Confirmatory factor analysis of the BRIEF2 in a sample of youth with Down syndrome.

BACKGROUND: The factor structure of the Behavior Rating Inventory of Executive Function, second edition (BRIEF2) has been widely examined in both typically developing children and specific clinical samples. Despite the frequent use of the BRIEF2 for measuring executive functioning in individuals with Down syndrome, no study has investigated the factorial validity or dimensionality of the BRIEF2 in this population. This study aimed to address this notable gap in the literature. METHODS: Parents of 407 children and youth with Down syndrome aged 6-18 years completed the BRIEF2 as part of different studies led by six sites. Three competing models proposed by previous studies were analysed using Confirmatory Factor Analysis: the theoretical structure of the BRIEF2 where the scales were constrained to load on three factors labelled as Cognitive, Behavioral, and Emotional Regulation, a two-factor correlated model with the merged Behavioral and Emotional regulation, and a single-factor model. RESULTS: The three-factor model provided a better fit than the one- and two-factor models, yet a large correlation was observed between Behavioural and Emotional regulation factors. The results provide meaningful explanatory value for the theoretical structure of the BRIEF2. However, the Behavioral and Emotional regulation factors might be less differentiated and the two-factor structure of the BRIEF2 may also make theoretical and empirical sense. CONCLUSIONS: Although more studies are needed to further examine the factor structure of the BRIEF2 in youth with Down syndrome, this investigation provides preliminary support for the interpretation of the three executive function index scores provided by the BRIEF2: Cognitive, Behavioral, and Emotional Regulation.

Intraocular pressure changes after neodymium-YAG laser capsulotomy in eyes pretreated with timolol.

Sixty eyes undergoing Q-switched neodymium-YAG laser posterior capsulotomy were randomly assigned to pretreatment with either 0.5% timolol maleate or placebo. Half of the eyes in each group underwent capsulotomies performed with six 2-mJ bursts of energy, and the remaining eyes underwent capsulotomies performed with three 4-mJ bursts of energy. There was no significant difference in pressure responses between eyes treated with 2 or 4 mJ. The mean rise in intraocular pressure was significantly less in the timolol-pretreated group one hour after capsulotomy. After four hours, the difference between groups was not significant. Pretreating with timolol did not prevent late pressure rises. Nonpseudophakic eyes were more likely to sustain pressure increases greater than 10 mm than were pseudophakic eyes.

Intraocular pressure changes after neodymium-YAG laser posterior capsulotomy.

Thirty-seven Q-switched neodymium-YAG laser posterior capsulotomies were performed on 33 aphakic or pseudophakic eyes. The average intraocular pressure increase during the first 24 hours after treatment was 12.0 +/- 6.9 mm Hg from a baseline value of 17.7 mm Hg in the treated eye v +0.7 +/- 3.5 mm Hg in the untreated eye. Seven eyes had larger capsulotomies performed, averaging 250.7 millijoules (mJ) of energy per treatment. Thirty eyes had smaller posterior capsulotomies performed, averaging 48.3 mJ per treatment. Average IOP increases within the first day were 16.1 and 12 mm Hg, respectively. All eyes in which IOP increased more than 5 mm Hg showed the increase within the first 48 hours. In some eyes, IOP remained elevated more than 10 mm Hg above preoperative levels for several weeks. Higher pressures were associated with larger capsulotomies and increased energy. Minimizing debris and shock waves are recommended as well as thorough postoperative pressure monitoring.