Association Between Physical, Social, and Attitudinal Environments and Quality of Life in Adolescents With Cerebral Palsy: Insights From the SPARCLE Cross-Sectional Study
Bibliographic record
Abstract
Objective To assess the correlation between the adequacy of the environment (the quantity of met individual environmental needs) and quality of life (QoL) in adolescents with cerebral palsy (CP) and to examine the magnitude of effects against personal and family factors. Design Cross-sectional study. Setting Nine administrative regions in Denmark, France, Germany, Ireland, Italy, Sweden, and the United Kingdom. Participants Adolescents with confirmed diagnosis of CP, born 1991-1997, aged 13-17 years at the time of data collection. Nonwalkers (GMFCS IV-V) were overrepresented. Intervention Not applicable. Main Outcome Measures Parent reports of the adequacy of the environment (using the European Child Environment Questionnaire) and their adolescent's QoL (using the Kidscreen-52 generic instrument, focusing on 4 domains: physical well-being, psychological well-being, autonomy, and school environment). Results Six hundred sixty-four adolescents with CP participated in the study: 57.2% boys, mean age 15.1 years, 45.1% with GMFCS IV-V, and 45.7% attending mainstream schools. The adequacy of the environment was positively associated with QoL. More specifically, once adjusted for personal and family factors, positive correlations were observed between the adequacy of social support in the community and physical well-being, a supportive attitudinal environment from peers and psychological well-being, a supportive attitudinal environment from peers and teachers and satisfaction with school life, and the adequacy of physical environment at home and QoL in the autonomy domain, the latter only in the subgroup of those with GMFCS IV-V . Among personal and family factors, impairments, pain, behavioral problems, or parenting stress correlated slightly higher with QoL than with the adequacy of the environment. Conclusions The adequacy of the environment relates to adolescent QoL. Personal and family factors correlated slightly higher with QoL than with environmental factors.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".