Correlation between Language Development and Motor Skills, Physical Activity, and Leisure Time Behaviour in Preschool-Aged Children

Sedentary behaviour has a negative impact on children's physical and mental health. However, limited data are available on language development. Therefore, this pilot study aimed to analyse the associations between language development and possible predictors such as motor skills and leisure time behaviour in preschool-aged children. Methods: In this cross-sectional analysis, motor skills and speech development status were assessed in 49 healthy preschool children. Physical activity and screen time were assessed via a parental questionnaire. Results: On average, physical activity was 8.2 +/- 6.5 h/week; mean screen time was 154.2 +/- 136.2 min/week. A positive relationship between the results in the item 'One-leg stand' and 'Phonological working memory for nonwords' (beta-coefficient -0.513; p < 0.001) resp. 'Formation of morphological rules' (beta-coefficient -0.626; p = 0.004) was shown within backward stepwise regression. 'Lateral jumping', resp. 'Sit and Reach' were positively associated with 'Understanding sentences' (beta-coefficient 0.519; p = 0.001 resp. beta-coefficient 0.735; p = 0.002). 'Physical inactivity' correlated negatively with all language development subtests (each p < 0.05). Media consumption had a negative predictive effect on the subdomain 'Understanding Sentences' (beta-coefficient -0.530, p = 0.003). Conclusions: An inactive lifestyle correlated negatively with selected subtests of language development in early childhood. These results should be verified in larger groups and longitudinally but support the need for early health promotion

Versicherungsmedizin und die Cochrane Collaboration

36Die Cochrane Collaboration, ein weltweites Netzwerk aus praktizierenden Ärzten und Wis-senschaftlern, hat sich zum Ziel gesetzt, die wissenschaftliche Evidenz zur Gesundheits- und Krankenversorgung aufzufinden, zusammen-zufassen und zur Verfügung zu stellen, um die Zeitspanne zwischen Forschungserkenntnis und Anwendung in der Praxis zu verkürzen. Diese Vision traf den Nerv aller Gesundheitssysteme und erklärt die weltweite Verbreitung der Cochrane Collaboration innerhalb von 20 Jah-ren. Auch die Schweiz hat seit Oktober 2010 ihr Cochrane Zentrum. Die Versicherungsmedizin hat einen enormen Bedarf an wissenschaftlichen Grundlagen, der bisher nur ungenügend adressiert wird. Der Artikel legt dar, wie ein Cochrane Feld Versiche-rungsmedizin helfen könnte, das vorhandene versicherungsmedizinische Forschungswissen zusammenzutragen, Wissensdefizite zu benen-nen und diese auf einer (inter-) nationalen For-schungsagenda zu priorisieren

The reproducibility of psychiatric evaluations of work disability: two reliability and agreement studies

Expert psychiatrists conducting work disability evaluations often disagree on work capacity (WC) when assessing the same patient. More structured and standardised evaluations focusing on function could improve agreement. The RELY studies aimed to establish the inter-rater reproducibility (reliability and agreement) of 'functional evaluations' in patients with mental disorders applying for disability benefits and to compare the effect of limited versus intensive expert training on reproducibility.; We performed two multi-centre reproducibility studies on standardised functional WC evaluation (RELY 1 and 2). Trained psychiatrists interviewed 30 and 40 patients respectively and determined WC using the Instrument for Functional Assessment in Psychiatry (IFAP). Three psychiatrists per patient estimated WC from videotaped evaluations. We analysed reliability (intraclass correlation coefficients [ICC]) and agreement ('standard error of measurement' [SEM] and proportions of comparisons within prespecified limits) between expert evaluations of WC. Our primary outcome was WC in alternative work (WC; alternative.work; ), 100-0%. Secondary outcomes were WC in last job (WC; last.job; ), 100-0%; patients' perceived fairness of the evaluation, 10-0, higher is better; usefulness to psychiatrists.; Inter-rater reliability for WC; alternative.work; was fair in RELY 1 (ICC 0.43; 95%CI 0.22-0.60) and RELY 2 (ICC 0.44; 0.25-0.59). Agreement was low in both studies, the 'standard error of measurement' for WC; alternative.work; was 24.6 percentage points (20.9-28.4) and 19.4 (16.9-22.0) respectively. Using a 'maximum acceptable difference' of 25 percentage points WC; alternative.work; between two experts, 61.6% of comparisons in RELY 1, and 73.6% of comparisons in RELY 2 fell within these limits. Post-hoc secondary analysis for RELY 2 versus RELY 1 showed a significant change in SEM; alternative.work; (- 5.2 percentage points WC; alternative.work; [95%CI - 9.7 to - 0.6]), and in the proportions on the differences ≤ 25 percentage points WC; alternative.work; between two experts (p = 0.008). Patients perceived the functional evaluation as fair (RELY 1: mean 8.0; RELY 2: 9.4), psychiatrists as useful.; Evidence from non-randomised studies suggests that intensive training in functional evaluation may increase agreement on WC between experts, but fell short to reach stakeholders' expectations. It did not alter reliability. Isolated efforts in training psychiatrists may not suffice to reach the expected level of agreement. A societal discussion about achievable goals and readiness to consider procedural changes in WC evaluations may deserve considerations