Evaluating quality of life in hip and knee replacement: psychometric properties of the World Health Organization Quality of Life short version instrument

Objective: To evaluate the psychometric properties of the World Health Organization Quality of Life short version instrument (WHOQOL-BREF), and to determine its responsiveness in assessing early outcome after total hip or knee replacement surgery.

Methods: At baseline (entry to an orthopedic waiting list), 279 participants completed the WHOQOL-BREF instrument, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Assessment of Quality of Life (AQOL) instrument, Kessler Psychological Distress (K10) scale, and the modified Health Assessment Questionnaire (MHAQ). A total of 74 patients completed reassessments 3 months after surgery.

Results: The WHOQOL-BREF demonstrated acceptable internal consistency for all domains (Cronbach's = 0.76-0.84) and moderate concurrent validity for the physical and psychological domains (r = 0.67 for physical versus AQOL; r = -0.71 for psychological versus K10). Minimal ceiling or floor effects were identified at baseline or 3 months, except for the social relationships domain. The disease-specific WOMAC subscales were most responsive to change (relative efficiency [RE] 0.66-1.00). Apart from social relationships, all WHOQOL-BREF scores improved significantly after surgery. The physical domain was more responsive than the AQOL (RE 0.50 versus 0.42) and was similar to the MHAQ (RE 0.55 for MHAQ). The responsiveness of the psychological domain was similar to that of the K10 scale (RE 0.11 versus 0.08).

Conclusion: The WHOQOL-BREF has good psychometric properties for use in persons with severe joint disease, and by providing complementary information, it offers clinicians and researchers an additional tool for comprehensively assessing quality of life in this patient group.

The Obsessive Beliefs Questionnaire (OBQ) : Examination in nonclinical samples and development of a short version

The study aimed to examine the factor structure of the Obsessive Beliefs Questionnaire (OBQ), the most widely used measure of dysfunctional beliefs in obsessive—compulsive disorder (OCD). Multiple exploratory methods (exploratory factor analysis, cluster analysis by variable, multidimensional scaling) were used to examine the questionnaire. Confirmatory factor analyses were also performed in two large nonclinical samples from Australia (N = 1,234) and Israel ( N = 617). Our analyses suggested a four-factor solution with 38 items, where threat and responsibility formed separate dimensions (the “OBQ-TRIP”). This version had superior fit statistics across the two divergent confirmatory samples, when compared with four alternative models suggested by previous authors. Of the OBQ dimensions, the threat scale correlated most strongly with OCD symptom measures, even when controlling for depression. A short, 20-item version of the scale is offered for further study. Implications and limitations are discussed.

Development of a reliable measure of walking within and outside the local neighbourhood: RESIDE's neighborhood physical activity questionnarire.

Background: The RESIDential Environment project (RESIDE) is a longitudinal study evaluating the impact of a new residential design code on walking. Objective: To develop a reliable measure of walking – undertaken within and outside the neighborhood – and overall physical activity. Methods: A test–retest reliability study was undertaken (n = 82, mean age 39 years). The instrument was based on the International Physical Activity Questionnaire (IPAQ-short version) and Active Australia Survey. It measured usual frequency and duration of (1) recreational- and transport-related walking within and outside the neighborhood and (2) other vigorous and moderate physical activities. Results: Reliability of recall of whether participants had walked within (k = 0.84) and outside (0.73) the neighborhood was acceptable. Similarly, recall of frequency and duration of transport and recreational-related walking within the neighborhood was excellent (ICC ≥ 0.82), as was recall of transport-related walking trips outside the neighborhood (ICC ≥ 0.84). Reliability for duration of recreational walking outside the neighborhood was fair to good (ICC = 0.55). The reliability of indices of total physical activity based on MET min/week (ICC = 0.82) and MET min/week dichotomized to ‘sufficient’ physical activity for health (kappa = 0.67) were both acceptable. Conclusions:  The Neighborhood Physical Activity Questionnaire (NPAQ) is sufficiently reliable for studies examining environmental correlates of walking within the neighborhood.

The PTT-20 : UK normative data for 5-11 year olds on a 20 item past tnese taskThe PTT-20: UK normative data for 5- to 11-year-olds on a 20-item past-tense task

Background: Grammatical morphology, particularly the use of the past tense in English, has been identified as a behavioural marker for specific language impairment. However, there is a dearth of instruments that assess key verb features, are short and easy to administer for clinical use, and have normative data for the UK population.

Aims: The present study aimed to develop a short version of a past-tense task (named the PTT-20) and to provide UK normative data for a large control sample of primary school-age children.

Methods & Procedures: The task consisted of 20 items taken from a well-known 52-item task developed by Marchman, Wulfeck, and Ellis Weismer in 1999, retaining the key features and variety of verbs of the original design. It was administered to 424 typically developing children aged 5;0 to 11;6 years.

Outcomes & Results: The short version reduced administration time by two-thirds to around 5–8 minutes. Normative data revealed developmental progression in performance throughout the primary school years, with the task exhibiting ceiling effects in 29% of children by age 11 years. Expected and impaired performance indicators are presented by age band, that is, 5, 6, 7, 8, 9, 10, and 11 years. Comparisons between identified children with specific language impairment and typically developing children revealed significant differences in performance. The PTT-20 correlated highly with the full 52-item task and had good internal consistency.

Conclusions & Implications: The PTT-20 can be a useful tool in the identification and assessment of young school-age children with suspected language difficulties. It can also be used in research and practice as a benchmark against which to compare the ability of children with identified language impairments.

Educational and mental health implications of the multidimensional model of the self-concept for adolescent girls : comparison of clinical and non-clinical samples

The importance of a positive self-concept as an educational outcome and a facilitator of other desirable outcomes are well established within the education research field. Although the multidimensional and hierarchical model of the self-concept is widely accepted within the educational psychology, this perspective is not widely used within the mental health research. Hence, the purpose of the present investigation is to compare the psychometric properties of the short version of the Self-Description Questionnaire (SDQII-S) based on responses by a large sample of female adolescent high school students (N= 829) and a clinical sample of adolescent girls who have been diagnosed with anorexia nervosa (N= 75). The well-established psychometric properties of the longer version of the SDQII generalise well to both samples of adolescent girls, and analyses provided good support for the invariance of the factor structure across the two samples. Furthermore, analyses employing new structural equation modelling approaches to comparing the latent mean differences indicated that there were differences (although surprisingly small) between the two groups that were generally consistent with a priori predictions. The important educational and clinical implications of these results are discussed.

Effect of questionnaire length, personalisation and reminder type on response rate to a complex postal survey : randomised controlled trial

Background: Minimising participant non-response in postal surveys helps to maximise the generalisability of the inferences made from the data collected. The aim of this study was to examine the effect of questionnaire length, personalisation and reminder type on postal survey response rate and quality and to compare the costeffectiveness of the alternative survey strategies.
Methods: In a pilot study for a population study of travel behaviour, physical activity and the environment, 1000 participants sampled from the UK edited electoral register were randomly allocated using a 2 × 2 factorial design to receive one of four survey packs: a personally addressed long (24 page) questionnaire pack, a personally addressed short (15 page) questionnaire pack, a non-personally addressed long questionnaire pack or a nonpersonally addressed short questionnaire pack. Those who did not return a questionnaire were stratified by initial randomisation group and further randomised to receive either a full reminder pack or a reminder postcard. The effects of the survey design factors on response were examined using multivariate logistic regression.
Results: An overall response rate of 17% was achieved. Participants who received the short version of the questionnaire were more likely to respond (OR = 1.48, 95% CI 1.06 to 2.07). In those participants who received a reminder, personalisation of the survey pack and reminder also increased the odds of response (OR = 1.44, 95% CI 1.01 to 1.95). Item non-response was relatively low, but was significantly higher in the long questionnaire than the short (9.8% vs 5.8%; p = .04). The cost per additional usable questionnaire returned of issuing the reminder packs was £23.1 compared with £11.3 for the reminder postcards.
Conclusions: In contrast to some previous studies of shorter questionnaires, this trial found that shortening a relatively lengthy questionnaire significantly increased the response. Researchers should consider the trade off between the value of additional questions and a larger sample. If low response rates are expected, personalisation may be an important strategy to apply. Sending a full reminder pack to non-respondents appears a worthwhile, albeit more costly, strategy.

Factorial invariance of the DASS-21 among adolescents in four countries

The use of scales to measure constructs in populations or contexts other than that in which they were established is highly controversial. Despite this, the use of scales without reference to "local" psychometric data is still widespread. In this study we examined the factor structure of the short 21-item form of the Depression, Anxiety, and Stress Scales (DASS-21), when it was applied to adolescent samples recruited from high schools in Australia (N = 371), Chile (N = 448), China (N = 558), and Malaysia (N = 388). Multigroup confirmatory factor analyses revealed that the purported three-factor structure of the DASS-21 was supported in each location with structural invariance across locations. While convergent and divergent validity studies are required to support this finding, the DASS-21 appears to be suitable for use with adolescents in these locations.

Short term load forecasting using a hybrid neural network

Short Term Load Forecasting (STLF) is very important from the power systems grid operation point of view. STLF involves forecasting load demand in a short term time frame. The short term time frame may consist of half hourly prediction up to weekly prediction. Accurate forecasting would benefit the utility in terms of reliability and stability of the grid ensuring adequate supply is present to meet with the load demand. Apart from that it would also affect the financial performance of the utility company. An accurate forecast would result in better savings while maintaining the security of the grid. This paper outlines the STLF using a novel hybrid online learning neural network, known as the Gaussian Regression (GR). This new hybrid neural network is a combination of two existing online learning neural networks which are the Gaussian Adaptive Resonance Theory (GA) and the Generalized Regression Neural Network (GRNN). Both GA and GRNN implemented online learning, but each of them suffers from limitation. Originally GA is used for unsupervised clustering by compressing the training samples into several categories. A supervised version of GA is available, namely Gaussian ARTMAP (GAM). However, the GAM is still not capable on solving regression problem. On the other hand, GRNN is designed for solving real value estimation (regression) problem, but the learning process would involve of memorizing all training samples, hence high computational cost. The hybrid GR is considered an enhanced version of GRNN with compression ability while still maintains online learning properties. Simulation results show that GR has comparable prediction accuracy and has less prototype as compared to the original GRNN as well as the Support Vector Regression.

Adaptation and validation of the Japanese version of the health education impact questionnaire (heiQ-J) for the evaluation of self-management education interventions

Aim:  

Neighborhood environment walkability scale : validity and development of a short form

Purpose : The aim of this study was to examine the factorial and criterion validity of the Neighborhood Environment Walkability Scale (NEWS) and to develop an abbreviated version (NEWS-A).

Methods : A stratified two-stage cluster sample design was used to recruit 1286 adults. The sample was drawn from residential addresses within eight high- and eight low-walkable neighborhoods matched for socioeconomic status. Subjects completed the NEWS and reported weekly minutes of walking for transport and recreation using items from the International Physical Activity Questionnaire.

Results : Multilevel confirmatory factor analysis was used to develop measurement models of the NEWS and NEWS-A. Six individual-level and five blockgroup-level factors were identified. Factors/scales gauging presence of diversity of destinations, residential density, walking infrastructure, aesthetics, traffic safety, and crime were positively related to walking for transport. Aesthetics, mixed destinations, and residential density were associated with walking for recreation.

Conclusions : The NEWS and NEWS-A possess adequate levels of factorial and criterion validity. Alternative methods of scoring for different purposes are presented.

Short form health surveys and related variants in spinal cord injury research : a systematic review

CONTEXT: 'Short Form' health surveys - such as the SF-36 and SF-12 - are widely used in medical research. Spinal cord injury (SCI) is no exception, despite oft-cited concerns regarding measurement properties for populations with physical impairment.OBJECTIVE: To provide a comprehensive overview of the use of Short Form health surveys and their variants within the SCI literature.METHODS: Papers published between database inception and September 2012 were identified from 11 electronic databases; a supplementary reference list search was also conducted. Data extraction focused on details regarding the range of different Short Form surveys and variants used in SCI research, the respective frequency of use, the nature of reporting (complete versus partial reporting) and the method of survey administration.RESULTS: One hundred seventy-four papers were identified. Thirty-six-item Short Form health surveys were frequently administered as complete instruments (n = 82); in 69 of these 82 studies (84%), it was not clearly stated which 36-item version had been used (e.g. SF-36v1, SF-36v2, RAND-36). Data for individual items and domains were often reported (29% of identified studies), indicating significant partial use of standardized measures. Modified variants of standardized health surveys were administered in 12 studies.CONCLUSION: Although standardized Short Form health surveys are common within SCI research, attempts to add, delete, or modify items have resulted in a number of variants, often with minimal supportive psychometric evidence. Using established, generic outcome measures is appealing for a number of reasons. However, validity is paramount and requires further explicit consideration within the SCI research community.