The Capacity to Change and Child and Youth Care Practice: A Program Example and Framework

Child and youth care practitioners are in the practice of facilitating and supporting change in individuals, families and communities. Therefore, as change agents it is important to uncover and understand the perspectives that direct ones practice. Personal and professional experiences, as well as a multitude of theoretical orientations, merge to create a child and youth care practitioners tool box. This article offers a brief foray into various change theories and provides examples of how these change theories direct and inform practice with youth and families at the Maples Adolescent Centre in British Columbia, Canada. This article suggests that systemic interventions are necessary to support enduring change in individuals and provides examples of how this is actualized with families and communities at the Maples Adolescent Centre. It concludes by advocating for the use of multiple theoretical orientations to direct child and youth care practitioners work as change agents.     

Measuring Primary Care for Children of Latino Farmworkers: Reliability and Validity of the Parent’s Perceptions of Primary Care Measure (P3C)

This study evaluates the feasibility, reliability, and validity of the Parents Perceptions of Primary Care measure (P3C) in an underserved population: children of Latino farm workers. Bilingual research assistants verbally administered the P3C, as well as a measure of child health-related quality of life (HRQL: the PedsQL 4.0) and demographic questions to 297 Latino farm worker parents of young children, in San Diego and Imperial Counties. The P3C was found to be feasible, as measured by a very low percent of missing/do not know values. Internal consistency reliability for the Total Scale and most subscales was strong. The P3Cs validity was demonstrated through factor analysis of the subscales, by showing that scores were lower for children without a regular physician and for children experiencing foregone health care, and by demonstrating that P3C scores were related to HRQL. The P3C can be useful to various stakeholders in measuring primary care for vulnerable populations.     

Changes in plasma,liver, and ovary vitellogenin in landlocked atlantic salmon following exposure to sublethal cyanide

Female landlocked Atlantic salmon (Salmo salar Ouananiche) were exposed to 0.005 mg/L hydrogen cyanide (HCN) for 12 days at 7±1°C during late vitellogenesis (October). Plasma vitellogenin and liver and gonad vitellogenin levels were measured by homologous radioimmunoassay (RIA) specifically developed for this species. Results indicated that plasma vitellogenin levels increased in cyanide exposed fish. Vitellogenin levels in the liver did not change relative to control fish suggesting that the increased levels of plasma vitellogenin did not result from a change in synthesis in the liver. Vitellogenin levels declined in the gonad relative to the controls by day 12. Elevated plasma vitellogenin levels along with decreased vitellogenin in the gonads suggest that exposure of female salmon to sublethal HCN during late vitellogenesis inhibits the uptake of vitellogenin at the ovarian level.Marine Sciences Research Laboratory Contribution No. 675.     

Socioeconomic status, overweight and obesity in prepuberal children: A study in an area of Northern Italy

The aim of this study was to determine whether socio-economical status (SES) is associated with overweight and obesity in prepuberal children. In an area of North-Western Italy a sample of 1420 children, aged 10–11 years, had his/her height and weight recorded, (overweight and obesity were defined, respectively, as relative body weight 120% and 140%), and parents were requested to compile a questionnaire exploring some demographic and social conditions. 23% of the sample resulted overweight or obese. Prevalence rate ratios (PRR) of overweight and obesity (together) were calculated, adjusting for parents' age, parents' area of birth, and school district. PRR for mother's lowest educational level compared to the highest was 1.59 (95% CI: 1.19–2.13), while for father's education was 1.21 (0.90–1.63). PRRs for unemployed or manual mother compared to upper non manual were respectively 1.83 (1.20–2.79) and 2.20 (1.31–3.68), while for unemployed or manual father were 2.63 (1.97–2.63), and 1.63 (1.27–2.09). The cultural resources of the mother, and the economical resources of the family seem to influence the prevalence of weight gain in prepuberal children. This should be taken into account when planning programs for the prevention or reduction of obesity in children.     

Changes in job stress,musculoskeletal symptoms,and complaints of unfavorable working conditions among nurses after the adoption of a computerized order communication system

Objectives Order communication system (OCS) is a real-time computerized hospital information system that supports communication of orders from the ward users to the service departments. The adoption of an OCS may profoundly alter the service patterns of healthcare workers. As a result, job stress, musculoskeletal symptoms, and complaints of unfavorable working conditions can be expected to increase. This study investigated changes in job stress, musculoskeletal symptoms, and complaints of unfavorable working conditions among nurses after an OCS had been adopted and whether adoption of the system affected the changes.Methods A group of nurses employed in a university hospital in Korea was surveyed 1 month before and 3 months after the OCS had been adopted. We used Karaseks job contents questionnaire (JCQ) to evaluate job stress. The cumulative trauma disorder (CTD) questionnaire was used to assess the presence of musculoskeletal symptoms. The presence of unfavorable working conditions was also assessed. Next, we evaluated whether non-work factors (such as demographic factors and life events) had influence on job stress, musculoskeletal symptoms, and complaints of unfavorable working conditions after adoption of the OCS.Results One hundred thirty nurses from the hospital (51.2%) responded to both surveys. Several JCQ scales were notably altered after OCS adoption; psychological job demand was significantly decreased (P<0.01), although subjective assessment for hazardous conditions was significantly increased (P<0.01). There was a significant increase in back complaints (P<0.05). There was considerable decrease in the number of nurses who complained of increase in work intensity (P<0.05), increase of staying time to deal with remaining duties (P<0.05), and abrupt change of duties (P<0.01). According to the analysis for the associations between non-work factors and significantly changed variables, only two non-work factors, tenure and conflicts with friend(s), showed statistical significance with complaints of increase in work intensity (P<0.05)Conclusions This study suggests that a newly adopted computerized system might have provoked changes in job stress, musculoskeletal symptoms, and the complaints of unfavorable working conditions. It was found that, despite the overall favorable changes, complaints of hazardous conditions and back symptoms increased.     

‘U’ technique and standard technique of Norplant removal

Objectives To compare the side effects and time required for Norplant removal between the U technique (using the no-scalpel vas deferens holding forceps) and the standard technique.Materials and methods A randomized controlled clinical trial was carried out of acceptors in family planning clinics in Dr Kariadi Hospital, Semarang, who wanted to have Norplant removal. The Norplant was removed by experienced doctors who had been trained for both the U technique and the standard technique. Removal time, capsule condition and complications were examined.Results From 41 clients in the U technique group and 41 clients in the standard technique group, the removal times were 2.75±1.28 and 6.57±2.93 minutes, respectively (p<0.01). One week after Norplant removal, complications were found in 5 clients, 1 from the U technique group (2.44%) and 4 from the standard technique group (9.76%). Two weeks after Norplant removal no complications were found.Conclusion The U technique was quicker and less complicated compared with the standard technique.

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ResumenObjectivos Comparar los efectos secundarios y el tiempo requerido para el retiro de Norplant con la técnica U y la técnica estándar.Materiales y métodos Un ensayo clínico controlado aleatorizado de aceptadoras en la clínica de planificación familiar Dr. Kariadi Hospital Semarang que deseaban que se retirase el Norplant. El Norplant fue retirado por médicos experimentados que habían sido adiestrados tanto en la técnica U como en la estándar. Se examinaron el tiempo de retiro, el estado de las cápsulas y las complicaciones.Resultados En 41 clientas en la técnica U y 41 clientas en la técnica estándar, el tiempo de retiro fue 2,75±1,28 y 6,57±2,93 minutos (p<0,01) respectivamente. Se detectaron complicationes después de una semana del retiro de Norplant en 5 clientas, 1 caso (2,44%) en la técnica U y 4 (9,76%) en la técnica estándar. Dos semanas después no se detectaron complicaciones.Conclusión La técnica U fue más rápida y señaló menos complicaciones que la técnica estándar.

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ResumèObjectifs Comparer les effets secondaires et le temps nécessaire pour le retrait du Norplant, entre la technique en U et la technique standard.Matériels et méthodes Un essai clinique randomisé a été effectué sous contrôle à la clinique de planning familial de l'hôpital Dr. Kariadi de Semarang sur des patientes sollicitant le retrait du Norplant. Celui-ci a été retiré par des médecins expérimentés qui avaient, été formés à la technique de retrait dite en U et à la technique standard. On a relevé les temps de retrait, l'état des implants et les complications survenues.Résultats Pour 41 patientes soumises à la technique en U et 41 patientes à la technique standard, les temps de retrait ont été respectivement de 2,75±1,28 et 6,57±2,93 minutes (p<0,01). Des complications ont été observées une semaine après le retrait de Norplant chez 5 femmes, soit 1 cas (2,44%) pour la technique en U et 4(9,76%) pour la technique standard. Deux semaines plus tard, aucune complication n'a été constatée.Conclusion La technique en U est plus rapide et entraîne moins de complications que la technique standard.

     

Health-related quality of life of mothers of children with leukemia in Japan

Objective: The study compared the health-related quality of life (HRQOL) of Japanese mothers of children with leukemia to that of mothers of children without leukemia. Method: We used the Medical Outcomes Study 36-item Short-Form (SF-36) to measure the HRQOL of 97 mothers of children (average age 6.2, range 0–14) with leukemia diagnosed between 1999 and 2000, and compared their scores to those of 240 mothers of children without leukemia matched to the children with leukemia. Main results: Of the eight unadjusted domain scores of the SF-36, five were significantly low among mothers of children with leukemia compared to mothers of children without leukemia: role-physical functioning (RP), general health perception (GH), vitality (VT), social functioning (SF) and mental health (MH). Their SF-36 domain scores, when adjusted for demographic and clinical factors were also significantly low in RP, GH, VT, SF, RE and MH. The MH and SF scores in mothers of children with leukemia requiring hospital care were, respectively, approximately 20 points (1 standard deviation (SD), p < 0.0001) and 30 points (1.5 SD, p < 0.0001) lower than that of mothers of children without leukemia. Conclusion: Mothers of children with leukemia requiring hospital care have poor HRQOL, particularly with regard to mental health and social functioning, and are at a greater risk for depression. These results suggest that the current system for treating leukemic diseases of children in Japan should also include close monitoring of mothers mental health, and provision of appropriate treatment and psycho-social support.     

The association of respiratory problems in a community sample with self-reported chemical intolerance

This epidemiological study evaluated respiratory histories in those individuals reporting chemical intolerance (CI) in a community population sample. The subsample of 181 completed standard Respiratory Health Questionnaires. CI was determined from self-ratings of feeling moderately to severly ill from exposure to at least three of five common chemicals (paint, pesticides, car exhaust, new carpet, and perfume); the prevalence rate was 22.7%. The comparison group (CN) (31.5% of the sample) were selected from their reports of never feeling ill from the same chemicals. The prevalence rate of CI in females was over twice that in males (28% vs 12.9%), a significant difference. There were no significant differences in smoking, age, or education between CI and CN. Prevalence rates for symptoms and Relative Risk Ratios (RR) indicated that the CI were significantly more likely to report chronic cough, phlegm, wheeze, chest tightness, exertional dyspnea, acute respiratory illnesses, hay fever, child respiratory trouble, and physician confirmed asthma. Several of these respiratory symptoms were significantly, though differentially, related to current asthma and hay fever reports. Results suggest a potential vulnerability to and greater interference from respiratory illness for the CI, which have implications for women's health and quality of life.     

Frequency of consumption of selected indicator foods and serum cholesterol

The relationship between frequency of consumption of eleven indicator foods (milk, meat, liver, carrots, green vegetables, fruit, eggs, ham, fish, cheese and alcohol) and serum cholesterol was investigated in the comparison group of a case-control study of acute myocardial infarction conducted in Italy. Data were collected on 792 subjects from various Italian regions, admitted to hospital for acute conditions unrelated to any known or potential risk factor for myocardial infarction or to long-term modifications in diet. No statistically or epidemio-logically meaningful relationship emerged between serum cholesterol level and frequency of consumption of any of these foods. Cholesterol levels rose according to increasing consumption tertiles for most of the indicator foods considered. Higher values for the higher tertile of consumption were observed for meat, ham and eggs, but also for fruit, carrots and green vegetables. However, correlation coefficients between frequency of consumption of various food items and serum cholesterol level were uniformly low for all food items considered, ranging between –0.09 (for milk) and 0.19 (for ham). Although a more comprehensive diet history may lead to different indications, the present data are not suggestive of any major influence of long-term frequency of consumption of a few selected indicator foods on serum cholesterol levels.GISSI-EFRIM (Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto — Epidemiologia dei Fattori di Rischio dell'Infarto Miocardico). Scientific Advisory Board: G.A. Feruglio, M.G. Franzosi, C. La Vecchia, A.P. Maggioni, A. Maseri, G. Tognoni. Participating Clinical Centers: Alba (S. Boscarino); Asti (M. Alciati); Avellino (G. Amoroso); Bari Di Venere (N. D'Amato); Barletta (M.A. Messina); Belluno (A. Darold, A. De Biasi); Biella (A. Pagliarini); Bolzano (C. Romeo); Bozzolo (E. Franzi); Brindisi (C. Andriulo); Broni (B. Albonico); Cagliari (M. Sias); Casale Monferrato (M. Pezzana); Casarano (S. Ciricugno); Caserta (R. Di Sarno); Castel San Giovanni (D. Bozzarelli); Castellammare di Stabia (R. Longobardi); Cento (L. Orselli); Chiari (C. Gentilini); Colleferro (E. Venturini); Copertino (A. Calcagnile); Crotone (R. Lumare); Desio (G. Iacuitti); Fidenza (S. Callegari); Foligno (A. Mattioli); Gallarate (G. Filippini); Genova Galliera (G. Scarsi); Grosseto (A. Cresti); Guastalla (V. Manicardi); Legnago (P. Todesco); Leno (A. Lanzini); Lodi (C. Pezzi); Lugo (T. Tognoli, M. Gobbi); Magenta (G. Ventura, R. Turato); Mantova (A. Izzo, G.P. Guerra); Matera (A. Rizzi); Menaggio (S. Silvani); Messina Policlinico (G. Di Tano); Mestre (G. Gasparini); Milano Niguarda II° divisione (C. Corsini); Milano Policlinico (M. Marconi); Mirano (A. Zanocco); Monza (F. Achilli); Napoli Cardarelli ' (F. Piantadosi, R. Giuliano, G. Sepe, S. Pezzella); Novi Ligure (L. Fasciolo); Nuoro (G. Tupponi); Palermo Cervello (A. Ledda); Palermo Benfratelli (R.G. La Malfa); Palermo Villa Sofia (A. Pizzuto); Perugia (S. Brando); Pescia (L. Iacopetti); Piombino (S. Bechi); Pisa (U. Conti); Pistoia (F. Fantoni); Putignano (A. Marco); Riccione (F. Brighi, A. Benati); Rieti (S. Orazi); Rimini (F. Bologna, D. Santoro); Roma Nuova ITOR (M. Rocchi); Roma S. Pietro (P. Giuliani); Roma Policlinico (P. De Paolis); Saluzzo (P. Allemanno, S. Reinaud); San Donà di Piave (P. Delia Valentina); Sassuolo (G. Fontana, P. Orlandi); Savigliano (V. Cravero); Savona (A. Gandolfo); Sciacca (C. Catalano); Sondrio (M. Marieni); Termoli (M. Esposito); Torino Maria Vittoria (L. Faccio, L. Mussano); Trapani (G.B. Biondo); Treviso (F. Perissinotto); Udine (C. Fresco); Vasto (E. Bottari); Voghera (G. Ferrari).     

Bioethical blind spots: Four flaws in the field of view of traditional bioethics

In this paper it is argued that bioethics has tended to emphasise: high tech areas of medicine at the expense of low tech areas such as psychiatry; problems arising in treatment at the expense of those associated with diagnosis; questions of fact at the expense of questions of value; and applied ethics at the expense of philosophical theory. The common factor linking these four bioethical blind spots is a failute to recognise the full extent to which medicine is an ethical as well as scientific discipline. Once this is acknowledged it leads to a full-field bioethics in which the different areas are mutually complementary. In particular, it paves the way for a fruitful two-way exchange between the more abstract aspects of philosophical theory and the contingencies of day-to-day clinical work. The arguments of the paper are illustrated with recent work on the abuse of psychiatry.     

Effects of perceived job stress on mental health. A longitudinal survey in a Japanese electronics company

We conducted a cohort study for 2 years to examine the causal relationship between perceived job stress and mental health. Questionnaire surveys, including a 30-item General Health Questionnaire (GHQ) and a questionnaire on perceived job stress were carried out every 6 months for 2 years. To clarify the causal relationship between job stress and mental health, we followed a group of workers who initially had a GHQ score 7. Out of 462 workers who were thought to be in a healthy mental state, 282 were successfully followed for 2 years. We considered subjects who developed unhealthy mental health states (GHQ score 8) as hazardous cases. To control potential confounding factors, proportional hazard analysis was done. The overall proportion hazardous cases detected in the development of an unhealthy mental health state over two years was 55.7%. Using Cox's proportional hazard model, workers who complained of perceived job stress had a greater hazard than those without job stress. In particular, the item poor relationship with superior showed the largest adjusted hazard ratio [95% confidence interval (CI)] of 1.51 (1.06–2.15). The item too much trouble at work also had a significant hazardous effect on mental health with an adjusted hazard ratio (95% CI) of 1.43 (1.00–2.04). Some specific items of perceived job stress could cause mental ill health in workers.     

Quality of life of caregivers in Parkinson’s disease

Objective: To assess the impact of PD on informal caregivers of patients and identify the main factors related to caregiver strain. Patients and methods: Pairs of PD patients and their caregivers. Evaluation by neurologists included the Hoehn and Yahr, Schwab and England, UPDRS (parts 1–3), ISAPD, and Pfeiffers SPMSQ rating scales. Patients completed the Euro-QoL 5D, PDQ-8, and Hospital Anxiety and Depression Scale. The SQLC was used to assess caregivers quality of life (QoL), with caregivers, in turn, applying the Euro-QoL and PDQ-8 to assess patients health-related quality of life (HRQoL). Multiple linear regression models were fitted to ascertain factors linked to the SQLC. Results: Significant correlations were in evidence between the following scores: SQLC and clinical rating scales and SQLC and patients HRQoL. Based on multiple regression analysis, patients functional state (ADL) proved to be the main predictor of caregivers QoL. Self- and caregiver-assessed patients HRQoL also proved to be a relevant factor. Conclusions: (1) Patients functional state was significantly related to caregivers psychosocial burden; (2) patients HRQoL proved to be an additional factor linked to caregiver QoL; (3) improvement of patient disability and HRQoL might alleviate caregiver strain.     

Risk of health complaints and disabilities among Dutch firefighters

Objectives: The purpose of the present study was threefold: (1) to compare the work demands on firefighters (FFs) and office workers (OWs), (2) to compare the prevalence of health complaints and disabilities in the work situation in these two groups, and (3) to explore the effect of work demands on the risk of health complaints. Methods: Self-reported information was gathered from 1,624 FFs (55% response) and 630 OWs (80% response), at the same fire departments in different regions of the Netherlands, on work demands (sitting, and biomechanically and energetically demanding activities and 24-h shifts), health complaints and disabilities. First, we compared the work demands and prevalence rates of health complaints and related disabilities in the two groups, then we explored the risk of health complaints in workers with high and low exposure to work demands. Results: Compared with office workers, FFs reported: (1) less exposure to sitting and more to biomechanically and energetically demanding activities, (2) more knee (OWs 14% vs FFs 20%) and ankle (3% vs 10%) complaints and disabilities resulting from back complaints (30% vs 47%), and (3) less hypertension (7% vs 5%), stomach (13% vs 7%), heart (6% vs 2%), neck (26% vs 16%), shoulder (16% vs 14%) and arm (14% vs 6%) complaints. A higher risk of subjective fatigue was found in workers highly exposed to energetically demanding activities, and of neck, shoulder and arm complaints in workers highly exposed to sitting. Conclusions: Firefighters reported higher physical demands (with the exception of sitting) than office workers did. The prevalence rate of certain complaints or disabilities among FFs was higher (knee and ankle complaints and disabilities related to back complaints) or lower (hypertension, stomach, heart, neck, shoulder and arm complaints) than among OWs. The results suggest that exposure to highly biomechanically demanding activities might cause an increased risk of knee and ankle complaints and that exposure to highly energetically demanding activities might increase the risk of subjective fatigue.     

Relation between children’s height and outdoor air pollution from coal-burning sources in the British 1946 birth cohort

Objective Air pollution is associated with a number of health outcomes in childhood. In this study, we investigated whether air pollution is related to childrens height.Methods The 1946 British birth cohort study recruited 5,362 children born in 1 week in March 1946. Height was measured when the children were aged 2, 4, 6, 7, 11 and 15 years. Data on socio-economic conditions and other characteristics were obtained in interviews. Areas of childrens residence were categorised into four groups of air pollution on the basis of published coal-consumption data.Results After controlling for socio-economic factors, we found that air pollution was associated with childrens height at several ages. The association, adjusted for socio-economic factors, was strongest at the age of 7 years, when children in the most polluted areas were 1.2 (95% confidence interval 0.5–1.8) cm shorter than those in the least polluted areas. After the age of 7 years the effect of air pollution diminished and disappeared by the age of 15 years. Further adjustment for birth weight and respiratory illness in childhood did not change this pattern.Conclusions Childrens height was inversely associated with air pollution, but the magnitude of the effect depended on age. However, the biological mechanisms linking childrens growth with air pollution are not evident, and it remains to be confirmed whether the relationship is genuine and causal.     

Spirituality in Child and Youth Care: Considering Spiritual Development and “Relational Consciousness”

In response to the identification of spiritual development as part of children's lives in both the United Nations Convention on the Rights of the Child (1991) and the Association for Child and Youth Care Practice's document: Competencies for Professional Child and Youth Work Practitioners (Mattingly & Stuart, 2001), this paper considers a theoretical model of children's spirituality, relational consciousness, as proposed by Hay and Nye (1998). The paper encourages the introduction of a framework for understanding and exploring spiritual development in child and youth care research and practice that respects the cultural and social diversity of both religious and nonreligious settings and the lifespan developmental processes of children.     

The Po River Delta epidemiological survey: Reference values of total serum IgE levels in a normal population sample of North Italy (8–78 yrs)

The aim of this paper was to define, for the first time in Italy, normal levels of total serum IgE in a general population sample of North Italy. Total serum IgE in 1905 subjects, living in Po Delta area (near Venice), were measured by PRIST method. Normal values were derived from 558 subjects without asthma and/or asthmatic/rhinitic symptoms, noncurrent smokers, skin prick-test negatives (normals). Cut-off values to differentiate normals from the remaining part of the sample (others), from asthmatic, and from rhinitic subjects, were established with the IgE value midway between the upper limit of the 95% confidence intervals (CI) of the geometric mean for normals and the lower limit for others, asthmatics, and rhinitics, respectively. Geometric mean of normal children–adolescents was 45 kU/L (SD: 2.6; 95% CI: 38–63). In normal adults geometric mean was 29 kU/L (SD: 3.3; 95% CI: 25–40) in males and 19 kU/L (SD: 3.8; 95% CI: 16–22) in females. The diagnostic sensitivity of IgE test was low, while the specificity was very high. A good positive predictive value in discriminating normals from others was found, on the contrary, we found a good negative predictive value in discriminating normals from asthmatics or from rhinitics. In conclusion, our results confirm that it is necessary to provide separate total serum IgE reference values for what concerns age in children–adolescents and in adults, and gender, in adults. Low level of total serum IgE are helpful to exclude allergic asthma or rhinitis.     

The influence of cardiovascular disease on quality of life in type 2 diabetics

Background and Aims: In type 2 diabetes mellitus, disease-related complications have a considerable effect on the quality of life. We studied the influence of cardiovascular disease on quality of life in type 2 diabetic patients in a longitudinal design. We also studied whether quality of life in any way predicts the manifestation of cardiovascular disease. Materials and methods: A prospective cohort study from April 1996 to October 1999. In 1996 and 1999 all known type 2 diabetics from the population of Urk, the Netherlands, were invited by their general practitioners (GPs) for extensive check-up. In both years quality of life was assessed using the generic RAND-36 and the disease-specific Diabetes Health Profile (DHP) In the intermediate period, cardiovascular morbidity and mortality were registered by the GPs. Results: In 1996, 281 patients were examined and 248 (88.3%) persons completed the questionnaires. After 3 years 189 persons (67.3%) were re-examined and 161 (85.2%) handed in the questionnaire. When compared to diabetics without cardiovascular disease, diabetics with cardiovascular disease had a lower quality of life. Multiple regression analysis showed that contracting cardiovascular disease negatively affects the RAND-36 dimensions 'social functioning, vitality and health change. Cox's regression analysis showed a negative relation between the RAND-36 dimensions physical functioning, and time to the manifestation of cardiovascular disease. The DHP appeared not to be suitable to measure quality of life in relation to cardiovascular disease. Conclusions: In type 2 diabetics, cardiovascular disease has a negative effect on quality of life. A decreased quality of life is associated with a short-term manifestation of cardiovascular disease.     

The SEIQoL-DW is a valid method for measuring individual quality of life in stroke survivors attending a secondary prevention clinic

Objectives: This paper examines the applicability and construct validity of the Schedule for the Evaluation of Individual Quality of Life-Direct Weight (SEIQoL-DW) for measuring quality of life in stroke survivors living at home that attend a secondary prevention clinic. Participants and methods: Forty-six individuals attending a secondary prevention clinic following a stroke or transient ischaemic attack participated in a semi-structured interview to complete a range of outcome measures. Assessments of cognitive impairment, disability, and handicap were conducted using the Mini mental State Examination (MMSE), Barthel Index (BI), and Rankin Scale (RS). Measures to assess quality of life included perceived health status (PHS), Visual Analogue Mood Scale (VAMS), the Hospital Anxiety and Depression Scale (HADS), and the SEIQoL-DW. The construct validity of the SEIQoL-DW was assessed by correlation with the other measures. Results: According to the cues elicited from the SEIQoL-DW, participants nominated relationships with family and friends as the most important life domain, followed by social and leisure activities, and health. Spearmans rho correlation coefficients demonstrated significant relationships between the SEIQoL-DW index scores, PHS (r=0.35, p=0.016), VAMS (r=0.419, p=0.004), and the HADS anxiety (r=–0.546, p < 0.0001) and depression (r=–0.701, p < 0.0001) subscale scores. Conclusions: The SEIQoL-DW demonstrated reasonable construct validity for use in assessing individual quality of life in a group of individuals following stroke or TIA that attend a secondary prevention clinic.     

Reliability and validity testing of a Chinese-translated version of the 39-item Parkinson’s Disease Questionnaire (PDQ-39)

The trend toward international cooperation in research projects emphasizes the need to translate existing validated tools into local languages. The purpose of this study was to test the reliability and validity of a Chinese-translated version of the 39-item Parkinsons Disease Questionnaire (PDQ-39). Seventy-three Taiwanese individuals with Parkinsons disease were consecutively recruited. The internal consistency reliability was satisfactory for all domains (Cronbachs =0.80–0.96), except for the social support, cognition, and bodily discomfort domains (=0.58–0.63). The convergent validity was also supported by strong correlations between domains measuring related constructs of the PDQ-39 and Unified Parkinsons Disease Rating Scale (r=0.81–0.86), and between those of the PDQ-39 and SF-36 (r=–0.70––0.93). Except for the bodily discomfort domain, all domains of the PDQ-39 significantly discriminated patients at different stages, as indicated by the Hoehn and Yahr scale. Overall, the results of this study are consistent with the reports of the PDQ-39 in other countries (e.g., UK, Spain, US, and Greece), which suggests that the PDQ-39 is appropriate for use among Taiwanese individuals with PD. This study lays the foundation for future combinations and comparisons of data cross-nationally.     

An application of structural equation modeling to detect response shifts and true change in quality of life data from cancer patients undergoing invasive surgery

The objective is to show how structural equation modeling can be used to detect reconceptualization, reprioritization, and recalibration response shifts in quality of life data from cancer patients undergoing invasive surgery. A consecutive series of 170 newly diagnosed cancer patients, heterogeneous to cancer site, were included. Patients were administered the SF-36 and a short version of the multidimensional fatigue inventory prior to surgery, and 3 months following surgery. Indications of response shift effects were found for five SF-36 scales: reconceptualization of general health, reprioritization of social functioning, and recalibration of role-physical, bodily pain, and vitality. Accounting for these response shifts, we found deteriorated physical health, deteriorated general fitness, and improved mental health. The sizes of the response shift effects on observed change were only small. Yet, accounting for the recalibration response shifts did change the estimate of true change in physical health from medium to large. The structural equation modeling approach was found to be useful in detecting response shift effects. The extent to which the procedure is guided by subjective decisions is discussed.