Testing the structural and cross-cultural validity of the KIDSCREEN-27 quality of life questionnaire

OBJECTIVES: The aim of this study is to assess the structural and cross-cultural validity of the KIDSCREEN-27 questionnaire. METHODS: The 27-item version of the KIDSCREEN instrument was derived from a longer 52-item version and was administered to young people aged 8-18 years in 13 European countries in a cross-sectional survey. Structural and cross-cultural validity were tested using multitrait multi-item analysis, exploratory and confirmatory factor analysis, and Rasch analyses. Zumbo's logistic regression method was applied to assess differential item functioning (DIF) across countries. Reliability was assessed using Cronbach's alpha. RESULTS: Responses were obtained from n = 22,827 respondents (response rate 68.9%). For the combined sample from all countries, exploratory factor analysis with procrustean rotations revealed a five-factor structure which explained 56.9% of the variance. Confirmatory factor analysis indicated an acceptable model fit (RMSEA = 0.068, CFI = 0.960). The unidimensionality of all dimensions was confirmed (INFIT: 0.81-1.15). Differential item functioning (DIF) results across the 13 countries showed that 5 items presented uniform DIF whereas 10 displayed non-uniform DIF. Reliability was acceptable (Cronbach's alpha = 0.78-0.84 for individual dimensions). CONCLUSIONS: There was substantial evidence for the cross-cultural equivalence of the KIDSCREEN-27 across the countries studied and the factor structure was highly replicable in individual countries. Further research is needed to correct scores based on DIF results. The KIDSCREEN-27 is a new short and promising tool for use in clinical and epidemiological studies.

Behavioral decision making and the levels of change: An application of the transtheoretical model to prenatal smoking in low -income women

Despite continued research and public health efforts to reduce smoking during pregnancy, prenatal cessation rates in the United States have decreased and the incidence of low birth weight has increased from 1985 to 1991. Lower socioeconomic status women who are at increased risk for poor pregnancy outcomes may be resistant to current intervention efforts during pregnancy. The purpose of this dissertation was to investigate the determinants of continued smoking and quitting among low-income pregnant women.^ Using data from cross-sectional surveys of 323 low-income pregnant smokers, the first study developed and tested measures of the pros and cons of smoking during pregnancy. The original decisional balance measure for smoking was compared with a new measure that added items thought to be more salient to the target population. Confirmatory factor analysis using structural equation modeling showed neither the original nor new measure fit the data adequately. Using behavioral science theory, content from interviews with the population, and statistical evidence, two 7-item scales representing the pros and cons were developed from a portion (n = 215) of the sample and successfully cross-validated on the remainder of the sample (n = 108). Logistic regression found only pros were significantly associated with continued smoking. In a discriminant function analysis, stage of change was significantly associated with pros and cons of smoking.^ The second study examined the structural relationships between psychosocial constructs representing some of the levels of and the pros and cons of smoking. The cross-sectional design mandates that statements made regarding prediction do not prove causation or directionality from the data or methods analysis. Structural equation modeling found the following: more stressors and family criticism were significantly more predictive of negative affect than social support; a bi-directional relationship was found between negative affect and current nicotine addiction; and negative affect, addiction, stressors, and family criticism were significant predictors of pros of smoking.^ The findings imply reversing the trend of decreasing smoking cessation during pregnancy may require supplementing current interventions for this population of pregnant smokers with programs addressing nicotine addiction, negative affect, and other psychosocial factors such as family functioning and stressors. ^

Axis-alignment affects perceptual grouping: evidence from simultanagnosia

We examined the effect of grouping by the alignment of implicit axes on the perception of multiple shapes, using a patient (GK) who shows simultanagnosia as part of Blint's syndrome. Five experiments demonstrated that: (1) GK was better able to judge the orientation of a global configuration if the constituent local shapes were aligned with their major axes than if they were aligned with their edges; (2) this axis information was used implicitly, since GK was unable to discriminate between configurations of axis-aligned and edge-aligned shapes; (3) GK's sensitivity to axis-alignment persisted even when the orientations of local shapes were kept constant, indicating some form of cooperative effect between the local elements; (4) axis-alignment of shapes also facilitated his ability to discriminate single-item from multi-item configurations; (5) the effect of axis-alignment could be attributed, at least partially, to the degree to which there was matching between the orientations of local shapes and the global configuration. Taken together, the results suggest that axis-based grouping can support the selection of multiple objects.

What's in a broken promissory obligation? Developing and testing a multiple component form measure of psychological contract breach

While the literature has suggested the possibility of breach being composed of multiple facets, no previous study has investigated this possibility empirically. This study examined the factor structure of typical component forms in order to develop a multiple component form measure of breach. Two studies were conducted. In study 1 (N = 420) multi-item measures based on causal indicators representing promissory obligations were developed for the five potential component forms (delay, magnitude, type/form, inequity and reciprocal imbalance). Exploratory factor analysis showed that the five components loaded onto one higher order factor, namely psychological contract breach suggesting that breach is composed of different aspects rather than types of breach. Confirmatory factor analysis provided further evidence for the proposed model. In addition, the model achieved high construct reliability and showed good construct, convergent, discriminant and predictive validity. Study 2 data (N = 189), used to validate study 1 results, compared the multiple-component measure with an established multiple item measure of breach (rather than a single item as in study 1) and also tested for discriminant validity with an established multiple item measure of violation. Findings replicated those in study 1. The findings have important implications for considering alternative, more comprehensive and elaborate ways of assessing breach.

Evaluating two morningness scales with item response theory

Using a student sample (n = 692) and an organization sample (n = 180), we scrutinized two morning-evening orientation scales using item response theory (IRT) methods. We used IRT to compare the measurement precision of the Composite Scale (CS) and the Early/Late Preferences Scale (PS). The CS had slightly higher measurement precision at all ranges of orientations, except for extreme morning and evening orientations for which the PS had slightly higher precision. IRT item-level statistics were also computed to try to understand how morning-orientation items functioned. Items that asked questions about morning activities tended to be more discriminating indicators of morning-orientation than items that asked about evening or peak performance activities. Items that involved unpleasant activities were less frequently endorsed than items that involved neutral or enjoyable activities. Implications for measurement of morning-evening orientation are discussed. (C) 2002 Elsevier Science Ltd. All rights reserved.

Scales and causes of heterogeneity in bars in a large multi-channel river: Rio Parana, Argentina

To date, published studies of alluvial bar architecture in large rivers have been restricted mostly to case studies of individual bars and single locations. Relatively little is known about how the depositional processes and sedimentary architecture of kilometre-scale bars vary within a multi-kilometre reach or over several hundreds of kilometres downstream. This study presents Ground Penetrating Radar and core data from 11, kilometre-scale bars from the Rio Parana, Argentina. The investigated bars are located between 30km upstream and 540km downstream of the Rio Parana - Rio Paraguay confluence, where a significant volume of fine-grained suspended sediment is introduced into the network. Bar-scale cross-stratified sets, with lengths and widths up to 600m and thicknesses up to 12m, enable the distinction of large river deposits from stacked deposits of smaller rivers, but are only present in half the surface area of the bars. Up to 90% of bar-scale sets are found on top of finer-grained ripple-laminated bar-trough deposits. Bar-scale sets make up as much as 58% of the volume of the deposits in small, incipient mid-channel bars, but this proportion decreases significantly with increasing age and size of the bars. Contrary to what might be expected, a significant proportion of the sedimentary structures found in the Rio Parana is similar in scale to those found in much smaller rivers. In other words, large river deposits are not always characterized by big structures that allow a simple interpretation of river scale. However, the large scale of the depositional units in big rivers causes small-scale structures, such as ripple sets, to be grouped into thicker cosets, which indicate river scale even when no obvious large-scale sets are present. The results also show that the composition of bars differs between the studied reaches upstream and downstream of the confluence with the Rio Paraguay. Relative to other controls on downstream fining, the tributary input of fine-grained suspended material from the Rio Paraguay causes a marked change in the composition of the bar deposits. Compared to the upstream reaches, the sedimentary architecture of the downstream reaches in the top ca 5m of mid-channel bars shows: (i) an increase in the abundance and thickness (up to metre-scale) of laterally extensive (hundreds of metres) fine-grained layers; (ii) an increase in the percentage of deposits comprised of ripple sets (to >40% in the upper bar deposits); and (iii) an increase in bar-trough deposits and a corresponding decrease in bar-scale cross-strata (<10%). The thalweg deposits of the Rio Parana are composed of dune sets, even directly downstream from the Rio Paraguay where the upper channel deposits are dominantly fine-grained. Thus, the change in sedimentary facies due to a tributary point-source of fine-grained sediment is primarily expressed in the composition of the upper bar deposits.

Application of Gaussian multi-scale representation to feature tracking in meteorological satellite imagery

Gaussian multi-scale representation is a mathematical framework that allows to analyse images at different scales in a consistent manner, and to handle derivatives in a way deeply connected to scale. This paper uses Gaussian multi-scale representation to investigate several aspects of the derivation of atmospheric motion vectors (AMVs) from water vapour imagery. The contribution of different spatial frequencies to the tracking is studied, for a range of tracer sizes, and a number of tracer selection methods are presented and compared, using WV 6.2 images from the geostationary satellite MSG-2.

Analysis of frequency and intensity of European winter storm events from a multi-model perspective, at synoptic and regional scales

This study focuses on the analysis of winter (October-November-December-January-February-March; ONDJFM) storm events and their changes due to increased anthropogenic greenhouse gas concentrations over Europe. In order to assess uncertainties that are due to model formulation, 4 regional climate models (RCMs) with 5 high resolution experiments, and 4 global general circulation models (GCMs) are considered. Firstly, cyclone systems as synoptic scale processes in winter are investigated, as they are a principal cause of the occurrence of extreme, damage-causing wind speeds. This is achieved by use of an objective cyclone identification and tracking algorithm applied to GCMs. Secondly, changes in extreme near-surface wind speeds are analysed. Based on percentile thresholds, the studied extreme wind speed indices allow a consistent analysis over Europe that takes systematic deviations of the models into account. Relative changes in both intensity and frequency of extreme winds and their related uncertainties are assessed and related to changing patterns of extreme cyclones. A common feature of all investigated GCMs is a reduced track density over central Europe under climate change conditions, if all systems are considered. If only extreme (i.e. the strongest 5%) cyclones are taken into account, an increasing cyclone activity for western parts of central Europe is apparent; however, the climate change signal reveals a reduced spatial coherency when compared to all systems, which exposes partially contrary results. With respect to extreme wind speeds, significant positive changes in intensity and frequency are obtained over at least 3 and 20% of the European domain under study (35–72°N and 15°W–43°E), respectively. Location and extension of the affected areas (up to 60 and 50% of the domain for intensity and frequency, respectively), as well as levels of changes (up to +15 and +200% for intensity and frequency, respectively) are shown to be highly dependent on the driving GCM, whereas differences between RCMs when driven by the same GCM are relatively small.

Markov blanket-based approach for learning multi-dimensional Bayesian network classifiers: An application to predict the European Quality of Life-5 Dimensions (EQ-5D) from the 39-item Parkinson's Disease Questionnaire (PDQ-39)

Multi-dimensional Bayesian network classifiers (MBCs) are probabilistic graphical models recently proposed to deal with multi-dimensional classification problems, where each instance in the data set has to be assigned to more than one class variable. In this paper, we propose a Markov blanket-based approach for learning MBCs from data. Basically, it consists of determining the Markov blanket around each class variable using the HITON algorithm, then specifying the directionality over the MBC subgraphs. Our approach is applied to the prediction problem of the European Quality of Life-5 Dimensions (EQ-5D) from the 39-item Parkinson’s Disease Questionnaire (PDQ-39) in order to estimate the health-related quality of life of Parkinson’s patients. Fivefold cross-validation experiments were carried out on randomly generated synthetic data sets, Yeast data set, as well as on a real-world Parkinson’s disease data set containing 488 patients. The experimental study, including comparison with additional Bayesian network-based approaches, back propagation for multi-label learning, multi-label k-nearest neighbor, multinomial logistic regression, ordinary least squares, and censored least absolute deviations, shows encouraging results in terms of predictive accuracy as well as the identification of dependence relationships among class and feature variables.

Leaf morphology scales multi-annual trends in nutrient cycling and leaf, flower, and fruiting phenology among species in the sub-tropical hardwood forests of the northern Florida Keys

The subtropical hardwood forests of southern Florida are formed by 120 frost-sensitive, broadleaved angiosperm species that range throughout the Caribbean. Previous work on a series of small sized forest component patches of a 20 km2, forest preserve in northern Key Largo indicate that a shift in species composition was associated with a 100 year forest developmental sequence, and this shift was associated with an increasingly evergreen canopy. This document investigates the underlying differences of the biology of trees that live in this habitat, and is specifically focused on the impact of leaf morphology on changing nutrient cycling patterns. Measurements of the area, thickness, dry mass, nutrient content and longevity of several leaves from 3-4 individuals of ten species were conducted in combination with a two-year leaf litter collection and nutrient analysis to determine that species with thicker, denser leaves cycled scarce nutrients up to 2-3 times more efficiently than thin leaved tree species, and the leaf thickness/density index predicts role in forest development in a parallel direction as the index predicts nutrient cycling efficiency. A three year set of observations on the relative abundance of new leaves, flowers and fruits of the same tree species provides an opportunity to evaluate the consequences the leaf morphology/nutrient cycling/forest development relationship to forest habitat quality. Results of the three documents support a mechanistic link between forest development and nutrient cycling, and suggests that older forests are likely to be better habitats based on the availability of valuable forest products like new leaves, flowers, and fruits throughout the year.

The clusters Abell 222 and Abell 223: a multi-wavelength view

Context. The Abell 222 and 223 clusters are located at an average redshift z similar to 0.21 and are separated by 0.26 deg. Signatures of mergers have been previously found in these clusters, both in X-rays and at optical wavelengths, thus motivating our study. In X-rays, they are relatively bright, and Abell 223 shows a double structure. A filament has also been detected between the clusters both at optical and X-ray wavelengths. Aims. We analyse the optical properties of these two clusters based on deep imaging in two bands, derive their galaxy luminosity functions (GLFs) and correlate these properties with X-ray characteristics derived from XMM-Newton data. Methods. The optical part of our study is based on archive images obtained with the CFHT Megaprime/Megacam camera, covering a total region of about 1 deg(2), or 12.3 x 12.3 Mpc(2) at a redshift of 0.21. The X-ray analysis is based on archive XMM-Newton images. Results. The GLFs of Abell 222 in the g' and r' bands are well fit by a Schechter function; the GLF is steeper in r' than in g'. For Abell 223, the GLFs in both bands require a second component at bright magnitudes, added to a Schechter function; they are similar in both bands. The Serna & Gerbal method allows to separate well the two clusters. No obvious filamentary structures are detected at very large scales around the clusters, but a third cluster at the same redshift, Abell 209, is located at a projected distance of 19.2 Mpc. X-ray temperature and metallicity maps reveal that the temperature and metallicity of the X-ray gas are quite homogeneous in Abell 222, while they are very perturbed in Abell 223. Conclusions. The Abell 222/Abell 223 system is complex. The two clusters that form this structure present very different dynamical states. Abell 222 is a smaller, less massive and almost isothermal cluster. On the other hand, Abell 223 is more massive and has most probably been crossed by a subcluster on its way to the northeast. As a consequence, the temperature distribution is very inhomogeneous. Signs of recent interactions are also detected in the optical data where this cluster shows a ""perturbed"" GLF. In summary, the multiwavelength analyses of Abell 222 and Abell 223 are used to investigate the connection between the ICM and the cluster galaxy properties in an interacting system.

Outcomes after multi-modality treatment of musculoskeletal tumours

Outcomes of treatment of musculoskeletal tumours are evaluated for effectiveness of chemotherapy protocols, function obtained after surgery and survival after treatment. Quality of life achieved after multi-modality treatment is dependent on a combination of all of these factors. Quality of life varies significantly along the treatment pathway, and continuously through the life of a patient. The patient's perception of outcome is based on the total effect of the disease and its treatment, rather than necessarily focussing on separate items of treatment. We have found that visual analogue scales can be used effectively to gauge the patient's perception of their quality of life. Such a method has shown that, overall, perceptions of quality of life seem to be better for those patients who have undergone successful limb salvage surgery when compared with those who have undergone amputation, but the differences are not as great as might be assumed.

Clinical Validity of the Protocol for Multi-Professional Centers for the Determination of Signs and Symptoms of Temporomandibular Disorders. Part II

The aims of this study were to analyze the criterion and construct validity of Part II of the protocol for multi-professional centers for the determination of signs and symptoms of temporomandibular disorders (ProTMDMulti) as a measure of TMD severity. The study was conducted on eight asymptomatic subjects (CG) and 30 subjects with articular TMD (TMDG), according to the Research Diagnostic Criteria for TMD (RDC/TMD). The ProTMDMulti-Part II was validated using the Helkimo Clinical Dysfunction Index (Di). The construct validity was tested using the analysis of the ability of ProTMDMulti-part II to differentiate the CG from the TMDG and to measure the changes that occurred in the TMDG between the period before and after TMD treatment. Correlations between the Di and the ProTMDMulti-Part II scores were calculated using the Spearman test. Inter- and intragroup comparisons were made (p<0.05). There was a statistically significant correlation between the Helkimo Clinical Dysfunction Index (Di) and the severity scores of the ProTMDMulti-Part II. There was a significant difference between TMDG and CG regarding the severity of signs and symptoms. The present study provides statistical evidence of the clinical validity of the ProTMDmulti-Part II as a measure of the severity of TMD symptoms.

Multi-scale modeling of the mechanical behavior of polymer-based materials

Polymers have become the reference material for high reliability and performance applications. In this work, a multi-scale approach is proposed to investigate the mechanical properties of polymeric based material under strain. To achieve a better understanding of phenomena occurring at the smaller scales, a coupling of a Finite Element Method (FEM) and Molecular Dynamics (MD) modeling in an iterative procedure was employed, enabling the prediction of the macroscopic constitutive response. As the mechanical response can be related to the local microstructure, which in turn depends on the nano-scale structure, the previous described multi-scale method computes the stress-strain relationship at every analysis point of the macro-structure by detailed modeling of the underlying micro- and meso-scale deformation phenomena. The proposed multi-scale approach can enable prediction of properties at the macroscale while taking into consideration phenomena that occur at the mesoscale, thus offering an increased potential accuracy compared to traditional methods.