Development of a Video-based Evaluation Tool in Rett Syndrome

This paper describes the development of a video-based evaluation tool for use in Rett syndrome (RTT). Components include a parent-report checklist, and video filming and coding protocols that contain items on eating, drinking, communication, hand function and movements, personal care and mobility. Ninety-seven of the 169 families who initially agreed to participate returned a videotape within 8 months of the first request. Subjects whose videos were returned had a similar age profile to those who did not provide a video but were more likely to have classical than atypical RTT. Evidence of the content and social validity and inter-rater reliability on 11 videos is provided. Video may provide detailed, objective assessment of function and behaviour in RTT.

Population-based study of carotid endarterectomy in Western Australia

Background

Previous studies reported an increase in the rates of operation following the publication of major trials that demonstrated the benefit of carotid endarterectomy in reducing stroke. The aim of this study was to determine whether carotid endarterectomy rates have continued to rise despite the reducing trend in most manifestations of atherosclerotic cardiovascular disease.

Methods

Record linkage was used to select patients who had a carotid endarterectomy during the interval from 1988 to 2001. Incidence rates were age-standardized and trends were examined with Poisson regression.

Results

The rate increased by 13·8 per cent per year between 1988 and 1998; however, from 1999 onwards the rate of carotid surgery fell by 15·8 per cent per year. In octogenarians, the rate increased steadily from 0·9 to 5·1 per 100 000 person-years between 1992 and 2000. The proportion of octogenarians also increased significantly from 0·9 per cent in 1988–1990 to 19·5 per cent in 2000–2001 (χ2 = 60·11, 4 d.f., P < 0·001).

Conclusion

For the first time a recent decline has been observed in the rate of carotid endarterectomy, most likely owing to a combination of the deceasing incidence of atherosclerosis and more widespread use of effective drugs in the treatment of cardiovascular disease. The rate and proportion of operations in patients aged 80 years or older has increased steadily.