Validity of BMI as a measure of obesity in Australian white Caucasian and Australian Sri lankan children

Background: Body mass index ( BMI) is used to diagnose obesity. However, its ability to predict the percentage fat mass (% FM) reliably is doubtful. Therefore validity of BMI as a diagnostic tool of obesity is questioned. Aim: This study is focused on determining the ability of BMI- based cut- off values in diagnosing obesity among Australian children of white Caucasian and Sri Lankan origin. Subjects and methods: Height and weight was measured and BMI ( W/H-2) calculated. Total body water was determined by deuterium dilution technique and fat free mass and hence fat mass derived using age- and gender- specific constants. A % FM of 30% for girls and 20% for boys was considered as the criterion cut- off level for obesity. BMI- based obesity cut- offs described by the International Obesity Task Force ( IOTF), CDC/ NCHS centile charts and BMI- Z were validated against the criterion method. Results: There were 96 white Caucasian and 42 Sri Lankan children. Of the white Caucasians, 19 ( 36%) girls and 29 ( 66%) boys, and of the Sri Lankans 7 ( 46%) girls and 16 ( 63%) boys, were obese based on % FM. The FM and BMI were closely associated in both Caucasians ( r = 0.81, P < 0.001) and Sri Lankans ( r = 0.92, P< 0.001). Percentage FM and BMI also had a lower but significant association. Obesity cut- off values recommended by IOTF failed to detect a single case of obesity in either group. However, NCHS and BMI- Z cut- offs detected cases of obesity with low sensitivity. Conclusions: BMI is a poor indicator of percentage fat and the commonly used cut- off values were not sensitive enough to detect cases of childhood obesity in this study. In order to improve the diagnosis of obesity, either BMI cut- off values should be revised to increase the sensitivity or the possibility of using other indirect methods of estimating the % FM should be explored.

On the existence of uni-instantaneous Q-processes with a given finite mu-invariant measure

Let S be a countable set and let Q = (q(ij), i, j is an element of S) be a conservative q-matrix over S with a single instantaneous state b. Suppose that we are given a real number mu >= 0 and a strictly positive probability measure m = (m(j), j is an element of S) such that Sigma(i is an element of S) m(i)q(ij) = -mu m(j), j 0 b. We prove that there exists a Q-process P(t) = (p(ij) (t), i, j E S) for which m is a mu-invariant measure, that is Sigma(i is an element of s) m(i)p(ij)(t) = e(-mu t)m(j), j is an element of S. We illustrate our results with reference to the Kolmogorov 'K 1' chain and a birth-death process with catastrophes and instantaneous resurrection.

Using extreme value theory to measure value-at-risk for daily electricity spot prices

The recent deregulation in electricity markets worldwide has heightened the importance of risk management in energy markets. Assessing Value-at-Risk (VaR) in electricity markets is arguably more difficult than in traditional financial markets because the distinctive features of the former result in a highly unusual distribution of returns-electricity returns are highly volatile, display seasonalities in both their mean and volatility, exhibit leverage effects and clustering in volatility, and feature extreme levels of skewness and kurtosis. With electricity applications in mind, this paper proposes a model that accommodates autoregression and weekly seasonals in both the conditional mean and conditional volatility of returns, as well as leverage effects via an EGARCH specification. In addition, extreme value theory (EVT) is adopted to explicitly model the tails of the return distribution. Compared to a number of other parametric models and simple historical simulation based approaches, the proposed EVT-based model performs well in forecasting out-of-sample VaR. In addition, statistical tests show that the proposed model provides appropriate interval coverage in both unconditional and, more importantly, conditional contexts. Overall, the results are encouraging in suggesting that the proposed EVT-based model is a useful technique in forecasting VaR in electricity markets. (c) 2005 International Institute of Forecasters. Published by Elsevier B.V. All rights reserved.

Development of a measure to assess coping for auditory hallucinations

This paper describes the development of an instrument to assess coping strategies for auditory hallucinations. An inventory of coping strategies was obtained by conducting semi-structured interviews with 17 male participants. This inventory was then used to develop a 27-item questionnaire, the Responses to Auditory Hallucinations Questionnaire (RAHQ). The RAHQ was administered to 125 respondents. Measures of symptom severity, appraisal, anxiety, depression and coping dissatisfaction were also administered. Factor Analysis of the RAHQ yielded three coping subscales, Active coping, Passive coping and Suppression coping. The subscales were shown to be empirically distinct and to possess satisfactory internal reliability. For a small subgroup of participants, two of the three subscales demonstrated satisfactory test-retest reliability. Construct validity was assessed within a stress and coping framework. The RAHQ will facilitate the investigation of the efficacy of coping strategies for the management of auditory hallucinations.

Reliability of a measure of prediagnosis physical activity for cancer survivors

Purpose: This study was conducted to examine the test-retest reliability of a measure of prediagnosis physical activity participation administered to colorecial cancer survivors recruited from a population-based state cancer registry. Methods: A total of 112 participants completed two telephone interviews. I month apart, reporting usual weekly physical activity in the year before their cancer diagnosis. Intraclass correlation coefficients (ICC) and standard en-or of measurement (SEM) were used to describe the test-retest reliability of the measure across the sample: the Bland-Altman approach was used to describe reliability at the individual level. The test-retest reliability for categorized total physical activity (active, insufficiently active, sedentary) was assessed using the kappa statistic. Results: When the complete sample was considered, the ICC ranged from 0.40 (95% Cl: 0.24, 0.55) for vigorous gardening to 0.77 (95% Cl: 0.68, 0.84) for moderate physical activity. The SEM, however, were large. indicating high measurement error. The Bland-Altman plots indicated that the reproducibility of data decreases as the aniount of physical activity reported each week increases The kappa coefficient for the categorized data was 0.62 (95% Cl: 0.48, 0.76). Conclusion: Overall. the results indicated low levels of repeatability for this measure of historical physical activity. Categorizing participants as active, insufficiently active, or sedentary provides a higher level of test-retest reliability.

The development of a new measure of quality of life for children with congenital cardiac disease

The purpose of the study was to develop a questionnaire measuring health-related R1 quality of life for children and adolescents with congenital heart disease, the ConQol, that would have both clinical and research applications. We describe here the process of construction of a questionnaire, the piloting and the development of a weighted scoring system, and data on the psychometric performance of the measure in a sample of 640 children and young people recruited via 6 regional centres for paediatric cardiology from across the United Kingdom. The ConQol has two versions, one designed for children aged from 8 to 11 years, and the other for young people aged from 12 to 16 years. Initial findings suggest that it is a valid and reliable instrument, is acceptable to respondents, and is simple to administer in both a research and clinical context.

Use of optical density as a measure of Claviceps africana conidial suspension concentration

Sorghum ergot, caused by Claviceps africana, has remained a major disease problem in Australia since it was first recorded in 1996, and is the focus of a range of biological and integrated management research. Artificial inoculation using conidial suspensions is an important tool in this research. Ergot infection is greatly influenced by environmental factors, so it is important to reduce controllable sources of variation such as inoculum concentration. The use of optical density was tested as a method of quantifying conidial suspensions of C. africana, as an alternative to haemocytometer counts. This method was found to be accurate and time efficient, with possible applications in other disease systems.