METHODS: Exploratory and confirmatory factor analyses were used in this study to evaluate the psychometric features of the flexibility/inflexibility scale (MPFI) in a sample of Iranian university students.
FINDINGS: In the exploratory factor analysis involving a sample of 300 students, six factors were identified for flexibility and six for inflexibility (56.3% males and 43.7% females). In the confirmatory factor analysis with a sample of 388 participants, the results validated 60 items across a total of six flexibility and inflexibility factors. This outcome can serve as a robust estimate for flexibility, inflexibility, the second-order model, and the final model. Cronbach's alpha values for various components, including acceptance, present-moment awareness (or contact with the present moment), self as context, cognitive defusing, values, committed action, total flexibility, experiential avoidance, lack of present-moment awareness, self as content, fusion, lack of contact with values, inaction, and total inflexibility, were reported as follows: 0.818, 0.869, 0.862, 0.904, 0.935, 0.935, 0.942, 0.895, 0.839, 0.883, 0.904, 0.912, 0.941, and 0.941, respectively.
CONCLUSIONS: The Farsi version of the MPFI for university students has great psychometric qualities, making it a reliable assessment instrument for the ACT.
METHODS: We prospectively evaluated children with serologically confirmed Japanese encephalitis over an 8.3-year period. The patients were assessed and their outcomes were graded with a functional outcome score at hospital discharge and at follow-up appointments. We examined how patient outcome at hospital discharge compared with that at long-term follow-up visits, when changes in outcome occurred, and the prognostic indicators of the eventual outcome.
RESULTS: One hundred and eighteen patients were recruited into the study, and 10 (8%) died during the acute phase of illness. At hospital discharge, 44 (41%) of the 108 patients who survived had apparent full recovery; 3 (3%) had mild, 28 (26%) had moderate, and 33 (31%) had severe neurological sequelae. Eighty six of the 108 patients were followed up for a median duration of 52.9 months (range, 0.9-114.9 months). During follow-up, 31 patients experienced improvement, but 15 patients experienced deterioration in their outcome grade. In most cases, assessment during the first 3-6 months after hospital discharge was predictive of the long-term outcome. More than one-half of the patients continued to experience neuropsychological sequelae and behavioral disorders. A combination of poor perfusion, Glasgow coma score < or =8, and > or =2 witnessed seizures predicted a poor long-term outcome with 65% sensitivity and 92% specificity.
CONCLUSIONS: Neurological assessment of Japanese encephalitis survivors at hospital discharge does not predict long-term outcome. Seizures and shock are treatable risk factors for a poor outcome at hospital discharge and at long-term follow-up visits.