Standardization of the continuing care activity measure: a multicenter study to assess reliability, validity, and ability to measure change.

Background: There is a lack of standardized mobility measures specific to the long-term care (LTC) population. Therefore, the Continuing Care Activity Measure (CCAM) was developed.

Objective: This study determined levels of reliability, validity for clinical utilization, and sensitivity to change of this measure.

Demonstrating adherence to guidelines for the treatment of patients with borderline personality disorder.

Objective: To describe the development and implementation of General Psychiatric Management (GPM), a dynamically informed psychotherapeutic and case management approach along with symptom-targeted pharmacological interventions for the treatment of borderline personality disorder (BPD), derived from the American Psychiatric Association's (APA) guidelines for treating BPD.

Method: Clinician adherence to GPM was assessed using the General Psychiatric Management Adherence Scale (GPMAS), which measured the amount of emphasis accorded to therapeutic tools and strategies during individual therapy sessions. GPMAS surveys were completed by 9 different therapists every 6 weeks during 1 year for 50 patients.

Regional variability in the use of CT for patients with suspected mild traumatic brain injury.

Objective: To investigate the use of computed tomography (CT) scans in patients with suspected acute mild traumatic brain injury (mTBI) presenting to emergency departments.

Method: 850 potential mTBI cases were identified through reviews of three months of health records from nine selected emergency departments across the province of Ontario. Records for review were selected using the International Classification of Disease, 9th revision, Clinical Modification codes and Injury codes.

Implementation of the abilities-focused approach to morning care of people with dementia by nursing staff.

Background.  The efficacy of the abilities-focused approach to morning care has been demonstrated in two studies. However, the extent to which nurses are aware of and actually implement abilities-focused interventions in day-to-day practice is not known.

Quality of life in childhood epilepsy: what is the level of agreement between youth and their parents?

Children and parents evaluate the child's quality of life (QOL) from their own perspectives; therefore, responses may differ, especially in abstract domains. We examined differences between self- and proxy-reported QOL of children with epilepsy. Children with active epilepsy (N=375) and their parents (N=378) separately completed the CHEQOL-25, a condition-specific QOL measure.

Trial designs likely to meet valid long-term Alzheimer's disease progression effects: learning from the past, preparing for the future.

The International Society for CNS Clinical Trials and Methodology (ISCTM) held its 4th Annual Autumn Conference in Toronto, Ontario, October 6-7, 2008. The purpose of the present report is to provide an overview of one of the sessions at the conference which focused on the designs and methodologies to be applied in clinical trials of new treatments for Alzheimer's disease (AD) with purported "disease-modifying" effects. The session began with a discussion of how neuroimaging has been applied in multiple sclerosis clinical trials (another condition for which disease modification claims have been achieved).

The epidemiology of psychiatric disorders in Quebec's older adult population.

Objective: To document the prevalence of psychiatric disorders in Quebec's older adult population.

Method: Data came from the Enquête sur la santé des aînés study conducted in 2005--2006 using a representative sample (n = 2798) of community-dwelling older adults.

Results: Our results indicate that 12.

The Toronto Bedside Swallowing Screening Test (TOR-BSST): development and validation of a dysphagia screening tool for patients with stroke.

Background And Purpose: Dysphagia occurs in 55% of all acute stroke patients. Early identification of dysphagia from screening can lead to earlier treatments and thereby reduce complications. We designed and validated a new bedside dysphagia screening tool-the Toronto Bedside Swallowing Screening Test (TOR-BSST) for stroke survivors in acute and rehabilitative settings.

Implementation, process, and preliminary outcome evaluation of two community programs for persons with stroke and their care partners.

Purpose: This evaluation compared a new self-management program with land and water exercise (Moving On after STroke or MOST) to a standard education program (Living with Stroke or LWS).

Participants: Of 30 persons with stroke (average age 68 and 2 years post stroke), 18 selected MOST and 12 chose LWS. Sixteen care partners participated.

Working out the kinks: testing the feasibility of an electronic pain diary for adolescents with arthritis.

Background: Current approaches to evaluating pain in children with chronic arthritis suffer from methodological problems. A real-time data capture approach using electronic diaries has been proposed as a new standard for pain measurement. However, there is limited information available regarding the development and feasibility of this approach in children.

Impact of self-esteem on the oral-health-related quality of life of children with malocclusion.

Introduction: The purpose of this study was to examine the relationship between self-esteem and oral-health-related quality of life (OHRQoL) in a sample of children seeking orthodontic treatment in Toronto, Ontario, Canada.

Methods: This was a cross-sectional study of children aged 11 to 14 years, evaluating the associations among the child perception questionnaire (CPQ11-14), the self-esteem subscale of the child health questionnaire, and the dental aesthetic index (DAI).

Results: The CPQ11-14 scores were significantly related to the self-esteem scores and the DAI ratings.

Smell test predicts performance on delayed recall memory test in elderly with depression.

Introduction: Elderly with depression are at increased risk for cognitive dysfunction and dementia. Smell tests are correlated with performance on cognitive tests in the elderly and therefore might serve as a screening test for cognitive impairment in depressed elderly.

Purpose: To assess the validity of the CC-SIT (Cross-Cultural Smell Identification Test) as a screening test for cognitive impairment in elderly with depression.

Apathy in dementia: clinical and sociodemographic correlates.

The authors examine prevalence and the sociodemographic and clinical correlates of apathy in dementia. Apathy was assessed in 121 outpatients in a behavioral neurology clinic using the Informant and Clinician versions of the Apathy Evaluation Scale (AES-I, AES-C). Apathy was found to be very prevalent across the dementias.

The effect of cholinesterase inhibitors on decline in multiple functional domains in Alzheimer's disease: a two-year observational study in the Sunnybrook dementia cohort.

Background: Despite widespread use of second-generation cholinesterase inhibitors (CHEIs) for the symptomatic treatment of Alzheimer's disease (AD), little is known about possible long-term effects in different functional domains. This study seeks to assess change in activities of daily living (ADLs) over two years in AD patients treated with CHEIs matched to untreated patients in the same longitudinal cohort study.

Methods: This study is based on the two-year prospective cohort study at the Memory Clinic in Sunnybrook Health Sciences Centre, University of Toronto.

The effect of depression on heart rate variability during pregnancy. A naturalistic study.

Depression during pregnancy has been associated with a number of adverse outcomes, but the underlying physiological mechanisms involved remain unclear. The purpose of this study was to examine the effects of maternal depression during pregnancy on the autonomic modulation of heart rate, in a naturalistic setting. Eighty-one pregnant women were studied between 25 and 31 weeks of gestation and were identified as either Depressed (n = 46), or healthy, Control (n = 35), based on depression scores and lifetime psychiatric history.

Limitations of the Millon Behavioral Medicine Diagnostic (MBMD) with bariatric surgical candidates.

Background: In this paper, we critique the Millon Behavioral Medicine Diagnostic's (MBMD) psychometric characteristics for use with bariatric surgery patients.

Methods: The reliability data presented by the test authors in their manual were examined.

Results: The results found 16 of 32 scales of have internal consistency reliability coefficients that do not meet minimal standards for use with bariatric populations.

The social epidemiology of affective and anxiety disorders in later life in Canada.

Objective: To examine the association between markers of social position and psychiatric disorder among older adults, and test whether social support mediates the association between social position and psychiatric disorder in this population.

Methods: We used data from the Canadian Community Health Survey: Mental Health and Well-Being to examine the social patterning of disorder. Using a series of logistic regression analyses, we regressed indicators of mood, anxiety, and any disorder on markers of social position and social support.

Factor structure and reliability of the brain impairment behavior scale.

Stroke is a leading cause of adult disability because of its physical and cognitive consequences. Cognitive changes are important contributors to family caregivers' experiences of emotional distress. To date, measures to assess cognition treat it as a global construct, but it is more likely that unique domains differentially affect family caregivers.

Comorbid depression and anxiety in later life: patterns of association, subjective well-being, and impairment.

Objective: Very little epidemiological work has examined comorbidity between depression and anxiety disorders in community-dwelling older adults, despite the fact these disorders are known to co-occur in younger adults and that this co-occurrence is associated with greater clinical severity. In this study, the authors examine psychiatric comorbidity and associated impairment of four disorders (major depression, panic disorder, social phobia, and agoraphobia) in a community-based sample of adults aged 55 and older.

Setting: Population-based sample of older adults (N=12,792) from the Canadian Community Health Survey-Mental Health and Well-Being (CCHS 1.

Health-related quality of life of children with epilepsy in Hong Kong: how does it compare with that of youth with epilepsy in Canada?

Objective: The primary aim of our study was to compare the health-related quality of life (HRQL) of children with epilepsy in Hong Kong with that of children with epilepsy in Canada, and to explore possible factors affecting these findings. A second interest was to determine agreement between proxy reports and self-ratings among children with epilepsy in Hong Kong, compare these with findings in Canada, and identify factors that influence the concordance.

Methods: Child self-report and parent-proxy questionnaires on an epilepsy-specific HRQL measure, appropriately translated and validated in Chinese, were administered to 266 Hong Kong children and their parents.