Development of the behaviour observation scale for psychomotor therapy for elderly people with dementia (BPMT-dem). Reliability and concurrent validity

This article describes the development of the Behaviour observation scale for Psychomotor Therapy for elderly people with dementia (BPMT-dem). This scale was developed in the late 1980s in order to evaluate the effect of psychomotor group therapy on the cognitive, social, and emotional functioning of elderly people with dementia within the therapy situation. The currently described research investigates inter-assessor reliability and internal consistency of the ten subscales (such as memory, orientation, contact with others, initiative, anxious behaviour, aggressive behaviour) and three domains, as well as the scale's correlation with other observation scales (concurrent validity) in two different patient groups. The first group consisted of clients receiving psychomotor therapy in a nursing home or a psychiatric hospital (N = 130). Inter-assessor reliability (Cohen's kappa) varied between 0.27 and 1.00 the internal consistency of the subscales (Cronbach's alpha) was calculated between 0.46 and 0.86, and that of the domains between 0.76 and 0.81. Based on the findings of this study 15 of the original 88 items were removed, 5 items were moved to other subscales and the text of 2 items was changed. Next, the subscale internal consistency and concurrent validity of this modified (73-item version) BPMT-dem was investigated in a group of 41 elderly participating in a support programme in meeting centres for elderly people with dementia and their caregivers. Cronbach's alpha for the subscales in this study was calculated between 0.47 and 0.86. To determine concurrent validity, the BPMT-dem was compared with (subscales of) the Assessment Scale for Elderly Patients (ASEP), Behavioural assessment for Intramural Psychogeriatrics (BIP), Brief Cognitive Rating Scale (BCRS) and the Cornell Scale for Depression in Dementia. Correlations with related BPMT-dem subscales varied between 0.38 and 0.75. The inter-assessor reliability and concurrent validity of the 73-item version of the BPMT-dem are satisfactory. The internal consistency of 6 subscales is sufficient, and recommendations are proposed to improve the consistency of the remaining subscales. Further research to test the unidimensionality and scalability of the subscales of the BPMT-dem, as well as the effect of the recommended reformulation and removal of items, is recommended. Before the instrument can be used in actual practice, the psychometric qualities of the BPMT-dem73 need to be studied in a larger and in terms of severity of dementia more heterogeneous study sample, so that statements can also be made on which norms to use in various subgroups of elderly with dementia.     

Reliability and validity of body composition measures in female athletes.

The purpose of this investigation was to determine the reliability and validity of bioelectrical impedance (BIA) and near-infrared interactance (NIR) for estimating body composition in female athletes. Dual-energy X-ray absorptiometry was used as the criterion measure for fat-free mass (FFM). Studies were performed in 132 athletes [age = 20.4 +/- 1.5 (SD) yr]. Intraclass reliabilities (repeat and single trial) were 0.987-0.997 for BIA (resistance and reactance) and 0.957-0.980 for NIR (optical densities). Validity of BIA and NIR was assessed by double cross-validation. Because correlations were high (r = 0.969-0.983) and prediction errors low, a single equation was developed by using all 132 subjects for both BIA and NIR. Also, an equation was developed for all subjects by using height and weight only. Results from dual-energy X-ray absorptiometry analysis showed FFM = 49.5 +/- 6.0 kg, which corresponded to %body fat (%BF) of 20.4 +/- 3.1%. BIA predicted FFM at 49.4 +/- 5.9 kg (r = 0.981, SEE = 1.1), and NIR prediction was 49. 5 +/- 5.8 kg (r = 0.975, SEE = 1.2). Height and weight alone predicted FFM at 49.4 +/- 5.7 kg (r = 0.961, SEE = 1.6). When converted to %BF, prediction errors were approximately 1.8% for BIA and NIR and 2.9% for height and weight. Results showed BIA and NIR to be extremely reliable and valid techniques for estimating body composition in college-age female athletes.     

Reliability and validity of the Ethiopian version of the hospital anxiety and depression scale (HADS) in HIV infected patients

Background

The hospital anxiety and depression scale (HADS) is a widely used instrument for evaluating psychological distress from anxiety and depression. HADS has not yet been validated in Ethiopia. The aim of this study was to evaluate the reliability and validity of the Amharic (Ethiopian language) version of HADs among HIV infected patients.

Methods

The translated scale was administered to 302 HIV/AIDS patients on follow up for and taking anti-retroviral treatment. Consistency assessment was conducted using Cronbach''s alpha, test-retest reliability using intra-class correlation coefficients (ICC). Construct validity was examined using principal components analysis (PCA). Parallel analysis, Kaiser''s criterion and the scree test were used for factor extraction.

Results

The internal consistency was 0.78 for the anxiety, 0.76 for depression subscales and 0.87 for the full scale of HADS. The intra-class correlation coefficient (ICC) was 80%, 86%, and 84% for the anxiety and depression subscales, and total score respectively. PCA revealed a one dimensional scale.

Conclusion

This preliminary validation study of the Ethiopian version of the HADs indicates that it has promising acceptability, reliability and validity. The adopted scale has a single underlying dimension as indicated by Razavi''s model. The HADS can be used to examine psychological distress in HIV infected patients. Findings are discussed and recommendations made.     

Reliability and validity of two isometric squat tests

The purpose of the present study was first to examine the reliability of isometric squat (IS) and isometric forward hack squat (IFHS) tests to determine if repeated measures on the same subjects yielded reliable results. The second purpose was to examine the relation between isometric and dynamic measures of strength to assess validity. Fourteen male subjects performed maximal IS and IFHS tests on 2 occasions and 1 repetition maximum (1-RM) free-weight squat and forward hack squat (FHS) tests on 1 occasion. The 2 tests were found to be highly reliable (intraclass correlation coefficient [ICC](IS) = 0.97 and ICC(IFHS) = 1.00). There was a strong relation between average IS and 1-RM squat performance, and between IFHS and 1-RM FHS performance (r(squat) = 0.77, r(FHS) = 0.76; p < 0.01), but a weak relation between squat and FHS test performances (r < 0.55). There was also no difference between observed 1-RM values and those predicted by our regression equations. Errors in predicting 1-RM performance were in the order of 8.5% (standard error of the estimate [SEE] = 13.8 kg) and 7.3% (SEE = 19.4 kg) for IS and IFHS respectively. Correlations between isometric and 1-RM tests were not of sufficient size to indicate high validity of the isometric tests. Together the results suggest that IS and IFHS tests could detect small differences in multijoint isometric strength between subjects, or performance changes over time, and that the scores in the isometric tests are well related to 1-RM performance. However, there was a small error when predicting 1-RM performance from isometric performance, and these tests have not been shown to discriminate between small changes in dynamic strength. The weak relation between squat and FHS test performance can be attributed to differences in the movement patterns of the tests     

Reliability and validity of bioelectrical impedance in determining body composition

This study was designed to examine the reliability and validity of the bioelectrical impedance method (BIA) of measuring body composition and compare its accuracy with the results obtained by standard anthropometric methods BIA, skinfold fat, and hydrostatically measured percent fat (% fat) were obtained on 44 women and 24 men. Each subject was tested four times by two testers on two different days. Generalizability theory was used to estimate reliability and measurement error that considered both day-to-day and intertester error. The BIA, skinfold fat, and hydrostatic methods were all found to be reliable (Rxx = 0.957-0.987) with standard errors ranging from 0.9 to 1.5% fat. An additional 26 men (n = 50) and 38 women (n = 82) were tested once and combined with the data used for the reliability analysis to cross-validate BIA estimates of % fat with hydrostatically determined % fat. The cross-validation correlations for the BIA determinations of % fat ranged from 0.71 to 0.76, which were significantly lower than that obtained with the sum of seven (sigma 7) skinfolds equations (rxy = 0.92 for men and 0.88 for women). The correlations between the weight-to-height ratio body mass index (BMI) and hydrostatically determined % fat were 0.75 and 0.74 for men and women, respectively. The standard errors of estimate for the two BIA models ranged from 4.6 to 6.4% fat compared with 2.6 and 3.6% fat for the sigma 7 equations. The BIA method for measuring body composition was comparable to the BMI method, with height and weight accounting for most of the variance in the BIA equation.     

Reliability and factorial validity of squat and countermovement jump tests

The primary aim of this study was to determine reliability and factorial validity of squat (SJ) and countermovement jump (CMJ) tests. The secondary aim was to compare 3 popular methods for the estimation of vertical jumping height. Physical education students (n = 93) performed 7 explosive power tests: 5 different vertical jumps (Sargent jump, Abalakow's jump with arm swing and without arm swing, SJ, and CMJ) and 2 horizontal jumps (standing long jump and standing triple jump). The greatest reliability among all jumping tests (Cronbach's alpha = 0.97 and 0.98) had SJ and CMJ. The reliability alpha coefficients for other jumps were also high and varied between 0.93 and 0.96. Within-subject variation (CV) in jumping tests ranged between 2.4 and 4.6%, the values being lowest in both horizontal jumps and CMJ. Factor analysis resulted in the extraction of only 1 significant principal component, which explained 66.43% of the variance of all 7 jumping tests. Since all jumping tests had high correlation coefficients with the principal component (r = 0.76-0.87), it was interpreted as the explosive power factor. The CMJ test showed the highest relationship with the explosive power factor (r = 0.87), that is, the greatest factorial validity. Other jumping tests had lower but relatively homogeneous correlation with the explosive power factor extracted. Based on the results of this study, it can be concluded that CMJ and SJ, measured by means of contact mat and digital timer, are the most reliable and valid field tests for the estimation of explosive power of the lower limbs in physically active men.     

Construct validity of the OMNI resistance exercise scale

This study examined the construct validity of the Adult OMNI Perceived Exertion Scale for Resistance Exercise (OMNI-RES). Forty (20 men and 20 women) subjects performed 1 repetition of the knee extension exercise at 40, 50, 60, 70, 80, and 90% of the 1 repetition maximum. Active muscle and overall body ratings of perceived exertion (RPE) were collected from the Borg 15-category RPE scale and the OMNI-RES immediately following each repetition. Construct validity was established by correlating RPE from the OMNI-RES with RPE from the Borg RPE scale using regression analysis. The results indicated a positive and linear relationship between RPE from the OMNI-RES and RPE from the Borg scale for both men and women. Validity coefficients ranged from r = 0.94 to 0.97. The high level of construct validity indicates that the OMNI-RES measures the same properties of exertion as the Borg RPE scale during resistance exercise and suggests that the 2 scales can be used interchangeably during resistance exercise.     

Plant functional types and climate at the global scale

Abstract. Globally applicable sets of terrestrial plant functional types (PFTs) have been identified as a major need in the development of dynamic global vegetation models for use with global atmospheric models. Global sets of PFTs should represent the world's most important plant types; characterize them through their functional behavior; and provide complete, geographically representative coverage of the world's land areas. Three main schools of thought on PFTs have emerged: (1) a physiological focus on internal function, especially at the level of basic metabolism; (2) an ecological focus on function in relation to plant form and environmental conditions; and (3) a geophysical focus on how plant functions affect the adjacent atmosphere. A structural approach based on pheno-physiognomy permits ready identification of relatively familiar, recognizable plant types. Many of the criteria cited by other approaches also are intimately related to structure and its seasonal changes. An earlier global system of structural-functional PFTs and their climatic relations has been improved, including addition of less well-known plant types, and is briefly described. A more strictly ‘functional’ approach is proposed, in which major aspects of plant function, initially metabolism and water balance, are used to classify functional types and suggest how these are constrained by climate. Such functional considerations, however, are closely linked to structural manifestations - but also require other functional criteria for more completely functional classifications. A recent global model of potential natural vegetation types suggested ca. 15 major plant types as necessary to cover the world's main terrestrial vegetation patterns. These essential types correspond well with a first-cut set of structural types implied by metabolic considerations.     

Stoichiometry of soil enzyme activity at global scale

Extracellular enzymes are the proximate agents of organic matter decomposition and measures of these activities can be used as indicators of microbial nutrient demand. We conducted a global-scale meta-analysis of the seven-most widely measured soil enzyme activities, using data from 40 ecosystems. The activities of beta-1,4-glucosidase, cellobiohydrolase, beta-1,4-N-acetylglucosaminidase and phosphatase g(-1) soil increased with organic matter concentration; leucine aminopeptidase, phenol oxidase and peroxidase activities showed no relationship. All activities were significantly related to soil pH. Specific activities, i.e. activity g(-1) soil organic matter, also varied in relation to soil pH for all enzymes. Relationships with mean annual temperature (MAT) and precipitation (MAP) were generally weak. For hydrolases, ratios of specific C, N and P acquisition activities converged on 1 : 1 : 1 but across ecosystems, the ratio of C : P acquisition was inversely related to MAP and MAT while the ratio of C : N acquisition increased with MAP. Oxidative activities were more variable than hydrolytic activities and increased with soil pH. Our analyses indicate that the enzymatic potential for hydrolyzing the labile components of soil organic matter is tied to substrate availability, soil pH and the stoichiometry of microbial nutrient demand. The enzymatic potential for oxidizing the recalcitrant fractions of soil organic material, which is a proximate control on soil organic matter accumulation, is most strongly related to soil pH. These trends provide insight into the biogeochemical processes that create global patterns in ecological stoichiometry and organic matter storage.     

Large scale comparison of global gene expression patterns in human and mouse

Background  

It is widely accepted that orthologous genes between species are conserved at the sequence level and perform similar functions in different organisms. However, the level of conservation of gene expression patterns of the orthologous genes in different species has been unclear. To address the issue, we compared gene expression of orthologous genes based on 2,557 human and 1,267 mouse samples with high quality gene expression data, selected from experiments stored in the public microarray repository ArrayExpress.     

Reliability and validity of the Wolfram Unified Rating Scale (WURS)

Background

Wolfram syndrome (WFS) is a rare, neurodegenerative disease that typically presents with childhood onset insulin dependent diabetes mellitus, followed by optic atrophy, diabetes insipidus, deafness, and neurological and psychiatric dysfunction. There is no cure for the disease, but recent advances in research have improved understanding of the disease course. Measuring disease severity and progression with reliable and validated tools is a prerequisite for clinical trials of any new intervention for neurodegenerative conditions. To this end, we developed the Wolfram Unified Rating Scale (WURS) to measure the severity and individual variability of WFS symptoms. The aim of this study is to develop and test the reliability and validity of the Wolfram Unified Rating Scale (WURS).

Methods

A rating scale of disease severity in WFS was developed by modifying a standardized assessment for another neurodegenerative condition (Batten disease). WFS experts scored the representativeness of WURS items for the disease. The WURS was administered to 13 individuals with WFS (6-25 years of age). Motor, balance, mood and quality of life were also evaluated with standard instruments. Inter-rater reliability, internal consistency reliability, concurrent, predictive and content validity of the WURS were calculated.

Results

The WURS had high inter-rater reliability (ICCs>.93), moderate to high internal consistency reliability (Cronbach’s α = 0.78-0.91) and demonstrated good concurrent and predictive validity. There were significant correlations between the WURS Physical Assessment and motor and balance tests (r_s>.67, p<.03), between the WURS Behavioral Scale and reports of mood and behavior (r_s>.76, p<.04) and between WURS Total scores and quality of life (r_s=-.86, p=.001). The WURS demonstrated acceptable content validity (Scale-Content Validity Index=0.83).

Conclusions

These preliminary findings demonstrate that the WURS has acceptable reliability and validity and captures individual differences in disease severity in children and young adults with WFS.

     

Technical report: Reliability and validity of the iSAM 9000 isokinetic dynamometer

This study assessed the mechanical reliability and validity of the INRTEK iSAM 9000 isokinetic dynamometer, and compared the obtained torque values of the prototype device with those from a traditional device. Sixty volunteers (40 men and 20 women) were tested at 60 degrees per second for shoulder, knee, and trunk flexion, and extension on both the Cybex 6000 and a new isokinetic dynamometer (iSAM 9000). Intraclass correlation coefficients (ICC) and standard errors of measurement (SEM) revealed a high level of reproducibility and precision in the device's torque measurements (ICC range = 0.94-0.98; SEM range = 5.2-29.7). Pearson r values revealed very high relationships between the two instruments (set 1: r = 0.84-0.93; set 2: r = 0.87-0.93; P < 0.05). Significantly higher peak torque for both sets of left and right knee flexion and extension, right shoulder extension and trunk extension was found for the iSAM 9000 compared to the Cybex 6000 (P < 0.05). The strong ICCs and small SEMs support the device's mechanical reliability and validity. The high correlation coefficients between the prototype dynamometer and the Cybex 6000 support the new device's validity in the measurement of isokinetic torque. The findings of this study will be used to refine the next generation of the INRTEK isokinetic device with respect to test protocols and the reliability of measuring human muscle performance.     

Reliability and validity of three strength measures obtained from community-dwelling elderly persons

The purpose of this study was to describe the reliability and validity of 3 strength measures obtained from community-dwelling elderly individuals. The strength of 10 elders was tested initially and 6 and 12 weeks later using the MicroFET 2 hand-held dynamometer (knee extension strength), the Jamar dynamometer (grip strength), and the sit-to-stand (STS) test. Mobility was tested using the timed up-and-go (TUG) test and a timed walk test. Intraclass correlation coefficients, which were used to characterize the reliability of the strength tests, ranged from 0.807 to 0.981. Pearson correlations between the lower extremity strength measures and the TUG and gait speed ranged from 0.635 to -0.943. Our examination of the 3 measures for 12 weeks extends previous evidence of the stability of these strength measures and justifies the use of hand-held dynamometry and the STS test when investigating limitations in mobility.     

Reliability and validity of the physical disector method for estimating neuron number

The physical disector was proposed as an unbiased and efficient means to estimate neuron number; however, the validity and reliability of this method have been examined only infrequently. Estimates of neuron number in the dorsal root ganglia (DRG) of bullfrogs (Rana catesbeiana) were compared to nucleolar counts based on 3-dimensional reconstructions. Accuracy of disector estimates were not affected by size of the animal. Similarly, disector estimates were not systematically altered when area measurements were limited to cellular regions of the DRG versus inclusion of the entire cross-sectional area. However, the recommended protocol for applying the disector resulted in sampling errors that introduced considerable variability in repeated estimates of neuron number from a single ganglion. In addition to this lack of reliability, disector estimates were consistently lower than those obtained by means of a nucleolar counting method that was calibrated against 3-dimensional reconstructions of neuronal profiles. The systematic error of the disector method was greater when ganglia were cut parallel to the long axis of the DR than when they were cut perpendicular to this axis. Increasing the sample size beyond what was recommended increased the reliability of estimates obtained with the disector; however, the bias associated with the plane of section was not reduced. These results emphasize the need for empirical validation of methods used to estimate neuron number in the tissue to which they are to be applied. © 1996 John Wiley & Sons, Inc.     

Reliability and validity of measuring scapular upward rotation using an electrical inclinometer

The aim of this study was to assess the reliability and validity of a modified two-dimensional electrical inclinometer to measure scapular upward rotation during static humeral elevation. Numerous techniques have been proposed to qualitatively and quantitatively measure upward rotation of the scapula. These techniques are limited by expense or an inability to be synchronized with other measurements, such as muscle activity and force output. For validity testing, static scapular upward rotation was measured separately with a digital protractor and electrical inclinometer while participants were at rest and 60°, 90° and 120° of humeral elevation in the scapular plane. For reliability testing, either 20 min before or 20 min after validity testing, participants performed the testing positions while measurements were taken with the electrical inclinometer only. Significant correlations existed between the modified electrical inclinometer and digital protractor at all four positions (r>0.996, p<0.001). The electrical inclinometer demonstrated good to excellent intra-rater reliability (ICC(3,1)>0.892, 95%CI: 0.785-0.988 and SEM<1.8°). These results support the use of the electrical inclinometer to measure scapular upward rotation. These findings provide clinicians and researchers with a practical instrument that can accurately measure scapular upward rotation in synchrony with other measurements, such as electromyography and isokinetic data.     

Reliability and validity of a linear position transducer for measuring jump performance

This study determined the reliability and validity of a linear position transducer to measure jump performance by comparing the mean force, peak force, and time-to-peak force measurements with data obtained simultaneously with a force platform. Twenty-five men performed squat, countermovement, and drop jumps with the linear transducer connected from a waist belt and base, which were placed upon a force platform. The Pearson correlation coefficients across the 3 jumps for the mean force (r = 0.952-0.962), peak force (r = 0.861-0.934), and time-to-peak force (r = 0.924-0.995) were high, providing evidence that the linear-transducer and force-platform measurements were similar. The trial-to-trial reliability of the jumps measured by the linear position transducer gave an intraclass correlation coefficient of 0.924-0.975 for mean force, 0.977-0.982 for peak force, and 0.721-0.964 for time-to-peak force. The coefficients of variation were 2.1-4.5% for mean force, 2.5-8.4% for peak force, and 4.1-11.8% for time-to-peak force. Our findings showed that the calculations derived from the linear transducer were very similar to those of the force platform and hence provided evidence of the validity of this method. The data from the linear transducer were also shown to be reliable. Therefore, this method of calculating force may provide a cost-effective alternative to the force platform for measuring this variable.     

Evolutionary relationships of human populations on a global scale

Using gene frequency data for 29 polymorphic loci (121 alleles), we conducted a phylogenetic analysis of 26 representative populations from around the world by using the neighbor-joining (NJ) method. We also conducted a separate analysis of 15 populations by using data for 33 polymorphic loci. These analyses have shown that the first major split of the phylogenetic tree separates Africans from non-Africans and that this split occurs with a 100% bootstrap probability. The second split separates Caucasian populations from all other non-African populations, and this split is also supported by bootstrap tests. The third major split occurs between Native American populations and the Greater Asians that include East Asians (mongoloids), Pacific Islanders, and Australopapuans (native Australians and Papua New Guineans), but Australopapuans are genetically quite different from the rest of the Greater Asians. The second and third levels of population splitting are quite different from those of the phylogenetic tree obtained by Cavalli- Sforza et al. (1988), where Caucasians, Northeast Asians, and Ameridians from the Northeurasian supercluster and the rest of non- Africans form the Southeast Asian supercluster. One of the major factors that caused the difference between the two trees is that Cavalli-Sforza et al. used unweighted pair-group method with arithmetic mean (UPGMA) in phylogenetic inference, whereas we used the NJ method in which evolutionary rate is allowed to vary among different populations. Bootstrap tests have shown that the UPGMA tree receives poor statistical support whereas the NJ tree is well supported. Implications that the phylogenetic tree obtained has on the current controversy over the out-of-Africa and the multiregional theories of human origins are discussed.      

Evolution and virulence of serogroup 6 pneumococci on a global scale

To study the evolution and virulence of pneumococcal populations, we used multilocus sequence typing to identify the major clones among 212 carriage and invasive isolates expressing capsular serogroup 6 from 39 countries. The global population consisted of 8 major complexes and 6 minor complexes of related clones and 32 clones of diverse origin. Surprisingly, serotype 6A clones evolved by mutation nearly as often as by recombination, whereas serotype 6B clones evolved almost exclusively by recombination (P = 0.0029). This is the first report of population genetic differences among serotypes of this species. The largest clonal complex was associated with invasive disease (P = 0.019) and included a common ancestor for five previously identified drug-resistant clones. The putative ancestors of the major clonal complexes were represented by a greater proportion of carriage isolates than were their descendents (P = 0.001), and the ancestors tended to be less virulent than their descendents in a mouse model of infection. These data suggested that virulent serogroup 6 clones have evolved multiple times from less-virulent ancestral clones.