1,086 research outputs found

    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

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    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

    The Energy Sector and Groundwater

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    Derivatives of dihydrostreptomycin

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    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

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    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
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