A microsoft excel(®) 2010 based tool for calculating interobserver agreement

Validation of the Japanese version of the quality of life-Alzheimer's disease for nursing homes

OBJECTIVES

This study aims to validate the Japanese version of Quality of Life-Alzheimer's Disease for Nursing Homes (QOL-AD NH). This is the modified version of QOL-AD, initially developed for residents living with dementia in long-term care settings.

METHODS

Psychometric assessment was conducted in a sample of 101 residents and their professional care staff to obtain self-ratings and proxy-ratings of QOL, respectively. Residents' behavior was observed using Dementia Care Mapping (DCM) method, and their mood/engagement (ME) value was evaluated as a proxy measure of QOL.

RESULTS

Self-ratings were higher than proxy-ratings (t = 10.22, p<.001), with moderate correlation (r=.51, p<.001) and strong internal consistency (α=.87 for both). The exact agreement between the two groups was 38.23%. Convergent validity was confirmed with ME value and positive engagements of DCM. Exploratory factor analysis was performed for further validity testing. Three factors - self and life overall, social environment, and physical and psychological health, accounted for 85.9% of the total variance with Cronbach's α of .87, .73, .90, respectively.

CONCLUSION

Using a validated Japanese version of the QOL-AD NH may help assess the QOL of older residents living in long-term care settings to improve the continuum of care for dementia.

A Cultural Generalization: An Effective Training for Staff Integrity on DTT in the Application of the PEAK in Brazil

Promoting the Emergence of Advanced Knowledge (PEAK) direct training is an evidence-based curriculum with extensive research. Treatment integrity is one of the critical components of an effective treatment. In developing countries where training opportunities are scarce, providing precise training poses a challenge. The current study evaluated the effectiveness of behavioral skills training (BST) role-play to train three staff members to implement the PEAK-DT language curriculum, using discrete trial teaching (DTT) with three learners with autism spectrum disorder (ASD). Not only did the staff members implement the programs with high treatment integrity, but the learners also improved their performance on targeted skills. In addition, this study considered maintenance and generalization of the skills learned. Overall, data show that the BST role-play was successful as the staff members enhanced the skills of three learners with autism.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40617-022-00745-1.

Social referencing training in children with autism spectrum disorder: A randomized controlled study

Children with autism spectrum disorder (ASD) have been shown to exhibit fewer instances of social referencing compared to their typically developing peers. The current study evaluated the effectiveness of multiple-exemplar training, prompting, and social reinforcement to teach social referencing. We used a single-blind randomized control trial with a multiple-baseline design nested within the experimental group to evaluate treatment effects. Twenty-five children with ASD participated. Participants in the treatment group showed significantly higher social referencing scores. However, there were no statistically significant differences between the groups in the posttraining initiating and responding to joint attention scores. The clinical implications of our findings are discussed.

Web-Based Software Tools for Systematic Literature Review in Medicine: A Review and Feature Analysis (Preprint)

Background

Systematic reviews (SRs) are central to evaluating therapies but have high costs in terms of both time and money. Many software tools exist to assist with SRs, but most tools do not support the full process, and transparency and replicability of SR depend on performing and presenting evidence according to established best practices.

Objective

This study aims to provide a basis for comparing and selecting between web-based software tools that support SR, by conducting a feature-by-feature comparison of SR tools.

Methods

We searched for SR tools by reviewing any such tool listed in the SR Toolbox, previous reviews of SR tools, and qualitative Google searching. We included all SR tools that were currently functional and required no coding, and excluded reference managers, desktop applications, and statistical software. The list of features to assess was populated by combining all features assessed in 4 previous reviews of SR tools; we also added 5 features (manual addition, screening automation, dual extraction, living review, and public outputs) that were independently noted as best practices or enhancements of transparency and replicability. Then, 2 reviewers assigned binary present or absent assessments to all SR tools with respect to all features, and a third reviewer adjudicated all disagreements.

Results

Of the 53 SR tools found, 55% (29/53) were excluded, leaving 45% (24/53) for assessment. In total, 30 features were assessed across 6 classes, and the interobserver agreement was 86.46%. DistillerSR (Evidence Partners; 26/30, 87%), Nested Knowledge (Nested Knowledge; 25/30, 83%), and EPPI-Reviewer Web (EPPI-Centre; 24/30, 80%) support the most features followed by Giotto Compliance (Giotto Compliance; 23/30, 77%), LitStream (ICF), and SRDB.PRO (VTS Software). Fewer than half of all the features assessed are supported by 7 tools: RobotAnalyst (National Centre for Text Mining), SRDR (Agency for Healthcare Research and Quality), SyRF (Systematic Review Facility), Data Abstraction Assistant (Center for Evidence Synthesis in Health), SR Accelerator (Institute for Evidence-Based Healthcare), RobotReviewer (RobotReviewer), and COVID-NMA (COVID-NMA). Notably, of the 24 tools, only 10 (42%) support direct search, only 7 (29%) offer dual extraction, and only 13 (54%) offer living/updatable reviews.

Conclusions

DistillerSR, Nested Knowledge, and EPPI-Reviewer Web each offer a high density of SR-focused web-based tools. By transparent comparison and discussion regarding SR tool functionality, the medical community can both choose among existing software offerings and note the areas of growth needed, most notably in the support of living reviews.

Impact of an inner-city smoke-free zone on outdoor smoking patterns: a before-after study

Introduction

On September 2, 2019, Rotterdam’s first inner-city outdoor smoke-free zone encompassing the Erasmus MC, a large university hospital in the Netherlands, the Erasmiaans high school, the Rotterdam University of Applied Sciences and the public road in between, was implemented.

Aims and Methods

We aimed to assess spatiotemporal patterning of smoking before and after implementation of this outdoor smoke-free zone. We performed a before–after observational field study. We systematically observed the number of smokers, and their locations and characteristics over 37 days before and after implementation of the smoke-free zone.

Results

Before implementation of the smoke-free zone, 4098 people smoked in the area every weekday during working hours. After implementation, the daily number of smokers was 2241, a 45% reduction (p = .007). There was an increase of 432 smokers per day near and just outside the borders of the zone. At baseline, 31% of the smokers were categorized as employee, 22% as student and 3% as patient. Following implementation of the smoke-free zone, the largest decreases in smokers were observed among employees (–67%, p value .004) and patients (–70%, p value .049). Before and after implementation, 21 and 20 smokers were visibly addressed and asked to smoke elsewhere.

Conclusions

Implementation of an inner-city smoke-free zone was associated with a substantial decline in the number of smokers in the zone and an overall reduction of smoking in the larger area. Further research should focus on optimizing implementation of and compliance with outdoor smoke-free zones.

Implications

A smoke-free outdoor policy has the potential to denormalize and discourage smoking, support smokers who want to quit, and to protect people from secondhand smoke exposure. Implementation of an inner-city smoke-free zone encompassing a large tertiary hospital and two educational institutions was associated with a substantial decline in the number of smokers in the zone, as well as in the larger area. Voluntary outdoor smoke-free zones can help reduce the number of smokers in the area and protect people from secondhand smoke. There is a need to explore effectiveness of additional measures to further improve compliance.

Japanese Translation and Validation of the Environmental Assessment Tool-Higher Care

OBJECTIVE

The purpose of this study was to translate the Environmental Assessment Tool-Higher Care (EAT-HC) into Japanese and validate its use in small-scale group living facilities in Japan.

BACKGROUND

Environment of a facility is shown to improve its residents' quality of life (QOL). Japan's "welfare-based nursing homes for the elderly" are gradually shifting to a small-scale group living concept called group care units (GCUs). However, there is no appropriate environmental tool available for evaluating GCUs. The application of valid environmental assessment tools brings about a better understanding of the nature of good environments and the relationship between environments and outcomes for residents living with dementia.

METHODS

The study had a mixed method design conducted in several steps, covering translation and adaptation. The translation phase involved (1) forward translation and (2) backward translation. The adaptation phase involved (3) content validity and homogeneity reliability and (4) concurrent validity and interrater reliability.

RESULTS

71 Items (92%) met the acceptable level of content validity (item-content validity index [CVI] > .79) and had good scale-CVI of .88. Concurrent validity was confirmed between .65 and .78 (p < .001). For reliability test, the internal consistency of six subscales was between .88 and .98. Overall interobserver agreement was 90.3%. Intraclass correlation coefficients were .80-.98 (p < .001), and homogeneity reliability coefficient for all items was >.76 (p < .01).

CONCLUSIONS

Validation of the EAT-HC-Japanese Version (EAT-HC-JV) was confirmed as an appropriate tool for environmental assessment to enhance the QOL in Japan's GCUs. For future study, we plan to modify the EAT-HC-JV to adapt to Japanese cultural aspects in order to increase its usability in Japan.

Further Evaluation of Teaching Behavior Technicians to Input Data and Graph Using GraphPad Prism

We replicated and extended Mitteer, Greer, Fisher, and Cohrs (2018) by examining the effects of a video model on inputting data into GraphPad Prism, which is a necessary skill for graph construction. We used a concurrent multiple-probe-across-behavior design with two behavior technicians to assess data-input and graphing skills separately prior to and during access to relevant video models. We evaluated the generality of the training procedures by assessing both skills during data-input-plus-graphing sessions without access to the video models. The video models resulted in mastery of data-input and graphing skills when assessed individually. We observed training effects generalize to data-input-plus-graphing sessions once behavior technicians experienced all relevant video models. These results suggest that individuals should view both data-input and graphing video models prior to depicting single-case design data in Prism but that these skills can maintain at high levels of accuracy without continued access to the training materials.

Enlargement of the human adrenal zona fasciculata and chronic psychiatric illness - an autopsy-based study

Severe mental illness (SMI) is associated with a reduced life expectancy of up to 20 years. One possible contributor to this fact is dysregulation of the hypothalamus-pituitary-adrenal (HPA)-axis. Looking at the morphology of effector organs, such as the adrenal glands themselves, could reveal insights into organ function and response to possible HPA-dysregulation. This forensic autopsy-based study investigated if there were any morphological changes in adrenal glands between decedents who had previously been submitted to a psychiatric hospital with a diagnosis of schizophrenia (n = 34), bipolar (n = 5), or depressive disorder (n = 20), any other psychiatric diagnosis (n = 36) compared with decedents who had no previous psychiatric admission (n = 40). Length of admissions to psychiatric wards and admission in the 180 days preceding death was included in regression as proxy variables for severity of illness. On the macroscopic level, we found no difference in gland weight or volume. On the microscopic level, we found a 25% increase in cross-sectional area of the zona fasciculata (ZF) in decedents who had a diagnosis of schizophrenia compared with controls (p = 0.033). Other diagnosis groups did not differ from controls. Total admission length was positively correlated with area of the ZF.Lay SummaryPeople with a severe mental disorder may be in a constant state of increased stress, which is harmful. This study looked at the adrenal gland, which produces stress hormones, to see if they were different in deceased persons who had suffered from a severe mental illness. We found that the part of the adrenal gland that produces stress hormones is larger in deceased patients who suffered from schizophrenia, but not other types of psychiatric illnesses, compared to deceased persons with no history of psychiatric illness.

Parent, Child and Physiotherapist Perceptions of Effectiveness of Parent Performed Manually Assisted Cough on Children With Neuromuscular Disease

Published research exploring confidence and perceptions of effectiveness in performing a manually assisted cough on children with neuromuscular disease is not available. This descriptive study aimed to describe confidence and perceived effectiveness of parents, children, and therapists in parent performed manually assisted cough. A total of 28 children with neuromuscular disease, one of their parents, and physiotherapist participated. Overall, 40% of parents, 52% of children, and 46% of therapists were very confident in parents’ ability to perform effective manually assisted coughs. Parents, children, and therapists largely perceived the parental manually assisted coughs as somewhat effective (68%, 60%, and 57%, respectively). Approximately, half of parents (48%), children (52%), and therapists (50%) felt very confident in parents’ ability to retain the technique between clinic visits. Interestingly, percentage agreement statistics indicate that a reasonable proportion (30%) of pairs of respondents did not agree in their ratings. Overall, high percentages of favourable ratings were noted for all questions.

Effects of video modeling with video feedback on vocational skills of adults with autism spectrum disorder

OBJECTIVE

To examine the effectiveness of a video modeling (VM) with video feedback (VFB) intervention to teach vocational gardening skills to three adults with autism spectrum disorder (ASD).

METHOD

A multiple probe design across skills was used to assess the effects of the intervention on the three participants' ability to perform skills accurately.

RESULTS

The use of VM with VFB led to improvements across skills for two of the participants. The third participant required video prompting (VP) for successful skill acquisition. Skill performance generalized across personnel and settings for two of the participants, but it was not assessed for the third. Skill performance maintained at follow-up for all three participants. Social validity data gathered from participants, parents, and co-workers were positive.

CONCLUSION

These findings suggest that VM with VFB and VP with VFB were effective and socially acceptable interventions for teaching vocational gardening skills to young adults with ASD.

Behavioral and physiological reactions in dogs to a veterinary examination: Owner-dog interactions improve canine well-being

In order to improve well-being of dogs during veterinary visits, we aimed to investigate the effect of human social interactions on behavior and physiology during routine examination. Firstly, we assessed the impact of a standardized veterinary examination on behavioral and physiological indicators of stress in dogs. Secondly, we examined whether the owner's tactile and verbal interactions with the dog influenced behavioral and physiological stress-associated parameters. A randomized within-subjects crossover design was used to examine behavior (n=33), rectal temperature (n=33), heart rate (HR) (n=18), maximal ocular surface temperature (max OST) (n=13) and salivary cortisol concentrations (n=10) in healthy privately owned pet dogs. The study consisted of two experimental conditions: a) "contact" - owner petting and talking to the dog during the examination; b) "non-contact" - owner present during the examination but not allowed to interact with the dog. Our findings showed that the veterinary examinations produced acute stress responses in dogs during both "contact" and "non-contact" conditions, with significant increases in lip licking, HR, and max OST. A significant decrease in attempts to jump off the examination table (p=0.002) was observed during the examination in the "contact" compared to the "non-contact" condition. In addition, interactions of owners showed an attenuating effect on HR (p=0.018) and max OST (p=0.011) in their dogs. The testing order (first vs. second visit) had no impact on behavioral and physiological parameters, suggesting that dogs did not habituate or sensitize to the examination procedure. Moreover, the duration of the owner-dog interactions had no significant impact on the behavioral and physiological responses of their dogs. This study demonstrates that owner-dog interactions improve the well-being of dogs during a veterinary examination. Future research may assist in further understanding the mechanisms associated with reducing stress in dogs in similar settings.

Recording an Excel(®) Macro to Specify Date Ranges for Clinical Data

The individuals served by behavior analysts are often funded by Medicaid, insurance companies, or private pay. The first two options usually require progress notes detailing graphically and quantitatively the behavioral outcomes. These progress notes usually come in the form of a written account of milestones achieved or barriers faced, graphical displays of behavioral data, and summary tables. The graphical displays are monthly, quarterly, and annual reports for the individuals that they serve. Microsoft Excel® is one of the most accessible tools by which to accomplish this task; however, presenting the required date ranges can be a time-consuming task. A task analysis is outlined to automate this process and reduce the time taken to accomplish indirect service hours to the clients served.