admission. This proportion could already be greater in some parts of the country and may increase if referrals of cases of self-poisoning increase faster than the facilities for their assessment and management. The provision of social work and psychiatric expertise in casualty departments may be one means of preventing unnecessary medical admissions without risk to the patients. Dr Blake's and Dr Bramble's figures do not demonstrate, however, that any advantage would attach to medical teams taking over assessment from psychiatrists except that, by implication, assessments would be completed sooner by staff working on the ward full time. What the figures actually suggest is that if assessment of overdoses were left to house doctors there would be an increase in admissions to psychiatric units (by 19°U), outpatients (by 5O°'), and referrals to social services (by 140o). So for house doctors to assess overdoses would provide no economy for the psychiatric or social services. The study does not tell us what the consequences would have been for the six patients who the psychiatrists would have admitted but to whom the house doctors would have offered outpatient appointments. E J SALTER

Vitamin D deficiency.

Clinics in Developmental Medicine

J. KEVIN THOMPSON, LESLIE J. HEINBERG, MADELINE ALTABE, AND STACEY TANTELEFF-DUNN: Exacting Beauty: Theory, Assessment, and Treatment of Body Image Disturbance. American Psychological Association, Washington, D.C., 1998, 396 pp., $39.95, ISBN 1-55798-541-3. The goal of this book-the third on body image that was either authored or edited by J. Kevin Thompson-is "to attempt to integrate theory, assessment, and treatment for the field of body image; to provide a guide for researchers and clinicians interested in the field of body image disturbance and to bridge research and practice." After reading this text, the clinician would hope to come away with a clear sense of the etiology of body-image disturbances and then to be able to identify the best clinical treatment that would match patient diagnostic presentation. Although the research material is well handled, the treatment aspect is somewhat incomplete. The authors present a good overall view of the origin of body image and body-image disturbance, and an excellent historical review of research in the field of eating disorders, i.e., anorexia nervosa and bulimia nervosa, as well as bingeeating disorder and obesity. The book also addresses the complexity of defining, measuring, and creating theoretical models while exploring the social and cultural aspects of body image and the public media emphasis on thinness. And it outlines the current thinking about making a differential diagnosis of body-dysmorphic disorder, often a difficult matter. Some important work in body-dysmorphic disorder is missing, however, such as that of Eric Hollander, M.D. The book's forte is presenting the reader with a strong array of models for measurements and assessment and different testing methodologies, as well as including helpful tables, appendices, and references. The 11 chapters are divided into five parts: 1. An Overview: Prevalence, Diversity, Assessment, and Treatment; 2. Societal and Social Approaches; 3. Interpersonal Approaches; 4. Feminist Approaches; and 5. Behavioral, Cognitive, and Integrative Approaches. The term "approaches" is somewhat misleading because it infers presentation of several different treatment methodologies that the book only partially delivers. The authors conclude that the cognitive-behavioral modality of treatment, supported by "empirical findings," has been the most successful in the treatment of body image thus far, and they are not nearly as exhaustive in covering other treatment modalities, such as the feminist perspective. …

Exacting Beauty: Theory, Assessment, and Treatment of Body Image Disturbance

* Public Health Communication: Evidence for Behavior Change. Robert Hornik, ed. Mahwah, NJ: Lawrence Erlbaum Associates, Publishers, 2002. 405 pp. $99.95 hbk. $45 pbk. Public Health Communication: Evidence for Behavior Change is dedicated to answering a question that frustrates both health communication researchers and public health program planners worldwide: Do public health communication campaigns work? The book's answer to that question is a firm "yes," but the greatest value of the book is that it not only provides evidence supporting that conclusion but also helps us understand the circumstances under which campaigns successfully influence behavior. Perhaps even more importantly, it provides substantial explanation of the sorts of problems that may interfere with health communication campaign success. As Hornik's introduction notes, in recent years, several large-scale public health campaigns designed specifically to enable researchers to evaluate their effectiveness have produced discouraging results, suggesting that health communication campaigns have limited, if any, effects on behavior. In contrast, however, numerous other studies, along with the reality of increasing public adoption of many healthier behaviors, provide significant evidence that health communication campaigns can, indeed, produce positive behavior change. The book brings together a collection of sixteen case studies selected because, collectively, they support that conclusion. As the book notes, the cases selected are not meant to be representative of public health communication campaigns in general. Nonetheless, one of the strengths of the book is that Hornik has brought together a varied set of scholars writing on a wide variety of types of campaigns, conducted in numerous locations worldwide and focused on a broad range of health issues, including use of tobacco and marijuana among adults and adolescents, AIDS prevention behaviors, seat belt use, vaccination and other child health promotion behaviors, skin cancer prevention behaviors, and vasectomy adoption. In addition to the chapters examining intentional health campaigns, three chapters discuss how news coverage of health risks can influence behavior, often multiplying-but potentially also obscuring-the effects of intentional campaigns. Fan argues in the first of these three chapters that "the possibility should at least be contemplated that a major effect of an intervention effort is not the intervention itself but news about that intervention." Although this may be good news for the health promotion goals, it significantly complicates teasing out the effects of the intervention itself. As Viswanath and Finnegan note in the next chapter, the major community trials campaigns-those using intervention and control communities to enable evaluation of the campaign effects-largely have been underpowered to detect small differences between the intervention and reference communities. …

Public Health Communication: Evidence for Behavior Change

The Emergency Department

Background: With increasing age, the prevalence of chronic diseases increases Since health-promoting behaviors (HPB) are considered a basic way of preventing diseases, especially chronic diseases, it is important to assess HPB This study examines the validity and reliability of the Health Promoting Lifestyle Profile II (HPLP-II) Methods: This is a cross-sectional study which is conducted on 502 elderly individuals aged 60 and over in Tehran, Iran In order to determine the validity, content and construct validity were used The content validity index (CVI) was used to assess the content validity and to assess construct validity, confirmatory factor analysis (CFA), and item-total correlations were employed For reliability, test-retest analysis was used, and the internal consistency of the HPLP-II was confirmed by Cronbach's alpha For data analysis, SPSS-18 and Amos-7 software was used Results: The mean age of the subjects was 663 ± 53 years The CVI for the revised HPLP-II and all its subscales was higher than 082 The CFA confirmed a six-factor model aligned with the original HPLP-II Pearson correlation coefficients between the revised HPLP-II and their items were in range of 027-065 Cronbach's alpha of the revised HPLP-II was obtained as 078 and for their subscales were in the range of 067-084 Intraclass correlation coefficient was obtained 079 (95% confidence interval: 059-086, P Conclusions: The Iranian HPLP-II scale is an appropriate tool for assessing HPBs of the Iranian elderly

/pdf/validity-and-reliability-of-health-promoting-lifestyle-3dcrzy2gx7.pdf

Validity and reliability of health promoting lifestyle profile II in the Iranian elderly

Time Use in Mothers of Children with Cerebral Palsy: A Comparison Study:

/pdf/depression-and-perceived-social-support-in-the-elderly-3dkm6ls9nu.pdf

Depression and Perceived Social Support in the Elderly

Background In health related research, it is critical not only to demonstrate the efficacy of intervention, but to show that this is not due to chance or confounding variables. Content Single case experimental design is a useful quasi-experimental design and method used to achieve these goals when there are limited participants and funds for research. This type of design has various advantages compared to group experimental designs. One such advantage is the capacity to focus on individual performance outcomes compared to group performance outcomes. Conclusions This comprehensive review demonstrates the benefits and limitations of using single case experimental design, its various design methods, and data collection and analysis for research purposes.

Single case experimental design: an overview

Objectives: To determine the reliability and cross-cultural validation of the Persian translation of the Manual Ability Classification System (MACS) for children with cerebral palsy (CP). Methods: After the forward-backward translation procedures and investigation of face and content validity, inter-rater and test-retest reliability was assessed between parents and occupational therapists using the intraclass correlation coefficient (ICC). Parents and therapists classified 100 children (4–18 years, mean age of 8.13 years, SD=3.40, 63 boys, 37 girls) with various types of CP using MACS. Additional data on the Gross Motor Function Classification System (GMFCS), and accompanying conditions were also collected. Findings: The inter-rater reliability was high; the ICC was 0.96 (ranged between 0.94–0.97) among occupational therapists and parents. The ICC for the test-retest reliability was high; the ICC related to parents was 0.97 (ranged between 0.95–0.98) and the ICC related to occupational therapists was 0.97 (ranged between 0.96–0.98). Discussion: The Persian version of MACS is found to be valid and reliable, and is suggested to be appropriate for assessing the manual ability of children with CP within the Iranian population.

Robab Sahaf

Papers

Validity and reliability of health promoting lifestyle profile II in the Iranian elderly

Time Use in Mothers of Children with Cerebral Palsy: A Comparison Study:

Depression and Perceived Social Support in the Elderly

Single case experimental design: an overview

Cross-cultural validation of the Persian version of the Manual Ability Classification System for children with cerebral palsy