Top-down and bottom-up approaches to motor skill assessment of children : are child-report and parent-report perceptions predictive of children's performance-based assessment results?

Background/ Aim: Therapists use different types of tests, scales, and instruments to assess children's motor skills, including those classified as being top-down and bottom-up. The aim of the study was to investigate the ability of measures of children's motor skill performance from the perspectives of children and parents (a type of top-down assessment) to predict children's performance-based motor ability test results (a type of bottom-up assessment).
Methods: A convenience sample of 38 children and parents was recruited from Victoria, Australia. Motor skill performance was evaluated from a top-down perspective using the Physical Self-Description Questionnaire (PSDQ) and the Movement Assessment Battery for Children – Second Edition (MABC-2) Checklist to measure children's and parents' perspectives respectively. Motor skill performance was also evaluated from a bottom-up approach using the Bruininks-Oseretsky Test of Motor Proficiency – Second Edition (BOT-2). Data were analyzed using multiple linear regression analysis to determine whether the PSDQ or MABC-2 Checklist was predictive of the children's BOT-2 performance results.
Results: Two predictive relationships were identified based on parents' perspectives, where the total score of the MABC-2 Checklist was found to be a significant predictor of the BOT-2 Manual Coordination motor composite score, accounting for 8.35% of its variance, and the BOT-2 Strength and Agility motor composite score, accounting for 11.6% of its variance. No predictive relationships were identified between the children's self-report PSDQ perspectives and the BOT-2 performance scores.
Conclusions: Therapists are encouraged to utilize a combination of top-down and bottom-up approaches and purposefully to seek parents' and children's perspectives when evaluating children's motor skill performance.

Content validity of visual analog scales to assess symptom severity of acute angioedema attacks in adults with hereditary angioedema : an interview study

Background: Hereditary angioedema (HAE) is a rare, debilitating, potentially life-threatening condition characterized by recurrent acute attacks of edema of the skin, face/upper airway, and gastrointestinal and urogenital tracts. During a laryngeal attack, people with HAE may be at risk of suffocation, while other attacks are often associated with intense pain, disfigurement, disability, and/or vomiting. The intensity of some symptoms is known only to the person experiencing them. Thus, interview studies are needed to explore such experience and patient-reported outcome measures (PROMs) are required for systematic assessment of symptoms in the clinical setting and in clinical trials of treatments for acute HAE attacks.

Objective: The aim of this interview study was to assess the content validity and suitability of four visual analog scale (VAS) instruments for use in clinical studies. The VAS instruments were designed to assess symptoms at abdominal, oro-facial-pharyngeal-laryngeal, peripheral, and urogenital attack locations. This is the first known study to report qualitative data about the patient's experience of the rare disorder, HAE.

Methods: Semi-structured exploratory and cognitive debriefing interviews were conducted with 27 adults with a confirmed clinical/laboratory diagnosis of HAE (baseline plasma level of functional plasma protein C1 esterase inhibitor [C1INH] <50% of normal without evidence for acquired angioedema). There were 17 participants from the US and 10 from Italy, with mean age 42.5 (SD 14.5) years, range 18–72 years, mean HAE duration 21.3 (SD 14.1) years, range 1–45 years, 67% female, and 44% VAS-naïve. Experience of acute angioedema attacks was first explored, noting spontaneous mentions by participants of HAE symptomatology. Cognitive debriefing of the VAS instruments was undertaken to assess the suitability, comprehensibility, and relevance of the VAS items. Asymptomatic participants completed the VAS instruments relevant to their angioedema experience, reporting as if they were experiencing an acute angioedema attack at the time. Interviews were conducted in the clinic setting in the US and Italy over an 8-month period.

Results: Participants mentioned spontaneously almost all aspects of acute angioedema attacks covered by the four VAS instruments, thus providing strong support for inclusion of nearly all VAS items, with no important symptoms missing. Predominant symptoms found to be associated with acute angioedema attacks were edema and pain, and there was evidence of varying degrees of disruption to everyday activities supporting the inclusion of an overall severity item reflecting the disabling effects of HAE symptoms. VAS item wording was understood by participants.

Conclusion: This interview study explored and reported the patient experience of HAE attacks. It demonstrated the content validity of the four anatomical location HAE VAS instruments and their suitability for use in clinical trials of recombinant human C1INH (rhC1INH) treatment for ascertaining trial participants' assessments of the severity of acute angioedema symptoms.

Evaluation of two instruments of perceived symptom intensity in palliative care patients in an outpatient clinic

AIMS AND OBJECTIVES: To evaluate the test-retest stability in assessments of perceived symptom intensity on the Edmonton Symptom Assessment System-revised and the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative. The possible interchangeability between the instruments and the patients' experiences of completing the instruments were also studied. BACKGROUND: The two instruments assess the same symptoms, but the symptom intensity is assessed on 11-point numerical scales on the Edmonton Symptom Assessment System-revised and on four-point verbal descriptive scales on the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative. Both instruments are commonly used; however, uncertainty exists about which instrument should be recommended and about the interchangeability of the instruments. DESIGN: This study used a test-retest design with inter-scale comparisons. METHODS: Data from 54 patients with cancer who were receiving palliative care in an oncology outpatient clinic were self-reported by the patients in the clinic, at home and when patients returned to the clinic. RESULTS: The assessments on the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative verbal rating scales showed a higher level of test-retest stability than the assessments on the Edmonton Symptom Assessment System-revised numerical scoring scales, indicating higher reliability. The correspondence between the verbal categories and the numerical scores of symptom intensity were low because different verbal categories were used by patients who assessed the same numerical score. CONCLUSIONS: The test-retest stability in the assessments was higher on the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative and the results show that assessments on the two instruments could not be used interchangeably. Therefore, the symptom instrument chosen must be specified and unchanged within a patient to improve efficacy in clinical practice. RELEVANCE TO CLINICAL PRACTICE: The Edmonton Symptom Assessment System-revised or the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative can be used for initial assessments of patients, but should not be compared or used interchangeably. It is vitally important to have individual follow-up for all patients who score an instrument.

Multivariate modelling of landuse on in-stream salinity over multiple spatial scales

An impediment to sustainable dryland salinity management is the lack of information on contributing factors. GIS and satellite imagery now offer a cost-effective means of generating relevant land and water resource information for integrated regional management of salinity. In this paper the relationships between patterns in land uselcover distribution and base flow salt concentration in streams (indicated by EC) are investigated and modelled. The Glenelg-Hopkins area is a large regional watershed in southwest Victoria, Australia, covering approximately 2.6 million ha. It is currently estimated that 27,400 ha of land is affected by dryland salinity and this is predicted to rapidly increase in the next decade' if current conditions prevail. Salt concentration data from five gauging stations were analysed with multi-temporal land use maps obtained from satellite imagery. Multiple regression analyses demonstrated that the variables Native Vegetation and Dry/and Grain Cropping were the most significant influences on in~stream salinity in the whole catchment (1=88.9%) and 500 m V=88.3%) and 100 m riparian buffers (1=86.9%) during times of base flow. The implications for future land use planning, effectiveness of riparian zones and revegetation programmes is discussed. This work also demonstrates the utility of applying nmltivariate statistical analyses, spatial statistics, and remote sensing with data integrated in a GIS framework for the purpose of predicting and managing the regional salinity threat.

Using fractal geometry to make rapid field measurements of riverbed topography at ecologically useful spatial scales

A method is described for making rapid in situ field measurements of riverbed topography over spatial scales of ≅1–10 m. This method uses rolling balls to make quick, accurate measurements of river-bed roughness at several spatial scales. Random sampling and replication generate multiple estimates of the fractal dimension (d) that can be used to test for significant differences in the complexity of riverbed architecture between habitat types and spatial scales.

Development of body modification and excessive exercise scales for adolescents

The present study was designed to develop a Body Modification Scale (BMS) to measure body change among adolescents and to modify an Excessive Exercise Scale (EES) into a shorter form for adolescents. Two hundred and twenty-one girls and 192 boys from Grades 7 to 10 completed the BMS and the EES. Factor analysis revealed three identical factors for the BMS for girls and boys: weight loss, weight gain, and muscle mass. Two identical factors for girls and boys were also revealed for the EES. Both factor structures were further validated on a separate sample of 286 adolescents (140 girls, 146 boys). The BMS and EES demon-strated excellent reliability (alpha > .86) and high test-retest reliability (alpha > .82) over 1 month. Good concurrent validity was also found for the weight loss factor of the BMS. These findings demonstrate the utility of these two scales for use with adolescents.

Response : A defensible and workable approach to the income tax treatment of financial instruments

It is a privilege to have the opportunity to respond to the comments on my monograph1 provided by Mark Gergen, Glenn May, and Gordon Longhouse. Their comments, which are inevitably coloured by their very different perspectives, reflect the considerable expertise that each one of them has in the area of the income taxation of financial instruments. Indeed, it is with some hesitation that I offer a response in defence of various portions of the analysis presented in my monograph in support of some pretty modest proposals in this extremely difficult area of income tax law. Although I spent considerable time exploring some necessary first principles and their implications for the design of a system for the income taxation of financial instruments, I made several concessions to certain practical constraints that led me to support, in some measure, the status quo reflected in certain of the existing literature, as well as the legislation in a select group of countries. On the assumption that many readers may be unfamiliar with the monograph, I propose to respond by outlining much of my analysis in the monograph and the proposals that are the logical outcome. Throughout the outline, I will highlight and respond to what I see as the important points of difference emphasized by Gergen, May, and Longhouse.

Quality of life instruments for caregivers of patients with cancer : A review of their psychometric properties

The quality of life of caregivers of patients with cancer is an important construct given the substantial impact of caring on the physical, psychological, social, and financial well-being of caregivers. Moreover, caring for patients with cancer also affects family functioning and places burdens on caregivers. The reliability and validity of instruments used to assess the quality of life of caregivers of patients with cancer were reviewed to aid in the selection of the most appropriate measures For research and practice. MEDLINE (1980-2000) and c/NAHL (1982-2000) searches located relevant quality of life instruments using the keywords "cancer and quality of Iife" and "caregiver or spouse or partner." The search identified the following instruments: the Caregiver Quality of life Index-Cancer Scale, the 'Caregiver Quality of Life Index, the Quality of Life Tool, and the Quality of life Index-Cancer Version. Quality of life instruments developed specifically to measure the quality of life of caregivers of patients with cancer had the best psychometric properties. The Caregiver Quality of Life Index-Cancer Scale, in particular, met or exceeded minimum psychometric criteria for reliability and validity. The development of reliable and valid caregiver quality of life measures is an important factor in developing interventions to enhance quality of life of caregivers of patients with cancer.

Paediatric quality of life instruments: a review of the impact of the conceptual framework on outcomes

With an increasing number of paediatric quality of life (QOL) instruments being developed, it is becoming difficult for researchers and clinicians to select the most appropriate instrument. Reviews of QOL instruments tend to report only basic properties of the instruments such as domains and psychometric properties. This paper seeks to appraise critically the conceptual underpinnings of paediatric QOL instruments. A systematic review was conducted to identify QOL instruments for children aged 0 to 12 years, and to examine and compare their conceptual frameworks, definitions employed, and structure. Both generic and condition-specific measures were reviewed. Fourteen generic and 25 condition-specific QOL instruments were identified. Eleven types of definition of QOL and health-related QOL and three theories of QOL were identified. QOL was measured by a variety of domains including emotional, social and physical health, and well-being. Items commonly assessed difficulties, or intensity/frequency of feelings/symptoms, in contrast to positive aspects of life and happiness. The findings highlight the diversity that is apparent in the conceptualization of paediatric QOL and draw attention to the lack of empirical evidence for many of the fundamental assumptions. The impact of the conceptual underpinnings of the instruments on the resulting QOL scores is discussed.

Distribution and habitat requirements of the Yellow-Footed Antechinus Antechinus flavipes at multiple scales: a review

This review synthesises present knowledge of the distribution patterns and habitat requirements of the Yellow-footed Antechinus Antechinus flavipes. Factors influencing the distribution of A. flavipes are examined at several spatial scales ranging from the broad climatic conditions prevalent over the species’ entire range to the characteristics of nest sites used by individual animals. Analysis of the literature suggests that: 1) at the broad-scale, A. flavipes distribution is largely determined by warm, dry climatic conditions, the distribution of dry forests and woodlands and competition with closely related species; 2) at the landscape-scale the determinants of A. flavipes distribution are largely unknown, although initial investigations suggest some tolerance of fragmented landscapes; and 3) at a local-scale the distribution of A. flavipes is largely determined by the presence of large diameter trees, tree hollows, coarse woody debris, rocky crevices and leaf-litter. Directions for future research are suggested throughout the review.

Further evidence on the corporate use of derivatives in Australia : the case of foreign currency and interest rate instruments

In a recent issue of this journal Nguyen and Faff (2002) reported on an empirical exploration of the motives behind the aggregate use of financial derivatives by Australian companies. Employing the same sample of firms, the current paper extends their analysis to investigate similar issues, this time focussing separately on foreign currency and interest rate derivatives. At a specific level, our results reveal the following. A firm is more likely to use foreign currency derivatives if it is large and has more debt in its capital structure. Interest rate derivatives, on the other hand, are more likely to be used if a firm is larger, more levered, more liquid and pays higher dividends. These results are consistent with existing hedging theories. Market to book value (proxying growth opportunities), however, portrays an inconsistent relationship with the likelihood of interest rate derivative usage. When it comes to the extent of usage, a firm uses foreign currency derivatives more extensively if it is smaller, pays higher dividends and has more debt. Similarly, interest rate derivatives are used more extensively to address a high level of debt and a high dividend payout policy. At a general level, the current study confirms the core finding of Nguyen and Faff (2002), namely, that Australian companies use derivatives with a view to value maximisation.

Research methods in sales ethics: a review of the empirical literature

From a review of the empirical sales ethics literature, this paper reports findings about some of the research methods used to investigate the decision-making of sales practitioners under ethical conditions. The review identifies that several of the methodological deficiencies raised by previous reviewers of the literature have not been adequately addressed by subsequent researchers. The paper primarily reviews quantitative research studies because of their prevalence in the empirical sales ethics literature, and because studies similar to these have contributed much to marketing ethics theory. This discussion also focuses on sampling and data collection methods, the treatment of respondent and non-response bias, the use of instruments and scales, and the application of the scenario technique. Some suggestions are made that would improve the research methods in each of these areas.

Validity of the assessment of quality of life (AQoL) utility instrument in patients with operable and inoperable lung cancer

There have been few longitudinal studies of quality of life in patients with all stages of lung cancer, particularly those that have included measures of utility. The purpose of this study was to examine the psychometric properties of the Assessment of Quality of Life instrument (AQoL) in patients with lung cancer. The AQoL is a health-related quality of life questionnaire and provides a descriptive system for a multi-attribute utility instrument (MAU), so that scores can be used in cost-utility evaluations. In the present study the reliability (internal consistency) of the AQoL was examined and the concurrent validity was assessed using the Medical Outcomes 36-item Short Form Health Survey (SF-36) as the comparator instrument. The sensitivity to different health states of the AQoL and the responsiveness to change over time was also examined. A prospective, non-experimental cohort study was undertaken. Ninety-two participants with all stages of lung cancer were recruited from a tertiary multi-disciplinary lung cancer clinic. Ninety participants had non-small cell lung cancer (NSCLC) and two had limited stage small cell lung cancer. The AQOL and SF-36 surveys were administered concurrently at baseline. In patients with NSCLC the surveys were then repeated 3 and 6 months later. Correlations between the baseline AQoL summary scales and SF-36 summary scales support the divergent and convergent validity of the AQoL. Reliability was also found to be sufficient (Cronbach's Alpha = 0.76). In addition, in patients with inoperable NSCLC, baseline AQoL scores were found to be predictive of survival at 6 months in Cox proportional hazards multivariate analysis. However, the physical components summary score of the SF-36 was more sensitive to differences in health states between patients with different stages of NSCLC at 6 months of follow-up and more responsive to change over time in both operable and inoperable patients with NSCLC than the AQoL. The findings support the construct validity and reliability of the AQoL in this population. However, there remains some uncertainty about whether the AQoL has sufficient sensitivity to different health states in this population. Further studies using other MAU instruments may determine whether alternative instruments are more sensitive to different health states in individuals with lung cancer.

Financial institutions, instruments and markets

Latest information, developments and statistics, with website addresses provided to allow students to access up to the minute, real-world data. Real-world examples throughout the text help students relate theory to pracical situations.