A therapy-relevant casemix classification system for school-age children with disabilities.

OBJECTIVE: To develop a clinically meaningful classification system of resource-homogeneous groups to describe therapy resource use for school-age children with disabilities. DESIGN: Work-time allocation survey of therapy services (physical therapists, occupational therapists, and speech pathologists). SETTING: Three main disability agencies in Western Australia. CLIENTS: All children of two agencies, a random sample of children of the third. A total of 644 clients and their services were studied. MAIN OUTCOME MEASUREMENT: Minutes of therapy service time expected over a 10-week school term. RESULTS: Forty-six percent of the variance in a measure of time spent with clients can be explained using a classification system of nine groups, based on splitting a mobility measure (4 major groups), then the nature of primary disorder (2 subgroups), independence in self care (3 subgroups), and expressive communication (3 subgroups). CONCLUSION: This study defines a preliminary classification system for the distribution of therapy resources to school-age children with disabilities. This model has the potential to be used to purchase services on a fairer basis than traditional, historical funding methods have allowed.

Assessing pediatric clinical asthma practices and perceptions: a new instrument.

Over the past 20 years, the most substantial increases in prevalence, morbidity, and mortality of asthma have been observed among children aged 5-14 years. A survey instrument designed to measure clinical asthma management practices of primary care physicians was developed and evaluated. Study participants included 127 practitioners providing pediatric asthma care in inner-city communities in Baltimore, MD and Washington, DC. Study results found that the instrument assessed four separate dimensions of clinical assessments and five dimensions of physician perceptions. These dimensions should be considered in future research protocols and may be used to design tailored interventions to improve asthma care.

Image analysis of gunshot residue on entry wounds. II--A statistical estimation of firing range.

A statistical investigation of the relationship between firing range and the amount and distribution of gunshot residue (GSR), used automated image analysis (IA) to quantify GSR deposit resulting from firings into pig skin, from distances ranging between contact and 45 cm. Overall, for a Ruger .22 semi-automatic rifle using CCI solid point, high velocity ammunition, the total area of GSR deposit on the skin sections decreased in a non-linear fashion with firing range. More specifically there were significant differences in the amount of GSR deposited from shots fired at contact compared with shots fired from distances between 2.5 and 45 cm; and between shots fired from a distance of 20 cm or less, with shots fired at a distance of 30 cm or more. In addition, GSR particles were heavily concentrated in the wound tract only for contact and close range shots at 2.5 cm, while the particle distribution was more uniform between the wound tract and the skin surfaces for shots fired from distances greater than 2.5 cm. Consequently, for future scientific investigations of gunshot fatalities, once standards have been established for the weapon and ammunition type in question, image analysis quantification of GSR deposited in and around the gunshot wound may be capable of providing a reliable, statistical basis for estimating firing range.

Cognitive progress associated with gambling behaviour.

Gambling behaviours can be pathological if positive response is extreme, but very little is known about the psychological precursors of pathological gambling in Australia. This study examined the relationships between self-reported gambling behaviours and scores on locus of control measures. The sample of 80 male and 75 female undergraduate students completed the South Oaks Gambling Screen and Levenson's multidimensional Locus of Control Scale. No significant association was found for the self-reported gambling behaviours with scores on the Internal scale but a positive one obtained between scores on the Powerful Others subscale. Self-reported gambling behaviours differed significantly for men reported that they gambled more than women. For these Australian undergraduates an additional question on borrowing money increased the apparent frequency of pathological gambling. Thus an avenue for further research is the development of a valid and reliable measure of gambling behaviours in an Australian sample.

Development and psychometric validation of the Mental, Physical, and Spiritual Well-Being Scale.

Due to the growing interest in holistic health and well-being, the Mental, Physical, and Spiritual Well-being Scale was developed. This well-being scale has 30 items and incorporates mental, physical, and spiritual subscales. An initial set of items was developed and 186 university students responded to these. An exploratory factor analysis was conducted using principal components analysis with varimax rotation (N=100) to reduce the number of items in the scale. Three factors were extracted based on the eigenvalues, loading coefficients exceeding 0.3, and the screen test. Ten items from each of the three factors were selected, reducing the number of items from 66 to 30. Another factor analysis, performed on 129 employees of the Commonwealth Scientific and Industrial Research Organisation and 229 students from Monash University, indicated three factors were representative of the mental, physical, and spiritual subscales. Test-retest reliabilities over 1 mo. ranged from 0.87 to 0.97 for the three subscales whilst internal consistency ranged from 0.75 to 0.85. Concurrent validity was examined using the General Health Questionnaire and the Spiritual Well-being Scale. The discriminant validity of the MPS was also explored using three activity groups nominated as highly physical (weight training) or highly mental (chess) or highly spiritual (prayer). Out of a total of 88 cases, 77.3% of these were correctly classified into their actual activity group based on their scores. Sample sizes were moderate and testing was of limited samples. More psychometric work is needed but preliminary findings indicate an accurate and reliable test.

Contraceptive responsibility among male university students.

PIP: The male contribution to contraceptive mismanagement and unwanted pregnancy was assessed among 109 students at the University of Melbourne in Australia. The survey was conducted 3 months prior to annual examinations. The interview focused on a range of subjects including socioeconomic data, extent of formal sex education, patterns of sexual behavior both in the past and in the present, contraception used within various types of relationships, reasons for contraceptive choice, and involvement in unwanted pregnancy. The age range of the subjects was 17-35. 84% (92) of the men had experienced heterosexual intercourse. 2 main types of relationships emerged: an emotionally committed and usually long-term relationship and a usually brief and "casual" relationship. 30% of all subjects thought that females should always be responsible for contraception. 31% believed that contraception was a joint responsibility in steady relationships but the female's responsibility in casual relationships. 35% of all subjects felt that both partners had an equal responsibility in preventing conception irrespective of the type of relationship. 4 men believed that contraception was always the male's responsibility. Contraceptive technique was rated adequate for 32% of the 92 sexually experienced men who always relied on either condoms, diaphragms, IUDs, oral contraceptives, or sterilization. Intermittent contraceptive use was reported by 60% of sexually experienced men who alternated betwen reliable and unreliable methods. Almost 1/5 of the sexually experienced men reported that they had been involved in an unwanted pregnancy.^ieng