Mean Item Score Research Articles

Cognitive, emotional, and behavioral profile in children and adolescents with chronic pain associated with rheumatic diseases: A case-control study.

Background:The prevalence of chronic pain is about 30% in children and adolescents which suffer from severe emotional distress. The aim of this observational study is to investigate cognitive, emotional and behavioral consequences of benign chronic pain in children and adolescents suffering of reumathologic diseases.Materials and Methods:A total of 49 participants, chronic pain participants (CPPs) and controls (CGPs), affected by rheumatic diseases, were enrolled. Assessment included collection of sociodemographic data, pain characteristics, and administration of Visual Analog Scale (VAS), Depression Inventory for Children and Adolescents (CDI), Conners’ Parent Rating Scales–Revised (CPRS-R), Child Behavior Checklist (CBCL), and Screen for Child Anxiety–Related Disorders (SCARED). For the statistical analysis, Student’s t-test for independent samples and Pearson’s correlation were used. The significance value was set at p less than .05.Results:A significant difference of mean scores of CBCL items and of CPRS items between the two groups was found. In CPPs, a significant correlation between VAS and mean scores of several CBCL items and between VAS and mean scores of several CPRS items was found.Conclusion:Chronic pain is a real syndrome in which an interdisciplinary treatment should be applied, considering the psychopathological risk, especially in developmental age.

The National Sleep Foundation's Sleep Satisfaction Tool

ObjectivesThe National Sleep Foundation (NSF) sought to test, refine, and add statistical rigor to its previously described provisional Sleep Satisfaction Tool (SST). The tool assesses the general population's sleep satisfaction. DesignIn 2017, NSF created a provisional tool through systematic literature review and an expert consensus panel process. This tool was expanded, refined, and tested through an open-ended survey, 2 rounds of cognitive testing, and a national survey of a random sample of Internet users (aged 18-90). Factor analysis and final consensus panel voting produced the robust SST. ResultsThe exploratory, open-ended surveying for identifying additional factors important to the public led to question formulation around mind relaxation. Cognitive testing yielded significant refinement to question and response option formatting. Factor analysis of questions from field testing indicated loading on one construct identified as “sleep satisfaction.” The final 9-item SST demonstrated strong reliability and internal validity with overall SST scores of 56/100 (higher scores indicating greater sleep satisfaction). Individual SST item mean scores ranged from 39 to 66, and overall SST scores varied substantially across demographic groups. ConclusionsNSF used a series of development and validation tests on its provisional SST, producing a novel and reliable research tool that measures the general population's sleep satisfaction. The SST is a short, reliable, nonclinical assessment that expands the set of tools available to researchers that implements the individual, social, and environmental factors related to sleep satisfaction. Further research will explore refined scoring methods along with factor weighting and use within different populations.

Examining the impact of specific types of item-writing flaws on student performance and psychometric properties of the multiple choice question.

This article was migrated. The article was marked as recommended. Background: Item-writing flaws (IWFs) are common in multiple choice questions (MCQs) despite item-writing guidelines. Previous studies have shown that IWFs impact validity as observed through student performance, item difficulty, and discrimination. Most previous studies have examined IWFs collectively and have shown that they have a diverse impact. The aim of the study was to determine if the effects of individual types of IWFs are systematic and predictable. Method: A cross-over study design was used. 100 pairs of MCQ items (with and without an IWF) were constructed to test 10 types of IWFs. Medical students were invited to participate in a mock examination. Paper A consisted of 50 flawed followed by 50 unflawed items. Paper B consisted of 50 unflawed followed by 50 flawed items. The effect of each of the IWFs on mean item scores, item difficulty and discrimination were examined. Results: The hypothesised effect of IWFs on mean item scores was confirmed in only 4 out of 10 cases. ' Longest choice is correct', 'Clues to the right answer (Eponymous terms)' and ' Implausible distractors' positively impacted, while 'Central idea in choices rather than stem' negatively impacted mean item scores. Other flaws had either the opposite or no statistically significant effect. IWFs did not impact item difficulty or discrimination. Conclusion: The effect of IWFs is neither systematic nor predictable. Unpredictability in assessment produces error and thus loss of validity. Therefore, IWFs should be avoided. Faculties should be encouraged to invest in item-writing workshops in order to improve MCQs. However, the cost of doing so should be carefully weighed against the benefits of developing programmes of assessment.

An assessment of the relationship between pharmacy students’ perceptions of their preparedness to contribute to emergency responses and their current work status

IntroductionA study was conducted to assess if there is an association between pharmacy students’ perceptions of their preparedness to contribute to emergency responses and their current work status. MethodsA cross-sectional analysis was conducted using data from a student perception survey completed by third-year pharmacy students. The survey collected demographic information on age, gender, level of education, ethnicity, and pharmacy-related work experience. A series of Likert scale items were used to assess students’ perceptions regarding their competency in specific skills areas essential for participation in emergency responses. An independent samples t-test was used to compare mean scores for Likert scale items between working and nonworking students. Multivariate linear regression models were developed to determine if work status was an independent predictor of students’ self-reported competencies after adjusting for covariates. ResultsSixty-six of 69 (95.7%) students completed the student perception survey. Students currently working in a pharmacy reported higher mean scores on several of the measured competencies. After covariates adjustment, current work status was associated with higher scores on self-reported competencies related to proficiency in evaluating information from patient assessment and collaborating with other individuals to develop processes related to the optimizing flow of care. ConclusionsThese results suggest that students who are working tend to have more confidence in their ability to contribute to emergency responses as well as work better in a team setting. Incorporating cases related to emergency response readiness in pharmacy curriculum may be needed to enhance skills and confidence of non-working pharmacy students.

Visually Evoked Response Differences to Contrast and Motion in Children with Autism Spectrum Disorder.

High-density electroencephalography (EEG) was used to examine the utility of the P1 event-related potential (ERP) as a marker of visual motion sensitivity to luminance defined low-spatial frequency drifting gratings in 16 children with autism and 16 neurotypical children. Children with autism displayed enhanced sensitivity to large, high-contrast low-spatial frequency stimuli as indexed by significantly shorter P1 response latencies to large vs. small gratings. The current study also found that children with autism had larger amplitude responses to large gratings irrespective of contrast. A linear regression established that P1 adaptive mean amplitude for large, high-contrast sinusoidal gratings significantly predicted hyperresponsiveness item mean scores on the Sensory Experiences Questionnaire for children with autism, but not for neurotypical children. We conclude that children with autism have differences in the mechanisms that underlie low-level visual processing potentially related to altered visual spatial suppression or contrast gain control.

Assessing capacity and readiness to manage NCDs in primary care setting: Gaps and opportunities based on adapted WHO PEN tool in Zambia

IntroductionSub-Saharan Africa is experiencing an epidemiological transition as the burden of NCDs overtake communicable diseases. However, it is unknown what capacity and gaps exist at primary care level to address the growing burden of NCDs. This study aimed to assess the Zambian health system’s capacity to address in NCDs, using an adapted WHO Essential Non Communicable Disease Interventions (WHO PEN) tool.MethodologyThis was a cross-sectional facility survey in the three districts conducted from September 2017 to October 2017. We defined facility readiness along five domains: basic equipment, essential services, diagnostic capacity, counseling services, and essential medicines. For each domain, we calculated an index as the mean score of items expressed as percentage. These indices were compared to an agreed cutoff at 70%, meaning that a facility index or district index below 70% off was considered as ‘not ready’ to manage NCDs at that level. All analysis were performed using Stata 15 MP.ResultsThere appeared to be wide heterogeneity between facilities in respect of readiness to manage NCDs. Only 6 (including the three 1st level hospitals) out of the 46 facilities were deemed ready to manage NCDs. Only the first level hospitals scored a mean index higher than the 70% cut off; With regard to medications needed to manage NCDs, urban and rural health facilities were comparably equipped. However, there was evidence that calcium channel blockers (p = 0.013) and insulin (p = 0.022) were more likely to be available in urban and semi-urban health facilities compared to rural facilities.ConclusionOur study revealed gaps in primary health care capacity to manage NCDs in Zambia, with almost all health facilities failing to reach the minimum threshold. These results could be generalized to other similar districts in Zambia and the sub-region, where health systems remain focused on infectious rather than non-communicable Disease. These results should attract policy attention and potentially form the basis to review current approach to NCD care at the primary care level in Zambia and Sub-Saharan Africa.

Utilizing Bloom's taxonomy to design a substance use disorders course for health professions students

ABSTRACTBackground: Substance use disorders (SUDs) are a public health problem affecting millions of Americans. Despite their prevalence, there are few health care resources allocated for SUDs treatment. Relatively few health care professionals are exposed to SUDs education in their respective programs, which may be one reason for this resource insufficiency. In hopes of rectifying this gap, the authors developed a SUDs course for health professions students combining classroom learning with practical application to patient care. Methods: The authors used Bloom's taxonomy of cognitive, affective, and psychomotor learning domains as an educational framework to create numerous opportunities for students to deepen their knowledge, assess their attitudes, and develop their motivational interviewing skills. The primary outcome of the study was a comparison of students' scores on the Substance Abuse Attitude Scale (SAAS) pre- and post-course completion. Secondary outcome was to compare students' self-assessment scores of their patient counseling with residents' assessments of them on the Liverpool Communication Skills Assessment Scale (LCSAS). Results: One hundred twelve students participated in the authors' SUDs course over a 9-month period. Ninety-five students completed both the pre- and post-course SAAS surveys. The total SAAS survey score and individual domain scores for nonmoralizing, treatment optimism, and treatment intervention demonstrated significant improvement post-course. Eighty-nine students completed a motivational interview with a patient. Eighty students had a LCSAS self-assessment paired with a residents' assessment. Mean scores for individual items on the LCSAS for both groups' assessment were approximately 3.5, indicating that students' communication was assessed as “acceptable” to “good.” Conclusions: This study demonstrates that Bloom's taxonomy was a useful educational framework to ensure a systematic development of the authors' SUDs course. Through participation in our course, students touched each of the 3 domains in Bloom's taxonomy. The authors believe their course design may serve as a framework for future SUDs courses.

BENEFITS OF REMANUFACTURING THE ECONOMY AS A TRANSITION INTO A GREEN ECONOMY

Remanufacturing is the restoration of end of life products to almost new. It is a form of sustainability. The research set out to identify the benefits of remanufacturing to the Nigerian economy which could aid with the transition to green economy. A questionnaire survey was used to establish the benefits of remanufacturing to the Nigerian economy. Data analysis involving mean item score revealed development of an Industrial base, industrialisation to rural areas, boosting of export trade, conservation of natural resources are seen as important benefits of remanufacturing to the Nigerian economy. Factor analysis made known four clusters titled in the order of importance as benefits of remanufacturing environmentally, benefits of remanufacturing to trade, benefits of remanufacturing socially, benefits of remanufacturing to entrepreneurs as this clusters signify the benefits of remanufacturing to the Nigerian economy. Further discussed is the implication of the findings, firstly is the development of an industrial base, which will benefit Nigeria, as Nigeria is an under-industrialised nation. Furthermore, the entrenchment of the development of an industrial base would lead to a boosting of export trade in the form of exporting capital equipment to other countries as well as an inflow of foreign exchange. Lastly revealed is the industrialisation to the rural areas, which will stop the social scourge of rural and urban migration.

Can a quality-of-life assessment assist in identifying women at risk of prematurely discontinuing IVF treatment? A prospective cohort study utilizing the FertiQoL questionnaire.

This study aimed at assessing quality of life (QoL) by means of a validated measurement tool (FertiQoL) in German infertile patients before a first IVF/ICSI cycle with ancillary assessment of changes in FertiQoL scores after a failed first cycle and the predictive capacity of FertiQoL scores for treatment discontinuation. The validated FertiQoL tool consisting of 24 questions regarding fertility-specific aspects of QoL was used for this prospective cohort study conducted at a university affiliated IVF center in Germany. Female patients (n = 119) filled out the FertiQoL form and questionnaire on sociodemographic variables on initiation of a first- and second-cycle IVF/ICSI treatment, respectively. On initiation of a first IVF/ICSI cycle, the mean scores (± standard deviation) for subscales emotional, mind-body, relational, and social items were 62 (± 19), 75 (± 17), 82 (± 13), and 78 (± 14), respectively; the total FertiQoL score was 73 (± 12). The mean total FertiQoL score at initiation of a first treatment cycle did not differ between patients who continued vs. discontinued treatment in case of no pregnancy achievement in the first cycle (73) (± 10) vs. 74 (± 14), p = 0.46). Furthermore, the mean total FertiQoL score did not change after an unsuccessful first IVF cycle (74 vs. 76, p = 0.46). There was no statistical difference in a small sample size for FertiQoL scores between all groups. In this study, FertiQoL scores were, therefore, not usable to predict withdrawal from infertility treatment.

Project Portfolio Management Strategies in Housing Estate Development Organizations in Nigeria’s Built Environment

Nigeria is an African country with abundant natural and human resources with an aspiration to be among the top 20 economies in world by the year 2020. Such objective can only be achieved through requisite infrastructural development projects within the Nigeria’s built environment such as road, power plants and adequate housing estate development projects etc. However, Nigeria’s housing estate developments were insufficient in terms of demands; do not reflect the desired housing needs of the end-users; in some-cases affordable but not qualitative; do not possess green building features. These has led to challenges and questions about project portfolio management (PPM) strategies that align and fit portfolios with the organizational objectives while also delivering estate development projects that are less risky and marketable. The aim of this research paper is to assess the PPM strategies used by housing estate development organizations in Nigeria’s built environment with a view of identifying, examining, and highlighting the impact of these strategies on housing estate development project portfolios in Nigeria. Literature reviewed led to identification and assessment of five PPM strategies. Krejcie and Morgan table was used to determine the sample size, while Cronbach’s alpha, mean item scores, relative importance index, T-test statistics were used for data analyses. The results show that any chosen PPM strategy(ies) by Housing Estate Development organizations will not be easy to apply, use, implement nor will it be excellent in the strive to achieve the Organizational Objectives in any given Portfolio.

Impact of Rework on Building Project and Organisation Performance: A View of Construction Professionals in Nigeria

Rework has become a menace in the construction industry as it leads to undesired and unnecessary loss of efforts. It degrades project cost, quality and schedule performance, and it occurs at both the design and construction phases of construction projects. This study therefore examined the perception of construction professionals on the impact of rework on the performance of both the project and the performing organization. This was achieved by determining the most important effect of rework on project and organizational performance, and identifying variables in which the professionals view varies significantly. The study adopted a quantitative survey approach in which structured questionnaire was adopted as the research instrument. Mean item score was used in ranking the professionals perception of the effect of rework, and Kruskal-Wallis H test was used to identify the variables in which the professionals view varies. The study revealed that: rework has a very high impact of (MIS = 4.00) on project performance which results in projects over shooting their planned budget and planned duration, and degradation of project quality. Rework has a very high effect of (MIS = 4.04) on organizational performance leading to loss of profit/reduced profit, de-motivation of workers, and loss of future work/business. Disputes between contracted parties, design team dissatisfaction, de-motivation of workers and Fatigue are the factors in which the professionals’ view varied significantly. It was recommended that there is the need for the training of construction stakeholders on construction rework and other variables that cause projects to over shoot their budget, time and other resource.

Rework risks triggers in the Nigerian construction industry: a view of built environment professionals

Rework is systemic and a recurring decimal and It is triggered by several factors, which emergence create scenarios, which degrades project cost, quality and schedule performance, and overall project performance. This study therefore examined the perception of construction professionals on the factors that triggers the emergence of rework in the Nigerian construction industry. This was achieved by determining the predominant rework triggers that affect project performance, identifying rework triggers in which the professionals view varies significantly, and examining the category of rework risks triggers that contribute more to rework incidences. The study adopted a quantitative survey approach in which structured questionnaire was adopted as the research instrument. Mean item score was used in ranking the professionals perception on rework triggers, and Kruskal-Wallis H test was used to identify the variables in which the professionals view varies. The study concluded that: contractor-related and design-related causes are the major categories of rework risks triggers. Unclear instruction to workers, Shortage of skilled supervisors, incomplete and inaccurate information are the predominant triggers of rework. The professionals view varies significantly on nine factors which cut across the four categories of rework triggers. It was recommended that there is need for clarity, effectiveness and timeliness of instruction and information dissemination among project participants, and the use of skilled and experienced professionals, skilled supervisors and proper implementation of quality management practices by both the design consultant and contractor throughout the project’s phases

Evaluation of an Evidence-Based Medicine Curriculum in a PGY1 Pharmacy Residency Program Using the Fresno Test

Objective. To assess the effectiveness of a longitudinal evidence-based medicine (EBM) curriculum to improve pharmacy resident knowledge and skills in evidence-based practice as measured by the Fresno Test. Methods. Residency program director and clinical pharmacist preceptors in a community teaching hospital developed a longitudinal EBM curriculum for a postgraduate year one (PGY1) pharmacy practice residency. The program was offered as a yearlong series of 1-hour meetings to train residents in evidence-based practice. A pre/post study design was used to evaluate the program. The full 12-item Fresno Test was used to measure specific EBP skills: Ask, Acquire, Appraise, Apply and Assess. Pre/post composite and item mean scores were compared using Student's paired t-test. Results. Forty-three residents completed pre- and post-Fresno Test evaluations between 2008 and 2014 with a mean increase in pre- and post-training scores from 125.9 (SD 32.9) to 138.5 (SD 33.6), p=.02. Conclusion. A longitudinal training program in EBM in a pharmacy residency demonstrated improvement in core evidence-based practice abilities as measured by the Fresno Test.

Factors Influencing Saudi Construction Design Management

This study evaluates factors influencing Saudi construction design management. Through the use of literature review, questionnaire and interview surveys, the study identified and assessed the factors influencing design management in Saudi Arabia and suggested ways of improving the Saudi construction design management. The sample for the study was carefully selected with the use of purposive sampling technique. A total of one hundred and fifty questionnaires were administered online and of this number, fifty three respondents returned completed questionnaires. In addition, nine carefully sampled seasoned professionals were interviewed. Through the use of mean item score and content analysis for the interviews, the identified factors were assessed. The results obtained from descriptive analysis indicate that respondents ranked ‘effectiveness of communication channels and methods’ as the most important factor influencing design management in the study area. This was closely followed by ‘cultural differences’ and ‘deficient project documentations’. On ways to improve the Saudi construction design management, the respondents gave divergent views on the issue. Among the views expressed is that the government should ensure that the local consultants are well trained. The study recommends that the government should provide support for small and medium sized Saudi-based companies to integrate and collaborate with large foreign ones in order to work round the problem accruing from only foreign ones. This would further increase new innovative collaborative working.

Appraising the use of labour-only procurement system for building construction in Nigeria

Abstract Labour-only procurement system is gaining fast popularity among construction clients who want to make savings by procuring materials themselves, leaving the contractor to provide only the labour needed. This study, therefore, appraised this procurement system by assess­ing its cost performance, its suitability, construction par­ticipant’s willingness to use it for subsequent projects and its merits and demerits. Using a survey design approach through the use of questionnaire and a pro forma, data were gathered from a total of 98 construction profes­sionals and contractors who have been involved in the use of this procurement system. Analyses of data were done using percentage, mean item score, Mann-Whitney U test and paired samples t-test. The study revealed that this procurement system is best for procuring residential buildings and minor alteration works. Construction participants who have used this system before are willing to still use it for subsequent works, as it delivers projects within budget and discourages short-changing of specifi­cations and standard by contractors. However, the need for the time commitment and reduction in contractor’s profit are its major disadvantages. For its cost perfor­mance, an overall cost saving of about 2% was discovered for the assessed 32 projects. The findings of this study will be beneficial to various interest groups such as clients and estate developers in selecting the right procurement option to use.

Translation, revision, and validation of the Chinese version of the Satisfaction with Oral Anti-Diabetic Agent Scale (C-SOADAS) in patients with type 2 diabetes mellitus.

ObjectiveThe aim of this study was to translate, adapt, and validate the Satisfaction with Oral Anti-Diabetic Agent Scale (SOADAS) in type 2 diabetes mellitus (DM) patients taking oral antidiabetic drugs (OADs) in Taiwan.Patients and methodsThe SOADAS was translated to Chinese and was modified based on reviews of two physicians, five diabetes educators, and two patient focus groups. A cross-sectional interviewer-administered survey was conducted in adult patients with type 2 DM who were taking OADs. The Chinese version of the SOADAS (C-SOADAS), the EuroQol 5 dimensions 3-level (EQ-5D-3L) questionnaire, and a demographic questionnaire were administered to participants. Instrument structure, internal consistency, convergent validity, and known-group validity were assessed.ResultsA total of 260 DM patients were recruited. The mean score of an individual item ranged from 3.6 to 3.9, while the mean total score (out of 25 possible points) was 18.7 points. Overall, floor and ceiling effects were negligible. The Cronbach’s α value was 0.81. All the four predetermined hypotheses for known-group validity assessment were fulfilled. In convergent validity testing, the C-SOADAS total scores were found to be correlated with EuroQol-Visual Analog Scale (EQ-VAS) scores (r = 0.2; p < 0.01) but not with EuroQol 5 dimensions (EQ-5D) index scores (r = 0.02; p = 0.81).ConclusionThe 5-item C-SOADAS appears to be a psychometrically acceptable measure of OAD treatment satisfaction among type 2 DM patients in Taiwan. The tool may be incorporated into clinical practice to quickly assess treatment outcomes from patients’ perspectives.

Distress, uncertainty, and positive experiences associated with receiving information on personal genomic risk of melanoma.

The aim of this research was to understand how genomics-based personal melanoma risk information impacts psychological and emotional health outcomes in the general population. In a pilot randomized controlled trial, participants (n = 103) completed the Multidimensional Impact of Cancer Risk Assessment (MICRA) questionnaire, 3 months after receiving personal melanoma genomic risk information. Mean scores for MICRA items and subscales were stratified by genomic risk group (low, average, high), gender, education, age, and family history of melanoma. P values were obtained from t-tests and analysis of variance tests. We found that overall, participants (mean age: 53 years, range: 21-69; 52% female) had a total MICRA mean score of 18.6 (standard deviation: 11.1, range: 1-70; possible range: 0-105). The high genomic risk group had higher mean scores for the total (24.2, F2,100 = 6.7, P = 0.0019), distress (3.3, F2,100 = 9.4, P = 0.0002) and uncertainty (8.5, F2,100 = 6.5, P = 0.0021) subscales compared with average (17.6, 1.1, and 4.5, respectively) and low-risk groups (14.1, 0.5, and 2.5, respectively). Positive experiences scores were consistent across risk groups. In conclusion, MICRA scores for the total, distress and uncertainty subscales in our study were relatively low overall, but people who receive a high genomic risk result may benefit from increased support following testing.

Assessment of factors influencing the failure and abandonment of multi-storey building projects in Nigeria

PurposeThe failure and abandonment of construction projects have proven to be insurmountable problems incessantly militating against the efficient performance of the construction industry in Nigeria. The complexity, technicality and a host of other project execution issues unique to multi-storey building projects do increase their susceptibility to failure and abandonment. Thus, the purpose of this paper is to examine the factors influencing failure and abandonment of multi-storey building projects in Nigeria. This is with a view to provide inferential empirical data that could enhance successful delivery of multi-storey building projects in Nigeria.Design/methodology/approachPrimary data were used for the study. A structured questionnaire was administered on consultants and contractors’ personnel within Lagos State, Nigeria. A total of 180 copies of the questionnaire were administered ,and 134 copies which represent a combined response rate of 74.4 per cent were retrieved. The data were analysed using frequency distribution and percentages, Mean item score and factor analysis.FindingsThe factors most significant to the failure and abandonment of multi-storey building projects are inadequate funding by the client, improper planning at the pre-construction phase, structural failure in multi-storey building during construction, bankruptcy/business failure of the contractor, improper scheduling of the building project activities and failure to engage qualified professionals with technical expertise and experience. The rated factors clustered under human resources capability, planning and structural quality, contractor selection and variation, insecurity and variation, and force majeure and political risk.Research limitations/implicationsThe study was limited to multi-storey building projects in Lagos State, Nigeria. Further studies could focus on specific resuscitation strategies for abandoned multi-storey building projects.Practical implicationsThe study provided implications for effective project and contract management of multi-storey building projects which is very paramount to improve the delivery of complex, technical- and capital-intensive building projects in Nigeria.Originality/valueThe study provides specific implications for the management of multi-storey building projects, thereby enhancing the delivery of building projects.

Assessment of Interprofessional Team Collaboration Scale (AITCS): Further Testing and Instrument Revision.

The need to be able to assess collaborative practice in health care teams has been recognized in response to the direction for team-based care in a number of policy documents. The purpose of this study is to report on further refinement of such a measurement instrument, the Assessment of Interprofessional Team Collaboration Scale (AITCS) first published in 2012. To support this refinement, two objectives were set: Objective 1: to determine whether the items from the data collected in 2016 load on the same factors as found for the 2012 version of the 37-item AITCS. Objective 2: to determine whether the items in the subscales of the AITCS could be reduced while retaining psychometric properties similar to those from the earlier versions of the AITCS. Initially, the overall data sets of 1002 respondents from two hospitals and four community agencies were analyzed for demographics and scale and subscale mean values, SDs, and mean item scores. After deletion of respondents because of missing data, 967 respondents were available for the first analysis. An exploratory factor analysis was then conducted to determine the factor structure. All respondents with any random missing data were further removed to reduce the data set to 676 responses, followed by a confirmatory factor analysis to find a model fit resulting in an item reduction in the scale. The result was a 23-item AITCS-II for practitioners that retained acceptable levels of reliability and validity within 3 subscales-partnership (8 items), cooperation (8 items), and coordination (7 items). The shortened version of the AITCS-II is a valid and reliable instrument that can be used to assess collaboration in health care teams in practice settings.

F95. ASSESSING MANIC SYMPTOMS IN PATIENTS WITH SCHIZOPHRENIA USING THE YOUNG MANIA RATING SCALE

BackgroundVan Os and Kapur have proposed that the discrete categorical dichotomy of schizophrenia versus bipolar disorder be changed to a dimensional conceptualization. It is also known that manic symptoms can contribute to the clinical course and prognosis of schizophrenia. Hence, a domain for mania has been included in the Clinician-Rated Dimensions of Psychosis Symptom Severity (CRDPSS) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). However, the psychometric properties of the Young Mania Rating Scale (YMRS) have been little studied in subjects with schizophrenia.MethodsOne hundred and sixty-six inpatients with schizophrenia (diagnosed with DSM-5,2 age ≥ 18 years and ≤ 65 years, and length of hospital stay ≥ 2 weeks) were enrolled from two mental hospitals in Korea. The Institutional Review Board approved the study protocol, and informed consent was given by all study subjects before the start of the study. The Korean version of the YMRS was used to evaluate the severity of manic symptoms. In addition, the domain for mania in the CRDPSS was used to evaluate presence or absence of manic symptoms (0–1, absence; 2–4, presence).ResultsThe average age and age-at-onset of the subjects were 46.5 (SD = 11.2) and 25.2 (SD = 13.2) years, respectively. Half were men (51.5%), and most were unmarried (79.1%), religiously affiliated (61.5%) and educated below high school graduate level (73.0%). The mean chlorpromazine equivalent dose of prescribed antipsychotics was 921.1 (SD = 952.0) mg. The mean total score on the YMRS was 7.3 (SD = 6.9) and the mean item scores were: 0.2 (SD = 0.4) for elevated mood, 0.1 (SD = 0.4) for increased motor activity, 0.1 (SD = 0.4) for sexual interest, 0.1 (SD = 0.4) for sleep, 0.4 (SD = 0.8) for irritability, 0.6 (SD = 1.2) for speech, 0.8 (SD = 1.1) for language, 2.0 (SD = 3.3) for content, 0.2 (SD = 0.7) for aggressive behavior, 1.0 (SD = 1.0) for appearance, and 1.8 (SD = 1.7) for insight. The Cronbach α for the 11 YMRS items was 0.66, which is considered an acceptable level of internal consistency. Moreover, only 4% (n = 7) of the 166 subjects had manic symptoms as assessed by the mania domain in the CRDPSS. A receiver operating characteristic curve (ROC) showed that the optimal cut-off score distinguishing schizophrenia patients with and without manic symptoms was 10 with a sensitivity of 88.3% and specificity of 75.6% (area under curve = 0.803, P = 0.012).DiscussionSince a 10 point total score on the YMRS represents a mild level of Clinical Global Impression (CGI) severity of mania, we may conclude that our threshold on the YMRS for identifying manic symptoms in patients with schizophrenia is reasonable. Hence it may be useful to investigate the evaluation of manic symptoms in patients with schizophrenia from the perspective of deconstructing psychoses.