Validation of the repetitive behaviour questionnaire for use with children with autism spectrum disorder

The repetitive behaviour questionnaire (RBQ) (Turner, 1995) is one of the three most commonly used interview/questionnaire measures of repetitive behaviour (Honey et al., in preparation). Despite this there is a scarcity of information concerning its structure, reliability and validity. The psychometric properties of the RBQ were examined when used with children with an autism spectrum disorder, children of typical development and children with a learning disability. The questionnaire was found to examine two valid and reliable factors of repetitive behaviour and to have good levels of concurrent and construct validity. This novel study provides researchers and clinicians with information necessary to make decisions about the RBQ's utility and for the evaluation of conclusions drawn from existing research, which has used the RBQ.     

Longitudinal person-centered measurement: A psychometric evaluation of the Preparedness for Colorectal Cancer Surgery Questionnaire (PCSQ)

ObjectiveThe Preparedness for Colorectal Cancer Surgery Questionnaire (PCSQ) was previously developed in Swedish to assess patients’ knowledge seeking and sense making capabilities. Aiming to measure preparedness at different phases during the pre-surgery and recovery period, the objectives were to (a) evaluate psychometric properties of the longitudinal PCSQ, (b) establish measurement invariance over time, and (c) describe change in preparedness.MethodsElective colorectal cancer surgery patients completed a questionnaire at five time points from pre-surgery until 6 months post-surgery (n = 250). The longitudinal PCSQ consists of 23 items measuring four domains: Searching for and making use of information, Understanding and involvement in care, Making sense of recovery, Support and access to care. Psychometric analyses, including confirmatory factor analysis, were applied to evaluate internal consistency reliability and ascertain invariance over time of the measurement structure and parameters.ResultsThe psychometric analyses revealed good fit of the measurement models, high internal consistency reliability (≥.94), and support for configural, metric and scalar measurement invariance of the four PCSQ domains. Patients reported lower levels of preparedness after surgery than pre-surgery.ConclusionThe adapted version of the PCSQ can be used for longitudinal analyses.Practice implicationsThe measurement of preparedness is important for evaluating person-centred outcomes before and during recovery from colorectal cancer surgery.     

Development of a lyophilized soybean paste certified reference material for the analysis of ochratoxin A

A certified reference material (CRM) [²KRISS CRM # 108-10-018] for the analysis of ochratoxin A (OTA) in doenjang (fermented soybean paste and popular food in Korea) was produced to ensure the reliability of analytical results in testing laboratories. A home-made doenjang was chosen as a raw material after testing its OTA level. The raw material was freeze-dried, pulverized, sieved and homogenized. An isotope-dilution-liquid chromatography/tandem mass spectrometric method (ID-LC/MS/MS) which was previously developed and validated in this laboratory was used as a higher-order reference method for characterization, homogeneity studies, and short-term stability studies. The CRM had good between-bottle homogeneity with 0.56% relative standard deviation among 10 selected units. The stability of the CRM at −70 °C (the storage condition in our laboratory) and at −20 °C (the possible storage temperature at user sites) were tested for up to 8 months. No change in the OTA content was observed within the measurement uncertainty. The stability of the CRM at room temperature (for regular use and transportation) was also tested and confirmed. The certified value was (49.50 ± 1.17) μg/kg, where the expanded uncertainty was in the confidence level of 95%.     

Reliability of Auditory Function Tests in Severely Hearing-Impaired and Deaf Subjects

The test-retest variability of a series of auditory functions has been investigated in a group of severely hearing-impaired and deaf subjects (64 ears, median Fletcher index: 80 dB) and in a group of 10 controls with normal hearing. An adaptive forced-choice procedure was used for both groups. The functions were: tone audiogram, difference limen for intensity, difference limen for frequency, modulation transfer function and critical ratio. In spite of sometimes strongly deviating function values within the hearing-impaired group, the test-retest variability of the two groups was found to be of the same order of magnitude, except for the tone audiogram where the variability in the hearing-impaired group was twice that for the control group.

Nous avons examiné la variabilité des mesures répétées de quelques fonctions auditives dans un groupe de sujets ayant des troubles auditifs importants (64 oreilles; médiane de l'index de Fletcher 80 dB). Par comparaison nous avons aussi examiné un groupe de 10 sujets ayant une audition normale. Dans les deux groupes nous avons utilisé une procédure adaptive et de choix forcé. Nous avons examiné les seuils auditifs, les seuils différentiels d'intensité et de fréquence, la fonction de transfert de modulation et le rapport critique. Malgré les anomalies majeures du groupe des malentendants, la variabilité des mesures dans les deux groupes est équivalente, à l'exception de la variabilité des seuils auditifs qui est deux fois plus grande chez les malentendants.     

Psychometric properties of the Neck OutcOme Score,Neck Disability Index,and Short Form–36 were evaluated in patients with neck pain

ObjectiveTo assess reliability, construct validity, responsiveness, and interpretability for Neck OutcOme Score (NOOS), Neck Disability Index (NDI), and Short Form–36 (SF-36) in neck pain patients.Study Design and SettingInternal consistency was assessed by Cronbach alpha. Test-retest reliability was evaluated by intraclass correlation coefficient (ICC), and measurement error was estimated from the standard error of measurement. Responsiveness was assessed as standardized response mean (SRM) and interpretability from the minimal important difference (MID). Construct validity was tested correlating subscale scores from NOOS and SF-36 and NDI items.ResultsAt baseline, 196 neck pain patients were included. Cronbach α was adequate for most NOOS subscales, NDI, and SF-36 with few exceptions. Good to excellent reliability was found for NOOS subscales (ICC 0.88–0.95), for NDI, and for SF-36 with few exceptions. For NOOS, minimal detectable changes varied between 1.1 and 1.9, and construct validity was supported. SRMs were higher for NOOS subscales (0.19–0.42), compared to SF-36 and NDI. MID values varied between 15.0 and 24.1 for NOOS subscales.ConclusionsIn conclusion, the NOOS is a reliable, valid, and responsive measure of self-reported disability in neck pain patients, performing at least as well or better than the commonly used SF-36 and NDI.     

Bacteremia in the Spinal Cord Injury Population

Abstract

Positive blood cultures were found in 41 patients on the Spinal Cord Injury Service at the Milwaukee VAMC during the period of July, 1980 to December, 1985 giving an incidence of bacteremia of 1.3%. Mortality rate was 17%. Most common pathogens were E. Coli, Proteus mirabilis, Serratia marcescens and Staphylococcus aureus. A review of 29 available charts revealed genitourinary and respiratory tracts as the most common sources of infection (72.4% and 10.3% respectively). Other sources of infection were skin, postoperative, intravenous catheter site and cellulitis. Initial febrile response was seen in 93.1% of patients with 48.1% having temperature greater than 38.3°C. Hypotension (blood pressure less than 90/50 mm Hg) was noted in five out of the 29 (17.1%) patients. Clinical diagnosis of disseminated intravascular coagulation was made in two out of the 29 (6.9%) patients. Underlying risk factors were poor nutrition, respirator dependency, indwelling Foley catheters and manipulative procedures. Incidence and mortality rates are similar to the non-SCI population as reported elsewhere. The risk factors are different; therefore preventive management is extremely important.     

Evaluating the accuracy of a geographic closed-ended approach to ethnicity measurement,a practical alternative

PurposeMeasuring ethnicity accurately is important for identifying ethnicity variations in disease risk. We evaluated the degree of agreement and accuracy of maternal ethnicity measured using the new standardized closed-ended geographically based ethnicity question and geographic reclassification of open-ended ethnicity questions from the Canadian census.MethodsA prospectively designed study of respondent agreement of mothers of healthy children aged 1–5 years recruited through the TARGet Kids! practice-based research network. For the primary analysis, the degree of agreement between geographic reclassification of the Canadian census maternal ethnicity variables and the new geographically based closed-ended maternal ethnicity variable completed by the same respondent was evaluated using a kappa analysis.ResultsEight hundred sixty-two mothers who completed both measures of ethnicity were included in the analysis. The kappa agreement statistic for the two definitions of maternal ethnicity was 0.87 (95% confidence interval, 0.84–0.90) indicating good agreement. Overall accuracy of the measurement was 93%. Sensitivity and specificity ranged from 83% to 100% and 96% to 100%, respectively.ConclusionsThe new standardized closed-ended geographically based ethnicity question represents a practical alternative to widely used open-ended ethnicity questions. It may reduce risk of misinterpretation of ethnicity by respondents, simplify analysis, and improve the accuracy of ethnicity measurement.     

Inclinometric measurement of kyphotic curvature: Description and clinimetric properties

Background: Hyperkyphosis is associated with physical impairments, activity limitations, and reduced quality of life. Therefore, a simple, reliable, responsive, and valid clinical measure of dorsal kyphosis would be valuable to clinicians. Objective: To describe a novel procedure for measuring kyphotic curvature—the inclinometric kyphosis measure (IKM)—and provide an estimation of reliability, responsiveness, and validity. Methods: During 2 sessions spaced days apart, we used a bubble inclinometer to measure dorsal kyphosis in 68 patients receiving outpatient physical therapy. We also documented occiput-to-wall status and tragus-to-wall distance. Results: Intra-rater reliability of the IKM was supported by intra-class correlation coefficients (ICC_3,1) of 0.94 and 0.91 for relaxed and cued conditions, respectively. Responsiveness, as indicated by minimal detectable change, was 8.0 and 10.0 degrees under relaxed and cued conditions, respectively. Validity was supported by significant correlations between the IKM and tragus-to-wall and by differences in the IKM between: 1) relaxed and cued conditions; 2) patients who could and could not touch occiput to the wall; and 3) patients who were older versus younger than 50 years of age. Conclusions: The IKM is a simple, reliable, responsive, and valid method for assessing posture in patients with musculoskeletal conditions.     

Measuring hospital-acquired pressure injuries: A surveillance programme for monitoring performance improvement and estimating annual prevalence

AimsTo describe a surveillance approach for monitoring the effect of improvement initiatives on hospital-acquired pressure injuries and findings arising from that surveillance.MethodsRandom sampling of patients on the same day of each successive month from a campus of child and adult hospitals using a standard audit tool to identify presence of hospital-acquired pressure injury. Where multiple pressure injuries were present, the most severe grade injury contributed to prevalence. Statistical process control charts were used to monitor monthly performance and Maximum Likelihood Estimation to determine timing of step change.Results8274 patients were assessed over 3 years from an eligible population of 32,259 hospitalised patients. 517 patients had hospital-acquired pressure injuries giving an overall prevalence of 6.2% (95% CI 5.7–6.8%). Annual prevalence was 8.4% (95% CI 7.4–9.5%) in the first year, falling to 5.6% (95% CI 4.7–6.4%) in the second year and 4.8% (95% CI 4.0–5.6%) in the third year. A step change was signalled with mean prevalence up to July 2013 being 7.9% (95% CI 7.1–8.8%) and mean prevalence thereafter 4.8% (95% CI 4.2–5.4%). Hospital-acquired pressure injuries were found in all age ranges, but were more frequent in children up to 14 years (17.4%) and those aged 75 years or older (38.7%).ConclusionMonthly random sampling of patients within clinical units can be used to monitor performance improvement. This approach represents a rational alternative to cross-sectional prevalence surveys especially if the focus is on performance improvement.