Translation and adaptation of an international questionnaire to measure usage of complementary and alternative medicine (I-CAM-G)

BACKGROUND: The growing body of data on prevalence of complementary and alternative medicine (CAM) usage means there is a need to standardize measurement on an international level. An international team has published a questionnaire0020 (I-CAM-Q), but no validation has yet been provided. The aim of the present study was to provide a German measurement instrument for CAM usage (I-CAM-G) which closely resembles the original English version, and to assess it's performance in two potential samples for measuring CAM usage. METHODS: The English I-CAM-Q questionnaire was translated into German, and adapted slightly. The resulting I-CAM-G questionnaire was then pre-tested on N=16 healthy volunteers, and 12 cognitive interviews were carried out. The questionnaire was employed in a sample of breast cancer patients (N=92, paper and pencil), and a sample from the general population (N=210, internet survey). Descriptive analyses of items and missing data, as well as results from the cognitive interviews, are presented in this paper. RESULTS: The translated questionnaire had to be adapted to be consistent with the German health care system. All items were comprehensible, whereby some items were unambiguous (e.g. CAM use yes/no, helpfulness), while others gave rise to ambiguous answers (e.g. reasons for CAM use), or high rates of missing data (e.g. number of times the CAM modality had been used during the last 3 months). 78% of the breast cancer patients and up to 85% of a sample of the general population had used some form of CAM. CONCLUSIONS: Following methodologically sound and comprehensive translation, adaptation and assessment processes using recognized translation procedures, cognitive interviews, and studying the performance of the questionnaire in two samples, we arrived at a German questionnaire for measuring CAM use which is comparable with the international (English) version. The questionnaire appropriately measures CAM use, with some items being more appropriate than others. We recommend the development of a short version

Uterine adenocarcinoma with abdominal metastases in an ovariohysterectomised female cat

An adenocarcinoma of the uterine stump with abdominal metastases is described in a 12-year-old incompletely ovariohysterectomised female Domestic Short Haired (DSH) cat. At the time of presentation the adenocarcinoma had metastasised to the right peri-renal lymph node, the abdominal aorta, and the right ureter, resulting in the formation of a large cystic structure. This had compressed and displaced surrounding structures including the abdominal vena cava and the right kidney, and formed multiple adhesions to the body wall and adjacent abdominal structures. Metastatic extension to the aorta had resulted in its regression into a 2mm diameter non-pulsatile vessel

Copy Skills and Writing Abilities in Children With and Without Specific Learning Disabilities

Copying a text quickly and accurately is important both in school and in daily life. However, this skill has never been systematically studied, either in children with typical development (TD) or in children with specific learning disabilities (SLD). The aim of this research was to study the features of a copy task and its relationship with other writing tasks. For this purpose, 674 children with TD and 65 children with SLD from Grades 6 through 8 were tested with a copy task and other writing assessment tasks, measuring three aspects of writing: handwriting speed, spelling, and expressive writing. Children with SLD performed worse on the copy task, both in terms of speed and accuracy, than children with TD. Copy speed was predicted by grade level and by all three major writing skills for children with TD but only by handwriting speed and spelling for children with SLD. Copy accuracy was predicted by gender and the three major writing skills for children with TD but only by spelling for children with SLD. These results suggest that children with SLD also have difficulty copying a text and benefit less than children with TD from their other writing skills

The role of working memory on writing processes.

Literature has extensively demonstrated the coordination role of working memory (WM) in complex tasks such as writing. However, previous studies mostly concentrated on the relation between passive WM (e.g., WM span) components and specific writing tasks (e.g., dictation). Here, we aimed to investigate the relationship between different writing skills and the performance on a WM updating task measuring the more active components of WM. From a pool of 160 Italian pupils (grades 3–5), we selected 46 children divided in two groups based on their WM updating performance. The first group consisted of 21 children with low WM updating performance (≤10th percentile), the second group consisted of 25 children with high WM updating performance (≥90th percentile). All children were tested on a battery of writing tasks to assess writing speed, orthographic skills, and competences in expressive writing. MANOVAs and a discriminant analysis were computed to assess group differences and the contribution of the different writing tests in correctly predicting group membership. The results revealed that children with high WM updating performance scored significantly higher than children with low WM updating performance on most of the writing tasks. These results highlight the relevant role of the active components of WM on writing processes. In addition, they suggest that the improvement of writing skills should rely not only on the training of the specific processes implied in this complex task, but also on the training of the cognitive processes that support them, such as active WM processes

A new method for the estimate of H_0 from quadruply imaged gravitational lens systems

We present a new method to estimate the Hubble constant H_0 from the measured time delays in quadruply imaged gravitational lens systems. We show how it is possible to get an estimate of H_0 without the need to completely reconstruct the lensing potential thus avoiding any a priori hypotheses on the expression of the galaxy lens model. Our method only needs to assume that the lens potential may be expressed as r^{\alpha} F(\theta), whatever the shape function F(\theta) is, and it is thus able to fully explore the degeneracy in the mass models taking also into account the presence of an external shear. We test the method on simulated cases and show that it does work well in recovering the correct value of the slope \alpha of the radial profile and of the Hubble constant H_0. Then, we apply the same method to the real quadruple lenses PG1115+080 and B1422+231 obtaining H_0 = 58_{-15}^{+17} km/s/Mpc (68% CL).Comment: 12 pages, 5 figures, accepted for publication on Astronomy & Astrophysic

Delivering reform in English healthcare: an ideational perspective

A variety of perspectives has been put forward to understand reform across healthcare systems. Recently, some have called for these perspectives to give greater recognition to the role of ideational processes. The purpose of this article is to present an ideational approach to understanding the delivery of healthcare reform. It draws on a case of English healthcare reform – the Next Stage Review led by Lord Darzi – to show how the delivery of its reform proposals was associated with four ideational frames. These frames built on the idea of “progress” in responding to existing problems; the idea of “prevailing policy” in forming part of a bricolage of ideas within institutional contexts; the idea of “prescription” as top-down structural change at odds with local contexts; and the idea of “professional disputes” in challenging the notion of clinical engagement across professional groups. The article discusses the implications of these ideas in furthering our understanding of policy change, conflict and continuity across healthcare settings