Adaptation to Swedish and further development of the ‘Consequences of Screening – Breast Cancer’ questionnaire: a multimethod study

Scand J Caring Sci; 2013; 27; 475–486 Adaptation to Swedish and further development of the ‘Consequences of Screening – Breast Cancer’ questionnaire: a multimethod study Rationale: Experiencing a false‐positive screening mammography can cause considerable psychosocial distress. The Consequences of Screening – Breast Cancer questionnaire (COS‐BC parts 1 and 2), recently developed in Denmark, is the only condition‐specific questionnaire for measuring short‐ and long‐term psychosocial consequences of false‐positive mammographic screening. Additional studies are needed to further test the COS‐BC before use across cultures. Furthermore, studies have suggested that the consequences of false‐positive screening results are partly common across cancer screening settings, although this hypothesis remains largely untested. Objectives: This study (i) assesses content validity of a Swedish version of the COS‐BC, (ii) tests whether items expressing long‐term consequences of false‐positive lung cancer screening results are relevant in a breast cancer screening context and (iii) explores the usefulness of taking results from Rasch analyses of the source version as an aid in questionnaire translation and adaptation. Methods: Following dual‐panel translation, content validity was assessed through qualitative interviews with representatives of the target population and the content validity index (CVI). Item locations and Rasch model fit of the source questionnaires were considered in the translation and assessment process. Results: The COS‐BC items were generally found relevant and provided coverage of the target construct. Content validity was supported also for nine of 10 lung cancer screening items. Scale CVI values were ≥0.81. Previous Rasch data were useful in facilitating translation and assessing item content validity. The resulting Swedish version of the COS‐BC parts 1 and 2 consists of 34 and 23 items, respectively. Conclusion: This study illustrates the value of methodological triangulation and use of data from previous Rasch analyses in questionnaire translation and adaptation. We found support for the hypothesis that consequences of false‐positive screening are common across cancer screening settings. Psychometric properties of the Swedish COS‐BC remain to be established.     

Attention disengagement in children with Developmental Coordination Disorder

Purpose. Previous research has shown that children with Developmental Coordination Disorder (DCD) have poorly developed strategies for allocating attention. This study examines the allocation of attention and integration of visuo-spatial and motor systems in children with DCD in a motor (look+hit condition) and a motor-free (look condition) task.

Method. Three groups of control children were used to compare the performance of a group of children with DCD. Children were seated in front of a central fixation point and six peripheral targets, and were asked to look at or hit targets when illuminated. Saccade/hand movement latencies were measured on gap trials (gap between fixation offset and target onset) and overlap trials (fixation offset and target onset overlapped).

Results. DCD children were not slower than controls to disengage attention during the look condition. However, during the look+hit condition the DCD children showed a prolonged disengagement period, which was also seen in younger control children.

Conclusions. The results suggest that DCD children may have deficits in the allocation of attention for action, in both the speed of onset of a movement and the accuracy of the movement. It is concluded that attention disengagement may contribute to problems of visuo-motor integration in DCD.     

Case presentations of potential applications of computed tomographic angiography in the geriatric population

Recent technical advances have enabled the use of computed tomography (CT) to visualize the beating heart, including the coronary arteries. This ability to perform noninvasive coronary angiography and to precisely evaluate other cardiovascular structures using CT may be especially valuable in the geriatric population. CT angiography can be used not only to investigate chest pain syndromes in the elderly but also for preoperative evaluation before cardiac and noncardiac surgery to detect intracardiac thrombi and tumors and to evaluate valves, the myocardium, and other cardiovascular structures, including the aorta. The authors present examples of the application of CT angiography in various older adult patients with cardiovascular disease to highlight potential applications.     

Indications for coronary and cardiac computed tomographic angiography

Cardiovascular disease remains the leading cause of death and disability in the developed world. Over the last several years, many noninvasive imaging techniques have been used to enhance the diagnosis of cardiac disease. One of these advances, multidetector computed tomographic angiography (CTA), has transformed computed tomography from a single-slice transaxial imaging modality to a true 3-dimensional imaging technique with the ability to acquire submillimeter volumetric data. These benefits enable novel applications of CTA for the assessment of cardiac and coronary anatomy that were not previously possible. In this report, we discuss evolving indications for coronary CTA, noncoronary cardiac CTA, and several potential future indications for cardiac CTA.     

Detection of exercise induced changes in left ventricular performance by Doppler echocardiography

A study was performed to test the hypothesis that Doppler echocardiographic measurement of ascending aortic blood flow can detect exercise induced changes in left ventricular performance during exercise in patients suspected of having ischaemic heart disease. Acceleration and peak velocity of flow and stroke volume were determined by non-imaging Doppler echocardiography in the suprasternal notch in 38 patients as they underwent simultaneous exercise radionuclide ventriculography. The patients were divided into four groups: group 1 had resting ejection fractions greater than or equal to 50% and increased their ejection fractions greater than or equal to 5% during exercise; group 2 had resting ejection fractions of greater than or equal to 50% but the ejection fraction either fell or rose less than 5% during exercise; group 3 had resting ejection fractions less than 50% but the ejection fraction rose greater than or equal to 5% during exercise; and group 4 had resting ejection fractions less than 50% and the exercise ejection fraction either fell or rose less than 5% during exercise. Acceleration, velocity, and stroke volume all rose significantly during exercise in group 1. Acceleration also increased in group 2 but to a lesser extent; velocity and stroke volume did not increase. In group 3 acceleration and velocity increased but to a lesser extent than in group 1; stroke volume did not increase. In group 4 velocity increased slightly during exercise but acceleration and stroke volume were unchanged. Doppler echocardiography thus appears capable of detecting exercise induced changes in left ventricular performance and can identify normal and abnormal responses, as defined by radionuclide ventriculography.     

A prospective etiologic study of community-acquired pneumonia in Taiwan.

BACKGROUND AND PURPOSE: The treatment of community-acquired pneumonia (CAP) is complicated by the growing threat of antimicrobial resistance and the tendency to rely on empirical therapy. This study investigated the etiologic agents of adult CAP in Taiwan and the susceptibility of Streptococcus pneumoniae isolates from these patients. METHODS: A collaborative group was established in the emergency department to conduct a prospective study of the etiology of adult CAP. The etiologic agent was determined by a combination of microscopic, culture, serologic and antigen detection methods. Pneumococcal susceptibility testing was performed to determine the extent of penicillin resistance. RESULTS: A total of 100 consecutive cases of mild to moderate adult CAP prior to the severe acute respiratory syndrome epidemic were enrolled. The etiologic agent was determined in 72% of cases. The 5 most common causative pathogens were S. pneumoniae (26%), Mycoplasma pneumoniae (20%), Chlamydia pneumoniae (13%), Haemophilus influenzae (9%), and Klebsiella pneumoniae (5%). Atypical pathogens accounted for 40% of CAP. Bacteremic pneumonia was diagnosed in 6.2% of cases. Co-infections with 2 or more pathogens were found in 16% of the cases. Among the 20 isolates of S. pneumoniae, 85% (17/20) were susceptible to penicillin, 3 (15%) were intermediate, and none were resistant to penicillin. CONCLUSION: S. pneumoniae, M. pneumoniae and C. pneumoniae were the 3 leading causes of mild to moderate CAP in Taiwan. This study indicates that penicillin-resistant S. pneumoniae play a very limited role in this condition in adults.     

Hepatic Angiosarcoma May Have Fair Survival Nowadays

Hepatic angiosarcoma (HAS) is rare but often fatal. A review of literature in 1979 found that only 3% of the 70 patients lived for more than 2 years, but the survival might have been improved over the years. We conducted a retrospective study and reviewed the medical records of patients who visited a teaching hospital in Taiwan from January 2000 to August 2010 and had pathological proof of HAS. In addition, we conducted a review of literature and compared those who survived for 2 years or more to those who did not. Of the 3503 patients with primary liver cancer we identified, 9 had HAS, of whom 3 (33.3%) survived for 2 years or more. One survived for 24 months without surgical resection, and the other two received surgery with postoperative chemotherapy and were still alive 32 and 37 months later, respectively. Through reviewing literature, we identified 3 more patients in Taiwan who had survived for 2 years or more. One survived for 42 months without surgical resection, the other two received segmentectomy with postoperative chemotherapy or radiotherapy. We also identified 8 such cases outside Taiwan, including 1 who received chemotherapy without surgery and survived for 53 months. None of the differences in the clinical characteristics between those who had and had not survived for 2 years or more reached statistical significance. In conclusion, we believe the combination of surgery and adjuvant chemotherapy may be able to achieve long-term survival in some HAS patients nowadays, and it is even possible to achieve fair survival using chemotherapy alone.