The use of the EQ-5D-Y health related quality of life outcome measure in children in the Western Cape, South Africa: psychometric properties, feasibility and usefulness - a longitudinal, analytical study

Abstract Background The EQ-5D-Y, an outcome measure of Health Related Quality of Life (HRQoL) in children, was developed by an international task team in 2010. The multinational feasibility, reliability and validity study which followed was undertaken with mainly healthy children. The aim of this study was to investigate the psychometric properties of the EQ-5D-Y when used to assess the HRQoL of children with different health states. Method A sample of 224 children between eight and twelve years were grouped according to their health state. The groups included 52 acutely ill children, 67 children with either a chronic health condition or disability and 105 mostly healthy, mainstream school children as a comparator. They were assessed at baseline, at three months and at six months. An analysis of the psychometric properties was performed to assess the reliability, validity and responsiveness of the EQ-5D-Y in the different groups of children. Cohen’s kappa, the intraclass correlation coefficient, Pearson Chi-square, Kruskal-Wallis ANOVA and effect size of Wilcoxon Signed-rank test were used to determine the reliability, validity and responsiveness of the instrument. Results The EQ-5D-Y dimensions were found to be reliable on test-retest (kappa varying from 0.365 to 0.653), except for the Usual Activities dimension (kappa 0.199). The Visual Analogue Scale (VAS) was also reliable (ICC = 0.77). Post-hoc analysis indicated that dimensions were able to discriminate between acutely ill and healthy children (all differences p < 0.001). The acutely ill children had the lowest ranked VAS (median 50, range 0–100), indicating worst HRQoL and was the only group significantly different from the other three groups (p < 0.001 in all cases). Convergent validity between all similar EQ-5D-Y and PedsQL, WeeFIM and Faces Pain Scale dimensions was only evident in the acutely ill children. As expected the largest treatment effect was also observed in these children (Wilcoxon Signed-rank test for VAS was 0.43). Six of the nine therapists who took part in the study, found the measure quick and easy to apply, used the information in the management of the child and would continue to use it in future. Conclusions The EQ-5D-Y could be used with confidence as an outcome measure for acutely-ill children, but demonstrated poorer psychometric properties in children with no health condition or chronic conditions. It appears to be feasible and useful to include the EQ-5D-Y in routine assessments of children

“When David Bowie created Ziggy Stardust” The Lived Experiences of Social Workers Learning Through Work

The findings from this qualitative study sit at the intersection of knowledge about workplace and professional learning, offering new insights into how social workers learn through work. The study explored the unique lived experiences of social workers’ learning through an Interpretative Phenomenological Analysis (IPA) study (Smith et al., 2009). IPA was selected to focus on the nature of the social workers’ lifeworld and their lived experiences of learning in the workplace. In-depth individual interviews gathered rich descriptions from sixteen social workers. The double-hermeneutic cycle, a feature of IPA, explored the meaning that the social workers drew from their experiences and the researcher making sense of the participants’ sense-making. Individual and unique experiences of the participants were explored, generating themes for the social workers through an immersive process of analysis for each case in turn. Superordinate themes were then identified across the group that revealed the complexity of social workers’ learning experiences. These were, Journey of the self; Navigating landscape and place; Navigating tasks; Learning through the body; Learning through others; Practices and conceptions of learning; and, Learning by chance. These aspects of the social workers’ lived experiences weave together in a complex and enmeshed web, each thread connected to the others as part of the learning process. Striking metaphors were used by social workers to convey the meaning they associated with their learning in the workplace. The thesis shows the nature and complexity of individual social workers’ experiences and how understanding these can help design more effective workplace continuing professional learning opportunities. Drawing on rich theoretical ideas from phenomenology and workplace learning, the thesis offers a hybrid conceptual web model for social work professional development. This model acknowledges the unique experience of social workers within a complex context involving navigation of task, place and embodied learning

Derivatives of dihydrostreptomycin

The work already carried out on the chemical modification of naturally occurring antibiotics is reviewed. The reasons for carrying out these modifications are discussed. Antibiotics which have been modified chemically in some way include the penicillins, the cephalosporins, the tetracyclines, griseofulvin and the aminoglycoside antibiotics including streptomycin itself. The value of these modifications varies from compound to compound, the most successful derivatives which have been prepared, to date, being the derivatives of penicillin. Compounds have been prepared which are more active, which are active orally and which are active against penicillinase producing micro-organisms. Derivatives of other antibiotics have, generally, been less successful, although valuable information about structure-action relationships has been obtained. The derivatives of dihydrostreptoraycin which are considered in this thesis are glycosides of dihyirostreptobiosamine, a disaccharide composed of dihydrostreptose linked glycosidically with N-methyl -L glucosamine. The methods available for glycoside synthesis, the Koenigs-Knorr, the Helferich and the Fischer syntheses, are reviewed. A modification of the Fischer synthesis was used for the preparation of the bensyl glycoside of dihydrostreptobiosamine, using methyl dihydrostreptoblosaminlde as starting material. No clear mechanism for this reaction has so far been postulated and therefore a series of reactions was carried out in order to elucidate the mechanism. A and B-methyl dihydrosterptobiosaminides were prepared and separated in the form of their acetates which were then used to prepare benzyl penta-acetyldihydrostreptobiosaminide by transglycosidation. The fact that the a-anomer was formed in both cases indicates that, every time, it is the more stable isomer which is formed. Direct benzyl alcoholysis of dihydrostreptomycin also gave a-benzyl penta-acetyldihydrostreptobiosaminide, confirming that theory. Methanolsys of a-benzyl-acetyldihydrosteptobiosaminide gave only the a-anomer of methyl penta-acetyldihdrostrantobiosaminide. There is some indication that the furanose ring of dihydrostraptose facilitates the reaction, in analogy with the Fisoher glycoside synthesis

High BMI and Low Muscular Fitness Predict Low Motor Competence in School-Aged Children Living in Low-Resourced Areas

Childhood obesity is a relatively new problem for Sub-Saharan developing countries. Especially in children with a low socioeconomic background, the link between motor competence, muscular fitness, and body mass index (BMI) remains poorly investigated. Due to the interrelatedness of BMI and physical fitness, the aim of this study is to determine the predictive value of these factors in relation to low motor competence in school-aged children living in low-resourced areas. Motor competence and physical fitness were assessed in 1037 school-aged Ghanaian and South African children using the Performance and Fitness test battery (PERF-FIT). “Low motor competence” was predicted using odds ratios calculated from backward logistic regression analyses. Low motor competence was less prevalent in Ghanaian children (3.7–11.1%) compared to the South African children (21.9–24.2%). Increased BMI and decreased muscular fitness predicted low motor competence in both Ghanaian and South African children. For example, the chance for a Ghanaian child to have low static balance increased by 22.8% (OR = 1.228, p &lt; 0.001) with a 1-point increase in BMI, whereas this decreased by 30.0% (OR = 0.970, p &lt; 0.001) with a 10-cm increase on the standing long jump. In the case of the South African children, if their BMI increased by 1 point, the chance for those children of having low static balance increased by 7.9%, and if their SLJ performance decreased by 10 cm, their chance of low performance increased by 13%. Clearly, motor competence is associated with both BMI and muscular fitness. Policy makers can use this information to counteract the establishment of childhood obesity by promoting weight control through physical activity and stimulating motor competence at school

Eliciting student teacher's views on educational research to support practice in the modern diverse classroom: a workshop approach

Teachers’ professionalism includes using educational research to support their work in the modern diverse classroom. Student teachers’ views as they enter the profession are therefore important. Within a Higher Education Academy social science priority research strand, ‘Supporting research-informed teacher education in a changing policy environment’, this study developed workshops to ascertain student teachers’ views on educational research, preparing materials suitable for primary and secondary sectors. These could be updated, and used by other higher education courses. Face-to-face or email workshops asked participants about their current uses of educational research, and to read and comment upon one policy research extract and one ‘what works’ research review. Small-scale piloting suggested the workshops readily elicited views, and students identified some personal changes following participation. Participants were generally unfamiliar with the principles of ‘what works’ research. Thematic analysis suggested students considered educational research was often inaccessible, but wanted accessible research to inform their practice

The effect of exergames on functional strength, anaerobic fitness, balance and agility in children with and without motor coordination difficulties living in low-income communities

Children with Developmental Coordination Disorder (DCD) are physically less active, preferring more sedentary behavior and are at risk of developing health problems or becoming overweight. 18 children (age 6-10 years) with lower levels of motor coordination attending a primary school in a low-income community in South Africa (score on Movement Assessment Battery for Children Second edition equal to or below the 5th percentile) were selected to participate in the study and were age-matched with typically developing peers (TD). Both groups of children engaged in 20 min of active Nintendo Wii Fit gaming on the balance board, twice a week for a period of five weeks. All children were tested before and after the intervention using the lower limb items of the Functional Strength Measurement, the 5 x 10 meter sprint test, the 5 x 10 meter slalom sprint test, and the Balance, Running speed and Agility subtest of the Bruininks Oseretsky Test of Motor Proficiency 2nd edition (BOT-2). After intervention, both groups of children improved in functional strength and anaerobic fitness. The magnitude of these changes was not related to participant's motor coordination level. However, differences in change between the TD and DCD group were apparent on the motor performance tests; children with DCD seemed to benefit more in balance skills of the BOT-2, while the TD children improved more in the Running speed and Agility component of the BOT-2. Compliance to the study protocol over 5 weeks was high and the effect,on physical functioning was shown on standardized measures of physical performance validated for children with and without DCD. (C) 2016 Elsevier B.V. All rights reserved