The Child and Adolescent Scale of Environment (CASE): Further validation with youth who have chronic conditions

Objective: To further validate the Child and Adolescent Scale of Environment (CASE). Methods: Baseline data (n = 430) were analyzed from a longitudinal study on quality of life for youth with chronic conditions ages 11–17 in Ontario, Canada. Internal consistency and structure, and convergent and discriminant validity were examined via Cronbach’s alpha (α), exploratory factor analyses, correlation analyses and ANOVA. Results: The CASE had high internal consistency (α = 0.89). A three-factor solution was produced with 55% variance explained: (1) Community/Home Resources, (2) School Resources and (3) Physical Design/Access). CASE total and factor scores were significantly correlated with scores from measures of impairment and participation (i.e. youth with more problematic environments had more severe impairment and more restricted participation). Significant differences in CASE scores existed for primary condition and impairment severity, but not for age or gender. Conclusion: Results provide additional CASE validation evidence. Further testing is needed with more diverse and representative samples

A Case Study: Changing Human Resource Management Education to Fit the Field

The field of Human Resource Management has embarked upon a process of significant change. To keep up with changes to the field, Barksdale (1998) argued that so too must HR education change. This article presents an effort that changed the HR educational model from a functional silos focused model to an integrated outcome-based model. The logic for the change, what changes were made, and comments about the outcomes are presented

Nesting Ecology of Sedge Wrens in Hall County, Nebraska

The status of the Sedge Wren (Cistothorus platensis) in Nebraska is not well known. Cink (1973) summarized summer records from 1867 to 1971 and described only a few nest records. One nest discovered on 28 August 1902 at Capitol Beach, Lancaster Co., was assumed empty, apparently because of the late date. Bedell (1987) recorded July and August sightings in south central Nebraska and raised the question of whether these birds were migrants or nesting. Sedge Wrens are frequently polygynous (Crawford 1977, Burns 1982) and may exhibit two waves of nesting effort in some areas (Burns 1982). Nest initiation appears to fall into two periods depending on the latitude; one from early May to June in Michigan (Walkinshaw 1935), Minnesota (Burns 1982), North Dakota (stewart 1975), and Wisconsin (Manci and Rusch 1988), and the other beginning in late July through August in Kansas (Cink pers. comm., Williams 1981) and Arkansas (Meanley 1952) in addition to more northern latitudes as cited above. This may explain why Sedge Wrens are often not encountered during typical May and June breeding bird censuses, especially in southern and western portions of their nesting range (Robbins et al. 1986). This paper compares nesting densities on a grazed versus an ungrazed area and describes the nesting phenology of Sedge Wrens during the 1988 nesting season in Hall Co

The Youth Report Version of the Child and Adolescent Scale of Participation (CASP): Assessment of Psychometric Properties and Comparison With Parent Report

Objective The Child and Adolescent Scale of Participation (CASP) parent report is a brief and valid measure for use with children and youth with chronic conditions/disabilities that has been shown to have good coverage at the chapter level of the‘Activities and Participation’component of the International Classification of Functioning,Disability and Health.The purpose of this research was to assess the psychometric properties of a CASP youth self-report version,to further validate the parent report,and to compare parent and youth reports of youths’ activity and participation. Methods Baseline data from a longitudinal study examining predictors of changes in quality of life for youth with chronic conditions/disabilities were used.CASP data were collected on 409 youth aged 11–17 with various conditions/disabilities using youth and parent reports.Internal consistency and factor structure were examined for both versions using Cronbach’s alpha and exploratory factor analyses.Inter-rater agreement and magnitude of differences between youth and parent report were evaluated using intraclass correlation coefficients and paired t-tests respectively. Gender,age and condition/disability group differences in youth report CASP scores were examined using independent t-tests or analyses of variance. Results Strong internal consistency and internal structure validity was demonstrated for the CASP youth and parent report.The youth report factor structure was similar to the parent report in this and other studies.Youth reported their activity/participation to be significantly higher than did their parents.Significant differences in CASP scores were found among condition/disability groups. Conclusions Findings show that,from a psychometric standpoint,the youth version of the CASP is a promising new self-report measure of activity and participation.As youth perceive their activity and participation levels differently than their parents,it is important to collect data from both sources to obtain a more comprehensive understanding of this aspect of youths’ lives

Social Participation and Navigation with Adolescent and Young Adult Brain Tumor Survivors: Usability and Potential Benefits

Background: This study examined the usability and potential benefits of Social Participation and Navigation (SPAN), a virtual coaching goal planning intervention, which was modified for adolescent and young adult (AYA) brain tumor survivors who often experience social participation challenges. Methods: Four AYA brain tumor survivors participated in a brief trial of the modified SPAN consisting of four weekly coaching sessions with trained supervised occupational therapy graduate students and use of a website and web application to assist with goal planning and achievement. The participants rated their social participation and SPAN-specific skills pre/post program. The participants and parents completed 1-week and 1-month usability surveys post program. Effect sizes were computed to examine pre/post score changes. Descriptive statistics and content analyses were used to examine quantitative and qualitative usability data. Results: SPAN was well-received by the AYAs, parents, and coaches with high satisfaction ratings for coaching. All participants achieved at least one goal. The participants had increased post-intervention scores in social participation (overall, school, community) and SPAN skills (goal planning, self-regulation, reciprocal communication). Suggestions for improvement primarily focused on the SPAN web application. Conclusion: The results demonstrated the usability and potential benefits of SPAN for AYA brain tumor survivors and have informed a larger implementation trial

α-Amino-β-sulphone hydroxamates as potent MMP-13 inhibitors that spare MMP-1

A series of α-amino-β-sulphone hydroxamates was prepared and evaluated for potency versus MMP-13 and selectivity versus MMP-1. Various substituents were employed on the α-amino group (P1 position), as well as different groups attached to the sulphone group extending into P1′. Low nanomolar potency was obtained for MMP-13 with selectivity versus MMP-1 of \u3e1000× for a number of analogues. α-Amino-β-sulphone hydroxamates were prepared, which are potent MMP-13 inhibitors with selectivity versus MMP-1 of \u3e1000× for a number of analogues. Selected compounds exhibited oral bioavailability

Prediction of preterm birth with and without preeclampsia using mid-pregnancy immune and growth-related molecular factors and maternal characteristics.

OBJECTIVE:To evaluate if mid-pregnancy immune and growth-related molecular factors predict preterm birth (PTB) with and without (±) preeclampsia. STUDY DESIGN:Included were 400 women with singleton deliveries in California in 2009-2010 (200 PTB and 200 term) divided into training and testing samples at a 2:1 ratio. Sixty-three markers were tested in 15-20 serum samples using multiplex technology. Linear discriminate analysis was used to create a discriminate function. Model performance was assessed using area under the receiver operating characteristic curve (AUC). RESULTS:Twenty-five serum biomarkers along with maternal age <34 years and poverty status identified >80% of women with PTB ± preeclampsia with best performance in women with preterm preeclampsia (AUC = 0.889, 95% confidence interval (0.822-0.959) training; 0.883 (0.804-0.963) testing). CONCLUSION:Together with maternal age and poverty status, mid-pregnancy immune and growth factors reliably identified most women who went on to have a PTB ± preeclampsia

Recommendations for the use of common outcome measures in pediatric traumatic brain injury research

This article addresses the need for age-relevant outcome measures for traumatic brain injury (TBI) research and summarizes the recommendations by the inter-agency Pediatric TBI Outcomes Workgroup. The Pediatric Workgroup\u27s recommendations address primary clinical research objectives including characterizing course of recovery from TBI, prediction of later outcome, measurement of treatment effects, and comparison of outcomes across studies. Consistent with other Common Data Elements (CDE) Workgroups, the Pediatric TBI Outcomes Workgroup adopted the standard three-tier system in its selection of measures. In the first tier, core measures included valid, robust, and widely applicable outcome measures with proven utility in pediatric TBI from each identified domain including academics, adaptive and daily living skills, family and environment, global outcome, health-related quality of life, infant and toddler measures, language and communication, neuropsychological impairment, physical functioning, psychiatric and psychological functioning, recovery of consciousness, social role participation and social competence, social cognition, and TBI-related symptoms. In the second tier, supplemental measures were recommended for consideration in TBI research focusing on specific topics or populations. In the third tier, emerging measures included important instruments currently under development, in the process of validation, or nearing the point of published findings that have significant potential to be superior to measures in the core and supplemental lists and may eventually replace them as evidence for their utility emerges

Mycobacterium tuberculosis bloodstream infection prevalence, diagnosis, and mortality risk in seriously ill adults with HIV: a systematic review and meta-analysis of individual patient data.

BACKGROUND: The clinical and epidemiological significance of HIV-associated Mycobacterium tuberculosis bloodstream infection (BSI) is incompletely understood. We hypothesised that M tuberculosis BSI prevalence has been underestimated, that it independently predicts death, and that sputum Xpert MTB/RIF has suboptimal diagnostic yield for M tuberculosis BSI. METHODS: We did a systematic review and individual patient data (IPD) meta-analysis of studies performing routine mycobacterial blood culture in a prospectively defined patient population of people with HIV aged 13 years or older. Studies were identified through searching PubMed and Scopus up to Nov 10, 2018, without language or date restrictions and through manual review of reference lists. Risk of bias in the included studies was assessed with an adapted QUADAS-2 framework. IPD were requested for all identified studies and subject to harmonised inclusion criteria: age 13 years or older, HIV positivity, available CD4 cell count, a valid mycobacterial blood culture result (excluding patients with missing data from lost or contaminated blood cultures), and meeting WHO definitions for suspected tuberculosis (presence of screening symptom). Predicted probabilities of M tuberculosis BSI from mixed-effects modelling were used to estimate prevalence. Estimates of diagnostic yield of sputum testing with Xpert (or culture if Xpert was unavailable) and of urine lipoarabinomannan (LAM) testing for M tuberculosis BSI were obtained by two-level random-effect meta-analysis. Estimates of mortality associated with M tuberculosis BSI were obtained by mixed-effect Cox proportional-hazard modelling and of effect of treatment delay on mortality by propensity-score analysis. This study is registered with PROSPERO, number 42016050022. FINDINGS: We identified 23 datasets for inclusion (20 published and three unpublished at time of search) and obtained IPD from 20, representing 96·2% of eligible IPD. Risk of bias for the included studies was assessed to be generally low except for on the patient selection domain, which was moderate in most studies. 5751 patients met harmonised IPD-level inclusion criteria. Technical factors such as number of blood cultures done, timing of blood cultures relative to blood sampling, and patient factors such as inpatient setting and CD4 cell count, explained significant heterogeneity between primary studies. The predicted probability of M tuberculosis BSI in hospital inpatients with HIV-associated tuberculosis, WHO danger signs, and a CD4 count of 76 cells per μL (the median for the cohort) was 45% (95% CI 38-52). The diagnostic yield of sputum in patients with M tuberculosis BSI was 77% (95% CI 63-87), increasing to 89% (80-94) when combined with urine LAM testing. Presence of M tuberculosis BSI compared with its absence in patients with HIV-associated tuberculosis increased risk of death before 30 days (adjusted hazard ratio 2·48, 95% CI 2·05-3·08) but not after 30 days (1·25, 0·84-2·49). In a propensity-score matched cohort of participants with HIV-associated tuberculosis (n=630), mortality increased in patients with M tuberculosis BSI who had a delay in anti-tuberculosis treatment of longer than 4 days compared with those who had no delay (odds ratio 3·15, 95% CI 1·16-8·84). INTERPRETATION: In critically ill adults with HIV-tuberculosis, M tuberculosis BSI is a frequent manifestation of tuberculosis and predicts mortality within 30 days. Improved diagnostic yield in patients with M tuberculosis BSI could be achieved through combined use of sputum Xpert and urine LAM. Anti-tuberculosis treatment delay might increase the risk of mortality in these patients. FUNDING: This study was supported by Wellcome fellowships 109105Z/15/A and 105165/Z/14/A

Scoping Review of Interventions to Promote Social Participation in Adolescents and Young Adults with Neurodisability

Background: Social participation, described as taking part in, being involvement and engaged with, and doing or being with others, is an important health outcome. Adolescents and young adults with neurodisability are often restricted in their social participation, particularly if they experience social and executive functioning challenges. A scoping review was conducted to examine interventions aimed at improving social participation in adolescents and young adults with neurodisability characterized by these challenges. Method: The scoping review included peer-reviewed empirical studies published from 1990 to 2016 that employed psychosocial interventions to improve social participation in young people 13 to 24 years of age with acquired brain injuries, autism spectrum disorders, and attention deficit disorders. Results: Narrative synthesis of 32 included studies highlighted significant variation in both the definition and measurement of social participation outcomes. The lack of RCT studies with large samples was noted, with almost a third of the studies including fewer than 10 participants. The two dominant types of intervention were peer mentoring and social skills training. Conclusion: There is a lack of rigorously tested interventions that specifically address social participation challenges for individuals with neurodisability. Future research will need to be clearer in how social participation is conceptualized and operationalized to allow for improved measurement and comparison between studies