The validity of a latent class typology of adolescent drinking patterns

Objectives: This study examined the validity of a latent class typology of adolescent drinking based on four alcohol dimensions; frequency of drinking, quantity consumed, frequency of binge drinking and the number of alcohol related problems encountered. Method: Data used were from the 1970 British Cohort Study sixteen-year-old follow-up. Partial or complete responses to the selected alcohol measures were provided by 6,516 cohort members. The data were collected via a series of postal questionnaires. Results: A five class LCA typology was constructed. Around 12% of the sample were classified as �hazardous drinkers� reporting frequent drinking, high levels of alcohol consumed, frequent binge drinking and multiple alcohol related problems. Multinomial logistic regression, with multiple imputation for missing data, was used to assess the covariates of adolescent drinking patterns. Hazardous drinking was associated with being white, being male, having heavy drinking parents (in particular fathers), smoking, illicit drug use, and minor and violent offending behaviour. Non-significant associations were found between drinking patterns and general mental health and attention deficient disorder. Conclusion: The latent class typology exhibited concurrent validity in terms of its ability to distinguish respondents across a number of alcohol and non-alcohol indicators. Notwithstanding a number of limitations, latent class analysis offers an alternative data reduction method for the construction of drinking typologies that addresses known weaknesses inherent in more tradition classification methods.

A measure of satisfaction with food-related life

A measure of satisfaction with food-related life is developed and tested in three studies in eight European countries. Five items are retained from an original pool of seven; these items exhibit good reliability as measured by Cronbach's alpha, good temporal stability, convergent validity with two related measures, and construct validity as indicated by relationships with other indicators of quality of life, including the Satisfaction With Life and the SF-8 scales. It is concluded that this scale will be useful in studies trying to identify factors contributing to satisfaction with food-related life.

A systematic review of instruments related to family caregivers of palliative care patients

Support for family caregivers is a core function of palliative care. However, there is a lack of consistency in the way needs are assessed, few longitudinal studies to examine the impact of caregiving, and a dearth of evidence-based interventions. In order to help redress this situation, identification of suitable instruments to examine the caregiving experience and the effectiveness of interventions is required. A systematic literature review was undertaken incorporating representatives of the European Association for Palliative Care’s International Palliative Care Family Caregiver Research Collaboration and Family Carer Taskforce. The aim of the review was to identify articles that described the use of instruments administered to family caregivers of palliative care patients (pre and post-bereavement). Fourteen of the 62 instruments targeted satisfaction with service delivery and less than half were developed specifically for the palliative care context. In approximately 25% of articles psychometric data were not reported. Where psychometric results were reported, validity data were reported in less than half (42%) of these cases. While a considerable variety of instruments have been administered to family caregivers, the validity of some of these requires further consideration. We recommend that others be judicious before developing new instruments for this population.

Factor structure and validity of the Alcohol Use Disorders Identification Test (AUDIT) in a sample of mentally disordered offenders

Investigations of the factor structure of the Alcohol Use Disorders Identification Test (AUDIT) have produced conflicting results. The current study assessed the factor structure of the AUDIT for a group of Mentally Disordered Offenders (MDOs) and examined the pattern of scoring in specific subgroups. The sample comprised 2005 MDOs who completed a battery of tests including the AUDIT. Confirmatory factor analyses revealed that a two-factor solution – alcohol consumption and alcohol-related consequences – provided the best data fit for AUDIT scores. A three-factor solution provided an equally good fit, but the second and third factors were highly correlated and a measure of parsimony also favoured the two-factor solution. This study provides useful information on the factor structure of the AUDIT amongst a large MDO population, while also highlighting the difficulties associated with the presence of people with mental health problems in the criminal justice system.

Foveal relocation surgery:Is it a reasonable option for patients with age-related macular degeneration?

Foveal relocation (or translocation) has been reintroduced recently as a possible treatment for patients with subfoveal choroidal neovascular membranes secondary to age-related macular degeneration and degenerative myopia. Different surgical techniques have been proposed and the results, although encouraging, are not completely satisfactory yet. Most surgical procedures described are technically difficult and require special vitreo-retinal expertise. Furthermore, although marked improvements in visual acuity have been observed in some patients, others do not experience visual improvement, even after a successful surgery. Additionally, devastating complications, such as proliferative vitreo-retinopathy (PVR) can occur, impairing the final visual outcome. Although foveal relocation surgery may be a promising direction in research and development, as yet, there is no randomised controlled trial to show that it is more effective than any other forms of treatment for macular degeneration. The validity of this surgical approach needs to be evaluated by the results of longer-term follow-up. This article reviews the current surgical techniques for foveal relocation, their outcomes and complications, and discusses the surgical problems that vitreo-retinal surgeons face when performing foveal relocation surgery.

Validity of the Global Physical Activity Questionnaire (GPAQ) in assessing levels and change in moderate-vigorous physical activity and sedentary behaviour

Background

Feasible, cost-effective instruments are required for the surveillance of moderate-to-vigorous physical activity (MVPA) and sedentary behaviour (SB) and to assess the effects of interventions. However, the evidence base for the validity and reliability of the World Health Organisation-endorsed Global Physical Activity Questionnaire (GPAQ) is limited. We aimed to assess the validity of the GPAQ, compared to accelerometer data in measuring and assessing change in MVPA and SB.

Participants (n = 101) were selected randomly from an on-going research study, stratified by level of physical activity (low, moderate or highly active, based on the GPAQ) and sex. Participants wore an accelerometer (Actigraph GT3X) for seven days and completed a GPAQ on Day 7. This protocol was repeated for a random sub-sample at a second time point, 3–6 months later. Analysis involved Wilcoxon-signed rank tests for differences in measures, Bland-Altman analysis for the agreement between measures for median MVPA and SB mins/day, and Spearman’s rho coefficient for criterion validity and extent of change.

95 participants completed baseline measurements (44 females, 51 males; mean age 44 years, (SD 14); measurements of change were calculated for 41 (21 females, 20 males; mean age 46 years, (SD 14). There was moderate agreement between GPAQ and accelerometer for MVPA mins/day (r = 0.48) and poor agreement for SB (r = 0.19). The absolute mean difference (self-report minus accelerometer) for MVPA was −0.8 mins/day and 348.7 mins/day for SB; and negative bias was found to exist, with those people who were more physically active over-reporting their level of MVPA: those who were more sedentary were less likely to under-report their level of SB. Results for agreement in change over time showed moderate correlation (r = 0.52, p = 0.12) for MVPA and poor correlation for SB (r = −0.024, p = 0.916).

Levels of agreement with objective measurements indicate the GPAQ is a valid measure of MVPA and change in MVPA but is a less valid measure of current levels and change in SB. Thus, GPAQ appears to be an appropriate measure for assessing the effectiveness of interventions to promote MVPA.

Establishing the validity of English GP Patient Survey items evaluating out-of-hours care

Background A 2014 national audit used the English General Practice Patient Survey (GPPS) to compare service users’ experience of out-of-hours general practitioner (GP) services, yet there is no published evidence on the validity of these GPPS items. Objectives Establish the construct and concurrent validity of GPPS items evaluating service users’ experience of GP out-of-hours care. Methods Cross-sectional postal survey of service users (n=1396) of six English out-of-hours providers. Participants reported on four GPPS items evaluating out-of-hours care (three items modified following cognitive interviews with service users), and 14 evaluative items from the Out-of-hours Patient Questionnaire (OPQ). Construct validity was assessed through correlations between any reliable (Cochran's α>0.7) scales, as suggested by a principal component analysis of the modified GPPS items, with the ‘entry access’ (four items) and ‘consultation satisfaction’ (10 items) OPQ subscales. Concurrent validity was determined by investigating whether each modified GPPS item was associated with thematically related items from the OPQ using linear regressions. Results The modified GPPS item-set formed a single scale (α=0.77), which summarised the two-component structure of the OPQ moderately well; explaining 39.7% of variation in the ‘entry access’ scores (r=0.63) and 44.0% of variation in the ‘consultation satisfaction’ scores (r=0.66), demonstrating acceptable construct validity. Concurrent validity was verified as each modified GPPS item was highly associated with a distinct set of related items from the OPQ. Conclusions Minor modifications are required for the English GPPS items evaluating out-of-hours care to improve comprehension by service users. A modified question set was demonstrated to comprise a valid measure of service users’ overall satisfaction with out-of-hours care received. This demonstrates the potential for the use of as few as four items in benchmarking providers and assisting services in identifying, implementing and assessing quality improvement initiatives.

Paving the way for the use of the SDQ in economic evaluations of school-based population health interventions: an empirical analysis of the external validity of SDQ mapping algorithms to the CHU9D in an educational setting

Purpose
The Strengths and Difficulties Questionnaire (SDQ) is a behavioural screening tool for children. The SDQ is increasingly used as the primary outcome measure in population health interventions involving children, but it is not preference based; therefore, its role in allocative economic evaluation is limited. The Child Health Utility 9D (CHU9D) is a generic preference-based health-related quality of-life measure. This study investigates the applicability of the SDQ outcome measure for use in economic evaluations and examines its relationship with the CHU9D by testing previously published mapping algorithms. The aim of the paper is to explore the feasibility of using the SDQ within economic evaluations of school-based population health interventions.
Methods
Data were available from children participating in a cluster randomised controlled trial of the school-based roots of empathy programme in Northern Ireland. Utility was calculated using the original and alternative CHU9D tariffs along with two SDQ mapping algorithms. t tests were performed for pairwise differences in utility values from the preference-based tariffs and mapping algorithms.
Results
Mean (standard deviation) SDQ total difficulties and prosocial scores were 12 (3.2) and 8.3 (2.1). Utility values obtained from the original tariff, alternative tariff, and mapping algorithms using five and three SDQ subscales were 0.84 (0.11), 0.80 (0.13), 0.84 (0.05), and 0.83 (0.04), respectively. Each method for calculating utility produced statistically significantly different values except the original tariff and five SDQ subscale algorithm.
Conclusion
Initial evidence suggests the SDQ and CHU9D are related in some of their measurement properties. The mapping algorithm using five SDQ subscales was found to be optimal in predicting mean child health utility. Future research valuing changes in the SDQ scores would contribute to this research.

Reliability and factorial validity of Adolescent Time Inventory-Time Attitude (ATI-TA) Scores in Scottish and Northern Irish adolescents

The contemporary literature investigating the construct broadly known as time perspective is replete with methodological and conceptual concerns. These concerns focus on the reliability and factorial validity of measurement tools, and the sample-specific modification of scales. These issues continue to hamper the development of this potentially useful psychological construct. An emerging body of evidence has supported the six-factor structure of scores on the Adolescent Time Inventory-Time Attitudes Scale, as well as their reliability. The present study utilized data from the first wave of a longitudinal study in the United Kingdom to examine the reliability, validity, and cross-cultural invariance of the scale. Results showed that the hypothesized six-factor model provided the best fit for the data; all alpha and omega estimates were >. .70; scores on ATI-TA factors related meaningfully to self-efficacy scores; and the factor structure was invariant across both research sites. Results are discussed in the context of the extant temporal literature.

Development of a Parent Version of the Manchester-Minneapolis Quality of Life Survey for use by Parents and Crers of UK Children: MMQL-UK (PF).

Background Although it is now widely endorsed that children should as far as possible rate their own health related quality of life (HRQL), there are situations where proxy information on child HRQL may be useful, especially where a child is too ill or young to provide their own HRQL assessment. There is limited availability of generic HRQL scales that have a parallel child and parent version and that are reliable, valid, brief, comprehensible and suitable for use in UK populations. The aims of this study were therefore to develop and validate a parent version of the anglicised Manchester-Minneapolis Quality of Life child form (MMQL-UK (CF)) and to determine the level of association between the child and parent versions of this form. Methods This study was undertaken concurrently with the anglicisation and validation of the MMQL, a measure of HRQL developed for use with children in North America. At that time, no parent version existed, so the MMQL form for children (MMQL-UK (CF)) was used as the basis for the development of the MMQL-UK parent form (PF). The sample included a control group of healthy children and their parents and five exemplar groups; children diagnosed with asthma, diabetes or inflammatory bowel disease and their parents, children in remission from cancer and their parents and children in public care and their carers. Consistency of the MMQL-UK (PF) components were assessed by calculating Cronbach's alpha. Validation of the parent questionnaire was undertaken by comparing MMQL-UK (PF) component scores with comparable components on the proxy PedsQL™ quality of life scales, comparing MMQL-UK (PF) component scores between parents of healthy and chronic disease children and by comparison of component scores from children and their parents or carers. Reproducibility and responsiveness were assessed by retesting parents by follow-up questionnaires. Results A total of 874 children (completing MMQL-UK (CF)) and 572 parents or carers (completing MMQL-UK (PF)) took part in the study. The internal consistency of all the MMQL-UK (PF) components exceeding the accepted criterion of 0.70 and the construct validity was good with moderate correlations being evident between comparable components of the MMQL-UK (PF) and the proxy PedsQL™. Discriminant validity was demonstrated with significant differences being identified between parents of healthy children and those with chronic conditions. Intra-class correlations exceeded 0.65 for all MMQL-UK (PF) components demonstrating good reproducibility. Weak to moderate levels of responsiveness were demonstrated for all but social functioning. The MMQL-UK (PF) showed moderate parent-child correlation with the MMQL-UK (CF) for all components. The best correlations were seen for those components measuring the same construct (Pearson's r ranged from 0.31 to 0.61, p < 0.01 for equivalent components). Conclusion The MMQL-UK (PF) showed moderate to good correlations with the MMQL-UK (CF) component scores. The MMQL-UK (PF) will be of use when comparing child and parent/carer perception of the impact of a child's condition on their HRQL or where the child is too ill or young to provide their own report.

Validity and Test –retest Reliability of the TIVRE-Basket® Test for the Determination of Aerobic Power in Elite Male Basketball Players

The aims of this study were to 1) determine the relationship between performance on the court-based TIVRE-Basket® test and peak aerobic power determined from a criterion lab-based incremental treadmill test and 2) to examine the test-retest reliability of the TIVRE-Basket® test in elite male basketball players. To address aim 1, 36 elite male basketball players (age 25.2 + 4.7 years, weight 94.1 + 11.4 kg, height 195.83 + 9.6 cm) completed a graded treadmill exercise test and the TIVRE-Basket® within 72 hours. Mean distance recorded during the TIVRE-Basket® test was 4001.8 + 176.4m, and mean VO2 peak was 54.7 + 2.8 ml.kg.min-1, and the correlation between the two parameters was r=0.824 (P= <0.001). Linear regression analysis identified TIVRE-Basket® distance (m) as the only unique predictor of VO2 peak in a single variable plus constant model: VO2 peak = 2.595 + ((0.13* TIVRE-Basket® distance (m)). Performance on the TIVRE-Basket® test accounted for 67.8% of the variance in VO2 peak (t=8.466, P=<.001, 95% CI 0.01 - 0.016, SEE 1.61). To address aim 2, 20 male basketball players (age 26.7±4.2; height 1.94±0.92; weight 94.0±9.1) performed the TIVRE-Basket® test on two occasions. There was no significant difference in total distance covered between Trial 1 (4138.8 + 677.3m) and Trial 2 (4188.0 + 648.8m; t = 0.5798, P = 0.5688). Mean difference between trials was 49.2 + 399.5m, with an ICC of 0.85 suggesting a moderate level of reliability. Standardised TEM was 0.88%, representing a moderate degree of trial to trial error, and the CV was 6.3%. The TIVRE-Basket® test therefore represents a valid and moderately reliable court-based sport-specific test of aerobic power for use with individuals and teams of elite level male basketball players. Future research is required to ascertain its validity and reliability in other basketball populations e.g. across age groups, at different levels of competition, in females and in different forms of the game e.g. wheelchair basketball.

Increased body fat is independently and negatively related with cardiorespiratory fitness levels in children and adolescents with normal weight.

Body mass index (BMI) is related with cardiorespiratory fitness (CRF), but less is known regarding the combined relationships between BMI and body fat (BF) on CRF. Cross-sectional study included 2361 girls and 2328 boys aged 10–18 years living in the area of Lisbon, Portugal. BMI was calculated by measuring height and weight, and obesity was assessed by international criteria. BF was assessed by bioimpedance. CRF was assessed by the 20-m shuttle run and the participants were classified as normal-to-high or low-CRF level according to Fitness gram criterion-referenced standards. The prevalence of low CRF was 47 and 39% in girls and boys, respectively. The corresponding values for the prevalence of obesity were 4.8 and 5.6% (not significant) and of excess BF of 12.1 and 25.1% (P <0.001), respectively. In both sexes, BMI and BF were inversely related with CRF: r = – 0.53 and – 0.45 for BMI and % BF, respectively, in boys and the corresponding values in girls were – 0.50 and – 0.33 (all P <0.01). When compared with a participant with normal BMI and BF, the odds ratios (95% confidence interval) for low CRF were 1.94 (1.46–2.58) for a participant with normal BMI and high BF, and 6.19 (5.02–7.63) for a participant with high BMI and high BF. The prevalence of low-CRF levels is high in Portuguese youths. BF negatively influences CRF levels among children/adolescents with normal BMI.

Examining the incremental validity of psychopathy versus antisocial personality disorder in understanding patterns of criminal behavior

La psychopathie et le trouble de personnalité antisociale sont deux syndromes reliés qui ont été identifiés comme prédicteurs importants de comportements violents et de criminalité. Cependant, la recherche indique que les facteurs de la psychopathie centrés sur la personnalité ne sont pas des prédicteurs fiables de récidive violente chez les personnes atteintes de maladies mentales. Toutefois, peu d’études se sont centrées sur l’identification des facteurs associés au patron des antécédents criminels. Les 96 hommes de l’étude ont été déclarés non criminellement responsables en raison de troubles mentaux. Ils ont été évalués quant au trouble de la personnalité antisociale ainsi qu’à la psychopathie. Les dossiers criminels de la Gendarmerie Royale du Canada ont également été consultés afin de reconstituer l’histoire criminelle. Les résultats suggèrent que ni les traits de personnalité antisociaux, ni les facteurs de la psychopathie ne démontrent une validité prédictive incrémentielle les uns sur les autres quant au nombre ou à la sévérité des délits. La présence d’un grand nombre de traits antisociaux est associée à un plus grand nombre et à une plus importante sévérité d’actes criminels non-violents. Les résultats sont discutés en termes de l’utilité d’une classification du trouble de personnalité antisociale, et de la pertinence du construit de la psychopathie pour les personnes atteintes de maladies mentales graves.

Paraphilic Coercive Disorder : Behavioral Markers and Validity of Diagnostic Criteria

Le présent projet doctoral vise à considérer les lacunes dans la documentation scientifique sur le Trouble Paraphilique Coercitif (TPC) en mettant l’accent sur la validité des critères diagnostiques proposés pour inclusion dans le DSM-5 et les marqueurs comportementaux. À ce fait, les données archivées d’individus ayant sexuellement agressé des femmes adultes ont été étudiées. La thèse est constituée de trois articles empiriques. Le premier article présente des résultats clés découlant des analyses, élaborés dans les articles subséquents. Le second (N = 47) évalue les fréquences observées du TPC, la validité et l’impact du recours au nombre minimal de victimes comme critère diagnostique, ainsi que les indices prédisant la récidive sexuelle. Le troisième article (N = 52) compare les groupes diagnostiques sur une série de comportements délictuels, tels que les gestes sexuels et les comportements violents, dans le but d’identifier les marqueurs comportementaux associés avec la propension au viol qui pourraient assister dans le processus diagnostique. Dans le même ordre d’idées, nous avons créé des typologies de violeurs à partir des gestes sexuels commis, d’un côté, et des comportements violents, de l’autre côté. Conséquemment, les caractéristiques des typologies ainsi obtenues et leur association avec le TPC furent examinées. Dans l’ensemble, nos résultats ne soutiennent pas le recours au nombre de victimes. Nos données suggèrent que, globalement, les violeurs avec le TPC utilisent un niveau de gestes sexuels plus envahissant et un niveau de violence moindre que les violeurs n’ayant pas ce diagnostic, et que l’exhibitionnisme et l’attouchement pourraient servir de marqueurs comportementaux pour le TPC. En outre, les violeurs avec le TPC sont caractérisés davantage par demande indécente, exhibitionnisme, attouchement, masturbation, tentative de pénétration et pénétration digitale que par pénétration vaginale et sodomie. De plus, ces derniers font moins recours à l’utilisation d’armes, semblent ne pas frapper/donner des coups à la victime et sont caractérisés par la manipulation plutôt que par le recours aux menaces de mort, force excessive et utilisation d’armes. En somme, nos données soulignent la nécessité de s’appuyer sur une combinaison de méthodes d’évaluation afin d’améliorer la validité diagnostique et discriminante du TPC.

An Analysis of Work Related Stress Factor in Selected Industries in Kerala ,India

Occupational stress is becoming a major issue in both corporate and social agenda .In industrialized countries, there have been quite dramatic changes in the conditions at work, during the last decade ,caused by economic, social and technical development. As a consequence, the people today at work are exposed to high quantitative and qualitative demands as well as hard competition caused by global economy. A recent report says that ailments due to work related stress is likely to cost India’s exchequer around 72000 crores between 2009 and 2015. Though India is a fast developing country, it is yet to create facilities to mitigate the adverse effects of work stress, more over only little efforts have been made to assess the work related stress.In the absence of well defined standards to assess the work related stress in India, an attempt is made in this direction to develop the factors for the evaluation of work stress. Accordingly, with the help of existing literature and in consultation with the safety experts, seven factors for the evaluation of work stress is developed. An instrument ( Questionnaire) was developed using these seven factors for the evaluation of work stress .The validity , and unidimensionality of the questionnaire was ensured by confirmatory factor analysis. The reliability of the questionnaire was ensured before administration. While analyzing the relation ship between the variables, it is noted that no relationship exists between them, and hence the above factors are treated as independent factors/ variables for the purpose of research .Initially five profit making manufacturing industries, under public sector in the state of Kerala, were selected for the study. The influence of factors responsible for work stress is analyzed in these industries. These industries were classified in to two types, namely chemical and heavy engineering ,based on the product manufactured and work environment and the analysis is further carried out for these two categories.The variation of work stress with different age , designation and experience of the employees are analyzed by means of one-way ANOVA. Further three different type of modelling of work stress, namely factor modelling, structural equation modelling and multinomial logistic regression modelling was done to analyze the association of factors responsible for work stress. All these models are found equally good in predicting the work stress.The present study indicates that work stress exists among the employees in public sector industries in Kerala. Employees belonging to age group 40-45yrs and experience groups 15-20yrs had relatively higher work demand ,low job control, and low support at work. Low job control was noted among lower designation levels, particularly at the worker level in these industries. Hence the instrument developed using the seven factors namely demand, control, manager support, peer support, relationship, role and change can be effectively used for the evaluation of work stress in industries.