Development of toileting behaviour evaluation for Japanese older patients using wheelchairs in a hospital setting: a validation study.

BACKGROUND: Ageing limits the activities of daily living (ADLs). Among ADLs, a lack of toileting independence causes a decline in the quality of life, mental health, and social participation. Therefore, occupational therapists spend considerable time assessing toileting disability based on various assessment methods for toileting behaviour. However, these assessment methods have issues with the grading levels, number of items, and diseases covered, and they fail to evaluate toileting behaviour accurately and sensitively. Hence, this study developed a Toileting Behaviour Evaluation (TBE) on a 6-point ordinal scale for patients using wheelchairs, with 22 activity components for various diseases. METHODS: This study examined the reliability and validity of the TBE in acute and subacute hospitals in Japan. To this end, two occupational therapists assessed 50 patients for inter-rater reliability at different times and one assessed them twice within 7-10 days for intra-rater reliability using the TBE. Furthermore, occupational therapists assessed 100 patients for internal consistency using the TBE and for concurrent validity using the TBE and Functional Independence Measure (FIM). The patients had been diagnosed with various diseases. This study used the weighted kappa coefficient for statistical analysis of the inter-rater and intra-rater reliability, Cronbach's alpha coefficient for internal consistency, and Spearman's rank correlation coefficient for concurrent validity. We performed all statistical analyses using the IBM SPSS Statistics ver. 25 for Windows. All P-values < 0.05 were considered statistically significant. RESULTS: The minimum weighted kappa coefficients for the inter-rater and intra-rater reliability for each item were 0.67 and 0.79, respectively. Cronbach's alpha was 0.98 for the 22 items. The Spearman's rank correlation coefficient between the mean scores on the TBE and FIM for toilet-related items was 0.74 (P < .01). CONCLUSIONS: The TBE demonstrated good reliability and validity. This means that therapists can use it to identify impaired toileting behaviour. However, the relationship between impairments and each item of toileting behaviour should be explored in future studies. Additionally, studies should examine the creation of a specific index of functions of independence in each toileting behaviour.

What Will Happen to This Dog? A Qualitative Analysis of Rehoming Organisations' Pre-adoption Dog Behaviour Screening Policies and Procedures.

Rehoming organisations often undertake some type of behaviour evaluation to determine dogs' suitability for rehoming and/or the type of suitable home. Assessments can carry considerable weight in determining dogs' fates. Although evaluation of the validity and reliability of any test is important, a more fundamental consideration is if the nature of the information sought and the weight given to this in organisations' decision making is of more than anecdotal value. Therefore, this study's aim was to conduct a qualitative analysis of organisations' pre-adoption dog behaviour screenings and potential justifications, comparing this with the available scientific evidence. A written enquiry was sent electronically to rehoming organisations in the UK and US from February 2016-July 2017. Of 73 respondents, the majority conducted assessments for all dogs. Using a thematic analysis, nine themes and 71 sub-themes emerged concerning the types of information respondents aim to gather from assessments. The majority of respondents used, at least partially, pass/fail scoring, i.e., certain outcomes would lead to dogs being deemed unadoptable. Forty-one sub-themes and one theme were identified as potentially leading to a dog being deemed unadoptable. The evidence base for these factors was identified from the scientific literature relating to: increased risk for relinquishment, impact on a dog's quality of life, and human safety risk. Evidence supported 10 factors: "aggression towards people", "aggression towards cats or other animals", "aggression towards dogs", "biting or snapping", "resource guarding", "activity level or exercise needs", "destructiveness", "housetrained", "fearfulness", and "knowledge of basic commands and/or general training". Of those, seven were associated only with relinquishment risk, two ("resource guarding", "knowledge of basic commands") with human safety risk, and one ("fearfulness") with both. Thus, for >85% of characteristics organisations deemed important for dogs' adoptability, scientific evidence to support this is lacking. More research is needed to investigate the value of behaviour assessments, especially concerning the assessment of factors that could pose a public safety risk. However, given the current lack of scientific support for many decisions regarding dogs' rehoming suitability and recognised pressure on resources, it is suggested that organisations should focus on pre-adoption adopter education and post-adoption support.

Biological activity of Herissantia crispa (L) Brizicky / Atividade biológica da Herissantia crispa (L) Brizicky

O extrato metanólico bruto (EMeOH) das partes aéreas da Herissantia crispa (L.) Brizicky, planta rica em flavonóides e que não possui estudos farmacológicos, foi testada para avaliar sua atividade sob os parâmetros comportamentais e determinar a dose letal 50 (DL50) em camundongos; atividade antimicrobiana e antiulcerogênica. O EMeOH (5000 mg/kg, v.o. ou 2000 mg/kg i.p.) não alterou os parâmetros comportamentais e não causou mortes nos animais. A amostra vegetal em estudo inibiu o crescimento bacteriano. O EMeOH (750 mg/kg) apresentou atividade anti-diarréica. O EMeOH (250, 500 e 750 mg/kg) foi capaz de inibir as lesões gástricas induzidas pelo 0,3 M HCl/etanol 60 por cento em camundongos. Desta forma, pode-se concluir que a planta em estudo apresenta atividade antiulcerogênica, entretanto, se faz necessário avaliar tal atividade através de modelos mais específicos e estudar o mecanismo de ação pelo qual a amostra vegetal protege a mucosa gástrica.

The crude methanol extract (EMeOH) of the aerial parts of Herissantia crispa (L.) Brizicky, plant riches in flavonoids and without pharmacological studies, was tested to value its activity under the behaviour parameters and to determine the lethal dose (LD50) in mice; antimicrobial and antiulcerogenic activities. The EMeOH (5,000 mg/kg, v.o. or 2,000 mg/kg i.p.) did not alter the behaviour parameters and there were not mice deaths. The extract inhibited the bacterial growth. The EMeOH (750 mg/kg) showed anti-diarroeal activity. The EMeOH (250, 500 and 750 mg/kg) decreased the gastric lesions induced by 0.3 M HCl/ethanol 60 percent in mice. In conclusion, the EMeOH presents anti-ulcerogenic activity;, however it is necessary to value the antiulcerogenic activity in more specific models and to study the action mechanism by which the vegetable sample protects the gastric mucosa.