A Study of Convergent Validity Between the Adjustment Scales for Children and Adolescents (ASCA) and the Behavior Assessment System for Children-Teacher Rating Scale (BASC-TRS)

The Adjustment Scales for Children and Adolescents (ASCA) and the Behavior Assessment System for Children-Teacher Rating Scale (BASC-TRS) are two relatively new behavior assessment devices designed to measure youth problem behavior. Both scales are designed to be completed by the child\u27s classroom teacher and evaluated by qualified professionals. Both scales are unique in their construction and are considered to be technically adequate. Many of their syndromes/subscales and global scales/composites are similar in their name, nature, and descriptions according to their respective manuals. However, no research has been conducted establishing convergent evidence of construct validity between the two instruments. The present study attempted to provide this needed research by directly comparing the ASCA and BASC-TRS. A sample of children (n=52) referred for special education evaluation were participants in the study. Regular education teachers were asked to complete both scales on each child they referred. Comparisons between the two scales were studied through correlational analysis. Results indicated preliminary evidence for convergent validity between the two instruments on the core syndrome/subscale level with several correlation coefficients ranging from .50 to .70 for scales measuring similar traits. On the global scale/composite level, convergent validity was only established between the ASCA Overactivity global scale and the BASC-TRS externalizing composite. Nonsignificant mean differences between ratings on the two scales yielded further evidence of convergent validity among like syndromes/subscales and global scales/composites. The information provided in this study is beneficial to school psychologists and other educational professionals looking for a more psychometrically sound, less subjective methods of assessing problem behavior among youths

Pharmacokinetics of antimicrobial agents in anuric patients during continuous venovenous haemofiltration

Background. The optimal drug dosing in anuric patients undergoing continuous haemofiltration is a difficult task. More pharmacokinetic data is needed to derive practical guidelines for dosage adjustments. Methods. Drug elimination of various antimicrobial agents (amikacin, amoxycillin, ceftazidime, ciprofloxacin flucloxacillin, imipenem, netilmicin, penicillin G, piperacillin, sulphamethoxazole, tobramycin, vancomycin) was studied in 24 patients with acute renal failure treated by pump-assisted continuous venovenous haemofiltration (CVVH). Concentrations of serial blood and ultrafiltrate samples were determined by HPLC or by fluorescence polarization immunoassay. Total body clearance (CL) and haemofilter clearance (CLf) rates were determined by standard model-independent equations. Data from published literature on fractions not bound to proteins (fu), non-renal drug clearance fractions (Qo) and normal clearance values (CLn) were used to derive a pharmacokinetic model, taking into account drug removal by ultrafiltration and by non-renal clearance. Results. A total of 37 treatment periods was studied. Blood flow through the haemofilters was 100 ml/min resulting in an average ultrafiltrate flow rate (UFR) of 13.2±4.6 (range 3.2-22.1) ml/min. Acceptable correlations of calculated and measured haemofilter clearances and total body clearances were obtained. Conclusions. Total body clearance in anuric patients during CVVH is predictable from drug properties, which are generally known. The individual dosage requirements may be calculated by multiplying Qo+fu UFR/CLn with the dose considered appropriate in the absence of renal impairmen

New challenges in studying nutrition-disease interactions in the developing world.

Latest estimates indicate that nutritional deficiencies account for 3 million child deaths each year in less-developed countries. Targeted nutritional interventions could therefore save millions of lives. However, such interventions require careful optimization to maximize benefit and avoid harm. Progress toward designing effective life-saving interventions is currently hampered by some serious gaps in our understanding of nutrient metabolism in humans. In this Personal Perspective, we highlight some of these gaps and make some proposals as to how improved research methods and technologies can be brought to bear on the problems of undernourished children in the developing world

The Global Health System: Lessons for a Stronger Institutional Framework

Governmen

Weekly low-dose treatment with intravenous iron sucrose maintains iron status and decreases epoetin requirement in iron-replete haemodialysis patients

Background. Haemodialysis patients need sustained treatment with intravenous iron because iron deficiency limits the efficacy of recombinant human epoetin therapy in these patients. However, the optimal intravenous iron maintenance dose has not been established yet. Methods. We performed a prospective multicentre clinical trial in iron-replete haemodialysis patients to evaluate the efficacy of weekly low-dose (50 mg) intravenous iron sucrose administration for 6 months to maintain the iron status, and to examine the effect on epoetin dosage needed to maintain stable haemoglobin values in these patients. Fifty patients were enrolled in this prospective, open-label, single arm, phase IV study. Results. Forty-two patients (84%) completed the study. After 6 months of intravenous iron sucrose treatment, the mean ferritin value showed a tendency to increase slightly from 405 ± 159 at baseline to 490 ± 275 µg/l at the end of the study, but iron, transferrin levels and transferrin saturation did not change. The haemoglobin level remained stable (12 ± 1.1 at baseline and 12.1 ± 1.5 g/dl at the end of the study). The mean dose of darbepoetin alfa could be reduced from 0.75 to 0.46 µg/kg/week; epoetin alfa was decreased from 101 to 74 IU/kg/week; and the mean dose of epoetin beta could be reduced from 148 to 131 IU/kg/week at the end of treatment. Conclusions. A regular 50 mg weekly dosing schedule of iron sucrose maintains stable iron stores and haemoglobin levels in haemodialysed patients and allows considerable dose reductions for epoetins. Low-dose intravenous iron therapy may represent an optimal approach to treat the continuous loss of iron in dialysis patient

Interleukin-1©¬ (IL-1©¬), IL-1 receptor antagonist, and TNF¥á production in whole blood

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