第一報 日本語版Nursing Activity Scale(1992年)の信頼性・妥当性の検証 : 日本の臨床看護職における専門職的自律性

Activity Scales and ATP Hydrolysis: Understanding the Thermodynamics of Molecular Motor Kinesin

Background and purposeThe Rasch‐Built Pompe‐Specific Activity (R‐PAct) scale is a patient‐reported outcome measure specifically designed to quantify the effects of Pompe disease on daily life activities, developed for use in Dutch‐ and English‐speaking countries. This study aimed to validate the R‐PAct for use in other countries.MethodsFour other language versions (German, French, Italian, and Spanish) of the R‐PAct were created and distributed among Pompe patients (≥16 years old) in Germany, France, Spain, Italy, and Switzerland and pooled with data of newly diagnosed patients from Australia, Belgium, Canada, the Netherlands, New Zealand, the USA, and the UK and the original validation cohort (n = 186). The psychometric properties of the scale were assessed by exploratory factor analysis and Rasch analysis.ResultsData for 520 patients were eligible for analysis. Exploratory factor analysis suggested that the items separated into two domains: Activities of Daily Living and Mobility. Both domains independently displayed adequate Rasch model measurement properties, following the removal of one item ("Are you able to practice a sport?") from the Mobility domain, and can be added together to form a "higher order" factor as well. Differential item functioning (DIF)‐by‐language assessment indicated DIF for several items; however, the impact of accounting for DIF was negligible. We recalibrated the nomogram (raw score interval‐level transformation) for the updated 17‐item R‐PAct scale. The minimal detectable change value was 13.85 for the overall R‐PAct.ConclusionsAfter removing one item, the modified‐R‐PAct scale is a valid disease‐specific patient‐reported outcome measure for patients with Pompe disease across multiple countries.

Purpose Children with incomplete recovery from Brachial Plexus Birth Injury (BPBI) experience varying degrees of upper limb impairment, and 20–30% require interventions to optimize function. A psychometrically validated measure of upper limb activity capacity is essential to guide shared clinical decisions for surgical and rehabilitation interventions. Materials and methods Following the Joanna Briggs Institute Manual for Evidence Synthesis, this systematic review included studies on the measurement properties of the Brachial Plexus Outcome Measure (BPOM) – Activity Scale, a performance-based outcome measure of upper limb activity capacity in children with BPBI. Three databases were searched from inception to October 2023. Methodological quality was assessed and summarized using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN)’s Risk of Bias checklist. Results Of 11 screened, 6 studies were included. The quality of measurement property studies was very good (27%, n = 4), adequate (7%, n = 1), doubtful (20%, n = 3) and inadequate (47%, n = 7). The BPOM – Activity Scale demonstrated strong internal consistency, with good reliability and construct validity. Additional evidence on its content validity and reliability is necessary. Conclusions Overall, the BPOM – Activity Scale has the potential to provide evidence-based information to support the rehabilitation of children with BPBI.

Introduction. The effect of physical activity on disease activity and enthesitis in patients with spondyloarthritis is unknown. We aimed to describe clinical and enthesis features and disease activity of spondyloarthritis patients and to assess the association between physical activity and disease activity. Methods. We conducted a cross-sectional study including consecutive patients followed for radiographic axial spondyloarthritis. For each patient, we performed ultrasonography of entheses and assessed disease activity. Physical activity level was assessed using the University of California and Los Angeles (UCLA) activity scale and the Tegner activity scale. Results. We examined 518 entheses in 37 patients. There were 29 men (78%) and 8 women (22%). The mean age was 44.62 ± 12.31 years. Exercise was performed in 51% of patients. The median (IQR 25%-75%) UCLA activity scale was 4 (4-5) and the median (IQR 25%-75%) Tegner physical activity scale was 3 (3-5). Exercise was asso­ciated with a lower risk of disease activity (OR 0.123, p = 0.022, 95%CI 0.020-0.742). We didn’t find a significant difference in enthesis ultrasound characteristics between the patients practicing or not practicing exercise. Patients doing exercise had a signifi­cantly lower risk of having > 3 ultrasonographic enthesophytes and plantar aponeuro­sis enthesophytes. Nevertheless, those who engage in physical activity have a signifi­cantly higher risk of hypoechogenicity in the lateral epicondylar tendons. Conclusions. Our study showed that exercise was associated with lower clinical disease activity. Physical activity can be responsible for ultrasonographic tendon inser­tion damage, but it doesn’t accentuate the structural damage. The promotion of phys­ical activity should be considered a healthcare priority.

BackgroundThe assessment of active aging levels in Pakistani older adults is crucial yet; research tools are scarce in the local language. Therefore, this study aims to translate and validate the English version of an Active Aging Scale into a cross-culturally sensitive Urdu version to assess active aging levels in Pakistani older adults.MethodsTo translate and validate the scale, we used the ISPOR (International Society for Pharmacy Economic and Outcome Research) standards. Reliability, concurrent validity, construct validity, convergent validity, and discriminatory validity were checked on a total sample of 160 community-dwelling older adults. After two weeks, the test–retest reliability was examined. AMOS version 23 and SPSS version 23 were used to analyze the data.Results The average content validity index for clarity was 0.91 and relevancy was 0.80. The total variance in the pilot study of all items secured > 0.3 variances except for two items scored < 0.30 that were omitted before the validity and reliability test. The remaining items explained 65.46% of the overall variation and had factor loadings ranging from 0.46 to 0.90 in the principal factor analysis (PFA). The confirmatory factor analysis of the Active Aging Scale revealed that the model fit was good with a Chi-square value (418.18 (DF = 2.2) which is less than 3.00. This is further evidenced by the root mean square error of approximation (RMSEA) of 0.042, goodness of fit index (GFI) of 0.92, adjusted goodness of fit index (AGFI) of 0.94, and comparative fit index (CFI) values of 0.92 and 0.96 (unstandardized and standardized, respectively). The scale’s Cronbach’s alpha coefficient was 0.88, indicating dependability and its test–retest reliability with the significance of (P. < 0.05).ConclusionThe Urdu version of the Active Aging Scale was successfully translated and validated in a culturally sensitive manner, and can be used to evaluate the effectiveness of various active aging interventions for older adults in Pakistan.

Globally, thousands of kilometres of rivers are degraded due to the presence of elevated concentrations of potentially harmful elements (PHEs) sourced from historical metal mining activity. In many countries, the presence of contaminated water and river sediment creates a legal requirement to address such problems. Remediation of mining-associated point sources has often been focused upon improving river water quality; however, this study evaluates the contaminant legacy present within river sediments and attempts to assess the influence of the scale of mining activity and post-mining remediation upon the magnitude of PHE contamination found within contemporary river sediments. Data collected from four exemplar catchments indicates a strong relationship between the scale of historical mining, as measured by ore output, and maximum PHE enrichment factors, calculated versus environmental quality guidelines. The use of channel slope as a proxy measure for the degree of channel-floodplain coupling indicates that enrichment factors for PHEs in contemporary river sediments may also be the highest where channel-floodplain coupling is the greatest. Calculation of a metric score for mine remediation activity indicates no clear influence of the scale of remediation activity and PHE enrichment factors for river sediments. It is suggested that whilst exemplars of significant successes at improving post-remediation river water quality can be identified; river sediment quality is a much more long-lasting environmental problem. In addition, it is suggested that improvements to river sediment quality do not occur quickly or easily as a result of remediation actions focused a specific mining point sources. Data indicate that PHEs continue to be episodically dispersed through river catchments hundreds of years after the cessation of mining activity, especially during flood flows. The high PHE loads of flood sediments in mining-affected river catchments and the predicted changes to flood frequency, especially, in many river catchments, provides further evidence of the need to enact effective mine remediation strategies and to fully consider the role of river sediments in prolonging the environmental legacy of historical mine sites.

In this study, we describe and compare the compensatory responses of healthy young and older adults to sequentially increasing upper-body perturbations. The scaling of plantarflexor muscular activity and minimum time-to-contact (TtC(MIN)) was examined, and we determined whether TtC(MIN) predictions of instability (stepping transitions) for the older subjects were similar to those we previously reported for younger subjects (Hasson et al. in J Biomech 41:2121-2129, 2008). We found that the older subjects stepped at a lower perturbation level than the younger subjects; however, this response was appropriate based on their greater center of mass (CoM) accelerations, which may have been caused by differences in pre-perturbation states between the age groups. Although the CoM acceleration increased linearly with perturbation magnitude, the amount of gastrocnemius and soleus muscular activity increased nonlinearly in both age groups. There were no differences in the maximum plantarflexor torque responses, suggesting that the maximum torque capabilities of the older subjects were not limiting factors. As previously demonstrated in the younger subjects, the older subjects showed a quadratic decrease in TtC(MIN) with increasing perturbation magnitude. The vertices of the quadratics gave accurate predictions of stepping transitions in both age groups, even though the older subjects stepped at lower perturbation magnitudes. By probing the postural system's behavior through sequentially increasing upper-body perturbations, we observed a complementary nonlinear scaling of muscle activity and TtC(MIN), which suggests that subjects could use TtC or a correlate as an informational variable to help determine whether a step is necessary.

Patient-reported outcome measures (PROMs) are used increasingly, but for young patients with hip complaints, traditional scoring systems have a ceiling effect that limits their usability. We developed and validated the Super Simple Hip (SUSHI) score, a PROM specifically targeted at younger patients with hip complaints. Although the SUSHI measured hip problems adequately, the responsiveness of its activity rating component was considered inadequate. Consequently, we replaced the activity rating component by the University of California, Los Angeles (UCLA) activity scale. The aim of this study was to validate the resulting new 10-item SUSHI-UCLA score. A prospective multicentre observational cohort study was performed. Patients between 18 and 59 years, who visited the Orthopaedic Department with hip complaints, completed the SUSHI-UCLA and hip osteoarthritis outcome score (HOOS) twice before their 1st appointment, and once 16 months after. 142 patients were included (mean age 49 years; SD 8.8). The SUSHI-UCLA score correlated well with the HOOS, both before and after treatment (Spearman's rho = 0.739 and 0.847, respectively, both p < 0.001). The responsiveness of both the SUSHI-UCLA score and the UCLA activity scale was high (standardised response mean = 2.51 and 1.35 respectively). The reproducibility was good (interclass correlation coefficient for agreement = 0.962). The minimal important change was 21.2. No significant floor or ceiling effect was observed. The SUSHI-UCLA score is an adequate PROM to measure hip complaints in younger patients and includes a validated activity rating.

Stabilized activation scale estimation for precise Post-Training Quantization

To develop and validate a sports activity scale for patients with a diagnosis of femoroacetabular impingement (FAI). A nine level Hip Sports Activity Scale (HSAS) was constructed both in German and English languages. Fifty-nine consecutive patients undergoing surgical treatment for FAI at two centers in Switzerland and in the US completed a questionnaire set consisting of the HSAS, the University of California at Los Angeles (UCLA) activity scale and different hip joint-specific and generic outcome tools. For reliability assessment, the HSAS was completed twice about nine days apart. Evidence of reliability, validity and responsiveness was investigated by classical psychometric analyses. Reliability was excellent for both the German and the English versions with intraclass correlation coefficients of 0.94 and 0.96, respectively. Evidence of convergent validity was supported by moderate to high correlations with the UCLA activity scale and with the joint-specific measures used. Evidence of divergent validity was supported by low correlations with the SF-12 Mental Component Scale and the WOMAC stiffness subscale. The standardised response mean was 0.69. The HSAS is a reliable and valid tool to determine sports levels in patients suffering from FAI. Its use in future studies investigating outcomes in young patients with hip disease can be recommended. Level III, Diagnostic Studies - An independent, masked comparison with an appropriate population of patients, but reference standard not applied to all study patients.

BackgroundThe Active Movement Scale is a frequently used outcome measure for children with obstetric brachial plexus palsy (OBPP). Clinicians observe upper limb movements while the child is playing and quantify them on an 8 point scale. This scale has acceptable reliability however it is not known whether it accurately depicts the movements observed. In this study, therapist-rated Active Movement Scale grades were compared with objectively-quantified range of elbow flexion and extension and shoulder abduction and flexion in children with OBPP. These movements were chosen as they primarily assess the C5, C6 and C7 nerve roots, the most frequently involved in OBPP. Objective quantification of elbow and shoulder movements was undertaken by two-dimensional motion analysis, using the v-scope.MethodsYoung children diagnosed with OBPP were recruited from the Royal Children's Hospital (Melbourne, Australia) Brachial Plexus registry. They participated in one measurement session where an experienced paediatric physiotherapist facilitated maximal elbow flexion and extension, shoulder abduction and extension through play, and quantified them on the Active Movement Scale. Two-dimensional motion analysis captured the same movements in degrees, which were then converted into Active Movement Score grades using normative reference data. The agreement between the objectively-quantified and therapist-rated grades was determined using percentage agreement and Kappa statistics.ResultsThirty children with OBPP participated in the study. All were able to perform elbow and shoulder movements against gravity. Active Movement Score grades ranged from 5 to 7. Two-dimensional motion analysis revealed that full range of movement at the elbow and shoulder was rarely achieved. There was moderate percentage agreement between the objectively-quantified and therapist-rated methods of movement assessment however the therapist frequently over-estimated the range of movement, particularly at the elbow. When adjusted for chance, agreement was equal to chance.ConclusionVisual estimates of elbow and shoulder movement in children with OBPP may not provide true estimates of motion. Future work is required to develop accurate, clinically-acceptable methods of quantifying upper limb active movements. Since few children attained full range of motion, elbow and shoulder movement should be monitored and maintained over time to reduce disability later in life.

This article reports on an investigation into the validity of a widely used scale for measuring the extent to which higher education students employ active learning strategies. The scale is the active learning scale in the Australasian Survey of Student Engagement. This scale is based on the Active and Collaborative Learning scale of the National Survey of Student Engagement. The particular focus of the study was to investigate effects resulting from the addition of a small number of items to the active learning scale designed to capture some highly engaging, mostly online, activities. The items were developed in response to concerns that students studying in distance mode often report lower average scores on active learning scales than their on-campus counterparts. The additional items relate to activities such as working online with other students and faculty. The findings show that average scores on the Australasian Survey of Student Engagement/National Survey of Student Engagement scale increase significantly when the new items are included and that some differences between on-campus and distance education students narrow significantly. These findings have implications for the development of more robust and comprehensive instruments to measure active learning.

People with cerebral palsy (CP) are often unable to express pain owing to cognitive or speech impairments. Reports that rely on observation can be inaccurate, because behaviours such as grimacing, common in people with spastic CP, resemble pain expressions. We examined preliminary validity and reliability of the revised Face, Legs, Activity, Cry, and Consolability (r-FLACC) scale in people with spastic CP. Forty-eight young people and adults (35 females, 13 males; mean [SD] age 29y 2mo [13y]) were video-recorded during a standard examination, rating their pain (0-10) afterwards. Two raters completed the r-FLACC using the video recordings. Interrater reliability was assessed with an unconditional cross-classified random-effects model and item response theory approach; Pearson correlations measured agreement between raters and participants. Mean (SD) participant (n=48) pain scores were 2.48 (2.5) and mean (SD) r-FLACC scores were 1.46 (1.68). There was moderate agreement between raters (intraclass coefficient 0.41 and 0.57 respectively) but low agreement between participants and raters (r=0.26). There were no significant effects for raters (lay observers, nurses, physicians, and inexperienced raters). Results provide mixed support for the interrater reliability of the r-FLACC in people with spastic CP. The revised Face, Legs, Activity, Cry, and Consolability (r-FLACC) scale can be reliably used by experts and lay raters for people with spastic cerebral palsy (CP). Support is mixed for interrater reliability of the r-FLACC scale used with people with spastic CP.

PurposeSallis et al’s social support scale for physical activity (SSSPH) is one of the most widely used scales to measure exercise-related social support yet has never been translated and validated in Chinese. The current study aims to simplify, translate, and validate a short form of SSSPH in a Chinese population.Patients and MethodsA simplified Chinese version of the SSSPH (SSSPH-SC) retaining 6 items was achieved after the translation and back-translation process, which showed good content validity. The scale was then assessed among a convenience sample of 266 Chinese adults from various backgrounds. Internal consistency was tested by calculating Cronbach’s α. The a priori two-factor structure was tested with confirmatory factor analysis (CFA). Concurrent validity was examined by investigating the correlation of the SSSPH-SC with general social support, quality of life, and self-rated health.ResultsThe SSSPH-SC full scale and subscales showed good internal consistency with Cronbach’s alpha ranging from 0.87 to 0.92. The CFA supported the a priori two-factor structure: family support and friend support, with χ2/df=2.93, CFI = 0.98, TLI = 0.98, RMSEA = 0.07, SRMR = 0.035. The concurrent validity of the SSSPH-CS was further supported by its significant positive correlations with social support (r=0.26, p<0.001), quality of life (r=0.25, p<0.001), and self-rated general health depression (r=0.23, p<0.001).ConclusionThe SSSPH-SC had good reliability and validity and could be used as a simple and effective tool for assessing social support for physical activity in Chinese adults. The scale can be used as an effective tool to guide future health promotion programs as well as an evaluation tool to assess intervention effects.

1. Hierarchical partitioning of diversity is an effective tool in determining at what spatial scales diversity is generated. 2. This has important implications for managing diversity as we may wish to determine the appropriate scale for conservation activities. 3. We studied whether ant assemblages are compositionally distinct between different vegetation units and at which hierarchical scale (regional vs local) diversity is being generated. We did this in an attempt to determine at what spatial scales land use management and conservation activities for ants (and therefore invertebrates) should take place. 4. We sampled ants in 4 vegetation units in North West Province, South Africa, as part of a research expedition for the South African National Survey of Arachnida (SANSA); 92 ant species (Formicidae) were sampled in 25 genera within 6 subfamilies. 5. Partitioning of diversity showed that alpha diversity was high for points (sampling units) and extremely high for sites, but both were not significantly different from the random model. Although small relative to alpha diversity, beta diversity among points contributed significantly more than expected to overall diversity whereas turnover among vegetation units was significantly lower than expected from the null model. 6. These results indicate that turnover between points within vegetation units is relatively high; turnover at a regional scale was however very low, supported by the few number of species that were site specific. The lack of any spatial structure within sites might suggest that the studies’ grain was too fine or that ant assemblages in a vegetation unit are homogenous in space. 7. The high turnover observed in the study between points may be exactly that, and if so may well be attributed to habitat quality and ant dispersal mechanisms – supported by other studies. It may, however, simply be an artefact of incomplete sampling. The low beta diversity observed between vegetation types may be attributed to the fact that ants are extremely good dispersers. 8. Different colony founding mechanisms could explain why some species contributed more to the turnover between points. 9. Our results indicate that management activities for conservation of ants are sufficient at scales as fine as 400 m×400 m, yet we caution that small conservation areas should be nested within larger reserves in order to maintain landscape connectedness.