Cross-cultural validation of the Arabic version of the Developmental Coordination Disorder Questionnaire DCDQ'07, in a Lebanese sample of children.

BACKGROUND: The revised version of the Developmental Coordination Disorder Questionnaire (DCDQ'07) is a parent questionnaire designed to identify Developmental Coordination Disorder in 5-15-year-old children. AIM: The aim of this study was to carry out the translation and cross-cultural adaptation of the DCDQ'07, to examine psychometric properties, and to define the cut-off scores of the Arabic-Lebanese version of the questionnaire (DCDQ-AL). METHOD: 38 parents of children with and without motor difficulties participated in the translation and cross-cultural phase. As for the validation phase and the study of the psychometric properties, a total of one hundred and twenty-four typically developing children (N=124) aged between 5 and 15 years were recruited through schools in different districts across Lebanon, whereas the clinical sample (N = 56) of children with motor difficulties was recruited via psychomotor rehabilitation centers in Beirut and psychomotor therapists working in private clinics across the country. This study used the Movement Assessment Battery for Children - second edition (MABC-2) motor test developed to classify children according to their degree of motor impairment. RESULTS: For test-retest reliability and inter-rater reliability, excellent Intraclass Correlation Coefficients (ICC) were shown with values of 0.94 and 0.9, respectively. The internal consistency value for the DCDQ-AL was high (Cronbach's alpha = 0.947). Correlations between the DCDQ-AL scores and Movement Assessment Battery for Children (MABC-2) show adequate convergent validity (ρ = 0.65, p < .001). Differences in DCDQ-AL scores between children with and without motor difficulties (p < .001) provide clear evidence of discriminative validity. The Lebanese cut-offs are very similar to the Canadian version, except for the 5-7 age band. The DCDQ-AL shows a sensitivity of 0.91 and specificity of 0.77. The adapted questionnaire showed solid psychometric properties, allowing us to conclude that the DCDQ-AL can be used to support a diagnosis of DCD. CONCLUSION: The results provide evidence that the DCDQ-AL is a valid clinical screening tool for DCD that can assist Arabic speaking professionals in screening children aged 5-15 years old who are at risk of having DCD.

Temporal and Spatial Variances in Arterial Spin-Labeling Are Inversely Related to Large-Artery Blood Velocity.

BACKGROUND AND PURPOSE: The relationship between extracranial large-artery characteristics and arterial spin-labeling MR imaging may influence the quality of arterial spin-labeling-CBF images for older adults with and without vascular pathology. We hypothesized that extracranial arterial blood velocity can explain between-person differences in arterial spin-labeling data systematically across clinical populations. MATERIALS AND METHODS: We performed consecutive pseudocontinuous arterial spin-labeling and phase-contrast MR imaging on 82 individuals (20-88 years of age, 50% women), including healthy young adults, healthy older adults, and older adults with cerebral small vessel disease or chronic stroke infarcts. We examined associations between extracranial phase-contrast hemodynamics and intracranial arterial spin-labeling characteristics, which were defined by labeling efficiency, temporal signal-to-noise ratio, and spatial coefficient of variation. RESULTS: Large-artery blood velocity was inversely associated with labeling efficiency (P = .007), temporal SNR (P < .001), and spatial coefficient of variation (P = .05) of arterial spin-labeling, after accounting for age, sex, and group. Correction for labeling efficiency on an individual basis led to additional group differences in GM-CBF compared to correction using a constant labeling efficiency. CONCLUSIONS: Between-subject arterial spin-labeling variance was partially explained by extracranial velocity but not cross-sectional area. Choosing arterial spin-labeling timing parameters with on-line knowledge of blood velocity may improve CBF quantification.

A taxonomy and results from a comprehensive review of 28 maternal health voucher programmes.

It is increasingly clear that Millennium Development Goal 4 and 5 will not be achieved in many low- and middle-income countries with the weakest gains among the poor. Recognizing that there are large inequalities in reproductive health outcomes, the post-2015 agenda on universal health coverage will likely generate strategies that target resources where maternal and newborn deaths are the highest. In 2012, the United States Agency for International Development convened an Evidence Summit to review the knowledge and gaps on the utilization of financial incentives to enhance the quality and uptake of maternal healthcare. The goal was to provide donors and governments of the low- and middle-income countries with evidence-informed recommendations on practice, policy, and strategies regarding the use of financial incentives, including vouchers, to enhance the demand and supply of maternal health services. The findings in this paper are intended to guide governments interested in maternal health voucher programmes with recommendations for sustainable implementation and impact. The Evidence Summit undertook a systematic review of five financing strategies. This paper presents the methods and findings for vouchers, building on a taxonomy to catalogue knowledge about voucher programme design and functionality. More than 120 characteristics under five major categories were identified: programme principles (objectives and financing); governance and management; benefits package and beneficiary targeting; providers (contracting and service pricing); and implementation arrangements (marketing, claims processing, and monitoring and evaluation). Among the 28 identified maternal health voucher programmes, common characteristics included: a stated objective to increase the use of services among the means-tested poor; contracted-out programme management; contracting either exclusively private facilities or a mix of public and private providers; prioritizing community-based distribution of vouchers; and tracking individual claims for performance purposes. Maternal voucher programmes differed on whether contracted providers were given training on clinical or administrative issues; whether some form of service verification was undertaken at facility or community-level; and the relative size of programme management costs in the overall programme budget. Evidence suggests voucher programmes can serve populations with national-level impact. Reaching scale depends on whether the voucher programme can: (i) keep management costs low, (ii) induce a large demand-side response among the bottom two quintiles, and (iii) achieve a quality of care that translates a greater number of facility-based deliveries into a reduction in maternal morbidity and mortality.

Caracterização epidemiológica da raiva bovina no estado de Mato Grosso, Brasil, no período de 1996 a 2006 / Epidemiological characterization of bovine rabies in the state of Mato Grosso, Brasil, in the period from 1996 to 2006

Um levantamento epidemiológico de todos os casos de raiva bovina ocorridos no Estado de Mato Grosso durante os anos de 1996 a 2006 foi realizado pela análise da curva epidêmica, por meio do cálculo do somatório, média, desvio padrão, valores máximos e mínimos da ocorrência de casos de raiva nos três ecossistemas; análise estatística entre o efetivo bovino nos três biomas do estado e o número de casos de raiva bovina; a distribuição sazonal e a situação da doença no estado em relação ao panorama nacional. Para organização dos dados, levou-se em consideração o mês e o ano de ocorrência da raiva e a região geográfica de origem do material. Os diferentes municípios envolvidos foram classificados conforme sua localização nas regiões de Cerrado, Pantanal e Amazônia. Constatou-se que a variação no número de casos positivos da enfermidade tem sido crescente nos últimos anos, sendo que o maior número de casos deu-se no bioma Cerrado, que apresentou uma tendência de aumento anual. A partir do ano de 2004, o ecossistema Cerrado passou da situação de enzootia para epizootia, ficando pois, evidente que o principal problema de raiva em bovinos no Estado de Mato Grosso está situado no bioma Cerrado.

An epidemiological survey of all cases of bovine rabies that occurred in Mato Grosso, Brazil, during the years 1996 to 2006 was conducted by way of the analysis of the epidemic curve, by calculating the sum, average, standard deviation, maximum and minimum values of the occurrence of rabies in three ecosystems; statistical analysis between the actual cattle in the three biomes of the state and the number of cases of rabies cattle; and the seasonal distribution and disease situation in the state in relation to the national scene. The data were organized by taking into account the month and year of occurrence of rabies and the geographic region of the origin of the material. The different cities involved were classified according to their location in regions of Cerrado, the Pantanal and the Amazon. It was found that the variation in the number of positive cases of the disease has been increasing in recent years, with the largest number of cases occurring in the Cerrado biome, which showed a trend of annual increase. Beginning in the year 2004 the Cerrado ecosystem passed from the situation of enzootic to epizootic, making it evident that the main bovine rabies problem in the state of Mato Grosso is situated in the Cerrado biome.

Caracterização genética e distribuição geográfica do vírus rábico isolado de bovinos no estado de Mato Grosso, Brasil / Genetic characterization and geographic distribution of rabies virus isolates from cattle in Mato Grosso, Brazil

Foram caracterizados, geneticamente e geograficamente, o sequenciamento parcial da nucleoproteína (gene N) de 53 isolados do vírus da raiva (VR) originários do Estado de Mato Grosso, Brasil. Os isolados de bovinos, que se encontravam no grupo do VR relacionado a morcegos hematófagos, foram posteriormente subdivididos em sete subgrupos genéticos. Estes subgrupos foram distribuídos em regiões de terras planas, com alguns subgrupos separados por formações de pequenas montanhas e hidrografia. Estes resultados indicam que a raiva em bovinos é derivada de diversas variantes regionalmente definidas, o que sugere que sua distribuição geográfica está relacionada as populações de morcegos hematófagos.

A total of 53 rabies virus (RV) isolates originating from cattle in the state of Mato Grosso, Brazil, were genetically characterized. Partial nucleoprotein gene sequences of these isolates were phylogenetically and geographically analyzed. Cattle isolates, which clustered with the vampire bat related RV group, were further subdivided into 7 subgroups. These subgroups were distributed widely in lowland regions, with some subgroups separated from each other by small mountains and hydrographical features. These results indicate that cattle rabies is derived from several regionally-defined variants, which suggests that its geographical distribution is related to that of the vampire bat population.

Traumatic transdural spinal cord herniation and the nuclear trail sign: case report.

A woman with a history of spine injury in her remote past developed Brown-Sequard syndrome due to a thoracic transdural spinal cord herniation. A clue about the underlying mechanism was offered by the unexpected imaging feature of a nuclear trail sign just below the herniated cord. As suggested by Watters et al., who reported a similar case, this finding is consistent with the hypothesis that intrathecal rupture of disk material could have resulted in an acquired tear of the ventral dural, through which the cord herniated.