Spurious precision : variability in procedural validity of diagnostic procedures in psychotic disorders and implications for research and treatment

Very few studies have quantified the level of agreement among alternative diagnostic procedures that use a common set of fixed operational criteria. The authors examined the procedural validity of four independent methods of assigning DSM-III-R diagnoses of psychotic disorders. METHOD: The research was conducted as a satellite study to the DSM-IV Field Trial for Schizophrenia and Related Psychotic Disorders. The setting was the National Health and Medical Research Council Schizophrenia Research Unit's Early Psychosis Prevention and Intervention Centre, which focuses on first-episode psychosis. Consecutively admitted patients (N = 50) were assessed by independent raters who used four different procedures to determine a DSM-III-R diagnosis. These procedures were 1) the diagnostic instrument developed for the DSM-IV field trial, 2) the Royal Park Multidiagnostic Instrument for Psychosis, 3) the Munich Diagnostic Checklists, and 4) a consensus DSM-III-R diagnosis assigned by a team of clinician researchers who were expert in the use of diagnostic criteria. RESULTS: Concordance between pairs of diagnostic procedures was only moderate. Corresponding levels of percent agreement, however, ranged from 66% to 76%, with converse misclassification rates of 24%-34% (assuming one procedure to be "correct"). CONCLUSIONS: These findings have significant research and clinical implications. Despite the introduction of operationally defined diagnoses, there remained an appreciable level of differential classification or misclassification arising from variability in the method of assigning the diagnostic criteria rather than the criteria themselves. Such misclassification may impede neurobiological research and have harmful clinical effects on patients with first-episode psychosis.

Little Penguin (Eudyptula minor) variability in south-eastern Australia

This research examined the ecological, morphometric and genetic variability of the Little Penguin (Eudyptula minor) between seven colonies in south-eastern Australia. Significant differences in breeding ecology and morphology were noted for birds between colonies. However, most colonies were genetically homogeneous with respect to each other, with the exception of the Kangaroo Island colony.

Day-to-day and seasonal variability of physical activity during school recess

Objective : Children's physical activity levels are difficult to establish on a day-to-day or season-to-season basis. Most studies have attempted to measure reliability in habitual settings. This study investigated the variability in children's physical activity during recess.

Methods : Fifteen boys and 19 girls (aged 6 to 11 years) from 2 schools in North West England wore heart rate monitors for 5 consecutive days in summer and winter terms to assess day-to-day and seasonal variability during school recess. Data were collected in 2004. Repeated measures ANOVA's and intraclass correlations (ICC) analysed the day-to-day and seasonal variability in children's moderate-to-vigorous (MVPA) and vigorous physical activity (VPA) data.

Results : There were no significant differences in children's MVPA and VPA across days and seasons. ICCs for MVPA across 2 days ranged from 0.75 to 0.85 in summer, and from 0.53 to 0.81 in winter. Three-day MVPA ICCs were 0.83 in summer and 0.71 in winter.

Conclusions : The results revealed no significant variation in children's recess physical activity levels across days and seasons. Whilst children were free to choose their recess activities in school, the results suggested that children were relatively consistent in their choices, limiting physical activity variability.

Reliability and variability of day-to-day vault training measures in artistic gymnastics

Inter-day training reliability and variability in artistic gymnastics vaulting was determined using a customised infra-red timing gate and contact mat timing system. Thirteen Australian high performance gymnasts (eight males and five females) aged 11-23 years were assessed during two consecutive days of normal training. Each gymnast completed a number of vault repetitions per daily session. Inter-day variability of vault run-up velocities (at -18 to -12 m, -12 to -6 m, -6 to -2 m, and -2 to 0 m from the nearest edge of the beat board), and board contact, pre-flight, and table contact times were determined using mixed modelling statistics to account for random (within-subject variability) and fixed effects (gender, number of subjects, number of trials). The difference in the mean (Mdiff) and Cohen's effect sizes for reliability assessment and intra-class correlation coefficients, and the coefficient of variation percentage (CV%) were calculated for variability assessment. Approach velocity (-18 to -2 m, CV = 2.4-7.8%) and board contact time (CV = 3.5%) were less variable measures when accounting for day-to-day performance differences, than pre-flight time (CV = 17.7%) and table contact time (CV = 20.5%). While pre-flight and table contact times are relevant training measures, approach velocity and board contact time are more reliable when quantifying vaulting performance.

Moderate-intensity resistance exercise training in patients with chronic heart failure improves strength, endurance, heart rate variability, and forearm blood flow

Thirty-nine CHF patients (New York Heart Association Functional Class = 2.3±0.5; left ventricular ejection fraction 28%±7%; age 65±11 years; 33:6 male:female) underwent 2 identical series of tests, 1 week apart, for strength and endurance of the knee and elbow extensors and flexors, VO_2peak, HRV, FBF at rest, and FBF activated by forearm exercise or limb ischemia. Patients were then randomized to 3 months of resistance training (EX, n = 19), consisting of mainly isokinetic (hydraulic) ergometry, interspersed with rest intervals, or continuance with usual care (CON, n = 20), after which they underwent repeat endpoint testing. Combining all 4 movement patterns, strength increased for EX by 21±30% (mean±SD, P<.01) after training, whereas endurance improved 21±21% (P<.01). Corresponding data for CON remained almost unchanged (strength P<.005, endurance P<.003 EX versus CON). VO_2peak improved in EX by 11±15% (P<.01), whereas it decreased by 10±18% (P<.05) in CON (P<.001 EX versus CON). The ratio of low-frequency to high-frequency spectral power fell after resistance training in EX by 44±53% (P<.01), but was unchanged in CON (P<.05 EX versus CON). FBF increased at rest by 20±32% (P<.01), and when stimulated by submaximal exercise (24±32%, P<.01) or limb ischemia (26±45%, P<.01) in EX, but not in CON (P<.01 EX versus CON).

Temporal variability in a multicomponent trait : nuptial coloration of female two-spotted gobies

Animals that breed more than once may face different environmental and physiological conditions at each reproductive event. Costs and benefits of sexual ornaments could therefore vary both within and between breeding seasons. Despite this, the ornaments are often assumed to be fixed, and temporal changes in ornamentation have rarely been investigated. Female two-spotted gobies (Gobiusculus flavescens) have colorful orange bellies when sexually mature and nest-holding males prefer females with more colorful bellies. This nuptial coloration is caused both by the carotenoids-rich gonads being directly visible through the skin and by the chromatophore pigmentation of the abdominal skin. Toward the end of the breeding season, males become rare and females become the more competitive sex. We show that female ornamentation of G. flavescens is a complex multicomponent trait and that the separate components, as well as their interactions, are variable. As gonads matured, they became more colorful while the abdominal skin became more transparent, causing more intense belly coloration in sexually mature females. However, coloration varied greatly also among fully mature females, suggesting that it may not only be a signal of readiness to spawn. Indeed, belly coloration predicted gonad carotenoid concentration, but there were several important seasonal differences in color expression. Females sampled toward the end of the breeding season were more colorful. This was due to seasonal increases in both gonad carotenoid concentration and skin coloration. Thus, at a time when competition over males is stronger and the terminal reproductive event approaches, females appear to invest more in signaling.

Northward migration of Afro-Siberian Knots Calidris canutus canutus : high variability in Red Knot numbers visiting staging sites on the French Atlantic coast, 1979–2009

The Afro–Siberian Red Knot subspecies, Calidris canutus canutus, winters mainly on Banc d’Arguin, Mauritania, West Africa. An International Wader Study Group project carried out in 1979 suggested that during northward migration Red Knots cover their migration between the wintering grounds and the Siberian breeding grounds in two long-distance non-stop flights, stopping only in the Wadden Sea in Schleswig-Holstein, Germany. Each year Red Knots also visit staging sites along the French Atlantic coast in addition to the German Wadden Sea. Ever since 1979, the French staging sites have been counted on a regular basis and here we present the count data from these 30 years. In some years more than 20% of the population used the French Atlantic coast as a staging site, but numbers are highly variable from one year to the next. We suggest that high numbers in France might occur when birds have to stop short of the Wadden Sea because of head-winds and/or a lack of tail-winds en route from West Africa.

Temporal and spatial variability of breeding in Australian birds and the potential implications of climate change

Climate change has profound implications for biodiversity worldwide. To understand its effects on Australia's avifauna, we need to evaluate the effects of annual climatic variability and geographical climate gradients. Here, we use national datasets to examine variation in breeding of 16 species of common and widespread Australian landbirds, in relation to four variables: altitude, latitude, year and the Southern Oscillation Index. Analysis of 30 years of nesting records confirmed that breeding was generally later in colder altitudes and latitudes (geographic variation), but was not consistently related to year or the Southern Oscillation Index (temporal variation). However, power to detect expected temporal effects was low. The timing of breeding became significantly earlier with year only in south-eastern Australia. In contrast, an index of breeding activity (the proportion of atlas records for a species for which breeding was reported) increased with increasing winter values of the Southern Oscillation Index (generally wetter conditions) for all 16 species across Australia. This suggests that annual fluctuations in rainfall can have dramatic and immediate effects on breeding, even for largely sedentary, seasonally breeding species. If, as expected, climate change creates drier conditions over much of Australia, we predict a marked negative effect on bird breeding.

The impact of climate variability and change on cryptosporidiosis and giardiasis rates in New Zealand

Aim: To investigate the spatial relationship between climate variability and cryptosporidiosis and giardiasis notifications in New Zealand between 1997 and 2006.

Methods: Negative binomial regression was used to analyse spatial relationships between cryptosporidiosis and giardiasis notifications in New Zealand between 1997 and 2006, and climatological average rainfall and temperature at the Census Area Unit (CAU) level. The quality of domestic water supplies, urban-rural status and deprivation were included as covariates.

Main results: Giardiasis: There was a positive association between rainfall and giardiasis and between temperature and giardiasis.

Cryptosporidiosis: There was a positive association between rainfall and cryptosporidiosis and a negative association between temperature and cryptosporidiosis. The effect of rainfall was modified by the quality of the domestic water supply.

Conclusions: These findings suggest that climate variability affects protozoan disease rates in New Zealand. However, predicting the effect of climate change from this study is difficult, as these results suggest that the projected increases in temperature and rainfall may have opposing effects on cryptosporidiosis rates. Nevertheless, water supply quality appeared to modify the impact of increased rainfall on cryptosporidiosis rates. This finding suggests that improving water supply quality in New Zealand could reduce vulnerability to the impact of climate change on protozoan diseases.

Stability and variability of motivation to change in anorexia nervosa

Resistance to treatment is common among anorexic clients. Three studies indicated that although readiness to change and self-efficacy are applicable to this population, there is a large degree of variability and stability between symptoms. Multi-dimensional, continuous measures of readiness to change and self-efficacy may provide a more accurate, informative assessment.