent validity. The 4 subscales relating to auto eroticism did not distinguish between groups. Significant changes were demonstrated in 4 subscales following successful therapy of the sexual dysfunction. The scale was shown to be reliable.

Australia↗