Validity and suitability of the Bayley-III Low Motor/Vision version: A comparative study among young children with and without motor and/or visual impairments

The aim of the present study was to examine the validity of the Bayley-III Low Motor/Vision version, and its suitability for children with motor and/or visual impairment(s). This version contains accommodated items, that is, adaptations to minimize impairment bias, without altering what the test measures. We hypothesized that the accommodations would not affect the item scores of children without impairment, and that children with impairment(s) would benefit from the accommodations. We tested 41 children without impairment and 63 children with impairment with both the standard Bayley-III and the Low Motor/Vision versions, in randomly counterbalanced order. The test administrators filled in an evaluation form. Results showed that the accommodations did not affect the test scores of children without impairment and did improve the test scores of children with impairment on the Cognition scale, while no improvement was found for the other scales. The test administrators indicated that the vast majority of the children with impairment had been able to show their abilities on the test and that the accommodations were beneficial in 29 out of these 52 cases. For some children, the accommodated instrument appeared to be unsuitable because the impairment was too severe. The conclusion is that the accommodations improve the validity of the Bayley-III when used with children with mild to moderate motor and/or visual impairment, especially with regard to the Cognition scale.     

Language Matters: The Autism-Spectrum Quotient in English,Mandarin and Bahasa Malaysia

Journal of Autism and Developmental Disorders - The autism-spectrum quotient (AQ) measures autistic traits and has been studied in different countries, sometimes with the English version, and...     

Introducing Emergency Contraception in the Mexican Family Planning Official Norm

OBJECTIVES: Understand the process of including Emergency Contraception (EC) in the Mexican Family Planning Norm (NOM) and identify factors that influenced this achievement. MATERIALS AND METHODS: We conducted in-depth interviews with eight prominent decision-makers of state and federal government institutions. RESULTS: The determining factor for the inclusion of EC in the Norm was the external review of scientific evidence, done by experts from the National Centre for Equity of Gender and Reproductive Health, proving that EC pills are not abortifacients. Other important factors that contributed to the inclusion were the ample support of civil organizations, the population's demand and the Minister of Health's support of EC. The inclusion of EC in the essential drug list was perceived as a logical next step after its inclusion in the NOM. CONCLUSIONS: The introduction of EC in Mexico highlights the importance of scientific evidence for decision-making. The process took about a decade, which reflects the complexity of converting research results into public policies. Measures should be taken to speed the processes that benefit women and society as a whole.     

IL-13 genetic polymorphism identifies children with late wheezing after respiratory syncytial virus infection

BACKGROUND: The nature of wheezing after respiratory syncytial virus lower respiratory tract infection (RSV LRTI) is usually transient. However, some children will develop persistent or late wheezing. OBJECTIVE: We hypothesized that early and late postbronchiolitis wheezing are determined by distinct clinical, immunologic, and genetic variables. METHODS: A cohort of 101 children hospitalized for RSV LRTI was prospectively followed for 6 years. During RSV LRTI, cytokine studies were performed and genetic polymorphisms were determined. Parents performed daily log registration of respiratory symptoms during the first 3 years of follow-up and again at age 6 years during the winter season. RESULTS: Distinctive associations for early and late postbronchiolitis wheezing were found. We previously showed that airflow limitation during RSV LRTI as well as convalescent monocyte IL-10 production are associated with early wheezing. These variables were not associated with late wheezing. On the other hand, atopic family history was not associated with early wheezing, but it was associated with late wheezing. Most importantly, the IL-13 Gln allele was associated with late wheezing (odds ratio 3.27, 95% confidence interval 1.32-8.06), but it was not associated with early wheezing. CONCLUSION: This study revealed distinct clinical, immunologic, and genetic determinants of early and late wheezing after RSV LRTI, indicating distinct pathophysiological mechanisms. We conclude that late wheezing at age 6 years, but not early postbronchiolitis wheezing, is an asthmatic phenomenon and genetically related to a functional IL-13 polymorphism. CLINICAL IMPLICATIONS: After RSV LRTI, wheezing at age 6 years is not related to early postbronchiolitis wheezing and represents a distinct disease entity.     

Nurses’ perceptions towards the delivery and feasibility of a behaviour change intervention to enhance physical activity in patients at risk for cardiovascular disease in primary care: a qualitative study

Background

Self-management support is widely accepted for the management of chronic conditions. Self-management often requires behaviour change in patients, in which primary care nurses play a pivotal role. To support patients in changing their behaviour, the structured behaviour change Activate intervention was developed. This intervention aims to enhance physical activity in patients at risk for cardiovascular disease in primary care as well as to enhance nurses’ role in supporting these patients. This study aimed to evaluate nurses’ perceptions towards the delivery and feasibility of the Activate intervention.

Methods

A qualitative study nested within a cluster-randomised controlled trial using semistructured interviews was conducted and thematically analysed. Fourteen nurses who delivered the Activate intervention participated.

Results

Three key themes emerged concerning nurses’ perceptions of delivering the intervention: nurses’ engagement towards delivering the intervention; acquiring knowledge and skills; and dealing with adherence to the consultation structure. Three key themes were identified concerning the feasibility of the intervention: expectations towards the use of the intervention in routine practice; perceptions towards the feasibility of the training programme; and enabling personal development.

Conclusions

Delivering a behaviour change intervention is challenged by the complexity of changing nurses’ consultation style, including acquiring corresponding knowledge and skills. The findings have increased the understanding of the effectiveness of the Activate trial and will guide the development and evaluation of future behaviour change interventions delivered by nurses in primary care.

Trial registration

ClinicalTrials.gov NCT02725203.