http://nova.newcastle.edu.au/vital/access/services/Feed ${session.getAttribute("locale")} 5 http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:11858 The aim of this review was to evaluate the reliability and validity of methods used to assess the multiple components of sedentary behaviour (i.e. screen time, sitting, not moving and existing at low energy expenditure) in children and adolescents. Twenty-six studies met our inclusion criteria and were reviewed. Thirteen studies reported the reliability of self- and proxy-report measures of sedentary behaviour and seven of these were found to have acceptable test–retest reliability. Evidence for the criterion validity of self- and proxy-report measures was examined in three studies with mixed results. Seven studies examined the reliability and/or validity of direct observation and the findings were generally positive. Five studies demonstrated the utility of accelerometers to accurately classify sedentary behaviour. Self-report measures provide reliable estimates of screen time, yet their validity remains largely untested. While accelerometers can accurately classify participants’ behaviour as sedentary, they do not provide information about type of sedentary behaviour or context. Studies utilizing measures of sedentary behaviour need to more adequately report on the validity and reliability of the measures used. We recommend the use of objective measures of sedentary behaviour such as accelerometers, in conjunction with subjective measures (e.g. self-report), to assess type and context of behaviour. 2013-05-14T06:19:26.813Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:12320 Objective: To evaluate a self-report version of the Home Falls and Accidents Screening Tool (HOME FAST-SR). Study Design and Setting: The HOME FAST-SR was designed using expert review, pretesting and piloting. Agreement of selfreported home hazard ratings and ratings by health professionals was evaluated using the kappa statistic. The HOME FAST-SR was validated in a cross-sectional survey of 568 older community-living Australian women using endorsement rates for HOME FAST-SR items and the association of scores with self-reported falls. Results: The 87-item HOME FAST-SR was constructed, and a scoring system was devised to calculate equivalent scores for the health professional version of the HOME FAST (HOME FAST-HP). Endorsement rates demonstrated that no items needed to be removed. Agreement between self-reported and professional ratings was moderate with therapists under-reporting hazards compared with older people. The mean HOME FAST score for the 568 cross-sectional participants was 9.39 (95% confidence interval: 9.1, 9.7) with a range from 2 to 23 out of a possible 25. Fallers had a significantly higher HOME FAST score (P50.02). Conclusion: The HOME FAST-SR is a viable alternative to the HOME FAST-HP, and scores were associated with falls experienced by older women in a cross-sectional study. 2012-12-19T02:52:19.006Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:10757 Objective: to ascertain the accuracy of telephone-interview method for measuring older people's medication use (“self-report by phone”) by determining agreement between results from this method and from a home visit (“home inventory”). Study design and setting: an agreement study involving community-dwelling patients aged more than 65 years, selected from four general practices in the Hunter Region of Australia. Commonly used classes of drugs were selected for comparison. Results: of 154 patients, 14 participants were ineligible, because they had hearing problems (9) or did not use any medicines (5). The response rate was 70% (98 of 140). The observed overall agreement and prevalence-adjusted and bias-adjusted kappa coefficients were very high for all prescribed drug categories, but lower for over-the-counter (OTC) and complementary medicines. Specificity of the self-report by phone compared with home inventory was consistently high across all drug classes. Sensitivity values were more than 89% for all drug classes but were lower for OTC and complementary medicines (74%) and paracetamol (78%). Similar patterns were found for negative predictive values. Positive predictive values were lower for drugs used on an as-needed basis. Conclusion: measuring patient's medication use by telephone is an accurate and relatively inexpensive alternative to home-inventory methods, and has merit for use in future studies of older patients' drug use. 2012-05-07T23:50:06.809Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:10741 Objective: To determine the reproducibility and validity of a short FFQ (SFFQ) for Australian rural children aged 10 to 12 years, particularly Aboriginal and Torres Strait Islander children. Design: In this cross-sectional study participants completed the SFFQ on two occasions and three 24 h recalls. Concurrent validity was established by comparing results of the first SFFQ against food recalls; reproducibility was established by comparing the two SFFQ. Setting: The north coast of New South Wales in the Australian summer of late 2005. Subjects: Two hundred and forty-one children (ninety-two Aboriginal and Torres Strait Islander children and 100 boys) completed two SFFQ and were included in the reproducibility study; of these, 205 participants with a mean age of 10·8 (sd 0·7) years took part in the validity study.Results: The SFFQ showed moderate to good reproducibility among all children with kappa coefficients for repeated measures between 0·41 and 0·80. Eighteen of twenty-three questions demonstrated good validity against the mean of the 24 h recalls, with statistically significant increasing trends (P ≤ 0·05) for mean daily weight and/or frequency as survey response categories increased. A similar number of short questions showed good validity for Aboriginal and Torres Strait Islander children as for their non-Indigenous counterparts. Conclusions: Many short questions in this SFFQ are able to discriminate between different categories of food intake and provide information on relative intake within the given population. They can be used to monitor and/or evaluate population-wide health programmes, including those with rural Aboriginal and Torres Strait Islander children. 2012-05-04T05:43:56.450Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:10560 Purpose: To validate a self-report measure of physical activity for both Australian Aboriginal and Torres Strait Islander and non-Indigenous rural children, and to describe their physical activity participation. Methods: In this cross-sectional study, 84 Aboriginal and Torres Strait Islander and 146 non-Indigenous children aged 10–12 years old completed the Many Rivers Physical Activity Recall Questionnaire (MRPARQ), a modified version of the Adolescent Physical Activity Recall Questionnaire (APARQ). A sub-group (n=86) wore an accelerometer for seven consecutive days in order to validate the instrument. Results: Pearson and Intra Class Correlation coefficients between the survey and acceleromtery for weekdays only are 0.31 and 0.16, respectively, for Aboriginal and Torres Strait Islander children, and 0.38 and 0.31, respectively, for non-Indigenous children, and demonstrate a modest (p<0.05) correlation. Self-reported MVPA for Aboriginal and Torres Strait Islander children is between 162 and 172 minutes/day, and is 125 minutes by accelerometer; for non-Indigenous children MVPA is between 123 and 149 minutes (survey) and 107 minutes (accelerometer). Conclusion: Australian Aboriginal and Torres Strait Islander children's self-report of physical activity is at least as valid as non-Indigenous children, given culturally appropriate support; they tend to be more active than non-Indigenous children. Implications: The MRPARQ can be administered with Aboriginal and Torres Strait Islander and non-Indigenous children. 2012-04-02T01:08:16.446Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:10048 Background/aim: Stroke is the greatest contributor to disability in Australian adults and much of this disability results from a stroke-affected upper limb. This study aimed to determine the validity of hierarchal scoring for the upper limb subscale of the Motor Assessment Scale (UL-MAS) in acute stroke using Rasch analysis. Method: This study applied Rasch analysis to 40 UL-MAS assessment results across 25 subjects to determine the validity of the hierarchy of the three upper limb subsets: upper arm function (six), hand movements (seven) and advanced hand activities (eight). Rasch analysis examines the relationship between ‘item difficulty’ and ‘person ability’ and produces an output which represents the difficulty of each item in relation to each other. Results: As hypothesised, the hierarchy was upheld within subset 6. In subset 7, the hierarchy was not upheld. Results indicated that item 3 was the least difficult, followed by items 1, 4, 2, 5 and 6 in order of increasing difficulty. In subset 8 the hierarchy was not upheld. Results indicated that item 1 was the least difficult, followed by item 6, then 2 and 5 of equal value and then 3 and 4 of equal value. Conclusions: The hierarchal scoring is not supported for subsets 7 and 8 and future research is required to explore the validity of alternate scoring methods. At present, the authors recommend that the UL-MAS should be scored non-hierarchally, meaning that every item within the subsets should be scored regardless of its place within the hierarchy (UL-MAS-NH). 2012-03-21T03:50:06.207Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:9928 Background: Accreditation has become ubiquitous across the international health care landscape. Award of full accreditation status in health care is viewed, as it is in other sectors, as a valid indicator of high quality organisational performance. However, few studies have empirically demonstrated this assertion. The value of accreditation, therefore, remains uncertain, and this persists as a central legitimacy problem for accreditation providers, policymakers and researchers. The question arises as to how best to research the validity, impact and value of accreditation processes in health care. Most health care organisations participate in some sort of accreditation process and thus it is not possible to study its merits using a randomised controlled strategy. Further, tools and processes for accreditation and organisational performance are multifaceted. Methods/design: To understand the relationship between them a multi-method research approach is required which incorporates both quantitative and qualitative data. The generic nature of accreditation standard development and inspection within different sectors enhances the extent to which the findings of in-depth study of accreditation process in one industry can be generalised to other industries. This paper presents a research design which comprises a prospective, multi-method, multi-level, multi-disciplinary approach to assess the validity, impact and value of accreditation. Discussion: The accreditation program which assesses over 1,000 health services in Australia is used as an exemplar for testing this design. The paper proposes this design as a framework suitable for application to future international research into accreditation. Our aim is to stimulate debate on the role of accreditation and how to research it. 2012-03-12T07:48:33.362Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:7004 Objective: This study aimed to develop and validate a short version of the Supportive Care Needs Survey (SCNS) that would reduce respondent burden and could be used in routine cancer care, without compromising the psychometric properties of the original instrument. Methods: Secondary analyses of the data from two studies (n = 888 and 250) were undertaken. All 59 items of the original SCNS were assessed using psychometric analyses and evaluated for clinical utility. The 34 items retained were examined for internal consistency, ceiling and floor effects, known groups validity, convergent validity, sensitivity and readability. Results: The 34-item instrument has five factors (psychological, health system and information, physical and daily living, patient care and support, and sexuality needs) identical to the original instrument, explaining 73% of the variance. Internal consistency was high with Cronbach’s alpha coefficients for the five factors ranging from 0.86 to 0.96. Correlations of the 34-item short-form SCNS (SCNS-SF34) with three other measures of psychosocial well-being demonstrated convergent validity (r = 0.48–0.56). Kappa coefficients of at least 0.83 for each domain indicated almost perfect agreement between the 34-item and 59-item surveys to identify patients needing help. The 34-item SCNS maintained the psychometric properties of the original instrument and could be readily comprehended by people with seventh to eighth grade education. Conclusions: The SCNS-SF34 is a valid instrument for measuring cancer patients’ perceived needs across a range of domains, and could be utilized as part of routine cancer care. 2012-01-30T05:03:54.341Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:9671 Objective: The present study evaluates the reliability and validity of an FFQ designed for use with adolescents in urban Vietnam. Design: A cohort study was conducted between December 2003 and June 2004. The FFQ was administered three times over a 6-month period (FFQ 1–3) and nutrient intakes were compared to those obtained from four 24h recalls collected over the same period (24 h recalls 1–4) using crude, energy-adjusted and de-attenuated correlation coefficients. The level of agreement between the two measurements was also evaluated with Bland–Altman analysis. The percentage of nutrient intakes classified within one quintile, as well as quadratic-weighted kappa statistics, were calculated. Setting: Ho Chi Minh City, Vietnam. Subjects: A total of 180 students were recruited in three junior high schools. Results: Coefficients ranged from 0.22 for retinol to 0.78 for fibre for short-term reliability, and from 0.30 for retinol to 0.81 for zinc for long-term reliability. Coefficients for nutrient intakes between the mean of the three FFQ and mean of four 24h recalls were mostly around 0.40, but higher for energy-adjusted nutrients. After allowing for within-person variation, the mean coefficient was 0.52 for macronutrients and 0.46 for micronutrients. There were a relatively high proportion of nutrient intakes classified within one quintile and a small number grossly misclassified. Kappa values shows ‘fair’ to ‘good’ agreement for all food/nutrient categories, while the Bland–Altman plots indicated that the FFQ is accurate in assessing nutrient intake at a group level. Conclusions: This newly developed FFQ is a valid tool for measuring nutrient intake in adolescents in urban Vietnam. 2011-12-09T01:00:11.376Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:5832 Research Doctorate - Doctor of Philosophy (PhD) 2011-12-08T00:20:02.591Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:8721 Research Doctorate - Doctor of Philosophy (PhD) 2011-12-07T05:20:11.995Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:9522 Uncertainty regarding the accuracy of the computer as a data collection or patient screening tool persists. Previous research evaluating the validity of computer health surveys have tended to compare those responses to that of paper survey or clinical interview (as the gold standard). This approach is limited as it assumes that the paper version of the self-report survey is valid and an appropriate gold standard. The objectives are firstly, to compare the accuracy of computer and paper methods of assessing self-reported smoking and alcohol use in general practice with biochemical measures as gold standard. Second, to compare the test re-test reliability of computer administration, paper administration and mixed methods of assessing self-reported smoking status and alcohol use in general practice. A randomised cross-over design was used. Consenting patients were randomly assigned to one of four groups; Group 1. C–C : completing a computer survey at the time of that consultation (Time 1) and a computer survey 4–7 days later (Time 2); Group 2. C–P: completing a computer survey at Time 1 and a paper survey at Time 2; Group 3. P–C: completing a paper survey at Time 1 and a computer survey at Time 2; and Group 4. P–P: completing a paper survey at Time 1 and 2. At Time 1 all participants also completed biochemical measures to validate self-reported smoking status (expired air carbon monoxide breath test) and alcohol consumption (ethyl alcohol urine assay). Of the 618 who were eligible, 575 (93%) consented to completing the Time 1 surveys. Of these, 71% (N = 411) completed Time 2 surveys. Compared to CO, the computer smoking self-report survey demonstrated 91% sensitivity, 94% specificity, 75% positive predictive value (PPV) and 98% negative predictive value (NPV). The equivalent paper survey demonstrated 86% sensitivity, 95% specificity, 80% PPV, and 96% NPV. Compared to urine assay, the computer alcohol use self-report survey demonstrated 92% sensitivity, 50% specificity, 10% PPV and 99% NPV. The equivalent paper survey demonstrated 75% sensitivity, 57% specificity, 6% PPV, and 98% NPV. Level of agreement of smoking self-reports at Time 1 and Time 2 revealed kappa coefficients ranging from 0.95 to 0.98 in each group and hazardous alcohol use self-reports at Time 1 and Time 2 revealed kappa coefficients ranging from 0.90 to 0.96 in each group. The collection of self-reported health risk information is equally accurate and reliable using computer interface in the general practice setting as traditional paper survey. Computer survey appears highly reliable and accurate for the measurement of smoking status. Further research is needed to confirm the adequacy of the quantity/frequency measure in detecting those who drink alcohol. Interactive computer administered health surveys offer a number of advantages to researchers and clinicians and further research is warranted. 2011-11-29T04:20:10.234Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:7646 We congratulate del Junco et al. for undertaking a dedicated study of validity in their mammography screening trial. We are particularly interested in their randomized studies of the possible effects of completing baseline surveys and in their conceptualization of validity. The study population was randomly sampled, and screening rates in the assessed control group were compared with secular trends among nonparticipants, providing a robust test of whether study participation altered screening behavior, and thus whether the findings have external validity. 2011-05-02T23:20:17.033Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:7493 Diagnostic blocks can be a powerful tool for the investigation of spinal pain. However, for their use to be rational, blocks must have diagnostic or therapeutic utility, proven validity, and their use should be efficient. Of the 6 diagnostic blocks available for spinal pain, only some have been fully validated. Others still require particular validation studies. 2011-04-06T06:10:08.526Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:6646 A critical property of any diagnostic test is that it must be valid. If a test is not valid, the information that it provides will not be correct; the diagnosis will be wrong, and any treatment that ensues will not, be appropriate and will probably fail. Along with all other diagnostic tests, diagnostic blocks are subject to this requirement for validity. 2010-09-10T02:00:13.466Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:1916 The diagnosis of brain death as 'death' and organ transplantation have been closely historically linked since the mid twentieth century. It will be argued in this article that the development of a neurological definition of death was introduced to justify the removal of fresh viable organs for transplantation. Brain death cannot be diagnosed reliably using 'established practices'. Improved understanding of the pathophysiology of raised intracranial pressure has challenged our understanding of brain death. We need to move forward in our conceptualization of phenomenon of profound coma associated with massive brain damage. If examination for 'brain death' is to be carried out at all, there needs to be an examination and re-evaluation of practices and protocols. 2010-04-27T06:58:30.500Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:427 An investigation into personality factors possibly underlying ethical behaviour in medical students and doctors indicated the importance of two primary dimensions, empathy and narcissism. Experimental questionnaires based on these dimensions were constructed and administered to large samples of medical school applicants. Factor analyses suggested the presence of four factors, labelled Narcissism, Aloofness, Empathy and Confidence. These were combined in a 100-item instrument intended for screening purposes. This paper reports on two construct validation studies for the intrument, with New Zealand medical students (n = 237) and Scottish medical school applicants (n = 5 10), using overlapping batteries of personality scales. The validity coefficients for the samples indicate similar constructs for narcissism (related to disagreeableness, aggressiveness, aloofness from others, sensitivity to rewards, and anxiety), and empathy (related positively to emotional intelligence, extraversion, open-mindedness, compliance with others and negatively to aloofness). Factor analysis supports the hypothesis of separate dimensions for narcissistic aggression and empathic relationships. 2010-04-27T05:48:41.849Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:18 Objective: The aims of this study were to estimate average yearly weight gain in midage women and to identify the determinants of weight gain and gaining weight at double the average rate. Research Methods and Procedures: The study sample comprised 8071 participants (45 to 55 years old) in the Australian Longitudinal Study on Women's Health who completed mailed surveys in 1996, 1998, and 2001. Results: On average, the women gained almost 0.5 kg per year [average 2.42 kg (95% confidence interval, 2.29 to 2.54) over 5 years]. In multivariate analyses, variables associated with energy balance (physical activity, sitting time, and energy intake), as well as quitting smoking, menopause/hysterectomy, and baseline BMI category were significantly associated with weight gain, but other behavioral and demographic characteristics were not. After adjustment for all of the other biological and behavioral variables, the odds of gaining weight at about twice the average rate (> 5 kg over 5 years) were highest for women who quit smoking (odds ratio = 2.94; 95% confidence interval, 2.17, 3.96). There were also independent relationships between the odds of gaining > 5 kg and lower levels of habitual physical activity, more time spent sitting, energy intake (but only in women with BMI > 25 at baseline), menopause transition, and hysterectomy. Discussion: The average weight gain equates with an energy imbalance of only about 10 kcal or 40 kJ per day, which suggests that small sustained changes in the modifiable behavioral variables could prevent further weight gain. 2010-04-27T05:35:38.610Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:65 The short(s)-EMBU (Swedish acronym for Egna Minnen Betraffande Uppfostran [My memories of upbringing]) consists of 23 items, is based on the early 81-item EMBU, and was developed out of the necessity of having a brief measure of perceived parental rearing practices when the clinical and/or research context does not adequately permit application of time-consuming test batteries. The s-EMBU comprises three subscales: Rejection., Emotional Warmth, and (Over)Protection. The factorial and/or construct validity and reliability of the s-EMBU were examined in samples comprising a total of 1950 students from Australia, Spain, and Venezuela. The data were presented for the three national groups separately. Findings confirmed the cross-national validity of the factorial structure underlying the s-EMBU. Rejection by fathers and mothers was consistently associated with high trait-neuroticism and low self-esteem in recipients of both sexes in each nation, as was high parental emotional warmth with high femininity (humility). The findings on factorial validity are in keeping with previous ones obtained in East Germany, Greece, Guatemala, Hungary, Italy, and Sweden. The s-EMBU is again recommended for use in several different countries as. a reliable, functional equivalent to the original 81-item EMBU. 2010-04-27T05:34:40.548Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:5558 To construct a nutrient database for use with a large population-based cohort study, the Blue Mountains Eye Study, dietary intakes were estimated using the Australian electronic food composition nutrient databases to which values for additional nutrients were added, including folate, vitamin B 12, carotenoids and fatty acids. The addition of nutrient data from alternative, overseas, database sources may be useful in relation to the assessment of outcome measures, however the data obtained from these sources need to be interpreted with care, especially in relation to absolute quantities of intake. 2010-04-27T04:46:11.210Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:5500 Aim: To assess critically the face validity of theWorld Health Organization’s (WHO’s) International Guide for Monitoring Alcohol Consumption and Related Harm (MACRH) for deriving indicators, for the purposes of developing non-fatal alcohol-related injury indicators in New Zealand. Design: MACRH’s five solutions for deriving indicators are: (i) use only alcohol-specific cases; (ii) identify subsets of events known to be highly alcohol-related; (iii) utilize control indicators that are rarely alcohol-related; (iv) estimate alcohol attributable fractions (AAFs) and adjust indicators accordingly; and (v) develop composite indicators. These were assessed in terms of their face validity with particular reference to New Zealand. Findings: There are significant face validity issues with each of the five options. Solution 4 offers the greatest promise, provided that: (i) valid AAFs can be derived and they are updated regularly; and (ii) appropriate adjustment is made for extraneous influences on the estimates of alcohol-related harm. To date, the latter has not been carried out. Conclusions: Most potential sources of data on alcohol-related harmare subject to extraneous influences, which vary over time and space.While the attempt by WHO to offer solutions to this problem is laudable, the solutions do not address the problem adequately. MACRH guidelines need to be revised to include criteria for a valid outcome indicator. 2010-04-27T04:34:02.387Z ]]>