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This study examines the validity of the Delis–Kaplan Executive Function System (D‐KEFS) in a traumatic brain injury (TBI) population compared to participants with orthopaedic injuries and normative controls. The utility of the D‐KEFS was examined using a between groups design. One hundred patients with mild uncomplicated to severe TBI were recruited from a consecutive cohort of patients admitted as inpatients to a UK Major Trauma Centre and compared to 823 participants from the D‐KEFS normative sample and 26 participants with orthopaedic injuries. Data were filtered for performance validity. Sample discrimination was calculated from D‐KEFS subtest scores and derived index scores. Sensitivity to TBI severity was established. The TBI participants performed significantly lower on the D‐KEFS Trail Making Test, Colour Word Interference, Colour Word Switching, Letter Fluency and Verbal Fluency Category Switching Total Words Correct. The D‐KEFS index scores discriminated between TBI, orthopaedic and normative participants with large and moderate effect sizes, respectively. The D‐KEFS demonstrated a dose–response relationship with TBI severity. These effects were robust to differences in premorbid intellectual functioning; however, D‐KEFS performance was sensitive to performance on tests of mental processing speed. The use of a D‐KEFS index score provides a robust and reliable discrimination of TBI patients from healthy control participants. This discrimination is not accounted for by premorbid intellect or the non‐specific effects of trauma. The clinical and conceptual implications of these findings are considered. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the reliability, validity, and clinical utility of an idiographic, goal‐focused patient‐reported outcome measure: The Goals Form. Methods: Data were analyzed from 88 participants, across three samples, who had participated in collaborative–integrative psychotherapy at university‐based clinics in the UK. The samples were approximately 70% female with mean age of 30 years old. Results: The psychometric properties of the Goals Form were generally good. Noncompletion of individual items was low, temporal stability tended to be at target levels, and mean change scores showed moderate to good convergent validity against measures of psychological distress. The measure appeared sensitive to change in psychotherapy and was experienced by most patients as helpful. Conclusions: The Goals Form shows acceptable psychometric and clinical properties for routine outcome monitoring in psychotherapy. [ABSTRACT FROM AUTHOR]

Introduction: Impacted fetal head (IFH) is a challenging complication of cesarean section (CS) associated with significant morbidity. Training opportunities for IFH have been reported as inconsistent and inadequate. This study assessed the validity of a novel birth simulator for IFH at cesarean section. Material and methods: Obstetricians and midwives collaborated with model‐making company, Limbs & Things (UK), to modify the original PROMPT Flex® simulator and develop a new "Enhanced CS Module" for IFH at cesarean section. Changes included addition of a retractable uterus and restricted pelvic inlet, and the fetal mannequin was modified to allow accurate limb articulation and flexion at the waist. Obstetricians and midwives from three maternity units in Southwest England were individually recorded, each undertaking three simulated scenarios of IFH at cesarean section. Obstetricians were asked to deliver the fetal head and midwives, to perform a vaginal push‐up. Participants completed a questionnaire on realism (face validity) and usefulness for training (content validity) with five‐point Likert scale responses. Construct validity was assessed by testing an a priori hypothesis that "experts" (consultant obstetricians with >7 years' experience) would be more likely to achieve delivery than "novices" (registrars with <7 years' experience). Performance variables were compared between groups using Chi‐square and Mann–Whitney U‐tests. Results: In all, 105 simulated scenarios were undertaken by 35 obstetricians and midwives. A range of techniques were employed to deliver the IFH including change of hand, vaginal disimpaction and reverse breech extraction. Overall, 86% (30/35) described the model as fairly (4)/very realistic (5) (median = 4, interquartile range [IQR] = 4–5). The model was considered fairly (4)/very useful (5) for training by 97% (34/35; median = 5; IQR = 5–5). Experts delivered the fetal head in all simulations (36/36) and novices delivered the head in 76.9% (30/39) (p = 0.002). Experts delivered the fetal head 58% quicker than novices (median = 66.8 s, IQR = 53–86 vs median = 104 s, IQR = 67.7–137). Conclusions: This novel birth trainer realistically simulates IFH at cesarean section and allows rehearsal of all disimpaction techniques. It was reported to be very useful for training and distinguishes between novice and expert obstetricians. Techniques for IFH are difficult to learn experientially. Simulation is likely to provide an effective and safe form of training. [ABSTRACT FROM AUTHOR]

Aim: To design an individualised questionnaire to measure the impact of cancer and its treatments on quality of life (QoL). Materials & Methods: Design of the Cancer‐Dependent Quality of Life (CancerDQoL) questionnaire was based on the Audit of Diabetes Dependent QoL (ADDQoL) questionnaire and related –DQoLs for other conditions. Item selection, face validity and content validity were established through clinician and patient ratings of the importance and relevance of 60 domains from the –DQoL Item Library, and semi‐structured interviews with 25 English‐speaking participants with a range of cancers attending a cancer centre in Zimbabwe (age range: 25‐78 years; 16 women, 9 men). Ten interviews were subsequently conducted with UK English‐speaking participants with a range of cancers attending Maggie's Centres in London and Dundee (age range: 40‐76; 5 women, 5 men) to adapt the CancerDQoL for UK use. Results: The first draft of the CancerDQoL contained 25 domain‐specific items from the ‐DQoL Item Library plus four overview items. Zimbabwean participants indicated that cancer negatively impacted on all life domains included, except 'having children'. Weighted impact (impact ratings multiplied by importance) was most negative for 'sex life', 'depend on others' and 'physical capability'. The least negative weighted impact was found for 'having children', 'spiritual/religious life' and 'past medical/self‐care'. UK interviews confirmed no new items were required. Conclusions: Face and content validity of the CancerDQoL is established for an adult sample of English‐speaking cancer patients in Zimbabwe and confirmed in an adaptation following UK interviews. Key points: Generic and cancer‐specific health status and function tools are often misrepresented in the literature as if they are measures of (health‐related) quality of life (QoL)The Cancer Dependent Quality of Life (CancerDQoL) questionnaire was designed based on the Audit of Diabetes Dependent Quality of Life (ADDQoL) questionnaire and related ‐DQoLs for other conditions, to provide an individualised measure of the impact of cancer on QoLFace and content validity of the CancerDQoL is established through semi‐structured interviews with 25 English‐speaking cancer patients in Zimbabwe and confirmed in an adaptation following 10 UK interviews with English‐speaking cancer patientsBy accurately measuring the impact of cancer and its treatment on QoL using a genuine, individualised measure of QoL, rather than a health status tool, clinicians will be able to derive a more holistic view of the impact of cancer and its treatment on an individual's QoLA substantial dataset has now been collected to evaluate the psychometric properties of the CancerDQoL [ABSTRACT FROM AUTHOR]

Summary: Immune thrombocytopenia (ITP) is an acquired immune‐mediated disorder. Bleeding is the primary symptom that presents in varying severities. ITP has a negative impact on health‐related quality of life (HRQoL). The ITP Life Quality Index (ILQI) was developed as a 10‐item patient‐reported outcome measure to assess impact on HRQoL in ITP. The objective of the present study was to confirm the content validity of the ILQI with a qualitative interview study in the UK involving 15 adult participants with ITP. Combined concept elicitation (CE) and cognitive debriefing (CD) interviews were conducted to explore the symptoms and impacts associated with ITP and confirm content validity of the draft ILQI. The CE phase elicited 14 ITP symptom concepts, including: bruising (all 15 patients, 100%), fatigue (14, 93·3%) and bleeding gums/blood blisters (13, 86·7%). Impacts included decreased ability to participate in sport (all 15 patients, 100%) and anxiety (12, 80%). The CD phase resulted in an adjustment to the ILQI recall period from 1 week to 'the past month'. Updates were made to improve relevance and response options. The qualitative interviews support the content validity of the ILQI and confirm that the concepts assessed are relevant and consistently understood and interpreted by adult patients with ITP. [ABSTRACT FROM AUTHOR]

Objective: Charcot–Marie–Tooth disease (CMT) reduces health‐related quality of life (QOL), especially in children. Defining QOL in pediatric CMT can help physicians monitor disease burden clinically and in trials. We identified items pertaining to QOL in children with CMT and conducted validation studies to develop a pediatric CMT‐specific QOL outcome measure (pCMT‐QOL). Methods: Development and validation of the pCMT‐QOL patient‐reported outcome measure were iterative, involving identifying relevant domains, item pool generation, prospective pilot testing and clinical assessments, structured focus‐group interviews, and psychometric testing. Testing was conducted in children with CMT seen at participating sites from the USA, United Kingdom, and Australia. Results: We conducted systematic literature reviews and analysis of generic QOL measures to identify 6 domains relevant to QOL in children with CMT. Sixty items corresponding to those domains were developed de novo, or identified from literature review and CMT‐specific modification of items from the pediatric Neuro‐QOL measures. The draft version underwent prospective feasibility and face content validity assessments to develop a working version of the pCMT‐QOL measure. From 2010 to 2016, the pCMT‐QOL working version was administered to 398 children aged 8 to 18 years seen at the participating study sites of the Inherited Neuropathies Consortium. The resulting data underwent rigorous psychometric analysis, including factor analysis, test–retest reliability, internal consistency, convergent validity, item response theory analysis, and longitudinal analysis, to develop the final pCMT‐QOL patient‐reported outcome measure. Interpretation: The pCMT‐QOL patient‐reported outcome measure is a reliable, valid, and sensitive measure of health‐related QOL for children with CMT. ANN NEUROL 2021;89:369–379 [ABSTRACT FROM AUTHOR]

Introduction: Beliefs about the consequences of stress, stress mindsets, are associated with health and performance outcomes under stress. This article reports the development and examination of the psychometric properties of a measure of stress mindset: The Stress Control Mindset Measure (SCMM). The measure is consistent with theory on mindsets about self‐attributes and conceptualizes stress mindset as the extent to which individuals endorse beliefs that stress can be enhancing. Methods: The study adopted a correlational cross‐sectional survey design in two student samples. Undergraduate students from an Australian university (Sample 1, N = 218) and a UK university (Sample 2, N = 214) completed the SCMM and measures of health and well‐being outcomes. Results: Confirmatory factor analyses supported a four‐factor structure and strict measurement invariance across samples (ΔCFI < 0.01). Reliability, convergent validity, discriminant validity, and concurrent validity of the overall SCMM were supported in both samples. Incremental validity was supported for most outcomes, accounting for significantly more variance (between 2.2% and 5.9%) in health and well‐being outcomes than an existing measure. Conclusions: Current data provide preliminary support for the SCMM as a reliable and valid measure with good psychometric properties and theoretically consistent relations with health outcomes under stress. Findings provide initial evidence supporting the potential utility of the SCMM in future research examining relations between stress mindsets and health and performance outcomes. [ABSTRACT FROM AUTHOR]

Complex posttraumatic stress disorder (CPTSD) was added to the diagnostic nomenclature in the 11th revision of the International Classification of Diseases (ICD-11). Although considerable evidence exists supporting the construct validity of CPTSD, the distinguishability of CPTSD symptoms from those of borderline personality disorder (BPD) has been questioned. The present study examined the discriminant validity of CPTSD and BPD symptoms among a trauma-exposed population sample from the United Kingdom (N = 546). Participants completed self-report measures of CPTSD and BPD symptoms, and their latent structure was assessed using exploratory structural equation modeling (ESEM). A three-factor model with latent variables reflecting PTSD, disturbances in self-organization (DSO), and BPD symptoms provided the best fit of the data, χ2 (399, N = 546) = 1,650, p < .001; CFI = .944; TLI = .930; RMSEA = .077, 90% CI [.073, .081]. We identified multiple symptoms distinctive to individual constructs (e.g., disturbed relationships and suicidality) as well as symptoms shared across the constructs (e.g., affective dysregulation). The PTSD, β = .24; DSO, β = .23; and BPD, β = .27, latent variables were positively and significantly associated with childhood interpersonal trauma. The current findings support the discriminant validity of CPTSD and BPD symptoms and highlight various phenomenological signatures of each construct as well as demonstrate how these constructs share important similarities in symptom composition and exogenous correlates. [ABSTRACT FROM AUTHOR]

Objective: To develop and validate a novel 14‐item self‐completed questionnaire (in English and German) enquiring about the presence of non‐motor symptoms (NMS) during the past month in patients with craniocervical dystonia in an international multicenter study. Methods: The Dystonia Non‐Motor Symptoms Questionnaire (DNMSQuest) covers seven domains including sleep, autonomic symptoms, fatigue, emotional well‐being, stigma, activities of daily living, sensory symptoms. The feasibility and clinimetric attributes were analyzed. Results: Data from 194 patients with CD (65.6% female, mean age 58.96 ± 12.17 years, duration of disease 11.95 ± 9.40 years) and 102 age‐ and sex‐matched healthy controls (66.7% female, mean age 55.67 ± 17.62 years) were collected from centres in Germany and the UK. The median total NMS score in CD patients was 5 (interquartile range 3–7), significantly higher than in healthy controls with 1 (interquartile range 0.75–2.25) (P < 0.001, Mann–Whitney U‐test). Evidence for intercorrelation and convergent validity is shown by moderate to high correlations of total DNMSQuest score with motor symptom severity (TWSTRS: rs = 0.61), clinical global impression (rs = 0.40), and health‐related quality of life measures: CDQ‐24 (rs = 0.74), EQ‐5D index (rs = −0.59), and scale (rs = −0.49) (all P < 0.001). Data quality and acceptability was very satisfactory. Interpretation: The DNMSQuest, a patient self‐completed questionnaire for NMS assessment in CD patients, appears robust, reproducible, and valid in clinical practice showing a tangible impact of NMS on quality of life in CD. As there is no specific, comprehensive, validated tool to assess the burden of NMS in dystonia, the DNMSQuest can bridge this gap and could easily be integrated into clinical practice. [ABSTRACT FROM AUTHOR]

There is limited consensus about what constitutes humanly sensitive care, or how it can be sustained in care settings. A new humanised care assessment tool may point to caring practices that are up to the task of meeting persons as humans within busy healthcare environments. This paper describes qualitative development of a tool that is conceptually sensitive to human dimensions of care informed by a life‐world philosophical orientation. Items were generated to reflect eight theoretical dimensions that constitute what makes care feel humanly focused. An action research group process in 2014–2015 with researchers, service users, healthcare professionals in two diverse clinical settings (stroke rehabilitation and dermatology) was used. Feedback on conceptual content, transparency of meaning and readability was then gained from a panel in Sweden and third‐year student nurses in the UK. The tool can be applied to attune staff to human dimensions of care, offering items which point to concrete examples of humanising and dehumanising features of practice in ways that have not yet been fully captured in the caring literature. Based on theoretically led experiential items, with dedicated focus on what makes people feel more, or less than human, it may offer improvement on available assessments of care. [ABSTRACT FROM AUTHOR]

Context Longitudinal integrated clerkships ( LICs) represent a model of the structural redesign of clinical education that is growing in the USA, Canada, Australia and South Africa. By contrast with time-limited traditional block rotations, medical students in LICs provide comprehensive care of patients and populations in continuing learning relationships over time and across disciplines and venues. The evidence base for LICs reveals transformational professional and workforce outcomes derived from a number of small institution-specific studies. Objectives This study is the first from an international collaborative formed to study the processes and outcomes of LICs across multiple institutions in different countries. It aims to establish a baseline reference typology to inform further research in this field. Methods Data on all LIC and LIC-like programmes known to the members of the international Consortium of Longitudinal Integrated Clerkships were collected using a survey tool developed through a Delphi process and subsequently analysed. Data were collected from 54 programmes, 44 medical schools, seven countries and over 15 000 student-years of LIC-like curricula. Results Wide variation in programme length, student numbers, health care settings and principal supervision was found. Three distinct typological programme clusters were identified and named according to programme length and discipline coverage: Comprehensive LICs; Blended LICs, and LIC-like Amalgamative Clerkships. Two major approaches emerged in terms of the sizes of communities and types of clinical supervision. These referred to programmes based in smaller communities with mainly family physicians or general practitioners as clinical supervisors, and those in more urban settings in which subspecialists were more prevalent. Conclusions Three distinct LIC clusters are classified. These provide a foundational reference point for future studies on the processes and outcomes of LICs. The study also exemplifies a collaborative approach to medical education research that focuses on typology rather than on individual programme or context. [ABSTRACT FROM AUTHOR]

The article is a response by Mary Hilton to an article in the December 2007 issue of the "British Educational Research Journal" that critiqued an article of hers published in the December 2006 issue. The original article was a criticism by Hilton of the Progress in International Reading Literacy Study (PIRLS) as a means of measuring literacy internationally. Hilton feels that the examination did not account for unidimensionality and that the tests were biased both linguistically and culturally against minority children or those with inadequate English language skills. Hilton also addresses criticisms she had expressed for the texts that were chosen for the test. The PIRLS results were, Hilton states, were exaggerated by the New Labour Party and were adopted into a political agenda.

ObjectiveTo develop new methods of evaluating face validity in the context of a revised final professional examination for medical undergraduates, organized on three sites, over 2 days. MethodsThe opinion of the students and examiners was surveyed by Likert-style questionnaires, with additional open comments. Expert opinion was gathered from external examiner reports and a recent Quality Assurance Agency (QAA) Subject Review Report. ResultsThe questionnaires had an overall response rate of 84%. Internal reliability, assessed by comparing responses to appropriate questions, was good with an equivalence of 45% (weighted kappa 0·54) for the students and 33% (weighted kappa 0·41) for the assessors. There was little evidence of inconsistency between days or sites. The majority of the opinions from the students, examiners and external experts were positive. Negative comments related to time pressure and case mix. ConclusionThe measurement of face validity proved feasible and valuable and will assist in the further development of the course and the examination. [ABSTRACT FROM AUTHOR]

The article discusses British government policies regarding educational assessments. Topics include the reliability of educational assessment, the reliability of the General Certificate of Secondary Education (GCSE) standardized test, and problems with the statistical validity of education assessments.

The article comments on the ways in which the education system and student performance in Great Britain is evaluated, focusing on the role of standardized national tests such as the General Certificate of Secondary Education (GCSE) exam. Topics include testing validity, the role of coursework in assessment, and the attitudes of English literature teachers.