Wearable cameras can reduce dietary under-reporting: doubly labelled water validation of a camera-assisted 24 h recall

Preliminary research has suggested that wearable cameras may reduce under-reporting of energy intake (EI) in self-reported dietary assessment. The aim of the present study was to test the validity of a wearable camera-assisted 24 h dietary recall against the doubly labelled water (DLW) technique. Total energy expenditure (TEE) was assessed over 15 d using the DLW protocol among forty adults (n 20 males, age 35 (sd 17) years, BMI 27 (sd 4) kg/m2 and n 20 females, age 28 (sd 7) years, BMI 22 (sd 2) kg/m2). EI was assessed using three multiple-pass 24 h dietary recalls (MP24) on days 2-4, 8-10 and 13-15. On the days before each nutrition assessment, participants wore an automated wearable camera (SenseCam (SC)) in free-living conditions. The wearable camera images were viewed by the participants following the completion of the dietary recall, and their changes in self-reported intakes were recorded (MP24+SC). TEE and EI assessed by the MP24 and MP24+SC methods were compared. Among men, the MP24 and MP24+SC measures underestimated TEE by 17 and 9%, respectively (P< 0.001 and P= 0.02). Among women, these measures underestimated TEE by 13 and 7%, respectively (P< 0.001 and P= 0.004). The assistance of the wearable camera (MP24+SC) reduced the magnitude of under-reporting by 8% for men and 6% for women compared with the MP24 alone (P< 0.001 and P< 0.001). The increase in EI was predominantly from the addition of 265 unreported foods (often snacks) as revealed by the participants during the image review. Wearable cameras enhance the accuracy of self-report by providing passive and objective information regarding dietary intake. High-definition image sensors and increased imaging frequency may improve the accuracy further.

The internal consistency and construct validity of the partners in health scale : validation of a patient rated chronic condition self-management measure

PURPOSE: The purpose of this study was to test the internal consistency and construct validity of the revised 12-item self-rated Partners in Health (PIH) scale used to assess patients' chronic condition self-management knowledge and behaviours. METHODS: Baseline PIH data were collected for a total of 294 patients with a range of co-morbid chronic conditions including diabetes, cardiovascular disease and arthritis. Scale data for the initial sample of 176 patients were analysed for internal consistency and construct validity using Reliability Analysis and Factor Analysis. Construct validity was tested in a separate sample of 118 patients using confirmatory factor analysis and a structural equation model. RESULTS: Good internal consistency was indicated with a Cronbach's alpha coefficient of 0.82 in the initial sample. Factor analysis for this sample revealed four key factors (knowledge, coping, management of condition and adherence to treatment) across the twelve items of the scale. These four key factors were then confirmed by applying the exploratory structural equation model to the separate sample. CONCLUSION: The PIH scale exhibits construct validity and internal consistency. It therefore is both a generic self-rated clinical tool for assessing self-management in a range of chronic conditions as well as an outcome measure to compare populations and change in patient self-management knowledge and behaviour over time. The four domains of self-management provide a valid measure of patient competency in relation to the self-management of their chronic condition(s).

Validation of a computerized use of time recall for activity measurement in advanced-aged adults

BACKGROUND: The Multimedia Activity Recall for Children and Adults (MARCA) is a computerized recall instrument that records use of time during 24 hr the previous day and has been developed to address limitations of current self-report physical activity measures for those in advanced age. METHODS: Test-retest reliability and convergent validity of the adult MARCA were assessed in a sample of 45 advanced-age adults (age 84.9 SD ± 1.62 yr) as a subsample of the Life and Living in Advanced-Age Cohort Study New Zealand (LiLACS NZ). Test-retest methods required participants to recall the previous day's activity using the MARCA twice within the same day. Convergent validity was assessed against accelerometry. RESULTS: Test-retest reliability was high, with ICCs greater than .99 for moderate to vigorous physical activity (MVPA) and physical activity level (PAL). Compared with accelerometry, the MARCA demonstrated validity comparable to other self-report instruments with Spearman's coefficients of .34 and .59 for time spent in nonsedentary physical activity and PAL. CONCLUSION: The MARCA is a valid and reliable self-report tool for physical activity behaviors in advanced-age adults.

Doubly labeled water validation of a computerized use-of-time recall in active young people

OBJECTIVE: Low levels of daily energy expenditure (insufficient physical activity and increased sedentary time) have been associated with adverse health outcomes in young people. The Multimedia Activity Recall for Children and Adolescents (MARCA) is a computerized, self-report, use-of-time tool that can assess daily energy expenditure. The study aim was to validate the MARCA for the estimation of energy expenditure in young people, using the criterion standard doubly labeled water. MATERIALS/METHODS: Over a 15 day assessment period, 32 participants (10-18 years) completed the MARCA and underwent a doubly labeled water protocol. Indirect calorimetry was used to assess resting metabolic rate. Total daily energy expenditure (TEE) and activity-related energy expenditure (AEE) were estimated from both the MARCA and doubly labeled water. Association and agreement between methods for TEE and AEE were assessed using Spearman correlations and Bland-Altman plots, respectively. RESULTS: Compared to doubly labeled water, the MARCA over-estimated TEE by an average of 50 kcal/day (limits of agreement -1 589 to 1 490 kcal/day) and under-estimated AEE 105 kcal/day (limits of agreement -1 404 to 1 614 kcal/day). The MARCA showed strong correlation with doubly labeled water for TEE (rho=0.70, p<0.0001) and moderate correlation for AEE (rho=0.56, p=0.0009). CONCLUSIONS: Overall, the MARCA indicated moderate validity for the assessment of daily TEE and AEE. The wide limits of agreement indicate the MARCA has greater utility for group-level rather than individual-level estimates.

The actiheart in adolescents: a doubly labelled water validation

Background/Objective: This study investigated the validity of the Actiheart device for estimating free-living physical activity energy expenditure (PAEE) in adolescents. Subjects/Methods: Total energy expenditure (TEE) was measured in eighteen Canadian adolescents, aged 15–18 years, by DLW. Physical activity energy expenditure was calculated as 0.9 X TEE minus resting energy expenditure, assuming 10% for the thermic effect of feeding. Participants wore the chest mounted Actiheart device which records simultaneously minute-by-minute acceleration (ACC) and heart rate (HR). Using both children and adult branched equation modeling, derived from laboratory-based activity, PAEE was estimated from the ACC and HR data. Linear regression analyses examined the association between PAEE derived from the Actiheart and DLW method where DLW PAEE served as the dependent variable. Measurement of agreement between the two methods was analyzed using the Bland-Altman procedure. Results: A nonsignificant association was found between the children derived Actiheart and DLW PAEE values (R = .23, R2 = .05, p = .36); whereas a significant association was found between the adult derived Actiheart and DLW PAEE values (R = .53, R2 = .29, p < .05). Both the children and adult equation models lead to overestimations of PAEE by the Actiheart compared with the DLW method, by a mean difference of 31.42 kcal·kg−·d−1 (95% limits of agreement: −45.70 to −17.15 kcal·kg−1·d−1 and 9.80 kcal·kg−1·d−1 (95% limits of agreement: −21.22-1.72 kcal·kg−1·d−1), respectively. Conclusion: There is relatively poor measurement of agreement between the Actiheart and DLW for assessing free-living PAEE in adolescents. Future work should develop group based branched equation models specifically for adolescents to improve the utility of the device in this population.

The Short Questionnaire to Assess Health-Enhancing (SQUASH) physical activity in adolescents: a validation using doubly labeled water

Accurate assessment of physical activity energy expenditure (PAEE) among adolescents is important for surveillance, evaluating interventions, and understanding the relation between energy balance and normal physiological and behavioral growth and development. The purpose of this study was to examine the validity of the Short Questionnaire to Assess Health-Enhancing Physical Activity (SQUASH)13 for measuring PAEE among adolescents. Methods: The participants were seventeen adolescents (9 females; Mean age = 17.53; SD = 0.62). Energy expenditure was measured during a 9-day period with doubly labeled water (DLW). The SQUASH was self-administered on the morning of the 10th day and assessed commuting activities, leisure time activities, household activities, and activities at work and school over the previous 9 days. Results: A Bland-Altman plot indicated that the SQUASH underestimated PAEE compared with DLW by a mean difference of 126 kcal·d-1 (95% limits of agreement:-1,207 to 1,459 kcal·d-1), representative of a 10% underestimation. The Spearman rank order correlation coefficient showed there was a significant association between the SQUASH and DLW (r =.50, P =.04), for estimating PAEE. Conclusion: When using a sample of highly active adolescents, the SQUASH is a valid self-report tool for measuring PAEE at the group and individual rank order level.

Assessing sexual orientation-related obsessions and compulsions in Italian heterosexual individuals: Development and validation of the Sexual Orientation Obsessive-Compulsive Scale (SO-OCS).

Sexual Orientation-Obsessive-Compulsive Disorder (SO-OCD) is characterized by intrusive thoughts, images, and urges related to one's sexual orientation, and by consequent avoidance, reassurance seeking, and overt and covert compulsions. Currently there is no short self-report measure that assesses SO-OCD symptoms. The current article describes two studies that develop and evaluate the first version of the Sexual Orientation Obsessive-Compulsive Scale (SO-OCS), a 14-item Italian self-report measure targeted towards heterosexual individuals. In Study 1, the SO-OCS was developed and refined through item analysis and exploratory factor analysis from an initial pool of 33 items administered to 732 Italian nonclinical participants. The SO-OCS showed a unidimensional structure and an acceptable internal consistency. In Study 2, the factor structure, internal consistency, temporal stability, construct and criterion validity, and diagnostic sensitivity of the SO-OCS were investigated in three samples of Italian participants (294 from the general population, 52 OCD patients who reported sexual orientation-related symptoms or concerns as a primary complaint, and 51 OCD patients who did not report these symptoms as primary complaint). The SO-OCS was again found to have a unidimensional structure and good internal consistency, as well as to exhibit strong construct validity. Specifically, the SO-OCS showed an excellent criterion validity and diagnostic sensitivity, as it successfully discriminated between those with SO-OCD and all other groups of participants. Finally, evidence of temporal stability of the SO-OCS in a nonclinical subsample was found. The SO-OCS holds promise as a measure of SO-OCD symptoms in heterosexual individuals.

The validation of a Spanish version of the multidimensional inventory of religious/spiritual well-being in mexican college students

After the Multidimensional Inventory for Religious/Spiritual Well-Being (MI-RSWB) was validated as a reliable instrument for the Western European context it is primarily intended in this study to translate the measure into Spanish and adapt it for the Mexican culture. Furthermore we investigate whether spirituality/religiosity has a similar impact on indicators of personality and subjective well-being in Mexico as it does in samples drawn from Western European cultures. 190 students (99 females) from public and private universities in Guadalajara, all Mexican citizens, were involved in this study. We found strong evidential support for the six factor solution of the Original MI-RSWB in this Mexican population. By mirroring previous research the measure showed a highly satisfying internal consistency (α =.91 for the total score and.75 or higher for all six sub dimensions). Furthermore the total RSWB score was observed to be related with Eysenck's personality dimensions Extraversion (r =.24, p <.01), and Psychoticism (r = -.28, p <.001), although not with Neuroticism. There was also a positive correlation with Sense of Coherence (r =.31, p <.001). In conclusion, the dimensionality of RSWB and its associations with personality and subjective well-being was well supported in this first application within a Mexican cultural context.

Adaptation and validation of a survey instrument measuring perceived preparedness of nursing graduates

BACKGROUND: In Australia, a significant percentage of bachelor of nursing students are employed in the aged care sector, or in aged care settings, as assistants in nursing (AINs) or personal care assistants. However the value of aged care in nursing education is often overlooked. AIM: To outline the adaptation and validation of a survey, originally developed for medical graduates, for use with nursing graduates. DISCUSSION: Adaptation of the instrument was undertaken as part of a doctoral study that aimed to explore whether employment as an undergraduate assistant in nursing (AIN) in aged care prepares new graduates for clinical work. CONCLUSION: Outlining each step of the modification process can help nurse researchers who want to adapt existing instruments to meet their research objectives. IMPLICATIONS FOR PRACTICE: Undergraduate AIN employment has the potential to supplement clinical learning without the restrictions inherent in the student role. Furthermore, it has the potential to enhance recruitment and retention in the aged care sector.

MaramaAIC: tool support for consistency management and validation of requirements

Requirements captured by requirements engineers (REs) are commonly inconsistent with their client’s intended requirements and are often error prone. There is limited tool support providing end-to-end support between the REs and their client for the validation and improvement of these requirements. We have developed an automated tool called MaramaAIC (Automated Inconsistency Checker) to address these problems. MaramaAIC provides automated requirements traceability and visual support to identify and highlight inconsistency, incorrectness and incompleteness in captured requirements. MaramaAIC provides an end-to-end rapid prototyping approach together with a patterns library that helps to capture requirements and check the consistency of requirements that have been expressed in textual natural language requirements and then extracted to semi-formal abstract interactions, essential use cases (EUCs) and user interface prototype models. It helps engineers to validate the correctness and completeness of the EUCs modelled requirements by comparing them to “best-practice” templates and generates an abstract prototype in the form of essential user interface prototype models and concrete User Interface views in the form of HTML. We describe its design and implementation together with results of evaluating our tool’s efficacy and performance, and user perception of the tool’s usability and its strengths and weaknesses via a substantial usability study. We also present a qualitative study on the effectiveness of the tool’s end-to-end rapid prototyping approach in improving dialogue between the RE and the client as well as improving the quality of the requirements.

Cultural adaptation and validation of the Health Literacy Questionnaire (HLQ): robust nine-dimension Danish language confirmatory factor model

Health literacy is an important construct in population health and healthcare requiring rigorous measurement. The Health Literacy Questionnaire (HLQ), with nine scales, measures a broad perception of health literacy. This study aimed to adapt the HLQ to the Danish setting, and to examine the factor structure, homogeneity, reliability and discriminant validity. The HLQ was adapted using forward-backward translation, consensus conference and cognitive interviews (n = 15). Psychometric properties were examined based on data collected by face-to-face interview (n = 481). Tests included difficulty level, composite scale reliability and confirmatory factor analysis (CFA). Cognitive testing revealed that only minor re-wording was required. The easiest scale to respond to positively was 'Social support for health', and the hardest were 'Navigating the healthcare system' and 'Appraisal of health information'. CFA of the individual scales showed acceptably high loadings (range 0.49-0.93). CFA fit statistics after including correlated residuals were good for seven scales, acceptable for one. Composite reliability and Cronbach's α were >0.8 for all but one scale. A nine-factor CFA model was fitted to items with no cross-loadings or correlated residuals allowed. Given this restricted model, the fit was satisfactory. The HLQ appears robust for its intended application of assessing health literacy in a range of settings. Further work is required to demonstrate sensitivity to measure changes.

An automated collaborative requirements engineering tool for better validation of requirements

This demo introduces an automated collaborative requirements engineering tool, called TestMEReq, which is used to promote effective communication and collaboration between client-stakeholders and requirements engineers for better requirements validation. Our tool is augmented with real time communication and collaboration support to allow multiple stakeholders to collaboratively validate the same set of requirements. We have conducted a user study focusing on validating requirements using TestMEReq with a few groups of requirements engineers and client stakeholders. The study shows that our automated tool support is able to assist requirements engineers to effectively communicate with client-stakeholders to better validate the requirements virtually in real time. (Demo video: https://www.youtube.com/watch?v=7sWLOx-N4Jo).