The self-administered 24-item geriatric pain measure (GPM-24-SA): psychometric properties in three European populations of community-dwelling older adults

OBJECTIVE: To explore the feasibility and psychometric properties of a self-administered version of the 24-item Geriatric Pain Measure (GPM-24-SA). DESIGN: Secondary analysis of baseline data from the Prevention in Older People-Assessment in Generalists' practices trial, an international multi-center study of a health-risk appraisal system. PARTICIPANTS: One thousand seventy-two community dwelling nondisabled older adults self-reporting pain from London, UK; Hamburg, Germany; and Solothurn, Switzerland. OUTCOME MEASURES: GPM-24-SA as part of a multidimensional Health Risk Appraisal Questionnaire including self-reported demographic and health-related information. RESULTS: Among the 1,072 subjects, 655 had complete GPM-24-SA data, 404 had 30% missing GPM-24-SA data. In psychometric analyses across the three European populations with complete GPM-24-SA data, the measure exhibited stable internal consistency, good convergent, divergent and discriminant validity, and produced stable pain measurements. However, factor analysis indicated differences in the GPM-24-SA across sites with discrepancies mainly related to items of a single subscale that failed to load appropriately. Analyses including imputation for subjects with

„Neko bi pomislio da se barem delimično sačuva dogma o monarhiji”: Antilatinski traktati Varlaama Kalabrijskog u srpskoslovenskom prevodu 14. veka

Die antilateinischen Traktate von Gregorios Palamas und Barlaam von Kalabrien stellten für die serbischen Übersetzer des 14. Jahrhunderts eine grosse Herausforderung dar – nicht nur wegen ihres dogmatischen Inhalts, sondern auch wegen des ausgeprägt polemischen Charakters ihrer Argumentation. In diesem Aufsatz wird die argumentative Form der zwei Traktate („opuscula“ ) Barlaams von Kalabrien analysiert, die in cod. Dečani 88 enthalten sind (fol. 38r-81r). Der zweite von ihnen (fol. 69v-81r) richtet sich an ein griechisches (orthodoxes) Auditorium; die Anreden an die Lateiner, die sich darin finden, haben rein rhetorischen Charakter. Der erste Traktat (fol. 39r-69r), der während der Unionsverhandlungen des Jahres 1334/1335 entstand, hat jedoch eine für die byzantinische Unionspolemik eher ungewöhnliche Form: der Dialog mit der Gegenseite ist hier keine rhetorische Fiktion, sondern ein ernstes Anliegen des Autors. Dies hat bereits bei der Rezeption des Traktats im griechisch-athonitischen Milieu den Verdacht geweckt, Barlaam habe den Lateinern unzulässige Zugeständnisse gemacht. Barlaam hat versucht, diesen Verdacht durch metakommunikative Kommentare zu entkräften, die ausschliesslich in der serbisch-kirchenslavischen Übersetzung von Dečani 88 enthalten sind. Der Übersetzer der Traktate hat deren argumentative Form im wesentlichen nicht angetastet und nur gelegentlich versucht, die Zugehörigkeit der einzelnen Argumente dem Leser durch Marginalscholien deutlich zu machen.

Temporal trends in the characteristics of children at antiretroviral therapy initiation in southern Africa: the IeDEA-SA Collaboration

BACKGROUND Since 2005, increasing numbers of children have started antiretroviral therapy (ART) in sub-Saharan Africa and, in recent years, WHO and country treatment guidelines have recommended ART initiation for all infants and very young children, and at higher CD4 thresholds for older children. We examined temporal changes in patient and regimen characteristics at ART start using data from 12 cohorts in 4 countries participating in the IeDEA-SA collaboration. METHODOLOGY/PRINCIPAL FINDINGS Data from 30,300 ART-naïve children aged <16 years at ART initiation who started therapy between 2005 and 2010 were analysed. We examined changes in median values for continuous variables using the Cuzick's test for trend over time. We also examined changes in the proportions of patients with particular disease severity characteristics (expressed as a binary variable e.g. WHO Stage III/IV vs I/II) using logistic regression. Between 2005 and 2010 the number of children starting ART each year increased and median age declined from 63 months (2006) to 56 months (2010). Both the proportion of children <1 year and ≥10 years of age increased from 12 to 19% and 18 to 22% respectively. Children had less severe disease at ART initiation in later years with significant declines in the percentage with severe immunosuppression (81 to 63%), WHO Stage III/IV disease (75 to 62%), severe anemia (12 to 7%) and weight-for-age z-score<-3 (31 to 28%). Similar results were seen when restricting to infants with significant declines in the proportion with severe immunodeficiency (98 to 82%) and Stage III/IV disease (81 to 63%). First-line regimen use followed country guidelines. CONCLUSIONS/SIGNIFICANCE Between 2005 and 2010 increasing numbers of children have initiated ART with a decline in disease severity at start of therapy. However, even in 2010, a substantial number of infants and children started ART with advanced disease. These results highlight the importance of efforts to improve access to HIV diagnostic testing and ART in children.