Fall risk management intervention : a feasibility and validation study

A fall risk management intervention was undertaken by staff caring for older people in nursing homes. Its acceptability and usefulness was tested. 'High risk times' and 'at risk' individuals were found, thereby identfying times when staff should be vigilant, and specific residents to be targeted with fall prevention strategies.

A mobile phone based method to assess energy and food intake in young children: a validation study against the doubly labelled water method and 24 h dietary recalls

Mobile phones are becoming important instruments for assessing diet and energy intake. We developed the Tool for Energy Balance in Children (TECH), which uses a mobile phone to assess energy and food intake in pre-school children. The aims of this study were: (a) to compare energy intake (EI) using TECH with total energy expenditure (TEE) measured via doubly labelled water (DLW); and (b) to compare intakes of fruits, vegetables, fruit juice, sweetened beverages, candy, ice cream, and bakery products using TECH with intakes acquired by 24 h dietary recalls. Participants were 39 healthy, Swedish children (5.5 ± 0.5 years) within the ongoing Mobile-based Intervention Intended to Stop Obesity in Preschoolers (MINISTOP) obesity prevention trial. Energy and food intakes were assessed during four days using TECH and 24 h telephone dietary recalls. Mean EI (TECH) was not statistically different from TEE (DLW) (5820 ± 820 kJ/24 h and 6040 ± 680 kJ/24 h, respectively). No significant differences in the average food intakes using TECH and 24 h dietary recalls were found. All food intakes were correlated between TECH and the 24 h dietary recalls (ρ = 0.665-0.896, p < 0.001). In conclusion, TECH accurately estimated the average intakes of energy and selected foods and thus has the potential to be a useful tool for dietary studies in pre-school children, for example obesity prevention trials.

The development and validation of a psychological contract of safety scale

Introduction
This paper builds on previous research by the author and describes the development and validation of a new measure of the psychological contract of safety. The psychological contract of safety is defined as the beliefs of individuals about reciprocal safety obligations inferred from implicit and explicit promises.

Method
A psychological contract is established when an individual believes that perceived employer and employee safety obligations are contingent on each other. A pilot test of the measure is first undertaken with participants from three different occupations: nurses, construction workers, and meat processing workers (N = 99). Item analysis is used to refine the measure and provide initial validation of the scale. A larger validation study is then conducted with a participant sample of health care workers (N = 424) to further refine the measure and to determine the psychometric properties of the scale.

Results
Item and correlational analyses produced the final employer and employee obligations scales, consisting of 21 and 17 items, respectively. Factor analyses identified two underlying dimensions in each scale comparable to that previously established in the organizational literature. These transactional and relational-type obligations provided construct validity of the scale. Internal consistency ratings using Cronbach's alpha found the components of the psychological contract of safety measure to be reliable.

Impact on Industry
The refined and validated psychological contract of safety measure will allow investigation of the positive and negative outcomes associated with fulfilment and breach of the psychological contract of safety in future research.

Cross-validation of the factorial structure of the Neighborhood Environment Walkability Scale (NEWS) and its abbreviated form (NEWS-A)

Background : The Neighborhood Environment Walkability Scale (NEWS) and its abbreviated form (NEWS-A) assess perceived environmental attributes believed to influence physical activity. A multilevel confirmatory factor analysis (MCFA) conducted on a sample from Seattle, WA showed that, at the respondent level, the factor-analyzable items of the NEWS and NEWS-A measured 11 and 10 constructs of perceived neighborhood environment, respectively. At the census blockgroup (used by the US Census Bureau as a subunit of census tracts) level, the MCFA yielded five factors for both NEWS and NEWS-A. The aim of this study was to cross-validate the individual- and blockgroup-level measurement models of the NEWS and NEWS-A in a geographical location and population different from those used in the original validation study.

Methods : A sample of 912 adults was recruited from 16 selected neighborhoods (116 census blockgroups) in the Baltimore, MD region. Neighborhoods were stratified according to their socio-economic status and transport-related walkability level measured using Geographic Information Systems. Participants self-completed the NEWS. MCFA was used to cross-validate the individual- and blockgroup-level measurement models of the NEWS and NEWS-A.

Results : The data provided sufficient support for the factorial validity of the original individual-level measurement models, which consisted of 11 (NEWS) and 10 (NEWS-A) correlated factors. The original blockgroup-level measurement model of the NEWS and NEWS-A showed poor fit to the data and required substantial modifications. These included the combining of aspects of building aesthetics with safety from crime into one factor; the separation of natural aesthetics and building aesthetics into two factors; and for the NEWS-A, the separation of presence of sidewalks/walking routes from other infrastructure for walking.

Conclusion : This study provided support for the generalizability of the individual-level measurement models of the NEWS and NEWS-A to different urban geographical locations in the USA. It is recommended that the NEWS and NEWS-A be scored according to their individual-level measurement models, which are relatively stable and correspond to constructs commonly used in the urban planning and transportation fields. However, prior to using these instruments in international and multi-cultural studies, further validation work across diverse non-English speaking countries and populations is needed.

Validation of the 12-item partners in health scale to measure patient self-management behaviour and knowledge in Dutch patients with COPD

The 12-item Partner in Health (PIH) scale was developed in Australia to measure self-management behaviour and knowledge in patients with chronic diseases. The scale has undergone several changes since first published. Our study aim was to validate the latest PIH in Dutch COPD patients.The 12 items of the PIH are scored on a self-rated 9-point Likert scale (range: 0-8; higher scores indicate better self-management), providing total and subscale scores (knowledge, coping, recognition and management of functions, adherence to treatment).We used forward-backward translation of the latest version of the Australian PIH. Dimensionality and reliability analyses were performed to investigate the psychometric properties, and to determine whether the Dutch PIH replicated the same four subscales of self-management as the original PIH.Reanalysis of the original PIH validation study (186 Australian patients with chronic diseases) showed a single scale. Two scales (1. knowledge and coping; 2. recognition and management of symptoms, adherence to treatment) were found for the Dutch PIH (118 Dutch COPD patients). The correlation between the two Dutch scales was 0.43. The lower-bound of the reliability of the total scale was 0.81 (Australian PIH) and 0.84 (Dutch PIH).Different scale structures were found for the original Australian and the Dutch PIH. Our results did not support the 4-scale structure reported previously. To increase comparability and generalisability of our findings, the scale structure of the revised Australian PIH needs to be investigated further. Meanwhile, we advise using the PIH total score or two subscale scores when assessing COPD patients.

Validation of the SenseWear Mini activity monitor in 5-12-year-old children

OBJECTIVES: This study aimed to validate SenseWear Mini software algorithm versions 2.2 (SW2.2) and 5.2 (SW5.2) for estimating energy expenditure (EE) in children. DESIGN: Laboratory-based validation study. METHODS: 57 children aged 5-12 y completed a protocol involving 15 semi-structured sedentary (SED), light-intensity (LPA), and moderate- to vigorous-intensity (MVPA) physical activities. EE was estimated using portable indirect calorimetry (IC). The accuracy of EE estimates (kcal·min(-1)) from SW2.2 and SW5.2 were examined at the group level and individual level using the mean absolute percentage error (MAPE), Bland-Altman plots and equivalence testing. RESULTS: MAPE values were lower for SW5.2 (30.1±10.7%) than for SW2.2 (44.0±6.2%). Although mean differences for SW5.2 were smaller than for SW2.2 during SED (-0.23±0.22 vs. -0.61±0.20kcal·min(-1)), LPA (-0.69±0.76 vs. -1.07±0.46kcal·min(-1)) and MVPA (-2.22±1.15 vs. -2.57±1.15kcal·min(-1)), limits of agreement did not decrease for the updated algorithms. For all activities, SW2.2 and SW5.2 were not equivalent to IC (p>0.05). Errors increased with increasing intensity. CONCLUSION: The current SenseWear Mini algorithms SW5.2 underestimated EE. The overall improved accuracy for SW5.2 was not accompanied with improved accuracy at the individual level and EE estimates were not equivalent to IC.

Validation of thigh-based accelerometer estimates of postural allocation in 5-12 year-olds

OBJECTIVES: To validate activPAL3™ (AP3) for classifying postural allocation, estimating time spent in postures and examining the number of breaks in sedentary behaviour (SB) in 5-12 year-olds. DESIGN: Laboratory-based validation study. METHODS: Fifty-seven children completed 15 sedentary, light- and moderate-to-vigorous intensity activities. Direct observation (DO) was used as the criterion measure. The accuracy of AP3 was examined using a confusion matrix, equivalence testing, Bland-Altman procedures and a paired t-test for 5-8y and 9-12y. RESULTS: Sensitivity of AP3 was 86.8%, 82.5% and 85.3% for sitting/lying, standing, and stepping, respectively, in 5-8y and 95.3%, 81.5% and 85.1%, respectively, in 9-12y. Time estimates of AP3 were equivalent to DO for sitting/lying in 9-12y and stepping in all ages, but not for sitting/lying in 5-12y and standing in all ages. Underestimation of sitting/lying time was smaller in 9-12y (1.4%, limits of agreement [LoA]: -13.8 to 11.1%) compared to 5-8y (12.6%, LoA: -39.8 to 14.7%). Underestimation for stepping time was small (5-8y: 6.5%, LoA: -18.3 to 5.3%; 9-12y: 7.6%, LoA: -16.8 to 1.6%). Considerable overestimation was found for standing (5-8y: 36.8%, LoA: -16.3 to 89.8%; 9-12y: 19.3%, LoA: -1.6 to 36.9%). SB breaks were significantly overestimated (5-8y: 53.2%, 9-12y: 28.3%, p<0.001). CONCLUSIONS: AP3 showed acceptable accuracy for classifying postures, however estimates of time spent standing were consistently overestimated and individual error was considerable. Estimates of sitting/lying were more accurate for 9-12y. Stepping time was accurately estimated for all ages. SB breaks were significantly overestimated, although the absolute difference was larger in 5-8y. Surveillance applications of AP3 would be acceptable, however, individual level applications might be less accurate.

Determination of thalidomide by high performance liquid chromatography: plasma pharmacokinetic studies in the rat

A sensitive and simple high performance liquid chromatography (HPLC) method was developed and validated for the determination of thalidomide in rat plasma. Chromatography was accomplished with a reversed-phase Hypersil C18 column. Mobile phase consisted of acetonitrile-10 mM ammonium acetate buffer (pH 5.50) (28:72, v/v), at a flow rate of 0.8 ml/min. Thalidomide was monitored by ultraviolet detector at 220 nm and it gave a linear response as a function of concentration over 0.02–50 μM. The limit of quantitation in rat plasma was 0.50 ng (0.02 μM plasma concentration) with an aliquot of 20 μl. Results from a 3-day validation study indicated that this method allows for simple and rapid quantitation of thalidomide with excellent accuracy and reliability. Using this validated assay, the effect of coadministered irinotecan (CPT-11) on the plasma pharmacokinetics of thalidomide in rats was determined. Coadministration of CPT-11 (intravenously, 60 mg/kg) increased the maximum plasma concentration (C_max) and area under the plasma concentration–time curve (AUC_{0–10 h}) of thalidomide by 32.29 and 11.66%, respectively, as compared to the control, but none of the effect of CPT-11 was of statistical significance (P > 0.05). Concomitant CPT-11 also caused a 10.04% decrease in plasma clearance (CL) and 14.51% decrease in volume of distribution (V_d) (P > 0.05). These results suggest that coadministered CPT-11 did not significantly alter the plasma pharmacokinetics of thalidomide in rats. Further studies are warranted to explore the pharmacokinetic and pharmacodynamic interactions between CPT-11 and thalidomide.

Scale development of individual and organisation infrastructure for heart health promotion in regional health authorities

Objective : The purpose of this study was to validate measures of individual and organisational infrastructure for health promotion within Alberta's (Canada) 17 Regional Health Authorities (RHAs).

Design : A series of phases were conducted to develop individual and organisational scales to measure health promotion infrastructure. Instruments were designed with focus groups and then pre-tested prior to the validation study.

Setting : In 1993 all hospitals and Public Health Units in the province of Alberta were regionalised into 17 RHAs, with responsibility for public health, community health, and acute and long-term care. While regionalisation may offer more opportunity for community participation, reorganisation of the public health system may have fragmented and diluted resources and skills for heart health promotion in some RHAs. Infrastructure (for example, human and financial resources), amongst other items, is believed to contribute to the capacity to promote health.

Method : All 17 RHAs participated in the study, yielding a total of 144 individuals (that is board members, senior/middle management, and front line staff). These representative employees completed a self- administered questionnaire on individual- and organisational-level infrastructure measures.

Results : Psychometric analyses of survey data provided empirical evidence for the robustness of the measures. Principal component analyses verified the construct validity of the scales, with alpha coefficients ranging from 0.75 to 0.95.

Conclusion : The scales can be used by health professionals and researchers to assess individual- and organisational-level infrastructure, and tailor interventions to increase infrastructure for health promotion in health organisations.

Indicators for evaluating cancer organizations' support services: performance and associations with empowerment

Community-based cancer organizations provide services to support patients. An anticipated benefit of these services is patient empowerment. However, this outcome has not been evaluated because of the lack of validated health-related empowerment questionnaires in the cancer context. In this validation study, the authors assessed the extent to which 16 indicators used by the Canadian Cancer Society (CCS) and the Cancer Council Victoria, Australia (CCV) to evaluate their services were associated with health-related empowerment.

A five-gene hedgehog signature developed as a patient preselection tool for hedgehog inhibitor therapy in medulloblastoma

Purpose: 

Construct validity of the pictorial scale of perceived movement skill competence

Objectives: The Pictorial Scale of Perceived Movement Skill Competence (PMSC) assesses young children's perceptions of movement skill competence: 12 perceived Fundamental Movement skills (FMS; based on the Test of Gross Motor Development 2nd edition TGMD-2) and six Active Play activities (e.g. cycling). The main study purpose was to assess whether children's movement perception scores fit within the imposed constructs of Active Play and FMS by testing the latent structure and construct validity of the PMSC.

Design: Construct validation study.

Methods: Participants were part of the Melbourne Infant Feeding, Activity and Nutrition Trial (InFANT). The latent structure of the PMSC responses was tested through confirmatory factor analysis (CFA) and Bayesian Structural Equation Modeling (BSEM). Internal consistency was conducted using polychoric correlation-based alphas.

Results: The 303 children (boys 53.1%, n = 161) were aged 4-5 years (M = 4.7, SD = 0.46). The final model had an 18 item 3-factor solution with good fit indices (using CFA and BSEM). Factors were: Active Play (Bike, Board Paddle, Climb, Skate/Blade, Scooter, and Swim), Object Control - Hand Skills (Bounce, Catch, Hit, Throw), and FMS skills with a leg action (Gallop, Hop, Jump, Leap, Run, Step Slide, Kick, Roll). Alpha reliability values were: Active Play (0.78), Object Control-Hand Skills (0.76) and FMS-Dynamic Leg (0.84).

Conclusion: Young children can distinguish between movement perceptions. The factors reflect the hypothesized structure in terms of FMS being distinguished from Active Play. Further research should investigate how and if these constructs change in children over time.

Interpretation and feedback

Designed as a quick and easy tool to help assess the essential traits of the social and therapeutic atmosphere in forensic psychiatric settings (subsequently expanded for use in correctional facilities), the Essen Climate Evaluation Schema (EssenCES) was originally developed and first published in Germany. It has since been translated into a number of other languages and been included in a considerable number of studies, among them a broad validation study in the UK. Following this study andthe UK Commissioning for Quality and Innovation (CQUIN) initiating the regular use of the scale in forensic psychiatric services in the UK, we have received a large number of enquiries regarding support in using the scale and interpreting its findings. In particular, many researchers and clinicians have requested reference norms that would allow them to compare the EssenCES scores obtained in their particular unit/service with the scores obtained in other settings. This manual aims to respond to these enquiries. It outlines the background and the concept of the instrument and discusses the variety of ways in which the EssenCES might be used to support research and practice within forensic services.It also includes considerations regarding the limitations of previous studies that have utilised the concept of social climate and a discussion of how the contribution of climate evaluations might be further improved in the future.