The objective of this experiment was to evaluate the comparative value of cigarettes versus high dose e-cigarettes among nicotine-dependent cigarette smokers when compared with money or use of their usual cigarette brand. The experiment used a within-subject design with four sessions. After baseline assessment, participants attended two 15-min unrestricted smoking sessions: one cigarette smoking session and one e-cigarette smoking session. Participants then attended two multiple-choice procedure (MCP) sessions: a session comparing cigarettes and money and a session comparing e-cigarettes and money. Participants (n=27) had used cigarettes regularly, had never used e-cigarettes, and were not currently attempting to quit smoking. The sample consisted primarily of males (72%), with a mean age of 34 years. When given the opportunity to choose between smoking a cigarette or an e-cigarette, participants chose the cigarette 73.9% of the time. Findings from the MCP demonstrated that after the first e-cigarette exposure sessions, the crossover value for cigarettes ($3.45) was significantly higher compared with the crossover value for e-cigarettes ($2.73). The higher participant preference, self-reported smoking effects, and higher MCP crossover points indicate that cigarettes have a higher comparative value than high dose e-cigarettes among e-cigarette naive smokers.
Aim
To outline the development and examine the content and construct validity of a new tool, the Dyskinetic Cerebral Palsy Functional Impact Scale (D‐FIS), which measures the impact of dyskinesia on everyday activities in children with cerebral palsy (CP).
Method
D‐FIS content was informed by a systematic review of dyskinesia outcome measures, in collaboration with children with dyskinetic CP, parents, caregivers, and expert clinicians. The D‐FIS uses parent proxy to rate impact of dyskinesia on everyday activities. Construct validity was determined by examining internal consistency; known groups validity with the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Communication Function Classification System (CFCS), and Eating and Drinking Ability Classification System (EDACS); and convergent validity with the Barry‐Albright Dystonia Scale (BADS).
Results
Fifty‐seven parents of children (29 males, 28 females, mean [SD] age 11y 8mo [4y 4mo], range 2y 6mo–18y) completed the D‐FIS. Correlation between D‐FIS and GMFCS was r=0.86 (95% confidence interval [CI]: 0.77–0.91, p<0.001); MACS r=0.84 (95% CI: 0.73–0.90, p<0.001); CFCS r=0.80 (95% CI: 0.67–0.88, p<0.001); and EDACS r=0.78 (95% CI: 0.66–0.87). Correlation between D‐FIS and BADS was r=0.77 (95% CI: 0.64–0.86, p<0.001). Cronbach’s alpha was 0.96.
Interpretation
The D‐FIS demonstrates good construct validity and high internal consistency. The D‐FIS will be useful for identifying priorities for intervention. It adds to the measurement tool kit for children with dyskinetic CP by addressing functional impact of dyskinetic movements and postures.
The Dyskinetic Cerebral Palsy Functional Impact Scale (D‐FIS) assesses the perceived impact of dyskinesia on daily activities in children with cerebral palsy (CP).
The D‐FIS demonstrates good construct validity and high internal consistency.
The D‐FIS is a clinically feasible, family‐centred tool that fills a current gap in the dyskinetic CP assessment toolkit.
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