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      Cross cultural translation, adaptation and reliability of the Malay version of the Canadian Acute Respiratory Illness and Flu Scale (CARIFS)

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          Abstract

          Background

          The Canadian Acute Respiratory Illness and Flu Scale (CARIFS) is a parent-proxy questionnaire that assesses severity of acute respiratory infections in children. The aim was to (a) perform a cross-cultural adaptation and (b) prove that the Malay CARIFS is a reliable tool.

          Findings

          The CARIFS underwent forward and backward translations as recommended by international guidelines. A pilot study was performed on the harmonised version and the final version of the Malay version of CARIFS was produced. A test-retest, 1 h apart, was then performed on parents with children less than 13 years old, admitted with a respiratory tract infection. Parents of children with asthma and who were not eloquent in Malay, were excluded. The data was analysed for consistency (Cronbach’s alpha) and reliability (test-retest co-efficient). Thirty-three parents were recruited. Children were aged median (IQR) 6 (2.8, 13.3) months with a male: female ratio of 22:11 and 88 % were Malays. Parents were interviewed at median (IQR) 6 (3, 11.5) days of admission. The Cronbach’s α coefficient was 0.70 for all items. The test–retest reliability analysis had a minimum and maximum intraclass correlation coefficient of 0.63 and 0.97 respectively. Clinically, the longer patients were admitted, the lower the severity score ( r = −0.35, p < 0.05), indicating that they were getting better.

          Conclusion

          The Malay version of CARIFS is a valid and reliable tool to determine severity of respiratory illness in children. Parent-centred questionnaires are useful and should be an adjunct to other methods, in monitoring response to treatment.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12955-015-0336-z) contains supplementary material, which is available to authorized users.

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          Most cited references12

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          Oral oseltamivir treatment of influenza in children.

          Oral oseltamivir administration is effective treatment for influenza in adults. This study was conducted to determine the efficacy, safety and tolerability of oseltamivir in children with influenza. In this randomized, double blind, placebo-controlled study, children 1 through 12 years with fever [> or =100 degrees F (> or =38 degrees C)] and a history of cough or coryza <48 h duration received oseltamivir 2 mg/kg/dose or placebo twice daily for 5 days. The primary efficacy endpoint was the time to resolution of illness including mild/absent cough and coryza mild/absent, return to normal activity and euthermia. Of 695 enrolled children 452 (65%) had influenza (placebo, n = 235; oseltamivir, n = 217). Among infected children the median duration of illness was reduced by 36 h (26%) in oseltamivir compared with placebo recipients (101 h; 95% confidence interval, 89 to 118 vs. 137 h; 95% confidence interval, 125 to 150; P < 0.0001). Oseltamivir treatment also reduced cough, coryza and duration of fever. New diagnoses of otitis media were reduced by 44% (12% vs. 21%). The incidence of physician-prescribed antibiotics was significantly lower in influenza-infected oseltamivir (68 of 217, 31%) than placebo (97 of 235, 41%; P = 0.03) recipients. Oseltamivir therapy was generally well-tolerated, although associated with an excess frequency of emesis (5.8%). Discontinuation because of adverse events was low in both groups (1.8% with oseltamivir vs. 1.1% with placebo). Oseltamivir treatment did not affect the influenza-specific antibody response. Oral oseltamivir administration is an efficacious and well-tolerated therapy for influenza in children when given within 48 h of onset of illness.
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            Validation of a short form Wisconsin Upper Respiratory Symptom Survey (WURSS-21)

            Background The Wisconsin Upper Respiratory Symptom Survey (WURSS) is an illness-specific health-related quality-of-life questionnaire outcomes instrument. Objectives Research questions were: 1) How well does the WURSS-21 assess the symptoms and functional impairments associated with common cold? 2) How well can this instrument measure change over time (responsiveness)? 3) What is the minimal important difference (MID) that can be detected by the WURSS-21? 4) What are the descriptive statistics for area under the time severity curve (AUC)? 5) What sample sizes would trials require to detect MID or AUC criteria? 6) What does factor analysis tell us about the underlying dimensional structure of the common cold? 7) How reliable are items, domains, and summary scores represented in WURSS? 8) For each of these considerations, how well does the WURSS-21 compare to the WURSS-44, Jackson, and SF-8? Study Design and Setting People with Jackson-defined colds were recruited from the community in and around Madison, Wisconsin. Participants were enrolled within 48 hours of first cold symptom and monitored for up to 14 days of illness. Half the sample filled out the WURSS-21 in the morning and the WURSS-44 in the evening, with the other half reversing the daily order. External comparators were the SF-8, a 24-hour recall general health measure yielding separate physical and mental health scores, and the eight-item Jackson cold index, which assesses symptoms, but not functional impairment or quality of life. Results In all, 230 participants were monitored for 2,457 person-days. Participants were aged 14 to 83 years (mean 34.1, SD 13.6), majority female (66.5%), mostly white (86.0%), and represented substantive education and income diversity. WURSS-21 items demonstrated similar performance when embedded within the WURSS-44 or in the stand-alone WURSS-21. Minimal important difference (MID) and Guyatt's responsiveness index were 10.3, 0.71 for the WURSS-21 and 18.5, 0.75 for the WURSS-44. Factorial analysis suggested an eight dimension structure for the WURSS-44 and a three dimension structure for the WURSS-21, with composite reliability coefficients ranging from 0.87 to 0.97, and Cronbach's alpha ranging from 0.76 to 0.96. Both WURSS versions correlated significantly with the Jackson scale (W-21 R = 0.85; W-44 R = 0.88), with the SF-8 physical health (W-21 R = -0.79; W-44 R = -0.80) and SF-8 mental health (W-21 R = -0.55; W-44 R = -0.60). Conclusion The WURSS-44 and WURSS-21 perform well as illness-specific quality-of-life evaluative outcome instruments. Construct validity is supported by the data presented here. While the WURSS-44 covers more symptoms, the WURSS-21 exhibits similar performance in terms of reliability, responsiveness, importance-to-patients, and convergence with other measures.
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              Observer agreement for respiratory signs and oximetry in infants hospitalized with lower respiratory infections.

              To determine observer agreement for a clinical score and oximetry in lower respiratory infection in children less than 2 yr of age, a convenience sample of 56 infants hospitalized with bronchiolitis or pneumonia was assessed independently by two observers. A total of 12 infants had chronic lung disease of prematurity or congenital heart disease. Infants in whom oxygen supplementation could not be discontinued for at least 5 min were excluded. A severity score was assigned for each of four categories (respiratory rate, retractions, wheeze, and general appearance). A total for each patient was obtained by summing the score for each category. Oxygen saturation was measured using a Nellcor oximeter. Agreement beyond chance was measured using the kappa statistic. The relationship between observers for total score and oximetry and the mean total score and mean oximetry value for each patient was expressed as a Pearson correlation coefficient. A total of 56 infants and children were studied: 2 had pneumonia, 11 had an exacerbation of pulmonary signs and symptoms with their underlying cardiac or pulmonary disease, and 43 had bronchiolitis. Kappa was 0.48 for general assessment, 0.38 for respiratory rate, 0.31 for wheeze, and 0.25 for retractions. All values were statistically significantly greater than 0 at p less than 0.01. Correlations for total score and for oximetry were 0.68 and 0.88, respectively. The median difference between oximetry readings was 1. The correlation coefficient between total score and oximetry was -0.04. The limited agreement for clinical signs makes comparison of patient illness severity between studies difficult.(ABSTRACT TRUNCATED AT 250 WORDS)
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                Author and article information

                Contributors
                psr9900@hotmail.com
                rafdzah@hotmail.com
                rachaelanne7@gmail.com
                andee25@gmail.com
                sabrina_rin89@yahoo.com
                egkahpeng@yahoo.com
                sy_kee2004@yahoo.com
                cindysjteh@ummc.edu.my
                kartini.abduljabar@ummc.edu.my
                westcj@ummc.edu.my
                sthava@hotmail.com
                jessieadb@yahoo.com
                Journal
                Health Qual Life Outcomes
                Health Qual Life Outcomes
                Health and Quality of Life Outcomes
                BioMed Central (London )
                1477-7525
                4 September 2015
                4 September 2015
                2015
                : 13
                : 139
                Affiliations
                [ ]Department of Paediatrics, University Malaya, 50603 Kuala Lumpur, Malaysia
                [ ]University Malaya Paediatric and Child Health Research Group, University Malaya, 50603 Kuala Lumpur, Malaysia
                [ ]Department of Social & Preventive Medicine, Faculty of Medicine, Julius Centre University of Malaya, 50603 Kuala Lumpur, Malaysia
                [ ]Department of Paediatrics, University Putra Malaysia, 43400 Serdang, Selangor Malaysia
                [ ]Department of Microbiology, University Malaya, 50603 Kuala Lumpur, Malaysia
                [ ]Department of Biomedical Imaging, University Malaya Medical Centre, 50603 Kuala Lumpur, Malaysia
                Article
                336
                10.1186/s12955-015-0336-z
                4559942
                26338016
                753ad91b-fdfe-4d5f-8b3c-6677d062bec0
                © Nathan et al. 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 15 May 2015
                : 26 August 2015
                Categories
                Short Report
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                © The Author(s) 2015

                Health & Social care
                Health & Social care

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