Reliability, construct and criterion validity of the KIDSCREEN-10 score: a short measure for children and adolescents' well-being and health-related quality of life

Background To assess the criterion and construct validity of the KIDSCREEN-10 well-being and health-related quality of life (HRQoL) score, a short version of the KIDSCREEN-52 and KIDSCREEN-27 instruments. Methods The child self-report and parent report versions of the KIDSCREEN-10 were tested in a sample of 22,830 European children and adolescents aged 8–18 and their parents (n = 16,237). Correlation with the KIDSCREEN-52 and associations with other generic HRQoL measures, physical and mental health, and socioeconomic status were examined. Score differences by age, gender, and country were investigated. Results Correlations between the 10-item KIDSCREEN score and KIDSCREEN-52 scales ranged from r = 0.24 to 0.72 (r = 0.27–0.72) for the self-report version (proxy-report version). Coefficients below r = 0.5 were observed for the KIDSCREEN-52 dimensions Financial Resources and Being Bullied only. Cronbach alpha was 0.82 (0.78), test–retest reliability was ICC = 0.70 (0.67) for the self- (proxy-)report version. Correlations between other children self-completed HRQoL questionnaires and KIDSCREEN-10 ranged from r = 0.43 to r = 0.63 for the KIDSCREEN children self-report and r = 0.22–0.40 for the KIDSCREEN parent proxy report. Known group differences in HRQoL between physically/mentally healthy and ill children were observed in the KIDSCREEN-10 self and proxy scores. Associations with self-reported psychosomatic complaints were r = −0.52 (−0.36) for the KIDSCREEN-10 self-report (proxy-report). Statistically significant differences in KIDSCREEN-10 self and proxy scores were found by socioeconomic status, age, and gender. Conclusions Our results indicate that the KIDSCREEN-10 provides a valid measure of a general HRQoL factor in children and adolescents, but the instrument does not represent well most of the single dimensions of the original KIDSCREEN-52. Test–retest reliability was slightly below a priori defined thresholds.

QUALITY OF LIFE: A POTENTIALLY USEFUL MEASURE TO INDICATE SUBCLINICAL FLARES IN CROHN'S DISEASE

While quality of life (QoL) is a well-recognised outcome measure of Crohn disease (CD) activity, its influence on other outcome measures, including exacerbation of CD is poorly understood. If QoL measures were to be associated with intestinal inflammatory activity, they might be useful for early detection of subclinical flares.

The KIDSCREEN-27 quality of life measure for children and adolescents: psychometric results from a cross-cultural survey in 13 European countries

OBJECTIVE: To assess the construct and criterion validity of the KIDSCREEN-27 health-related quality of life (HRQoL) questionnaire, a shorter version of the KIDSCREEN-52. METHODS: The five-dimensional KIDSCREEN-27 was tested in a sample of 22,827. For criterion validity the correlation with and the percentage explained variance of the scores of the KIDSCREEN-52 instrument were examined. Construct validity was assessed by testing a priori expected associations with other generic HRQoL measures (YQOL-S, PedsQL, CHIP), indicators of physical and mental health, and socioeconomic status. Age and gender differences were investigated. RESULTS: Correlation with corresponding scales of the KIDSCREEN-52 ranged from r = 0.63 to r = 0.96, and r2 ranged from 0.39 to 0.92. Correlations between other HRQoL questionnaires and KIDSCREEN-27 dimensions were moderate to high for those assessing similar constructs (r = 0.36 to 0.63). Statistically significant and sizeable differences between physically and mentally healthy and ill children were found in all KIDSCREEN-27 dimensions together with strong associations with psychosomatic complaints (r = -0.52). Most of the KIDSCREEN-27 dimensions showed a gradient according to socio-economic status, age and gender. CONCLUSIONS: The KIDSCREEN-27 seems to be a valid measure of HRQoL in children and adolescents. Further research is needed to assess longitudinal validity and sensitivity to change.

A combined measure for quantifying and qualifying the topology preservation of growing self-organizing maps

The Self-OrganizingMap (SOM) is a neural network model that performs an ordered projection of a high dimensional input space in a low-dimensional topological structure. The process in which such mapping is formed is defined by the SOM algorithm, which is a competitive, unsupervised and nonparametric method, since it does not make any assumption about the input data distribution. The feature maps provided by this algorithm have been successfully applied for vector quantization, clustering and high dimensional data visualization processes. However, the initialization of the network topology and the selection of the SOM training parameters are two difficult tasks caused by the unknown distribution of the input signals. A misconfiguration of these parameters can generate a feature map of low-quality, so it is necessary to have some measure of the degree of adaptation of the SOM network to the input data model. The topologypreservation is the most common concept used to implement this measure. Several qualitative and quantitative methods have been proposed for measuring the degree of SOM topologypreservation, particularly using Kohonen's model. In this work, two methods for measuring the topologypreservation of the Growing Cell Structures (GCSs) model are proposed: the topographic function and the topology preserving map

A complexity measure for selective matching of signals by the brain.

We have previously derived a theoretical measure of neural complexity (CN) in an attempt to characterize functional connectivity in the brain. CN measures the amount and heterogeneity of statistical correlations within a neural system in terms of the mutual information between subsets of its units. CN was initially used to characterize the functional connectivity of a neural system isolated from the environment. In the present paper, we introduce a related statistical measure, matching complexity (CM), which reflects the change in CN that occurs after a neural system receives signals from the environment. CM measures how well the ensemble of intrinsic correlations within a neural system fits the statistical structure of the sensory input. We show that CM is low when the intrinsic connectivity of a simulated cortical area is randomly organized. Conversely, CM is high when the intrinsic connectivity is modified so as to differentially amplify those intrinsic correlations that happen to be enhanced by sensory input. When the input is represented by an individual stimulus, a positive value of CM indicates that the limited mutual information between sensory sheets sampling the stimulus and the rest of the brain triggers a large increase in the mutual information between many functionally specialized subsets within the brain. In this way, a complex brain can deal with context and go "beyond the information given."

Using a non-invasive stable isotope tracer to measure the absorption of water in humans

The development of solutions that prevent dehydration or promote adequate re-hydration play a vital role in preventing fatigue during exercise, however, the methods commonly used to assess the hydration ability of such solutions are invasive and often assess the components of absorption separately. This paper describes using a non-invasive deuterium tracer technique that assesses gastric emptying and intestinal absorption simultaneously to evaluate the uptake of water during rest and exercise. The kinetics of absorption are further examined by mathematical modelling of the data generated. For the rest group, 0.05 g/kg of body weight of deuterium, contained in gelatine capsules, was ingested with ordinary tap water and saliva samples were collected every 5 min for one hour while the subject remained seated. The deuterium was administered as above for the exercise group but sample collection was during one hour of exercise on a treadmill at 55% of the subject's maximum heart rate. The enrichment data for each subject were mathematically modelled and the parameters obtained were compared across groups using an independent samples t-test. Compared with the rest condition, the exercise group showed delayed absorption of water as indicated by significant differences for the modelling parameters t(2), t(1/2), maximum absorption rate and solution absorption amount at t(1). Labelling with a deuterium tracer is a good measure of the relative rate ingested fluids are absorbed by the body. Mathematical modelling of the data generates rates of maximum absorption and allows calculation of the percentage of the solution that is absorbed at any given time during the testing period. Copyright (C) 2004 John Wiley Sons, Ltd.

Appetitive motivation predicts the majority of personality and an ability measure: a comparison of BAS measures and a re-evaluation of the importance of RST

Our first study develops a measure of appetitive motivation and our second study compares several measures of Gray's (1987) behaviour activation system (BAS) in the prediction of the surface scales of personality. In particular, we were interested in determining the utility of the new appetitive motivation scale and Dickman's functional impulsivity scale. In comparison to other well-known measures, both scales were generally good predictors. We conclude that the appetitive motivation scale is a promising measure of BAS based upon construct validation. Contrary to previous studies which have suggested that BAS is a generally poor predictor of the surface scales of personality, we discovered appetitive motivation to be an important predictor of personality in general. Interestingly, the scale was also predictive of scores on the Baddeley reasoning test. (C) 2003 Elsevier Ltd. All rights reserved.

An alternative DEA measure:a case of OECD countries

Analysis of the production efficiency of industrialized countries, questioning whether certain countries perform better than others in producing more output with the same or less inputs, is an example of the importance of estimating production relationships. In order to estimate efficiency one needs an appropriate model for the two major inputs into production activity, namely labour and capital. A physical asset once installed is capable of contributing several years of output. This implies that investments made in previous years must be taken into account in order to produce a measure of the efficiency and productivity for any given year. The purpose of this article is to introduce a dynamic efficiency model and compare the results with previous work on the analysis of efficiency and productivity of OECD countries. The article proposes that dynamic models capture efficiency better than static models.

The development of an objective methodology to measure medication adherence to oral thiopurines in paediatric patients with acute lymphoblastic leukaemia - an exploratory study

Aims - To develop a method that prospectively assesses adherence rates in paediatric patients with acute lymphoblastic leukaemia (ALL) who are receiving the oral thiopurine treatment 6-mercaptopurine (6-MP). Methods - A total of 19 paediatric patients with ALL who were receiving 6-MP therapy were enrolled in this study. A new objective tool (hierarchical cluster analysis of drug metabolite concentrations) was explored as a novel approach to assess non-adherence to oral thiopurines, in combination with other objective measures (the pattern of variability in 6-thioguanine nucleotide erythrocyte concentrations and 6-thiouric acid plasma levels) and the subjective measure of self-reported adherence questionnaire. Results - Parents of five ALL patients (26.3%) reported at least one aspect of non-adherence, with the majority (80%) citing “carelessness at times about taking medication” as the primary reason for non-adherence followed by “forgetting to take the medication” (60%). Of these patients, three (15.8%) were considered non-adherent to medication according to the self-reported adherence questionnaire (scored ≥ 2). Four ALL patients (21.1%) had metabolite profiles indicative of non-adherence (persistently low levels of metabolites and/or metabolite levels clustered variably with time). Out of these four patients, two (50%) admitted non-adherence to therapy. Overall, when both methods were combined, five patients (26.3%) were considered non-adherent to medication, with higher age representing a risk factor for non-adherence (P < 0.05). Conclusions - The present study explored various ways to assess adherence rates to thiopurine medication in ALL patients and highlighted the importance of combining both objective and subjective measures as a better way to assess adherence to oral thiopurines.

CEO Humility: Development of an Unobtrusive Measure and Strategic Implications

Over the past 30 years, the Upper Echelons perspective of strategic management has sought to explain a given organization’s strategies and effectiveness as a reflection of the differences in personality, background, and other characteristics of the senior executives that guides each organization. An important stream of research within this field has linked a firm’s strategy to the grandiose way that executives are often thought to view themselves – namely through examining the narcissism, core self-evaluations (CSE), and hubris of Chief Executive Officers (CEOs). In this dissertation, I focus on understanding the strategic impact of CEO humility – a trait that has often been erroneously thought of to represent a poor view of oneself. Consistent with ancient writings and recent research, humility is defined herein as a multi-faceted trait that is the common core of four dimensions: self-awareness, developmental orientation/teachability, appreciation of others' strengths and contributions, and low self-focus. In the first essay, I explore the conceptual relevance and various potential implications of executive humility. Drawing on existing empirical research about the humility construct and general behavioral implications of humility, I argue that executive humility is a critical avenue toward a more rich and nuanced understanding of the delicate interplay and implications of executive self-concept. In essay two, I develop and validate an unobtrusive measure of CEO humility. Ten indicators of humility are suggested and then validated using a self-reported survey administered to a sample of 30 U.S. and Canadian CEOs. Two behaviors were found to be significantly positively related to self-reported humility: CEOs who volunteered some of their time for non-profit organizations and CEO’s who reported that part of their own firm’s success was due to the help of the board of directors. In essay three, I examine the relationship between the level of CEO humility and four firm-level outcomes. Employing a sample of 163 CEOs appointed to S&P 500 firms between 2005-2008, I show that firms led by humble CEOs (measured by the unobtrusive indicators) tend to outperform others in regards to corporate social performance, while at the same time showing that their financial performance is generally no better or worse.

A microelectrode impedance method to measure interaction of cells

An impedance method was developed to determine how immune system cells (hemocyte) interact with intruder cells (parasites). When the hemocyte cells interact with the parasites, they cause a defensive reaction and the parasites start to aggregate in clusters. The level of aggregation is a measure of the host-parasite interaction, and provides information about the efficiency of the immune system response. The cell aggregation is monitored using a set of microelectrodes. The impedance spectrum is measured between each individual microelectrode and a large reference electrode. As the cells starts to aggregate and settle down towards the microelectrode array the impedance of the system is changed. It is shown that the system impedance is very sensitive to the level of cell aggregation and can be used to monitor in real time the interaction between hemocyte cells and parasites.

The efficacy of releasing caught Nephrops as a management measure

The objective of this work was to examine if a policy of releasing caught lobsters, Nephrops, could be used to protect the Nephrops population off the south coast of Portugal. Such a measure, as an alternative to closing the fishery completely, would allow the continued operation of the fleet in targeting other species, resulting in a reduced economic and social impact compared with a complete closure. For such a proposal to be considered, information on survival rates of released lobsters is required. Nephrops were sampled randomly from the catch of commercial trawlers and put in cages, in an area with similar conditions to the area where they were caught, in order to evaluate survival rates. The cages were immersed for periods of 5–9 days. Several factors were considered to potentially affect survival, including duration of the tow and season, and biological characteristics of the individuals (e.g. size, sex and ovigerous condition). Survival was only affected by season (increased mortality inwarm months).Aglobal estimate of survival of released lobsters, taking into consideration survival and proportion of the catches for each season, was 35%. Simulation models were used to investigate the potential effect of a release measure on the population. Assuming the number of recaptured individuals is negligible, Z (instantaneous total mortality rate)would be considerably reduced if a release policy was implemented. This is particularly important if the levels of exploitation are high, which seems to be the case in this stock. It is our belief that the implementation of amanagement measure of returning all caught lobsters to the sea is worth considering as a means of aiding recovery of the resource. This measure would have the side effect of discouraging the choice of Nephrops as a target species, potentially reducing the fishing mortality even more significantly.

Correcting for bias when estimating the cost of hospital-acquired infection : an analysis of lower respiratory tract infections in non-surgical patients

Hospital acquired infections (HAI) are costly but many are avoidable. Evaluating prevention programmes requires data on their costs and benefits. Estimating the actual costs of HAI (a measure of the cost savings due to prevention) is difficult as HAI changes cost by extending patient length of stay, yet, length of stay is a major risk factor for HAI. This endogeneity bias can confound attempts to measure accurately the cost of HAI. We propose a two-stage instrumental variables estimation strategy that explicitly controls for the endogeneity between risk of HAI and length of stay. We find that a 10% reduction in ex ante risk of HAI results in an expected savings of £693 ($US 984).

High body mass index is not a barrier to physical activity: Analysis of international rugby players' anthropometric data

Recent data indicate that levels of overweight and obesity are increasing at an alarming rate throughout the world. At a population level (and commonly to assess individual health risk), the prevalence of overweight and obesity is calculated using cut-offs of the Body Mass Index (BMI) derived from height and weight. Similarly, the BMI is also used to classify individuals and to provide a notional indication of potential health risk. It is likely that epidemiologic surveys that are reliant on BMI as a measure of adiposity will overestimate the number of individuals in the overweight (and slightly obese) categories. This tendency to misclassify individuals may be more pronounced in athletic populations or groups in which the proportion of more active individuals is higher. This differential is most pronounced in sports where it is advantageous to have a high BMI (but not necessarily high fatness). To illustrate this point we calculated the BMIs of international professional rugby players from the four teams involved in the semi-finals of the 2003 Rugby Union World Cup. According to the World Health Organisation (WHO) cut-offs for BMI, approximately 65% of the players were classified as overweight and approximately 25% as obese. These findings demonstrate that a high BMI is commonplace (and a potentially desirable attribute for sport performance) in professional rugby players. An unanswered question is what proportion of the wider population, classified as overweight (or obese) according to the BMI, is misclassified according to both fatness and health risk? It is evident that being overweight should not be an obstacle to a physically active lifestyle. Similarly, a reliance on BMI alone may misclassify a number of individuals who might otherwise have been automatically considered fat and/or unfit.

The use of technology-based self-service on assessments of consumer satisfaction and consumer commitment

Technology-based self-service (TBSS) enables consumers to complete services themselves using a technological interface. As evaluations of consumer satisfaction and commitment have typically focused on interpersonal interactions, the effect of TBSS on these is under researched . This paper explores the impact of TBSS on consumer satisfaction and on a multidimensional measure of consumer commitment.Data are collected from 241 hotel guests. The results suggest personal-service is more important for satisfaction and commitment. This has implications for marketing as the benefits of adopting TBSS are not clear. Multi-dimensional commitment provides some interesting findings and suggests the need for further research into TBSS and commitment.