Geriatric Depression Scale Short Form and Zung Self-Rating Depression Scale

Abstract

This study investigates the correlation between the Zung Self-Rating Depression Scale and the short form of the Geriatric Depression Scale. A convenience sample of 118 homebound, ill, elderly persons was used. The age range was 65-93 and the mean was 78.3; 47% of the sample was between the ages of 75-84. The two scales were correlated (r = .76, p < .01) and internal reliability of the GDS was .825. For the GDS short form, 37% of the sample had scores of 8 or higher; for the SDS 20% had scores higher than 50, falling within the range of persons with probably depressive symptomatology. Results are discussed in terms of screening for depressive symptomatology in ill, elderly persons residing in the community.     

Scale invariance in the dynamics of spontaneous behavior

Typically one expects that the intervals between consecutive occurrences of a particular behavior will have a characteristic time scale around which most observations are centered. Surprisingly, the timing of many diverse behaviors from human communication to animal foraging form complex self-similar temporal patterns reproduced on multiple time scales. We present a general framework for understanding how such scale invariance may arise in nonequilibrium systems, including those that regulate mammalian behaviors. We then demonstrate that the predictions of this framework are in agreement with detailed analysis of spontaneous mouse behavior observed in a simple unchanging environment. Neural systems operate on a broad range of time scales, from milliseconds to hours. We analytically show that such a separation between time scales could lead to scale-invariant dynamics without any fine tuning of parameters or other model-specific constraints. Our analyses reveal that the specifics of the distribution of resources or competition among several tasks are not essential for the expression of scale-free dynamics. Rather, we show that scale invariance observed in the dynamics of behavior can arise from the dynamics intrinsic to the brain.     

Validation and modification of the Epworth Sleepiness Scale in Peruvian population

Purpose  

The main purpose of this study was to develop a cross-cultural adaptation of the Epworth Sleepiness Scale for Peruvian population (ESS-VP) and to provide evidence of reliability and validity to this scale. We also modified the ESS-VP for non-driving Peruvian population (ESS-MPV).     

Validation of the Videofluoroscopic Dysphagia Scale in Various Etiologies

The videofluoroscopic dysphagia scale (VDS) was developed as an objective predictor of the prognosis of dysphagia after stroke. We evaluated the clinical validity of the VDS for various diseases. We reviewed the medical records of 1,995 dysphagic patients (1,222 men and 773 women) who underwent videofluoroscopic studies in Seoul National University Hospital from April 2002 through December 2009. Their American Speech–Language–Hearing Association’s National Outcome Measurement System (ASHA NOMS) swallowing scale, clinical dysphagia scale (CDS), and VDS scores were evaluated on the basis of the clinical and/or videofluoroscopic findings by the consensus of two physiatrists. The correlations between the VDS and the other scales were calculated. The VDS displayed significant correlations with the ASHA NOMS swallowing scale and the CDS in every disease group (p < 0.001 in all groups, including central and peripheral nervous system disorders), and these correlations were more apparent for spinal cord injury, peripheral nerve system disorders, and neurodegenerative diseases (correlation coefficients between the VDS and the ASHA NOMS swallowing scale: ?0.603, ?0.602, and ?0.567, respectively). This study demonstrated that the VDS is applicable to dysphagic patients with numerous etiologies that cause dysphagia.     

Development and Validation of the Retrospective Alcohol Context Scale

Background: Few validated measures exist to capture the context and consequences of specific drinking events among college students. Objectives: This study sought to describe the development and validation of the Retrospective Alcohol Context Scale (RACS), a 30-day measure of drinking context among college students. Methods: A sample of 169 college students completed daily alcohol assessments for 30 days and completed the RACS at follow-up. Results: The RACS captured fewer negative consequences than daily assessments; however, high agreement was observed on context variables. Conclusion: Results support the validity of the RACS as a measure of drinking context among college students. The RACS may be most useful when information about drinking needs to be collected under limited time and resources. Scientific Significance: Further research is needed to examine the RACS among more diverse, probability samples and over longer time periods.     

Psychometric Properties and Validity of the Obsessive-Compulsive Drinking Scale

Abstinent alcoholics' self-reports of distressing alcohol-associated thoughts and compulsions to drink were evaluated by the Obsessive-Compulsive Drinking Scale (OCDS). Exploratory and confirmatory factor analyses on separate subject samples revealed that subjects' OCDS responses were best described by four correlated dimensions: alcohol obsessions, alcohol consumption, automaticity, and interference due to drinking. The validity of this four-factor solution was supported by the pattern of associations with drinking and coping style measures. In particular, alcohol obsessions were positively associated with alcohol dependence and use of passive/ avoidant coping. Automaticity was positively associated with the intensity and salience of drinking, and inversely associated with use of activefapproach coping. as well as abstinence duration. The obsession and automaticity subscales of the OCDS may be useful in evaluating cognitive-motivational processes associated with recovery from alcoholism.     

Limits of the Epworth Sleepiness Scale in older adults

Purpose

Excessive daytime sleepiness (EDS) in older adults is associated with obstructive sleep apnea, falls, reduced quality of life, and mortality. The Epworth Sleepiness Scale (ESS) is widely used to assess sleepiness. However, EDS assessment with the ESS may not be accurate in older adults. We aimed to (1) describe the responsiveness of nondemented older subjects to the ESS and (2) compare the self-report ESS scores to those of close relatives (CR) proxy and identify factors influencing any discrepancies between them.

Methods

This is a cross-sectional observational study including 104 independently living nondemented older subjects with daytime sleepiness complaints and 104 nondemented CRs. Cognitive tests (Mini-Mental State Examination) and the ESS were completed separately by subjects and CRs to assess the subject’s daytime sleepiness.

Results

Almost 60 % of subjects and CRs were not able to answer at least one question on the ESS. Despite the fact that all subjects complained of EDS, only 24 % of them had an abnormal ESS score (>10). Subjects rated their sleepiness lower (7.10?±?4.31) than their CR proxy did (9.70?±?5.14) (p?<?0.0001). In multivariate analysis, an increase in age and a decrease in cognitive status of the subjects appeared related to the difference in ESS between subject and CR.

Conclusions

The majority of older adults were not able to answer all of the ESS items. The ESS may underestimate sleepiness severity in older subjects. Despite EDS complaints in all subjects, only one quarter of them had a pathological ESS score.     

Feasibility and inter-rater reliability of the ICU Mobility Scale

Objectives

The objectives of this study were to develop a scale for measuring the highest level of mobility in adult ICU patients and to assess its feasibility and inter-rater reliability.

Background

Growing evidence supports the feasibility, safety and efficacy of early mobilization in the intensive care unit (ICU). However, there are no adequately validated tools to quickly, easily, and reliably describe the mobility milestones of adult patients in ICU. Identifying or developing such a tool is a priority for evaluating mobility and rehabilitation activities for research and clinical care purposes.

Methods

This study was performed at two ICUs in Australia. Thirty ICU nursing, and physiotherapy staff assessed the feasibility of the ‘ICU Mobility Scale’ (IMS) using a 10-item questionnaire. The inter-rater reliability of the IMS was assessed by 2 junior physical therapists, 2 senior physical therapists, and 16 nursing staff in 100 consecutive medical, surgical or trauma ICU patients.

Results

An 11 point IMS scale was developed based on multidisciplinary input. Participating clinicians reported that the scale was clear, with 95% of respondents reporting that it took <1 min to complete. The junior and senior physical therapists showed the highest inter-rater reliability with a weighted Kappa (95% confidence interval) of 0.83 (0.76–0.90), while the senior physical therapists and nurses and the junior physical therapists and nurses had a weighted Kappa of 0.72 (0.61–0.83) and 0.69 (0.56–0.81) respectively.

Conclusion

The IMS is a feasible tool with strong inter-rater reliability for measuring the maximum level of mobility of adult patients in the ICU.     

Validation and reliability of the Modified Elderly Mobility Scale

Objective: To establish concurrent validity, interrater and test–retest reliability of the Modified Elderly Mobility Scale (MEMS). Methods: Ninety elderly patients were scored on the MEMS. To establish concurrent validity, 75 patients MEMS scores were compared to Functional Independence Measure (FIM) scores using Spearman's correlation. Videotaped patient performances were used to establish interrater and test–retest reliability using percentage absolute agreement and intraclass correlation coefficients (ICCs). Results: The total MEMS score demonstrated a significant association with the motor (r = 0.725) and total FIM scores (r = 0.718). Absolute agreement for interrater reliability was greater than 93% for all test items, with 97 and 98% for the two new measures, respectively. Test–retest reliability demonstrated similar high levels of absolute agreement and had ICCs ranging from 0.870 to 1.0. Conclusions: The MEMS is a quick, valid and reliable test of motor function of elderly patients with a spread of functional levels.