Knowledge of historical fire activity tends to be focused at local to landscape scales with few attempts to examine how local patterns of fire activity scale to global patterns. Generally, fire activity varied globally and continuously since the last glacial maximum (LGM) in response to long-term changes in global climate and shorter-term regional changes in climate, vegetation, and human land use. We have synthesised sedimentary charcoal records of biomass burning since the LGM and present global maps showing changes in fire activity for time slices during the past 21,000 years (as differences in charcoal accumulation values compared to pre-industrial). There is strong broad-scale coherence in fire activity after the LGM, but spatial heterogeneity in the signals increases thereafter. In eastern and western North America and western Europe and southern South America, charcoal records indicate less-than-present fire activity from 21,000 to ~11,000 cal yr BP. In contrast, the tropical latitudes of South America and Africa show greaterthan-present fire activity from ~19,000 to ~17,000 cal yr BP whereas most sites from Indochina and Australia show greater-than-present fire activity from 16,000 to ~13,000 cal yr BP. Many sites indicate greater-than-present or near-present activity during the Holocene with the exception of eastern North America and eastern Asia from 8000 to ~2000 cal yr BP, Indonesia from 11,000 to 4000 cal yr BP, and southern South America from 6000 to 3000 cal yr BP where fire activity was less than present. Regional coherence in the patterns of change in fire activity was evident throughout the postglacial period. These complex patterns can be explained in terms of large-scale climate controls modulated by local changes in vegetation and fuel load.

Present findings suggest that classifying a respondent as nondepressed is not sufficient and is still not informative about his or her QOL and attitudes toward aging status.

Objective: Childhood trauma is known to be an important antecedent in those who engage in deliberate self-harm (DSH). We aimed to explore the mediating mechanisms between childhood trauma and subsequent DSH in a sample of women detained in a high secure setting.Method: From a previous incidence study into DSH, we subdivided a group of 50 women as follows: non-harmers (N = 13), infrequent harmers (N = 22) and frequent harmers (N = 15). These three groups were then compared on several measures believed to be associated with DSH.Results: The frequency of DSH was related to low self-esteem, increased dissociation, anger (both inwardly and outwardly directed), impulsivity, and a history of sexual and physical abuse. When these variables were entered into a path analytic model exploring the relationship between childhood trauma and subsequent DSH, two paths emerged: one major path which linked childhood sexual abuse to DSH via increased dissociation and another, more minor association, linking childhood sexual abuse via reduced self-esteem. Conclusion:This study shows a strong association between high levels of dissociation and an increased frequency of self-harming behaviour. This association is theoretically plausible and has therapeutic implications.Deliberate self-harm (DSH) is a behaviour which is especially common among women who have experienced childhood sexual abuse (CSA) (Herman, Perry, & van der Kolk,

Aim: To determine the level of consensus among experts regarding content, structure and sources of content for a new European measure of health‐related quality of life in children and adolescents. Methods: A three‐round Delphi questionnaire was sent by e‐mail to 24 experts in quality of life measurement in 9 European countries. Consensus was considered reached when ≫90% of experts either agreed or disagreed with a given statement, or where median scores were over 6 on a scale of 1–10, and score dispersion was within predefined limits. Results: Completed questionnaires were received from 20 panellists in each round. It was agreed that the new instrument should be a multidimensional, profile measure with 30–49 items covering 5–8 dimensions, which should take no more than 10–15 min to complete. Agreement was also reached on 8 specific dimensions to include in the questionnaire (psychological well‐being, self‐esteem, body image, cognitive functioning, mobility, energy/vitality, social relations, family/home function). Consensus was against the use of individualized questionnaires. Focus groups with children, parents and workers in the field, literature and instrument reviews were considered appropriate sources for content. Conclusion: Using a Delphi method in this way for the first time showed it to be a feasible and useful method for establishing a conceptual and operational framework for the Kidscreen questionnaire.

SynopsisThirty-eight subjects identified in a large community survey were found to attribute their fatigue to ‘myalgic encephalomyelitis’ (ME). They were matched randomly to two other groups of subjects who attributed their fatigue to either psychological or social factors. All three groups were followed up 18 months later and were asked to complete a series of questionnaires that examined fatigue, psychological distress, number of symptoms, attributional style and levels of disability. At onset the ‘ME’ group were found to be more fatigued, had been tired for longer but were less psychologically distressed than the other two groups. At follow-up the ‘ME’ group were more handicapped in relation to home, work, social and private leisure activities, even when controlling for both duration of fatigue and fatigue at time 1, but were less psychologically distressed. The relationships between psychological distress, specific illness attributions, attributional style and their effect on the experience of illness and its prognosis are discussed. Attributing fatigue to social reasons appears to be most protective.

OBJECTIVE:To evaluate the Brazilian version of WHOQOL-OLD Module and to test potential changes to the instrument to increase its psychometric adequacy. METHODS:A total of 424 older adults living in a city in Southern Brazil completed the WHOQOL-OLD instrument, in 2005. Rasch analysis was used to explore the psychometric performance of the scale, as implemented by the RUMM2020 software. Item-trait interaction, threshold disorders, presence of differential item functioning and item fi t, were analyzed. RESULTS:Two ("death and dying" and "sensory abilities") out of six domains showed inadequate item-trait interactions. Rescoring the response scale and deleting the most misperforming items led to scale improvement. The evaluation of domains and items individually showed that the "intimacy" domain does perform well in contrast to the fi ndings using the classical approach. In addition, the "sensory abilities" domain does not derive an interval measure in its current format. CONCLUSIONS:Unidimensionality and local independence were seen in all domains. Changes in the response scale and deletion of problematic items improved the scale's performance. The world has been experiencing a profound and irreversible demographic shift as older people are living longer and healthier than ever before. 24 The most dramatic increases in proportions of older people are evident in the most advanced age groups (people over 80 years old) with an almost fi vefold increase from 69 million in 2000 to 377 million in 2050. 24 The World Health Organization (WHO) has described this demographic shift as a major societal achievement, and a challenge 25 . Increased longevity has been experienced in the developed and the developing world alike, but where developed countries grew rich before it grew old, developing countries are growing old before they have grown rich. 25This shift in the age pyramid due to increased elderly population demands further research specifi cally approaching the aging process. One important area to be assessed is quality of life. Although there are several studies on this issue, systematic reviews have pointed out that the instruments most frequently used in these investigations are not sufficiently comprehensive and/or are not validated for application in older adult populations. 4,11RESUMO OBJETIVO: Analisar a versão brasileira do Módulo WHOQOL-OLD, indicando alterações potenciais do instrumento para aumentar a adequação psicométrica. MÉTODOS:O total de 424 idosos residentes em Porto Alegre, RS, responderam o instrumento WHOQOL-OLD em 2005. O modelo de Rasch foi utilizado para a análise do desempenho psicométrico da escala, a partir do software RUMM2020. Foram analisadas a interação item-traço, a presença de funcionamento diferencial dos itens e a adequação dos itens ao modelo de Rasch.RESULTADOS: Dois domínios ("morte e morrer" e "funcionamento do sensório") apresentaram interação item-total insufi ciente. Remodelar a escala de resposta e excluir itens com pior performance resultou em melhora da escala. A a...

Objectives-Patients with chronic fatigue syndrome complain of physical and mental fatigue that is worsened by exertion. It was predicted that the cognitive and motor responses to vigorous exercise in patients with chronic fatigue syndrome would diVer from those in depressed and healthy controls. Methods-Ten patients with chronic fatigue syndrome, 10 with depressive illness, and 10 healthy controls completed cognitive and muscle strength testing before and after a treadmill exercise test. Measures of cardiovascular functioning and perceived eVort, fatigue, and mood were taken during each stage of testing. Results-Depressed patients performed worst on cognitive tests at baseline. During the treadmill test, patients with chronic fatigue syndrome had higher ratings of perceived eVort and fatigue than both control groups, whereas patients with depression reported lower mood. After exertion, patients with chronic fatigue syndrome showed a greater decrease than healthy controls on everyday tests of focused (p=0.02) and sustained (p=0.001) attention, as well as greater deterioration than depressed patients on the focused attention task (p=0.03). No between group diVerences were found in cardiovascular or symptom measures taken during the cognitive testing. Conclusions-Patients with chronic fatigue syndrome show a specific sensitivity to the eVects of exertion on eVortful cognitive functioning. This occurs despite subjective and objective evidence of eVort allocation in chronic fatigue syndrome, suggesting that patients have reduced working memory capacity, or a greater demand to monitor cognitive processes, or both. Further insight into the pathophysiology of the core complaints in chronic fatigue syndrome is likely to be realised by studying the eVects of exercise on other aspects of everyday functioning. (J Neurol Neurosurg Psychiatry 1998;65:541-546)

Background: Aging has determined a demographic shift in the world, which is considered a major societal achievement, and a challenge. Aging is primarily a subjective experience, shaped by factors such as gender and culture. There is a lack of instruments to assess attitudes to aging adequately. In addition, there is no instrument developed or validated in developing region contexts, so that the particularities of ageing in these areas are not included in the measures available. This paper aims to develop and validate a reliable attitude to aging instrument by combining classical psychometric approach and Rasch analysis.