Evaluation of the Chinese version of the disability of the arm, shoulder and hand (DASH-HKPWH): cross-cultural adaptation process, internal consistency and reliability study

Abstract
The Disability of the Arm, Shoulder and Hand (DASH) was translated into Chinese by a physiotherapy team of the Prince of Wales Hospital, Hong Kong (DASH-HKPWH).

Objectives
This study evaluated the cross-cultural adaptation process, face validity, internal consistency and reliability of the DASH-HKPWH.

Method
Language officers and medical professionals from different fields were invited to translate and evaluate the face validity of the DASH-HKPWH. 88 patients were recruited to complete two DASH questionnaires on two occasions 1-2 weeks apart.

Results
Some adjustments were made to the translations based on the cultural and linguistic practice in Hong Kong. The face validity was satisfactory with a mean endorsement score of 3.2. The difference between the mean of DASH scores was not significant (t = −0.35, p = 0.73). The ICC (1,1) and Cronbach's alpha for the 30-item Disability/Symptom of the DASH-HKPWH was 0.77 and 0.94, respectively.

Conclusion
The translation was valid and reliable and acceptably equivalent to the original version. The questionnaire is suitable for measuring changes experienced by patients with any upper extremity disorders.

Dancing between diversity and consistency: refining assessment in postgraduate degrees in dance

Guidelines for best practice in Australian Doctoral and Masters by Research Examination, encompassing the two primary modes of investigation, written and multi-modal theses, their distinctiveness and their potential interplay.

Consistency of sensory testing with 4- and 5-year-old children

Rank-order and paired comparison tests are widely used methods to assess previous termsensorynext term perception of young children. Small age differences could, however, influence the ability of children to carry out such tasks. This study compared rank-order and paired comparison tests for previous termconsistencynext term in previous term4next term- and 5-year-old children. During previous termfournext term sessions, 22 young adults, 21 previous term4next term-year-old and 47 5-year-old children carried out rank-order and paired comparison tests to measure discriminatory ability (0.22 M, 0.25 M, 0.29 M, 0.34 M, 0.39 M sucrose in orangeade) and preference (0.14 M, 0.20 M, 0.29 M, 0.42 M, 0.61 M sucrose in orangeade). Young adults and 5-year-old children were able to discriminate between all solutions and showed a high previous termconsistencynext term between the rank-order and pair-wise tests for discriminatory ability (>76% previous termconsistency)next term and preference (>71% previous termconsistency)next term. In contrast, previous term4next term-year-olds detected differences in sweetness during the preference tests, but failed to distinguish sweetness intensities during the discriminatory ability tests. It is concluded that the dissimilarity between previous term4next term-and 5-year-olds in performing previous termsensorynext term tests was due to a difference in their cognitive skills rather than their previous termsensorynext term perceptual differences.

An examination of the consistency of investigative interviewers' performance

Three original studies were conducted to examine the consistency of investigative-interviewer performance across similar and distinct interview tasks. Overall, the degree of consistency depended on numerous factors, including the nature of the event and interview paradigm, the precision of the assessment measure and whether group versus individual stability was measured. The portfolio highlights and discusses some of the complexities that can arise when conducting a parenting capacity assessment with a patient who has, or is suspected of having, an intellectual disability. Four case studies are presented.

Factors influencing consistency of triage using the Australasian triage scale : implications for guideline development

Objective: To examine the influence of the nurse, the type of patient presentation and the level of hospital service on consistency of triage using the Australasian Triage Scale.

Methods: A secondary analysis of survey data was conducted. The main study was undertaken to measure the reliability of 237 scenarios for inclusion in a national training programme. Nurses were recruited from a quota sample of Australian ED according to peer group. Analysis was performed to determine concordance: the percentage of responses in the modal triage category. Analysis of variance (anova) and Pearson correlations were used to investigate associations between the explanatory variables and concordance.

Results: A total of 42/50 (84%) participants returned questionnaires, providing 9946 scenario responses for analysis. Significant differences in concordance were observed by variables describing the type of patient presentation and level of urgency. Mean scores for the comparison group (adult pain; 70.7%) were higher than the groups involving a mental health or pregnancy presentations (61.4%; P≤ 0.001; 65.0%; P= 0.02). Modal responses at the extreme ends of the scale were higher than in the middle categories (P≤ 0.001). There was a significant main effect on concordance by type of service according to peer group (P= 0.03). Of the nine variables that described nurse characteristics, age was the only factor to influence the outcome (P= 0.05).

Conclusion: We identified significant problems with the consistency of triage for mental health and pregnancy presentations. Further research is needed to improve the guidelines on the implementation of the Australasian Triage Scale for these populations.

Examination of the stability and consistency of investigative interviewer performance across similar mock interview contexts

Purpose. Three studies examined the degree to which investigative interviewers’ adherence to best-practice guidelines is consistent across similar mock interviews.
Method. In each study, two interviews were administered within a period of several hours. Further, group and individual stability of interviewer performance was analysed, and performance was measured by calculating the proportion of open-ended and leading questions as well as the presence of predetermined problem behaviours. The studies varied depending on the type of interview paradigm employed. Interviewer performance in Study 1was measured in a group context where participants rotated between the role of interviewer, child respondent, and observer. In Study 2, an adult played the role of a child recalling abuse but this occurred in isolation (participants did not observe others or play the child). Study 3 was similar to Study 2 except that in each interview an unfamiliar child aged 5–7 years recalled an innocuous event.
Results. Interviewer performance was relatively stable across tasks, although the strength of the relationship between measures varied across analyses. Improvement in open-ended question usage occurred in Study 1 but not Studies 2 and 3. Irrespective of the assessment context, the dichotomous rating scale yielded greater consistency than when questions were tallied. Further, group stability overestimated individual stability. The practical implications of these findings for trainers and researchers are discussed.

Examination of the consistency of interviewer performance across three distinct interview contexts

The current study examined the consistency of investigative interviewers' performance (n=31) across three distinct interview paradigms: (a) a mock interview where an adult actor played the role of a child recalling abuse, (b) a mock interview where a school child recalled an innocuous event that was staged at the child's school, and (c) a field interview where the interviewer elicited a statement of abuse from a child. Performance was measured by calculating the proportion of open-ended and leading questions, and by eliciting expert ratings of the presence of a range of problem behaviours commonly exhibited by interviewers. Overall, the performance of individual interviewers was relatively stable across the tasks. Heterogeneity in stability, however, differed according to the type of question and the nature of the event being examined. In particular, the mock interview paradigm where the adult acted the role of an alleged child abuse victim produced a measure of performance that was more similar to the field interview than the interview where a school child recalled an innocuous event. The implications of the findings for trainers, and directions for future research, are discussed.

Sample subset optimization for classifying imbalanced biological data

Data in many biological problems are often compounded by imbalanced class distribution. That is, the positive examples may largely outnumbered by the negative examples. Many classification algorithms such as support vector machine (SVM) are sensitive to data with imbalanced class distribution, and result in a suboptimal classification. It is desirable to compensate the imbalance effect in model training for more accurate classification. In this study, we propose a sample subset optimization technique for classifying biological data with moderate and extremely high imbalanced class distributions. By using this optimization technique with an ensemble of SVMs, we build multiple roughly balanced SVM base classifiers, each trained on an optimized sample subset. The experimental results demonstrate that the ensemble of SVMs created by our sample subset optimization technique can achieve higher area under the ROC curve (AUC) value than popular sampling approaches such as random over-/under-sampling; SMOTE sampling, and those in widely used ensemble approaches such as bagging and boosting.

Chronic stress alters the density and morphology of microglia in a subset of stress-responsive brain regions

The current study, in parallel experiments, evaluated the impact of chronic psychological stress on physiological and behavioural measures, and on the activation status of microglia in 15 stress-responsive brain regions. Rats were subjected, for 14 days, to two 30 min sessions of restraint per day, applied at random times each day. In one experiment the effects of stress on sucrose preference, weight gain, core body temperature, and struggling behaviour during restraint, were determined. In the second experiment we used immunohistochemistry to investigate stress-induced changes in ionized calcium-binding adaptor molecule-1 (Iba1), a marker constitutively expressed by microglia, and major histocompatibility complex-II (MHC-II), a marker often expressed on activated microglia, in a total of 15 stress-responsive nuclei. We also investigated cellular proliferation in these regions using Ki67 immunolabelling, to check for the possibility of microglial proliferation. Collectively, the results we obtained showed that chronic stress induced a significant increase in anhedonia, a decrease in weight gain across the entire observation period, a significant elevation in core body temperature during restraint, and a progressive decrease in struggling behaviour within and over sessions. With regard to microglial activation, chronic stress induced a significant increase in the density of Iba1 immunolabelling (nine of 15 regions) and the number of Iba1-positive cells (eight of 15 regions). Within the regions that exhibited an increased number of Iba1-positive cells after chronic stress, we found no evidence of a between group difference in the number of MHC-II or Ki67 positive cells. In summary, these results clearly demonstrate that chronic stress selectively increases the number of microglia in certain stress-sensitive brain regions, and also causes a marked transition of microglia from a ramified-resting state to a non-resting state. These findings are consistent with the view that microglial activation could play an important role in controlling and/or adapting to stress.

Habitat use throughout migration : linking individual consistency, prior breeding success and future breeding potential

1. Habitat use can influence individual performance in a wide range of animals, either immediately or through carry-over effects in subsequent seasons. Given that many animal species also show consistent individual differences in reproductive success, it seems plausible that individuals may have consistent patterns of habitat use representing individual specializations, with concomitant fitness consequences.

2. Stable-carbon isotope ratios from a range of tissues were used to discern individual consistency in habitat use along a terrestrial–aquatic gradient in a long-distance migrant, the Bewick’s swan (Cygnus columbianus bewickii). These individual specialisations represented <15% of the isotopic breadth of the population for the majority of individuals and were seen to persist throughout autumn migration and overwintering until aquatic habitats were no longer available.

3. Individual foraging specialisations were then used to demonstrate two consecutive carry-over effects associated with macroscale habitat segregation: consequences of breeding season processes for autumn habitat use; and consequences of autumn habitat use for future reproductive success. Adults that were successful breeders in the year of capture used terrestrial habitats significantly more than adults that were not successful, revealing a substantial cost of reproduction and extended parental care. Use of aquatic habitats during autumn was, however, associated with increased body condition prior to spring migration; and increased subsequent breeding success in adults that had been unsuccessful the year before. Yet adults that were successful breeders in the year of capture remained the most likely to be successful the following year, despite their use of terrestrial habitats.

4. Our results uniquely demonstrate not only individual foraging specializations throughout the migration period, but also that processes during breeding and autumn migration, mediated by individual consistency, may play a fundamental role in the population dynamics of long-distance migrants. These findings, therefore, highlight the importance of long-term consistency to our understanding of habitat function, interindividual differences in fitness, population dynamics and the evolution of migratory strategies.