Validity and Accuracy of the Tilburg Frailty Indicator Part B for Identification of Frailty in Older Adults Consulting a Rural Geriatric Medicine Clinic

The Tilburg Frailty Indicator (TFI) is a validated tool for determining frailty in older adults. This study examined the validity and accuracy of the TFI Part B (TFI-B) in a North American context. Seventy-two individuals ≥ 65 years of age recruited from a rural geriatric medicine clinic completed a set of self-reported and performance-based measures, including TFI-B. Frailty level was determined using modified Fried's Frailty Phenotype (FFP). Pearson correlation coefficients (r) assessed the concurrent relationships between the TFI-B and other measures. Accuracy of the TFI-B in classifying frailty level was assessed using assessing area under the curve (AUC). The TFI-B scores showed low correlations (r < 0.4) with gait speed and grip, suggesting that the TFI-B did not consider frailty as merely a physical problem. The AUC of 0.82 indicated that the TFI-B scores accurately classified frail versus non-frail individuals. The score of ≥ 5 on the TFI-B scores showed satisfactory sensitivity/specificity (73%/77%) and excellent negative predictive value (91.95%). This indicates that a TFI-B score of < 5 can be used to rule out frailty.

Measurement properties of the Physical Literacy Assessment for Youth (PLAY) Tools

The Physical Literacy Assessment for Youth (PLAY) Tools are a suite of tools to assess an individual's physical literacy. The purpose of this study is to examine the psychometric properties of the PLAY Tools, including inter-rater reliability, internal consistency, validity and the associations between the tools. In this study, 218 children and youth (aged 8.4 to 13.7 years) and a parent/guardian completed the appropriate physical literacy assessments (i.e., PLAYbasic, PLAYfun, PLAYparent and PLAYself) and the Bruiniks-Oseretsky Test of Motor Proficiency (BOT-2). Inter-rater reliability for PLAYfun was excellent (intraclass correlation coefficient = 0.94). The PLAYbasic, PLAYfun total, running and object control scores, and PLAYparent motor competence domain were higher in males than females, and PLAYfun locomotor skills were lower in males than females (p < 0.05). Age was positively correlated with PLAYbasic and PLAYfun (r = 0.14-0.32, p < 0.05). BOT-2 was positively correlated with PLAYfun and PLAYbasic (r = 0.19-0.59, p < 0.05). PLAYbasic is a significant predictor of PLAYfun (r² = 0.742, p < 0.001). PLAYfun, PLAYparent and PLAYself were moderately correlated with one another. PLAYfun, PLAYparent and PLAYself demonstrated acceptable internal consistency (α = 0.74-0.87, ω = 0.73-0.87). The PLAY Tools demonstrated moderate associations between one another, strong inter-rater reliability and good construct and convergent validity. Continued evaluation of these tools with other populations, such as adolescents, is necessary. Novelty: In school-age children, the PLAY Tools demonstrated strong inter-rater reliability, moderate associations with one another, acceptable internal consistency and good construct and convergent validity. The results suggest that that PLAY Tools are an acceptable method of evaluation for physical literacy in school-age children.

A Systematic Review of the Psychometric Properties of the Geriatric Anxiety Inventory

The Geriatric Anxiety Inventory (GAI) and its short form (GAI-SF) are self-reported scales used internationally to assess anxiety symptoms in older adults. In this study, we conducted the first critical comprehensive review of these scales' psychometric properties. We rated the quality of 31 relevant studies with the COSMIN checklist. Both the GAI and GAI-SF showed adequate internal consistency and test-retest reliability. Convergent validity indices were highest with generalized anxiety measures; lowest with instruments relating to somatic symptoms. We detected substantial overlap with depression measures. While there was no consensus on the GAI's factorial structure, we found the short version to be unidimensional. Although we found good sensitivity and specificity for detecting anxiety, cut-off scores varied. The GAI and GAI-SF are relevant instruments showing satisfactory psychometric properties; to broaden their use, however, some psychometric properties warrant closer examination. This review calls attention to weaknesses in the methodological quality of the studies.

The My Emotions Questionnaire: A self-report of mothers' emotional responses to infant crying

The purpose of this article was to examine the psychometrics of the My Emotions Questionnaire, a self-report designed to assess mothers' emotional reactions when their infants cry. Participants were 240 first-time mothers. When infants were 6 months and 1 year old, mothers completed the new questionnaire and measures assessing beliefs and behavioral responses to infant crying, and interview-based measures of mothers' emotional reactions and causal attributions about crying were administered. Maternal sensitivity and negative behaviors were observed when infants were 6 months and 1 and 2 years old. Mothers reported on their discipline practices when children were 2 years old. Five emotion factors emerged based on exploratory factor analysis (EFA) of the 6-month data: Amusement, Anxiety, Frustration, Sympathy, and Protective. The five-factor structure was supported via a confirmatory factor analysis (CFA) of the 1-year data. All scales demonstrated adequate internal consistency reliability and significant stability from 6 months to 1 year. Amusement, Frustration, and Protectiveness demonstrated the best convergent validity with cry cognitions and predictive validity to parenting measures, followed by Anxiety, although effects tended to be small to moderate. Evidence for the validity of Sympathy was less compelling. The potential utility of the questionnaire for basic and applied research is discussed.

Validity and reliability of methods to microscopically detect and quantify malaria parasitaemia

OBJECTIVES

The recommended microscopy method by WHO to quantify malaria parasitaemia yields inaccurate results when individual leucocyte (WBC) counts deviate from 8000 leucocytes/μl. A method avoiding WBC count assumptions is the Lambaréné method (LAMBA). Thus, this study compared validity and reliability of the LAMBA and the WHO method.

METHODS

Three methods for counting parasitaemia were applied in parallel in a blinded assessment: the LAMBA, the WHO method using a standard factor of 8000 leucocytes/μl ['simple WHO method' (sWHO)] and the WHO method using measured WBC counts ['accurate WHO method' (aWHO)]. Validity was assessed by comparing LAMBA and sWHO to the gold standard measurement of aWHO. Reliability was ascertained by computation of intraclass correlation coefficients (ICCs).

RESULTS

787 malaria-positive thick smears were analysed. Parasitaemia as determined by LAMBA and sWHO increasingly deviated from aWHO the more patients' WBCs diverged from 8000/μl. Equations of linear regression models assessing method deviation in percent from gold standard as function of WBC count were y = -0.00608x (95% CI -0.00693 to -0.00524) + 47.8 for LAMBA and y = -0.0125x (95% CI -0.01253 to -0.01247) + 100.1 for sWHO. Comparison of regression slopes showed that the deviation was twice as high for sWHO as for LAMBA (P < 0.001). ICCs were excellent (>90%) for both methods.

CONCLUSIONS

The LAMBA has higher validity than the sWHO and may therefore be preferable in resource-limited settings without access to routine WBC-evaluation.

A pilot study: Validity and reliability of the CSEP-PATH PASB-Q and a new leisure time physical activity questionnaire to assess physical activity and sedentary behaviours

The purpose of this study was to evaluate the accuracy of 2 newly developed physical activity questionnaires: the Canadian Society for Exercise Physiology (CSEP) Physical Activity and Sedentary Behaviour Questionnaire (PASB-Q) and a newly modified Leisure-Time Physical Activity Questionnaire (mLTPA-Q). These questionnaires were compared with objective measurements of physical activity and fitness (accelerometry and physiological assessments) in 35 adults, before and after a week of daily living activity. Objectively measured moderate- to vigorous-intensity aerobic physical activity (MVPA) was moderately correlated with the PASB-Q's physical activity vital sign (PAVS) (r = 0.50, p = 0.004) and the mLTPA-Q (r = 0.56, p = 0.001). Bland-Altman plots suggest minimal bias from self-reported to objective measures of MVPA. The ability of PAVS to accurately distinguish who does and does not achieve Canadian physical activity guidelines was 83% and 60%, respectively, compared with 82% and 73% of the mLTPA-Q. Self-reported sedentary time was greatly underestimated in the PASB-Q compared with the objective measure (6.4 ± 3.5 vs 12.2 ± 1.2 h/day). The results of this study suggest the PASB-Q and mLTPA-Q are valid and reliable measures of adult physical activity and provide reasonable indication of those individuals who meet physical activity guidelines. Future questionnaire development should take into account the underestimation of time spent engaging in sedentary activities.

CIHR Candrive Cohort Comparison with Canadian Household Population Holding Valid Driver's Licenses

We investigated whether convenience sampling is a suitable method to generate a sample of older drivers representative of the older-Canadian driver population. Using equivalence testing, we compared a large convenience sample of older drivers (Candrive II prospective cohort study) to a similarly aged population of older Canadian drivers. The Candrive sample consists of 928 community-dwelling older drivers from seven metropolitan areas of Canada. The population data was obtained from the Canadian Community Health Survey - Healthy Aging (CCHS-HA), which is a representative sample of older Canadians. The data for drivers aged 70 and older were extracted from the CCHS-HA database, for a total of 3,899 older Canadian drivers. Two samples were demonstrated as equivalent on socio-demographic, health, and driving variables that we compared, but not on driving frequency. We conclude that convenience sampling used in the Candrive study created a fairly representative sample of Canadian older drivers, with a few exceptions.

[Translation and validation of the Life Balance Inventory: An occupational therapy questionnaire]

BACKGROUND

Despite the interest in the concept of life balance, no questionnaire is currently available in French to measure it well.

PURPOSE

This study aimed to translate the Life Balance Inventory (Objective 1) and to verify the convergent validity of the French version (Objective 2).

METHOD

A cross-cultural validation was first carried out, followed by a cross-sectional descriptive study, with 152 adults ages 40 and over, with and without physical disabilities. Questionnaires were used to measure the following variables, life balance, stress, health, and quality of life.

RESULTS

A better life balance is associated with a lower degree of stress (r = -.36; p < .01) as well as higher physical health (r = .42; p = .01), mental health (r = .36; p = .01), and quality of life (r = .54; p < .01).

IMPLICATIONS

The French version of the Life Balance Inventory is a valid questionnaire to assist occupational therapists when assessing time use of their clients.

Dyadic Adjustment Scale: a validation study among older French-Canadians living in relationships

The principal objective of this study, the first of its kind to use this population, is to describe the factor analysis and validity of the Dyadic Adjustment Scale (EAD) among 895 French Canadian seniors living as couples. A confirmatory factor analysis was carried out using structural equation modeling. Results support Spanier's hierarchical model questionnaire (1976). Results also indicate evidence of validity and reliability satisfactorily set aside for the Affective Expression subscale having a lower Cronbach alpha coefficient. The results also indicate strong validity of the scale according to indices of convergent and discriminant validity. Finally, a discussion is presented addressing considerations to be taken into account for using the questionnaire among older couples.

[A validation of the Social Provisions Scale: the SPS-10 items]

The Social Provisions Scale-10 item (SPS-10) is a shortened version of the Social Provisions Scale (Cutrona and Russell, 1987) validated in French (Échelle de provisions sociales) by Caron (1996). The Social Provisions Scale (SPS) originally consisted of six subscales to measure the availability of social support: emotional support or attachment, social integration, reassurance of worth, tangible help, orientation and opportunity for nurturance. Four items allowed measuring of each subscales, two formulated positively and two negatively for a total of 24 items. The SPS-10 retains five subscales, opportunity for nurturance was excluded and it only keeps the positively worded items, two items per dimension of support. The article presents its validation on a representative sample of 2433 people of the general population of the southwest region of Montreal. It has a strong concurrent validity with the original scale of 24 items (SPS) (r = 0.930). All its items are highly correlated with total scores and its internal consistency is excellent. The alpha for the global scale is 0.880 and the alphas for the five subscales ranged from 0.528 to 0.690. Its construct validity is also preserved. The SPS-10 has an independence of its dimensions with moderate correlations between the subscales ranging between 0.469 and 0.632 and its five subscales are more strongly related to the support global score (r minimum = 0.755 p <0.001 and r maximum = 0.835), indicating that they are also indicators of the availability of social provisions. An exploratory factor analysis allows finding almost the same factors structure than the French version of SPS. The SPS-10 explains 14.1% of the variance in psychological distress and retains 95% of the predictive power of the SPS-24 items and all its subscales are negatively correlated with psychological distress. It also explains 25.4% of the variance in quality of life and its predictive power is equivalent to the SPS-24 items and all its subscales are positively correlated to QOL. The analyses suggest that the SPS-10 is a reliable and valid instrument for measuring the availability of social support with an administration time reduced by half. It is an excellent choice for epidemiological surveys.

Maternal recall of birthweight and birth size in Entebbe, Uganda

OBJECTIVES

To assess the reliability of maternally recalled birthweight and size in Entebbe, Uganda.

METHODS

The study population comprised 404 mothers, who were participants in the Entebbe Mother and Baby Study (EMaBS). Mothers were recruited to EMaBS during antenatal care, maternal characteristics were recorded during pregnancy, and birthweight was recorded at delivery. Four to seven years after delivery, mothers were asked to recall the child's birthweight and size. Their responses were compared with the birthweight recorded in the EMaBS database.

RESULTS

Of 404 interviewed mothers, 303 (75%) were able to give an estimate of birthweight and for 265 of these EMaBS data on recorded birthweights were available. Women who were educated and whose children had low birth order were more likely to be able to give an estimate: 37 (14%) recalled the exact recorded birthweight; a further 52 (20%) were accurate to within 0.1 kg of the recorded weight. On average, mothers overestimated birthweight by 0.06 kg (95% CI: 0.00-0.13 kg, P = 0.04). Recalled and recorded birthweights showed moderate agreement with an intraclass correlation coefficient of 0.64. Four hundered mothers gave an estimate of birth size: the sensitivity and specificity of recalled birth size for classifying low birthweight were 76% (95% CI: 50-93%) and 70% (95% CI: 65-75%), respectively.

CONCLUSIONS

Mothers' recall of birthweight was not precise but in absence of other data, recall of birthweight and size may have some value in epidemiological studies in these settings.

A shortened version of the Western ontario rotator cuff disability index: development and measurement properties

PURPOSE

The objective of this study was to develop and examine the measurement properties of a shortened version of the Western Ontario Rotator Cuff Index (WORC), the SHORTWORC, in individuals with rotator-cuff pathology.

METHODS

The study occurred in two stages, both using secondary analysis of existing data sets. The first stage used cross-sectional data from candidates for rotator-cuff surgery to develop the SHORTWORC. The second stage examined various measurement properties of the SHORTWORC by analyzing scores from the WORC, the American Shoulder and Elbow Surgeons questionnaire, and the Constant-Murley score obtained from patients before and after rotator-cuff surgery. Approaches to validating the SHORTWORC included calculating the standard error of measurement (SEM) at an instant in time, performing a confirmatory factor analysis, correlating findings among the questionnaires, and examining differences between men and women. Sensitivity to change was investigated using standardized response mean and relative efficiency.

RESULTS

Data for 712 patients were used to develop the SHORTWORC, the final version of which consisted of 7 questions. Data for 166 patients (86 men, 80 women; mean age 57±11 years) were used for validation. The SEM based on internal consistency (SEMIC) was calculated as 7.43 SHORTWORC points. The SHORTWORC had similar convergent validity (r=0.72-0.82) and sensitivity to change (SRM=1.20 vs. 1.25, p>0.05) to the longer version. The relative efficiency of the SHORTWORC was 3.19 times that of the WORC (95% CI, 1.50-71.51) in discriminating men's from women's level of disability.

CONCLUSIONS

The SHORTWORC has indicators of validity, relative efficiency, and sensitivity to change comparable to those of the original version but has a smaller response burden.

Purpose: The objective of this study was to develop and examine the measurement properties of a shortened version of the Western Ontario Rotator Cuff Index (WORC), the SHORTWORC, in individuals with rotator-cuff pathology. Methods: The study occurred in two stages, both using secondary analysis of existing data sets. The first stage used cross-sectional data from candidates for rotator-cuff surgery to develop the SHORTWORC. The second stage examined various measurement properties of the SHORTWORC by analyzing scores from the WORC, the American Shoulder and Elbow Surgeons questionnaire, and the Constant–Murley score obtained from patients before and after rotator-cuff surgery. Approaches to validating the SHORTWORC included calculating the standard error of measurement (SEM) at an instant in time, performing a confirmatory factor analysis, correlating findings among the questionnaires, and examining differences between men and women. Sensitivity to change was investigated using standardized response mean and relative efficiency. Results: Data for 712 patients were used to develop the SHORTWORC, the final version of which consisted of 7 questions. Data for 166 patients (86 men, 80 women; mean age 57±11 years) were used for validation. The SEM based on internal consistency (SEM_IC) was calculated as 7.43 SHORTWORC points. The SHORTWORC had similar convergent validity (r=0.72−0.82) and sensitivity to change (SRM=1.20 vs. 1.25, p>0.05) to the longer version. The relative efficiency of the SHORTWORC was 3.19 times that of the WORC (95% CI, 1.50–71.51) in discriminating men's from women's level of disability. Conclusions: The SHORTWORC has indicators of validity, relative efficiency, and sensitivity to change comparable to those of the original version but has a smaller response burden.