Development of a Parent Version of the Manchester-Minneapolis Quality of Life Survey for use by Parents and Crers of UK Children: MMQL-UK (PF).

Background Although it is now widely endorsed that children should as far as possible rate their own health related quality of life (HRQL), there are situations where proxy information on child HRQL may be useful, especially where a child is too ill or young to provide their own HRQL assessment. There is limited availability of generic HRQL scales that have a parallel child and parent version and that are reliable, valid, brief, comprehensible and suitable for use in UK populations. The aims of this study were therefore to develop and validate a parent version of the anglicised Manchester-Minneapolis Quality of Life child form (MMQL-UK (CF)) and to determine the level of association between the child and parent versions of this form. Methods This study was undertaken concurrently with the anglicisation and validation of the MMQL, a measure of HRQL developed for use with children in North America. At that time, no parent version existed, so the MMQL form for children (MMQL-UK (CF)) was used as the basis for the development of the MMQL-UK parent form (PF). The sample included a control group of healthy children and their parents and five exemplar groups; children diagnosed with asthma, diabetes or inflammatory bowel disease and their parents, children in remission from cancer and their parents and children in public care and their carers. Consistency of the MMQL-UK (PF) components were assessed by calculating Cronbach's alpha. Validation of the parent questionnaire was undertaken by comparing MMQL-UK (PF) component scores with comparable components on the proxy PedsQL™ quality of life scales, comparing MMQL-UK (PF) component scores between parents of healthy and chronic disease children and by comparison of component scores from children and their parents or carers. Reproducibility and responsiveness were assessed by retesting parents by follow-up questionnaires. Results A total of 874 children (completing MMQL-UK (CF)) and 572 parents or carers (completing MMQL-UK (PF)) took part in the study. The internal consistency of all the MMQL-UK (PF) components exceeding the accepted criterion of 0.70 and the construct validity was good with moderate correlations being evident between comparable components of the MMQL-UK (PF) and the proxy PedsQL™. Discriminant validity was demonstrated with significant differences being identified between parents of healthy children and those with chronic conditions. Intra-class correlations exceeded 0.65 for all MMQL-UK (PF) components demonstrating good reproducibility. Weak to moderate levels of responsiveness were demonstrated for all but social functioning. The MMQL-UK (PF) showed moderate parent-child correlation with the MMQL-UK (CF) for all components. The best correlations were seen for those components measuring the same construct (Pearson's r ranged from 0.31 to 0.61, p < 0.01 for equivalent components). Conclusion The MMQL-UK (PF) showed moderate to good correlations with the MMQL-UK (CF) component scores. The MMQL-UK (PF) will be of use when comparing child and parent/carer perception of the impact of a child's condition on their HRQL or where the child is too ill or young to provide their own report.

Risk Perception Influences Athletic Pacing Strategy.

PURPOSE: To examine risk-taking and risk-perception associations with perceived exertion, pacing and performance in athletes. METHODS: Two experiments were conducted in which risk-perception was assessed using the domain-specific risk-taking (DOSPERT) scale in 20 novice cyclists (Experiment 1) and 32 experienced ultra-marathon runners (Experiment 2). In Experiment 1, participants predicted their pace and then performed a 5 km maximum effort cycling time-trial on a calibrated KingCycle mounted bicycle. Split-times and perceived exertion were recorded every kilometer. In experiment 2, each participant predicted their split times before running a 100 km ultra-marathon. Split-times and perceived exertion were recorded at 7 check-points. In both experiments, higher and lower risk-perception groups were created using median split of DOSPERT scores. RESULTS: In experiment 1, pace during the first km was faster among lower compared to higher risk-perceivers, t(18)=2.0 P=0.03, and faster among higher compared lower risk-takers, t(18)=2.2 P=0.02. Actual pace was slower than predicted pace during the first km in both the higher risk perceivers, t(9)=-4.2 P=0.001, and lower risk-perceivers, t(9)=-1.8 P=0.049. In experiment 2, pace during the first 36 km was faster among lower compared to higher risk-perceivers, t(16)=2.0 P=0.03. Irrespective of risk-perception group, actual pace was slower than predicted pace during the first 18 km, t(16)=8.9 P<0.001, and from 18 to 36 km, t(16)=4.0 P<0.001. In both experiments there was no difference in performance between higher and lower risk-perception groups. CONCLUSIONS: Initial pace is associated with an individual's perception of risk, with low perceptions of risk being associated with a faster starting pace. Large differences between predicted and actual pace suggests the performance template lacks accuracy, perhaps indicating greater reliance on momentary pacing decisions rather than pre-planned strategy.

Internationalization’s Effect on Marketing Learning: A Study of Syrian Firms

The aim of the present study is to understand the effects of international expansion on firms’ acquisition of marketing learning. This study’s focus on marketing learning complements previous research on the impact of internationalization on the development of foreign-market and technological knowledge. The research finds that the scope of a firm’s international activities, perception of gaps in marketing knowledge, and external social capital positively influence firms’ acquisition of marketing learning. However, firm’s age at initial international market entry appears not to be a significant factor. The study adds to the very limited body of research on the marketing learning outcomes of international expansion, while also offering rare empirical insights from the Middle East on this important subject matter. The paper discusses implications for international managers, policy makers, and future researchers.