Does parent report measure performance? A study of the construct validity of the Functional Mobility Scale.

AIM: Parental report is often relied on to measure performance of activities in children with cerebral palsy (CP). This study examined whether the Functional Mobility Scale (FMS) accurately reflects performance of mobility in children with CP. METHOD: Eighteen children with spastic CP (11 males, seven females; mean age 12 y 8 mo, SD 2 y 8 mo, range 8-17 y) were recruited from a special development school. Children were in Gross Motor Function Classification System (GMFCS) levels II (n=5), III (n=4), or IV (n=9), and had quadriplegia (n=9), diplegia (n=7), or hemiplegia (n=2). The children's mobility was observed directly around and outside the home and at school and their mobility methods were recorded. The parent's FMS rating was obtained on the telephone by a physiotherapist. Agreement between direct observation and the FMS rating was examined using quadratic weighted kappa (kappa) statistics. RESULTS: Agreement between direct observation and the FMS was as follows: FMS 5m kappa=0.71, 45%; FMS 50m kappa=0.76, 94%; FMS 500m kappa=0.74, 95%. Differences in the range and number of mobility methods were observed by GMFCS level across environmental settings. INTERPRETATION: Substantial agreement was found between FMS ratings and direct observation, particularly over longer distances, providing evidence of the validity of the FMS as a measure of performance in children with CP.

Prevalence of drug use in commercial tractor-trailer drivers.

An enforcement emphasis project, "Operation Trucker Check," was established in order to determine the extent to which commercial tractor-trailer drivers were operating their vehicles while impaired by drugs. A total of 1079 drivers and their vehicles were assessed for driver and equipment violations, and drivers additionally underwent preliminary field sobriety tests conducted by drug recognition expert (DRE) officers. Anonymous urine specimens for drug analysis were requested, and 822 urine specimens were obtained in total. Compliance with the drug-testing portion was voluntary, and there was a 19% refusal rate. Overall, 21% of the urine specimens tested positive for either illicit, prescription, and/or over-the-counter drugs, and 7% tested positive for more than one drug. Excluding caffeine and nicotine, the largest number of positive findings (9.5%) were for CNS stimulants, such as methamphetamine, amphetamine, phentermine, ephedrine/pseudoephedrine, and cocaine. The second most frequently encountered drug class were the cannabinoids, with 4.3% of drivers testing positive for marijuana metabolites. Only 11 drivers (1.3%) were positive for alcohol. Sixteen truck drivers (1.6%) were charged with driving under the influence of drugs after a full DRE evaluation was conducted. The results indicate that in spite of comprehensive drug testing in the trucking industry, some tractor-trailer drivers are continuing to take illicit and other drugs with the potential of having a negative effect on their driving ability. On the other hand, only a few drivers were, in fact, deemed to be under the influence of drugs at the time of driving when evaluated by DRE officers.