Search

Context: Decreased trunk neuromuscular control is a risk factor for both upper- and lower-extremity injuries, yet there are few reliable and valid clinical tests to identify deficits. Objective: The purpose of this study was to determine the reliability and known-groups validity of a novel clinical test, the seated trunk control test (STCT). Design: Cross-sectional reliability and known-groups validity study. Setting: Laboratory. Participants: 89 unique participants: 34 were 3 months postoperative anterior cruciate ligament reconstruction (ACLR) and 55 healthy controls. Methods: For the STCT, participants sat on a balance board with their eyes closed for three 30-second trials while investigators counted balance errors. Intraclass correlations (ICCs) were used to assess interrater reliability (N = 20) and test–retest reliability (N = 40). To assess known-groups validity, independent t tests were used to compare STCT errors at 3 months post-ACLR with healthy matched controls (N = 34/group). Area under a receiver operating characteristic curve identified an optimal cutoff for distinguishing between groups. Results: The STCT had perfect interrater reliability (ICC2,3 = 1.00) and good test–retest reliability (ICC3,3 =.79; 95% confidence interval =.61–.89). The ACLR group made significantly more errors on the STCT (mean [SD] = 15.5 [5.4]) than controls (mean [SD] = 8.2 [4.1]; P <.001, Cohen d = 1.52). The STCT's ability to distinguish between groups was excellent (area under a ROC curve = 0.86). A cutoff of 12 errors maximized sensitivity (76%) and specificity (85%). Conclusions: The STCT is reliable between raters and across days. It also has excellent ability to distinguish between individuals with a recent ACLR and healthy matched controls, which provides initial evidence to suggest that the STCT may be clinically useful for identifying deficits in trunk neuromuscular control. [ABSTRACT FROM AUTHOR]

Context: To assess the reliability of a remote 2D markerless motion tracking method (Kinovea) to quantify knee and hip angles during dynamic tasks. Methods: Fourteen healthy adults performed body weight squats and lateral lunges while video recording themselves at home. Knee and hip angles were quantified in the sagittal plane for the squats and in the frontal plane for the lateral lunges. Two students each performed the video analysis procedure twice, 2 weeks apart. Intraclass correlation coefficients were used to calculate the intrarater and interrater reliability for angles at maximum depth. The intrarater and interrater agreement over the joint angle-time signals were quantified using a validation metric; an acceptable agreement threshold was set at a validation metric of 0.803 or higher. Standard error of measurement (SEM) was also calculated. Results: Reliability was good to excellent (intraclass correlation coefficients = .80-.98) for all angle comparisons at maximum depth. The agreement over the entire joint angle-time signal was acceptable for all squat variables except for the interrater hip angle comparison (validation metric = 0.797). None of the lateral lunge variables met the threshold of acceptable agreement. The mean SEM across participants for all joint angle-time signal and for maximum depth was acceptable (<5°) for all measurements (SEM = 1.2°-4.9°). Conclusions: Overall, the reliability, agreement, and SEM quantified in this study support the integration of remote methods to quantify lower-extremity kinematics into research and clinical practice. [ABSTRACT FROM AUTHOR]

To verify the psychometric properties of the Brazilian-Portuguese version of the Falls Behavioral (FaB-Brazil) Scale in Parkinson's disease (PD). Participants (n = 96) were assessed by disease-specific, self-report and functional mobility measures. Internal consistency of the FaB-Brazil scale was evaluated using Cronbach's alpha and inter-rater and test–retest reliability using intraclass correlation coefficients (ICC). The standard error of measurement (SEM), minimal detectable change (MDC), ceiling and floor effects, and convergent and discriminative validity were evaluated. Internal consistency was moderate (α = 0.77). Excellent inter-rater (ICC = 0.90; p < 0.001) and test–retest (ICC = 0.91; p < 0.001) reliability were found. The SEM was 0.20 and MDC was 0.38. Ceiling and floor effects were not found. Convergent validity was established by the positive correlations between the FaB-Brazil scale and age, modified Hoehn and Yahr, PD duration, Movement Disorders Society-Unified Parkinson's Disease Rating Scale, Motor Aspects of Experiences of Daily Living, Timed Up & Go and 8-item Parkinson's Disease Questionnaire, and negative correlations between the FaB-Brazil scale and community mobility, Schwab & England, and Activities-specific Balance Confidence scale. Females showed greater protective behaviors than males; recurrent fallers showed greater protective behaviors than non-recurrent fallers (p < 0.05). The FaB-Brazil scale is reliable and valid for assessing people with PD. Fall-related behaviors should be part of the fall risk assessment of community-dwelling people with Parkinson's disease. The Brazilian-Portuguese version of the Fall Behavioral (FaB-Brazil) Scale is reliable and valid for assessing everyday behaviors and actions related to falling in community-dwelling people with Parkinson's disease. The FaB-Brazil scale may be used to tailor individualized fall prevention programs. [ABSTRACT FROM AUTHOR]

Purpose: Nonword repetition (NWR) has been described as a clinical marker of developmental language disorder (DLD), as NWR tasks consistently discriminate between DLD and typical development (TD) cross-linguistically, with Cantonese as the only reported exception. This study reexamines whether NWR is able to generate TD/DLD group differences in Cantonese-speaking children by reporting on a novel set of NWR stimuli that take into account factors known to affect NWR performance and group differentiation, including lexicality, sublexicality, length, and syllable complexity. Method: Sixteen Cantonese-speaking children with DLD and 16 age-matched children with TD repeated two sets of high-lexicality nonwords, where all constituent syllables are morphemic in Cantonese but meaningless when combined, and one set of low-lexicality nonwords, where all constituent syllables are nonmorphemic. Low-lexicality nonwords were further classified on sublexicality in terms of consonant–vowel (CV) combination attestedness (whether or not CV combinations in nonword syllables occur in real Cantonese words). Results: Children with DLD scored significantly below their peers with TD. Effect sizes showed that high-lexicality nonwords and nonword syllables with attested CV combinations offered the greatest TD/DLD group differentiation. Nonword length and syllable complexity did not affect TD/DLD group differentiation. Conclusions: NWR can capture TD/DLD group differences in Cantonese speaking children. Lexicality and sublexicality effects must be considered in designing NWR stimuli for TD/DLD group differentiation. Future studies should replicate the present study on a larger sample size and a younger population as well as examine the diagnostic accuracy of this NWR test. [ABSTRACT FROM AUTHOR]

Purpose: Pitch variations (tone productions) have been reported as a measure to differentiate Cantonese-speaking children with and without childhood apraxia of speech (CAS). This study aims to examine fundamental frequency (F0) changes within syllables and the effects of syllable structure, lexical status, and syllable positions on F0 in Cantonese-speaking preschool children with and without CAS. Method: Six children with CAS, six children with non-CAS speech sound disorder plus language disorder (S&LD), 22 children with speech sound disorder only (SSD), and 63 children with typical speech-language development (TD) performed the tone sequencing task (TST). Growth curve analysis was employed to analyze and compare the F0 values within syllables with three Cantonese tones (high level, high rising, and low falling). The analysis considered the effects of syllable structure (vowel and consonant–vowel), lexical status (word and nonword), and syllable position (initial, medial, and final) on F0, as well as comparisons within and between groups. Results: Within each group, the effects of syllable structure and position on F0 values were found with different patterns. Between-group comparisons showed that the CAS group had reduced F0 contrasts. The CAS group could be differentiated from the control groups based on interactions of F0 with syllable structure and position, but not lexical status. The dissimilarity of F0 values detected between the CAS and SSD/TD groups was more prominent than that observed between the CAS and S&LD groups. Conclusions: This study demonstrated that Cantonese-speaking children with CAS had difficulty in varying F0 within syllables as compared to those without CAS, suggesting pitch variation difficulty and language-specific impairment profiles in CAS. Future investigations of objective measures for identifying Cantonese speakers with CAS and cross-linguistic investigations using growth curve analysis and the TST are suggested. [ABSTRACT FROM AUTHOR]

Nigeria has been reported as having the highest prevalence of low back pain (LBP) in Africa. Despite this, sexual disability among people with LBP in Nigeria is sparsely reported. To examine the prevalence of sexual disability and its relationship with pain intensity, quality of life and psychological distress among individuals with chronic low back pain (CLBP) in Nigeria. A descriptive cross-sectional study of individuals with CLBP was conducted. The Visual Analogue Scale (VAS) was used to assess pain intensity while sexual disability was assessed using the Oswestry Disability Index domain 8 (ODI-8). Quality of life was assessed using the Short-form Health Survey (SF-36) questionnaire and the 42-item Depression, Anxiety, and Stress Scale (DASS-42) was used to measure psychological distress. A total of 375 participants (mean age = 41.4 years, SD = 5.67) with CLBP participated in the study. The majority of the participants have a sexual disability (357, 95.2%), with 33.1% (124) of them reporting that their sex life was severely restricted by pain and 17.9% (67) reporting that pain prevents any sex life at all. Females have a lower quality of life and higher levels of sexual disability, pain, and psychological distress than males (p < 0.05). Sexual disability was strongly correlated with pain intensity, quality of life, and psychological distress (p < 0.05).The findings of this study indicate that there was a high prevalence of sexual disability among individuals with CLBP in Nigeria and this was strongly correlated with pain, quality of life and psychological distress. [ABSTRACT FROM AUTHOR]

This study explores the experiences of social work students of color (SOC) and their antiracism education within a school of social work at a public university. Twenty-one SOC participated in focus groups where they described their experiences with antiracism education. Several key themes were identified: (a) finding community through affinity groups, (b) SOC interactions with White students, (c) differentiating internalized racism and anti-Black racism, (d) the impact of White instructors and the lack of mentors and supervisors of color, (e) microaggressions and incidents of racism, and (f) taking up space. As this is an exploratory study, authors make recommendations for social work schools to pilot in the future. These recommendations include assessing White students' skill level with antiracism education and practice before placing them in classes with SOC, assessing faculty's skill set with antiracist teaching and providing ongoing support, creating sustained affinity spaces for SOC as a way to booster wellness, designing and piloting antiracist outcomes for social work students, and developing simulation-based learning with simulated patients as a tool to measure antiracist practice competencies. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the present study was two‐fold. Firstly, we aimed to develop and describe a technique for measurement of the transverse diameter (TD) of the levator ani muscle (LAM) hiatus in the coronal view using two‐dimensional (2D) transperineal ultrasound (TPUS) in nulliparous women with a term pregnancy. Secondly, we aimed to evaluate the feasibility and reproducibility of 2D‐TPUS assessment of LAM hiatal TD and assess intermethod agreement between 2D‐TPUS and three‐dimensional (3D) TPUS measurement of TD in the axial plane, which is considered the gold standard in nulliparous women with term pregnancy. Methods: We recruited a group of nulliparous women with term pregnancy before the onset of labor. The study was conducted in two phases: Phase 1 involved developing and describing the 2D‐TPUS technique for measuring LAM hiatal TD, and Phase 2 focused on assessing the technique's feasibility, reproducibility and intermethod agreement with 3D‐TPUS measurement of LAM hiatal TD. In Phase 1, we enrolled 30 women. Each woman underwent acquisition of a 3D‐TPUS volume, which was analyzed using multiplanar mode to identify and determine the appearance of the lateral borders of the LAM in the coronal plane, at the level of the plane of minimal hiatal dimensions. These borders were used as landmarks for TD measurement. Additionally, we measured the distance between the plane used for TD measurement and the center of the urethra in the axial view. In Phase 2, we recruited 100 women. Each woman underwent acquisition of three 2D‐TPUS videoclips in the coronal plane, each encompassing a sweep of the entire LAM hiatus, and a 3D volume, all obtained during rest. On the 2D videoclips, TD was measured twice by one operator and once by another operator. In the 3D volume, TD was measured once, by one operator, in the axial plane; this measurement was considered the gold standard. Each operator was blinded to all other measurements during their assessments. We analyzed intraobserver and interobserver reproducibility and performed an intermethod (2D vs 3D) comparison. Bland–Altman analysis was conducted, and Levene's W0 test and Student's t‐test were performed to explore clinical factors that might contribute to systematic differences. Results: In Phase 1, we identified successfully the landmarks denoting the lateral borders of the LAM hiatal TD in the coronal view. These appeared as two symmetrical hypoechogenic indentations located at the inner border of the hyperechogenic structure of the LAM, at the point of maximum distance between the two sides of the LAM. The distance between the urethra and the plane where TD should be measured using 3D‐TPUS in the axial plane had a median of 4 mm and varied from 0 to 9 mm. This enabled us to describe a method for assessing LAM hiatal TD in the coronal plane using 2D‐TPUS. In Phase 2, LAM hiatal TD was measured successfully in all 2D and 3D acquisitions from the entire group of 100 women. The analyses for intraobserver and interobserver reproducibility and the intermethod comparison (2D vs 3D) revealed almost perfect agreement in TD measurements using 2D‐TPUS, with intraclass correlation coefficients of 0.95 (95% CI, 0.92–0.96), 0.87 (95% CI, 0.78–0.92) and 0.85 (95% CI, 0.78–0.90), respectively. The average differences between measurements were 0.1 mm for intraobserver, 1.0 mm for interobserver and 0.2 mm for intermethod repeatability. No systematic differences were observed in any of the measurement sets, except in the interobserver analysis, although this difference was clinically not significant (38.2 vs 37.2 mm, P = 0.01). None of the examined clinical factors (maternal body mass index and maternal age) exhibited a statistically significant impact on intraobserver, interobserver or intermethod reliability. Conclusions: Utilizing our technique, described herein, to measure the LAM hiatal TD in the coronal view using 2D‐TPUS is not only feasible but also highly reproducible and accurate in nulliparous women with term pregnancy. Moreover, it yields measurements that are comparable to those obtained in the reconstructed axial plane generated by 3D‐TPUS. © 2024 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Objectives: The etiology of flatfoot and cavus foot is multicausal and controversial. So far, no literature reports the relationship between the sagittal morphology of subtalar joint and the alignment of foot. The purpose of this study was to explore whether the subtalar alignment would influence the configuration of foot. Methods: From January 2017 to January 2020, we included 109 feet in the flatfoot group, 95 feet in the cavus group, and 104 feet in the control group in this retrospective comparative study. The Gissane angle and calcaneal posterior articular surface inclination angle represented the sagittal morphology of the subtalar joint. Meary's angle, calcaneal pitch angle, and talar pitch angle reflected the alignment of foot. They were measured in the weightbearing foot X‐rays. The angles in different groups were compared via Mann–Whitney U test. We calculated the correlation between the sagittal alignment of subtalar joint and the alignment of foot using Spearman's correlation analysis. Interobserver and intraobserver reliability were calculated. Results: The Gissane angle, calcaneal posterior articular surface inclination angle, Meary's angle, talar pitch angle, and calcaneal pitch angle were significantly different in the three groups. The Gissane angle had an excellent correlation with the Meary's angle (r = 0.850, p < 0.0001), and the talar pitch angle (r = −0.825, p < 0.0001), and a good correlation with the calcaneal pitch angle (r = 0.638, p < 0.0001). The calcaneal posterior articular surface inclination angle had an excellent correlation with the Meary's angle (r = −0.902, p < 0.001), and the talar pitch angle (r = 0.887, p < 0.0001), and a good correlation with the calcaneal pitch angle (r = −0.702, p < 0.0001). The interobserver and intraobserver reliability for all radiographic measurements was good to excellent. Conclusion: A subtalar joint with a larger Gissane angle and a more horizontal calcaneal posterior articular surface angle tended to have a higher foot arch and vice versa. The inspiration from this study was that the deformities of flatfoot and cavus foot may relate to the subtalar deformity. [ABSTRACT FROM AUTHOR]

Early identification of children at risk of posttraumatic stress symptomatology or other emotional and behavioral problems is highly needed for the prevention of long-term consequences of traumatic events and abuse. However, the assessment of the traumatization of very young children is challenging because they cannot fully verbalize their psychological experiences. The purpose of this pilot study was to test the internal consistency, interrater reliability, and validity of the Odense Child Trauma Screening (OCTS) measure, a structured play test for signs of traumatization in young children. The total sample was comprised of 26 (50%) children from the community and 26 from risk groups in Lithuania. The mean age of the participants was 6.44 (SD = 1.63; range 3–9); 62% were girls. The OCTS interviews were conducted with all children. The Child and Adolescent Trauma Screen (CATS) and the Strengths and Difficulties Questionnaire (SDQ) were used to collect data about the child from the caregivers. Caregivers of the risk sample group reported significantly more potentially traumatic events experienced by the children (M = 2.73) than in the community sample (M = 1.00). The OCTS results indicated acceptable internal consistency and good inter-rater reliability. However, only one of the four OCTS stories scores was significantly higher in the risk group. We found no sex effects on the OCTS scores. This pilot study of the psychometric properties of the OCTS supports the reliability of the OCTS and indicates that the OCTS administration and coding procedures can be consistently applied in various settings. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to validate the Delirium Observation Screening Scale (DOSS) in a population of long‐term care facility (LTCF) residents in Flanders. Currently there is no validated screening tool for delirium available for the population in this setting in Flanders. Methods: A multisite, cross‐sectional study was conducted in six LTCFs. A total of 338 residents aged 65 years and older were included. Sociodemographic and clinical data, including data from the Montreal Cognitive Assessment (MoCA), Confusion Assessment Method (CAM) and DOSS, were obtained by three trained nurse researchers. For the DOSS, internal consistency was determined, and inter‐rater reliability was calculated. To validate the DOSS, the sensitivity, specificity, and positive and negative predictive value of the DOSS relative to the CAM were determined through receiver operating characteristic analysis. This article adheres to the Strengthening the Reporting of Observational Studies (STROBE) checklist for observational research. Results: For 338 residents, delirium assessments were completed during an early or late shift. The prevalence of delirium was 14.2% as measured with the DOSS. The reliability (α) for the CAM and DOSS was assessed, as was the inter‐rater reliability (κ) and the area under the curve. The sensitivity and specificity for a cut‐off value of 3 on the DOSS by Youden's index were very high, as was the negative predictive value. The positive predictive value was good. Conclusions: This study showed that the DOSS is a reliable and valid instrument to screen for delirium in LTCF residents in Flanders. Geriatr Gerontol Int 2024; 24: 619–625. [ABSTRACT FROM AUTHOR]

Background: Spinopelvic parameters, including pelvic tilt (PT), sacral slope (SS), and pelvic incidence, have been developed to characterize the relationship between lumbar spine and hip motion, but a paucity of literature is available characterizing differences in spinopelvic parameters among patients with femoroacetabular impingement syndrome (FAIS) versus patients without FAIS, as well as the effect of these parameters on outcomes of arthroscopic treatment of FAIS. Purpose: To (1) identify differences in spinopelvic parameters between patients with FAIS versus controls without FAIS; (2) identify associations between spinopelvic parameters and preoperative patient-reported outcomes (PROs); and (3) identify differences in PROs between patients with stiff spines (standing-sitting ΔSS ≤10°) versus those without. Study Design: Cohort study; Level of evidence, 2. Methods: The study enrolled patients ≥18 years of age who underwent primary hip arthroscopy for treatment of FAIS with cam, pincer, or mixed (cam and pincer) morphology. Participants underwent preoperative standing-sitting imaging with a low-dose 3-dimensional radiography system and were matched on age and body mass index (BMI) to controls without FAIS who also underwent EOS imaging. Spinopelvic parameters measured on EOS films were compared between the FAIS and control groups. Patients with FAIS completed the modified Harris Hip Score (mHHS) and Non-Arthritic Hip Score (NAHS) before surgery and at 1-year follow-up. Outcome scores were compared between patients with stiff spines versus those without. Associations between spinopelvic parameters and baseline outcome scores were assessed with Pearson correlations. Continuous variables were compared with Student t test and/or Mann-Whitney U test, and categorical variables were compared with Fisher exact test. Results: A total of 50 patients with FAIS (26 men; 24 women; mean age, 36.1 ± 10.7 years; mean BMI, 25.6 ± 4.2) were matched to 30 controls without FAIS (13 men; 17 women; mean age, 36.6 ± 9.5 years; mean BMI, 26.7 ± 3.6). Age, sex, and BMI were not significantly different between the FAIS and control groups (P >.05). Standing PT was not significantly different between stiff and non-stiff cohorts (P =.73), but sitting PT in the FAIS group was more than double that of the control group (36.5° vs 15.0°; P <.001). Incidence of stiff spine was significantly higher in the FAIS group (62.0% vs 3.3%; P <.001). Among FAIS patients, those with stiff spines had a significantly higher prevalence of cam impingement, whereas those with non–stiff spines had a higher prevalence of mixed impingement (P =.04). No significant differences were seen in preoperative mHHS or NAHS scores or pre- to postoperative improvement in scores between FAIS patients with stiff spines versus those without (P >.05), but a greater sitting SS was found to be positively correlated with a higher baseline mHHS (r = 0.36; P =.02). Conclusion: Patients with FAIS were more likely to have a stiff spine (standing-sitting ΔSS ≤10°) compared with control participants without FAIS. FAIS patients with stiff spines were more likely to have isolated cam morphology than patient without stiff spines. Although sitting SS was positively correlated with baseline mHHS, no significant differences were seen in 1-year postoperative outcomes between FAIS patients with versus without stiff spine. [ABSTRACT FROM AUTHOR]

A recent model of sound change posits that the direction of change is determined, at least in part, by the distribution of variation within speech communities. We explore this model in the context of bilingual speech, asking whether the less variable language constrains phonetic variation in the more variable language, using a corpus of spontaneous speech from early Cantonese–English bilinguals. As predicted, given the phonetic distributions of stop obstruents in Cantonese compared with English, intervocalic English /b d g/ were produced with less voicing for Cantonese–English bilinguals and word-final English /t k/ were more likely to be unreleased compared with spontaneous speech from two monolingual English control corpora. Whereas voicing initial obstruents can be gradient in Cantonese, the release of final obstruents is prohibited. Neither Cantonese–English bilingual initial voicing nor word-final stop release patterns were significantly impacted by language mode. These results provide evidence that the phonetic variation in crosslinguistically linked categories in bilingual speech is shaped by the distribution of phonetic variation within each language, thus suggesting a mechanistic account for why some segments are more susceptible to cross-language influence than others. [ABSTRACT FROM AUTHOR]

Purpose: The pivot‐shift test is used to clinically assess knee instability in patients with anterior cruciate ligament (ACL) lesions; however, it has low interobserver reliability. Dynamic radiostereometry (dRSA) is a highly precise and noninvasive method for the objective evaluation of joint kinematics. The purpose of this study was to quantify precise knee kinematics during a pivot‐shift test using dRSA imaging. Method: Eight human donor legs, including hemipelvises, were evaluated. Arthroscopic intervention was performed inducing ligament lesions in the ACL, and anterolateral ligament (ALL) section was performed as a capsular incision. The pivot‐shift test was recorded with dRSA on knees with intact ligaments, ACL‐deficient and ACL + ALL‐deficient knees. Results: A pivot‐shift pattern was identifiable after ligament lesion, as a change in tibial posterior drawer velocity from 7.8 mm/s (95% CI: 3.7; 11.9) in ligament intact knees to 30.4 mm/s (95% CI 23.0; 38.8) after ACL lesion to 35.1 mm/s (95% CI 23.4; 46.7) after combined ACL‐ALL lesion. The anterior‐posterior drawer excursion increased from 2.8 mm (95% CI 2.1; 3.4) in ligament intact knees to 7.2 mm (95% CI 5.5; 8.9) after ACL lesion to 7.6 mm (95% CI 5.5; 9.8) after combined lesion. A statistically significant increase in tibial external rotation towards the end of the pivot‐shift motion was observed when progressing from intact to ACL + ALL‐deficient knees (p < 0.023). Conclusion: This experimental study demonstrates the feasibility of dRSA to objectively quantify the kinematic laxity patterns of the knee during the pivot‐shift test. The dynamic parameters obtained through dRSA revealed the kinematic changes from ACL to combined ACL‐ALL ligament lesion. Level of Evidence: Not applicable. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to investigate whether malrotation of lateral knee radiographs influences posterior tibial slope (PTS) measurements. Methods: Lateral knee radiographs of all patients who underwent knee surgery at a single institution between June 2022 and January 2023 and received multiple lateral knee radiographs were included. Radiographs were categorised as malrotated lateral knee radiographs or lateral knee radiographs based on the radiographic distance between the medial and lateral posterior femoral condyles. Medial PTS (MPTS) and lateral PTS (LPTS) were evaluated on malrotated lateral knee radiographs and lateral knee radiographs and compared using the paired t test. Intra‐ and interrater reliability between four raters were assessed for MPTS and LPTS measurements. Results: A total of 92 lateral knee radiographs (46 pairs of malrotated lateral knee radiographs and lateral knee radiographs; 50.0% right side) from 46 patients (33.2 ± 12.4 years, 69.6% male) were included. Mean posterior femoral condyle distance in malrotated lateral knee radiographs was 8.1 ± 4.4 mm. Overall, MPTS and LPTS were significantly higher on malrotated lateral knee radiographs versus lateral knee radiographs (medial: 10.5 ± 3.2° vs. 9.7 ± 3.5°, p < 0.05; lateral: 10.6 ± 3.4° vs. 9.7 ± 3.3°, p < 0.05). Mean absolute difference between MPTS and LPTS on malrotated lateral knee radiographs versus lateral knee radiographs were |1.9| ± |1.5|° and |2.0| ± |1.8|°, respectively. Intrarater reliability was 'moderate' and interrater reliability was 'good' for both MPTS and LPTS. Conclusion: Malrotation of lateral knee radiographs led to a significant distortion of both the MPTS and LPTS. In clinical practice, attention should be placed on the (mal)rotation of lateral knee radiographs, especially in patients for whom a slope‐correcting osteotomy is being discussed. Level of Evidence: Level IV. [ABSTRACT FROM AUTHOR]

Purpose: Trochlear dysplasia is one of the main risk factors for recurrent patellar dislocation. The Dejour classification identifies four categories that can be used to classify trochlear dysplasia. The purpose of this study is to evaluate the inter‐ and intraobserver reliability of the Dejour classification for trochlear dysplasia. The hypothesis was that both intra‐ and interobserver reliability would be at least moderate. Methods: This is a cross‐sectional, reliability study. Twenty‐eight examiners from the International Patellofemoral Study Group 2022 meeting evaluated lateral radiographs of the knee and axial magnetic resonance images from 15 cases of patellofemoral instability with trochlear dysplasia. They classified each case according to Dejour's classification for trochlear dysplasia (A–D). There were three rounds: one with only computed radiograph (CR), one with only magnetic resonance imaging (MRI) and one with both. Inter‐ and intraobserver reliability were calculated using κ coefficient (0–1). Results: The mean age of patients was: 14.6 years; 60% were female and 53% had open physis. The interobserver reliability κ probabilities were 0.2 (CR), 0.13 (MRI) and 0.12 (CR and MRI). The intraobserver reliability κ probabilities were 0.45 (CR), 0.44 (MRI) and 0.65 (CR and MRI). Conclusion: The Dejour classification for trochlear dysplasia has slight interobserver reliability and substantial intraobserver reliability. Level of Evidence: Level I. [ABSTRACT FROM AUTHOR]

There is a dearth of psychological interventions for self-harm that have been tested and found acceptable by youth in low- and middle income countries. ĀTMAN (Sanskrit word meaning "self" or "self-existent essence") is one such contextually adapted psychological intervention developed in India. It has three key elements; problem-solving, emotion regulation, and social network strengthening skills. We delivered ATMAN in a series of young people who self-harm to optimize the content, structure and delivery mechanisms, and to assess their experiences of therapy and engagement. ATMAN was delivered sequentially by a psychiatrist and non-specialist counselor in 16 participants between 14 to 24 years who presented to a tertiary level public hospital in Mumbai with self-harm. Quantitative measurement tools included Beck's Scale for Suicidal Ideation (BSI), the Patient Health Questionnaire −9 (PHQ-9), Functional Assessment of Self-Mutilation, and session feedback form. Qualitative tools included PSYCHLOPS and exit interviews. Eight female and four male participants completed therapy with a mean of five sessions and an average duration of 50 min. There were no differences in module wise feedback ratings of the psychiatrist and counselor. There were significant differences in the pre- and post-therapy scores on BSI (mean difference (confidence interval)) (−16.8 (−20.2, −13.3)) and PHQ-9 (−10.8 (−14.5, −7.04)). Various content modifications were undertaken during this phase. ATMAN was acceptable to youth in India who self-harm. Modifications introduced during pilot trial phase make ATMAN better suited to the needs of the youth. ATMAN has the potential to be delivered by non- specialist counselors and to be integrated at all levels of health care settings including primary health care to reduce the burden of suicide in young people. However, an extended randomized controlled trial of ATMAN treatment with multiple counselors will help in identifying key competencies that should be developed during training and supervision, and various quality assurance measures that can be undertaken for effective implementation of ATMAN. [ABSTRACT FROM AUTHOR]

This study examined the intra- and inter-rater reliability of the Recorded Interaction Task (RIT); a novel tool to assess mother-infant bonding via observational methods. Mother-infant bonding describes the reciprocal early emotional connection between mother and infant. Whilst various tools exist to assess mother-infant bonding, many incorrectly confuse this construct with mother-infant attachment. Further, available tools are limited to those that employ self-report methods, thus may reflect perceived behaviour, rather than actual behaviour. The RIT is a novel tool for observational assessment of mother-infant bonding. A standard interaction between mother and infant is recorded, and later assessed against specified bonding-related behaviours. Before its use in research, reliability testing must be undertaken to ensure the RIT may be used consistently. The RIT was administered to 15 mother-infant dyads. Participant recordings were assessed by three trained raters at two time points, using the RIT observation scoring sheet. Intra-rater reliability was determined by comparing scores at each time point for each rater. Inter-rater reliability was determined by assessing reliability of scores at the first time point. Strong intra-rater reliability (ICC >0.86) and fair inter-rater reliability (ICC = 0.55) were observed. The current findings support the RIT's potential to reliably assess mother-infant bonding. [ABSTRACT FROM AUTHOR]

For decades, texts on methods in animal behavior research have stressed the need for observers of behavior to work to minimize potential unconscious biases in their coding of data. Two major ways of minimizing these biases are to carry out data coding blind to the key comparisons being made in the study and to have high inter‐observer reliability. Over 10 years ago, Burghardt et al. (2012, Ethology, 118, 511) reviewed five major journals in the field of animal behavior and coded randomly selected articles from five decadal volumes (1970 to 2010). That earlier article found poor rates of reporting these two common methods for minimizing potential biases. Here, we carried out similar coding for the 2020 volumes from those same five journals. We found that rates of reporting have increased in all five journals – some substantially. However, rates of reporting still lag behind the journal Infancy, which publishes research on human infant development and relies on many of the same behavioral observation and coding methods used by animal behavior researchers. Given increased calls for transparency and reproducibility in many different fields of scientific study, we argue that we – researchers, reviewers, and editors – can and need to do better at making sure we are actively conducting research in ways to minimize potential observer biases. [ABSTRACT FROM AUTHOR]

The Short Physical Performance Battery (SPPB) may be feasible for evaluating older adults undergoing myocardial revascularization surgery (MRS). However, it is necessary to verify its measurement properties and safety to use it for clinical practice. To investigate the reliability, hemodynamic responses, subjective perceived exertion (SPE), and adverse events during and after SPPB in older adults undergoing MRS. A cross-sectional and methodological study conducted with 85 older adults in the pre and postoperative periods of MRS. The hemodynamic responses [heart rate (HR) and systolic blood pressure (SBP)], SPE, and adverse events were evaluated before and after the SPPB. Two researchers performed the inter-rater reliability within a 30-minute interval, while the interval between measures for intra-rater reliability was 24 hours. The Friedman test was used to analyze hemodynamic and SPE responses. The intraclass correlation coefficient (ICC) and the coefficient variation of method error (CVME) were used for the reliability analysis. Increases in HR (p < 001), SBP (p < 0.01), and SPE (p < 0.01) were observed immediately after the SPPB. Only seven volunteers reported minor adverse events. Regarding reliability results, ICC(3,1) for intra-rater reliability varied from 0.66 to 0.87 and CVME from 4.80 to 8.82%. For inter-rater reliability, ICC(2,1) varied from 0.66 to 0.91 and CVME from 4.04 to 9.02%. The SPPB increased the HR, SBP, and SPE immediately after its execution. In addition, it showed light changes in SPE, few adverse events, and good reliability in older adults in the pre and postoperative MRS period. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the reliability and validity of the translated Chinese version of the Communication Complexity Scale (C-CCS) in a Chinese sample of preschool-aged children with minimal verbal skills. A total of 120 children with autism spectrum disorders or children with developmental delays aged 2 to 5 years with minimal verbal skills (i.e., produced less than 20 functional words) were recruited to complete the C-CCS. First, we tested the protocol with 20 children and shortened it based on their results. Second, the interrater reliability, test-retest reliability, and concurrent validity for 100 participants were examined. C-CCS scores were compared with scores from the Chinese Communicative Development Inventories (CCDI) for concurrent validity. Ten C-CCS interactive scripts were administered to 100 participants. Intraclass correlation coefficients (ICC) between independent observers were high. The ICCs for overall optimal scores, optimal BR scores and optimal JA scores were 0.978, 0.971 and 0.977 respectively. Agreement for scores within scripted opportunities and communication level were high-Kappa coefficients 0.869 and 1.000 respectively. The test-retest reliability was high (r = 0.911). A moderate correlation was found between the C-CCS and the CCDI (r = 0.401). The results indicate that C-CCS could be used as a measurement tool in research and clinical practice to describe communication levels in children with minimal verbal skills in China. The Chinese version of the Communication Complexity Scale was developed through a rigorous cultural adaptation process. The evidence shows that the Chinese version of the Communication Complexity Scale is a reliable and valid tool for children with minimal verbal skills in China. The Chinese version of the Communication Complexity Scale can be used in research and clinical practice to assess the general level of social communication skills of Chinese children who mainly communicate using preverbal communication and develop intervention programs. [ABSTRACT FROM AUTHOR]

Phubbing—i.e. excluding and ignoring others through smartphone use—is a pervasive phenomenon. Yet, a comprehensive understanding of its consequences is still lacking. This systematic meta-analytic review aimed to (1) synthesize the associations between being phubbed and emotional and cognitive, social, and behavioural well-being, (2) test the strength of these associations, and (3) investigate moderating influences. Literature searches according to PRISMA-guidelines yielded k = 83 included studies. Random-effects meta-analyses were conducted for 24 of 72 extracted consequences. Subgroup analyses were performed for phubbees' relationship to interlocutors, age group, and study design. The overall sample was N = 53,916 with a mean age of 19.68 years. Being phubbed was moderately to strongly (e.g. $\hat{{\rm \rho }}$ ρ ˆ =.23–.75) associated with various adverse consequences (e.g. depression, relationship dissatisfaction, derogation of interlocutors, smartphone addiction). Effects were larger for adolescents than for adults. The findings are in line with existing theoretical assumptions (e.g. the temporal need-threat model of ostracism) corroborating that phubbing is a detrimental experience. Thus, phubbing appears to be a public health issue which should be addressed through suitable interventions in order to enhance healthy human-human and human-technology interactions. [ABSTRACT FROM AUTHOR]

Children who lack functional spoken language are candidates for augmentative and alternative communication (AAC). Aided AAC and naturalistic interventions offer the potential to extend the communication functions demonstrated by children with autism spectrum disorder (ASD) who are nonspeaking. Related intervention research, however, has been limited, in that interventions have generally targeted a limited range of communication functions taught in highly structured, decontextualized environments. The aim of this study was to investigate the efficacy of an intervention that combined aided AAC with a naturalistic intervention – enhanced milieu teaching (AEMT) - to increase symbolic communication in children with autism spectrum disorder. Three children with autism spectrum disorder participated in a multiple probe design, in which a range of communication functions were targeted using the AEMT. Results showed increases in the use of symbolic communication from baseline to intervention phases, which were found to be statistically significant for two of the three children (phi 0.7–0.81; p <.001). Intervention outcomes were generalized to a communication partner not involved in the intervention and maintained over time for all children. The study provides preliminary evidence that communication functions beyond object requests could be taught using a systematic, multi-element approach implemented across activities. [ABSTRACT FROM AUTHOR]

Literacy skills can assist in the navigation and enjoyment of adult life. For individuals who have reached adulthood without strong literacy skills, opportunities for continued literacy learning are few. Redesigning AAC technologies to support literacy skill development could extend literacy learning opportunities for adults with developmental disabilities who have limited speech. The current preliminary study evaluated an AAC technology feature designed to support literacy development. The study used a multiple probe across participants design. Three adults with Down syndrome who had limited speech and only basic decoding skills participated. Results suggest the participants made modest gains in decoding accuracy after interacting using the AAC app with the literacy supportive feature, though performance was highly variable. Results also offer emerging evidence that, for two participants, some generalization to encoding performance may have also been achieved. Results showed that, for all the participants, interacting using the literacy supportive feature increased their reading confidence. Altogether, the study's results show preliminary evidence that the feature can support adults with Down syndrome in their ongoing literacy learning, though access to formal instruction is still critical. Future research is needed to continue to explore this and other AAC technology redesigns to increase learning opportunities for the people who use the technology every day to communicate. [ABSTRACT FROM AUTHOR]

Background: Deep discussions play an important role in students' online learning. However, researchers have largely focused on engaging students in deep discussions in online asynchronous forums. Few studies have investigated how to promote deep discussion via mobile instant messaging (MIM). Objectives: In this study, we applied learning analytical tools (i.e., KBdeX and word clouds) to enhance students' shared epistemic agency and thereby support their deep discussions in MIM. Methods: Forty Chinese college students participated in this study and reflected on their MIM engagement by participating in the learning analytics (LA)‐augmented meta‐discourse sessions. The study used multiple data analysis methods, including content analysis, statistical analysis, epistemic network analysis and lag sequential analysis. Results: We found that LA engaged students in deep discussions and shared epistemic agency‐related discourse, such as creating shared understanding, creating knowledge objects, and projective and regulative processes. In particular, word clouds engaged students in more complete shared epistemic agency discourse trajectory which started from creating awareness of unknowns, then progressed to setting projective plans and sharing information, and ultimately, creating shared understanding. Moreover, our analysis indicated that epistemic agency discourse moves of creating shared understanding led students to a high level of deep discussion. Implications: This study contributes to research by extending the 'comparison paradigm', which focuses on comparing (a)synchronous forums with MIM, to a 'design paradigm', which mobilises design features from (a)synchronous forums to MIM and using learning analytical tools to engage students in deep online discussions by promoting their epistemic agency. Lay Description: What is known in this subject matter: Supporting students' online deep discussions is important.Prior studies have shown multiple technological and pedagogical strategies to support deep discussions in (a)synchronous discussion forums, but few studies in mobile instant messaging (MIM).MIM is a quasi‐synchronous tool. It is difficult to transform the traditional external scaffolds (i.e., scripts or teachers' facilitation) which promote deep discussions from (a)synchronous forums to MIM. What this paper adds to this: We constructed a design framework which used learning analytical tools‐augmented meta‐discourse to engage students in shared epistemic agency discourse moves to promote their deep discussion in MIM.We conducted multiple types of analyses (content analysis, statistical analysis, epistemic network analysis and lag sequential analysis) on students' WeChat message (a major MIM in China).Results indicated both learning analytical tools helped engage students in shared epistemic agency discourse moves, such as creating shared understanding, creating knowledge objects, projective and regulative, thus, to promote students' deep discussions. Word cloud especially engaged students in more complete shared epistemic agency discourse trajectory. Moreover, analysis results indicated that shared epistemic agency discourse moves of creating shared understanding would lead students to a high level of deep discussions. Implications of study findings for practitioners: Our study provides a feasible way to educational practitioners who want to promote students' deep discussions in their online learning course (both fully online and flipped classroom mode).Knowledge Building Discourse Explorer (KBDeX presents the original analysis results of students' written messages in discussion forums as socio‐cognitive networks.) could be implemented in the classroom. The objective is to encourage students to understand the importance of connecting with peers' ideas in a one‐session implementation period.If time allows, teachers could use word cloud and meta‐discourse to engage students in socio‐metacognitive conversations in class to promote their shared epistemic agency discourse in online discussions. [ABSTRACT FROM AUTHOR]

Introduction: This was a multicenter, prospective, longitudinal, observational study involving eight Spanish tertiary hospitals to determine the interobserver reliability of an uveitis disease activity index, (UVEDAI) and assess its sensitivity to change in patients with receiving pharmacologic treatment. Methods: Patients aged ≥ 18 years diagnosed with active noninfectious uveitis were included. A complete baseline assessment was performed by two ophthalmologists who determined ocular inflammatory activity using the UVEDAI index independently of each other. The principal ophthalmologist made a new visit at 4 weeks to determine the change in inflammatory activity. The interobserver reliability analysis was performed by calculating the intraclass correlation coefficient (ICC), with the values of the variables and the UVEDAI obtained by both ophthalmologists in the more active eye at the baseline visit. Sensitivity to change in the UVEDAI index was assessed at 4 weeks from the start of pharmacologic treatment by determining the clinically relevant change, defined as a change in UVEDAI of ≥ 0.8 points over baseline. The mean change between both measures was compared using the repeated-measures t-test. Results: A total of 111 patients were included. In the interobserver reliability analysis, the ICC for the UVEDAI value was 0.9, and, when compared with the mean UVEDAI values obtained by the ophthalmologists, no statistically significant differences were found (p value > 0.05). As for the sensitivity to change in UVEDAI, statistically significant differences (p value = 0.00) were found for the mean values of the index compared with baseline. In all cases, the index value decreased by > 1 point at the 4-week visit. Conclusions: The interobserver reliability of the UVEDAI was high in the total sample. Furthermore, the index was sensitive in determining the change in inflammatory activity after treatment. We believe that UVEDAI is a disease activity index that enables objective comparison of results in clinical practice and trials. [ABSTRACT FROM AUTHOR]

Introduction: Simulation training is an important component of medical education. In former studies, diagnostic simulation training for direct and indirect funduscopy was already proven to be an effective training method. In this prospective controlled trial, we investigated the effect of simulator-based fundus biomicroscopy training. Methods: After completing a 1-week ophthalmology clerkship, medical students at Saarland University Medical Center (n = 30) were block-randomized into two groups: The traditional group received supervised training examining the fundus of classmates using a slit lamp; the simulator group was trained using the Slit Lamp Simulator. All participants had to pass an Objective Structured Clinical Examination (OSCE); two masked ophthalmological faculty trainers graded the students' skills when examining patient's fundus using a slit lamp. A subjective assessment form and post-assessment surveys were obtained. Data were described using median (interquartile range [IQR]). Results: Twenty-five students (n = 14 in the simulator group, n = 11 in the traditional group) (n = 11) were eligible for statistical analysis. Interrater reliability was verified as significant for the overall score as well as for all subtasks (≤ 0.002) except subtask 1 (p = 0.12). The overall performance of medical students in the fundus biomicroscopy OSCE was statistically ranked significantly higher in the simulator group (27.0 [5.25]/28.0 [3.0] vs. 20.0 [7.5]/16.0 [10.0]) by both observers with an interrater reliability of IRR < 0.001 and a significance level of p = 0.003 for observer 1 and p < 0.001 for observer 2. For all subtasks, the scores given to students trained using the simulator were consistently higher than those given to students trained traditionally. The students' post-assessment forms confirmed these results. Students could learn the practical backgrounds of fundus biomicroscopy (p = 0.04), the identification (p < 0.001), and localization (p < 0.001) of pathologies significantly better with the simulator. Conclusions: Traditional supervised methods are well complemented by simulation training. Our data indicate that the simulator helps with first patient contacts and enhances students' capacity to examine the fundus biomicroscopically. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to investigate the intrarater and interrater reliability and validity of range of motion measurements obtained with a universal goniometer, digital inclinometer, and smartphone application in patients with total knee arthroplasty. Methods: Range of motion of the knee joint was measured by two examiners with a universal goniometer, digital inclinometer, and a smartphone application. Data were obtained from 51 knees of 27 patients at postoperative 6 months. Two measurements made by the first examiner were compared to assess interrater reliability, and measurements from both examiners were compared to assess intrarater reliability. Statistical analysis was performed using intraclass correlation coefficient (ICC) and Spearman's rho values. Results: With all three methods, active and passive knee flexion range of motion measurements showed high intrarater and interrater reliability (ICC = 0.749–0.949). Concurrent validity analysis also demonstrated statistically significant, moderate to strong correlation among the three methods (r = 0.775–0.941). Conclusion: The universal goniometer, digital inclinometer, and smartphone application were all found to be reliable and valid assessment tools in clinical practice for patients with total knee arthroplasty. [ABSTRACT FROM AUTHOR]

Purpose: To validate a semiautomated method for segmenting vein of Galen aneurysmal malformations (VGAM) and to assess the relationship between VGAM volume and other angioarchitectural features, cardiological findings, and outcomes. Methods: In this retrospective study, we selected all subjects with VGAM admitted to the Gaslini Children's Hospital between 2009 and 2022. Clinical data were retrieved from electronic charts. We compared 3D-Slicer segmented VGAM volumes obtained by two independent observers using phase-contrast MR venography to those obtained with manual measurements performed on T2-weighted images. The relationship between VGAM volumes and clinical and neuroimaging features was then explored. Results: Forty-three subjects with VGAM (22 males, mean age 6.56 days) were included in the study. Manual and semiautomated VGAM volumes were well correlated for both readers (r = 0.86 and 0.82, respectively). Regarding reproducibility, the inter-rater interclass correlation coefficients were 0.885 for the manual method and 0.992 for the semiautomated method (p < 0.001). The standard error for repeated measures was lower for the semiautomated method (0.04 versus 0.40 of manual method). Higher VGAM volume was associated with superior sagittal sinus narrowing, jugular bulb stenosis, and aqueductal stenosis (p < 0.05). A weak correlation was found between VGAM volume and straight sinus dilatation (r = 0.331) and superior sagittal sinus index (r = − 0.325). No significant associations were found with cardiac findings, post-embolization complications, and outcome (p > 0.05). Conclusions: Semiautomated VGAM volumetry is feasible and reliable with improved reproducibility compared to the manual method. VGAM volume is not a prognostic factor for clinical outcome, but it is related to other venous findings with potential hemodynamic effects. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to compare the radiological tumor (T)-category using multiparametric MRI with the pathological T category in patients with oral tongue squamous cell carcinoma (OTSCC) and to examine which is a better predictor of prognosis. Methods: This retrospective study included 110 consecutive patients with surgically resected primary OTSCC who underwent preoperative contrast-enhanced MRI. T categories determined by maximum diameter and depth of invasion were retrospectively assessed based on the pathological specimen and multiparametric MRI. The MRI assessment included the axial and coronal T1-weighted image (T1WI), axial T2-weighted image (T2WI), coronal fat-suppressed T2WI, and axial and coronal fat-suppressed contrast-enhanced T1WI (CET1WI). Axial and coronal CET1WI measurements were divided into two groups: measurements excluding peritumoral enhancement (MEP) and measurements including peritumoral enhancement. The prognostic values for recurrence and disease-specific survival after radiological and pathological T categorization of cases into T1/T2 and T3/T4 groups were compared. Results: The T category of MEP on coronal CET1WI was the most relevant prognostic factor for recurrence [hazard ratio (HR) = 3.30, p = 0.001] and the HR was higher than the HR for pathological assessment (HR = 2.26, p = 0.026). The T category determined by MEP on coronal CET1WI was also the most relevant prognostic factor for disease-specific survival (HR = 3.12, p = 0.03), and the HR was higher than the HR for pathological assessment (HR = 2.02, p = 0.20). Conclusion: The T category determined by MEP on the coronal CET1WI was the best prognostic factor among all radiological and pathological T category measurements. [ABSTRACT FROM AUTHOR]

To develop a consumer nutrition environment assessment tool to assess policy, systems, and environmental initiatives that are implemented in food pantries, which incorporates recent national guidance, and evaluate its validity and reliability. Illinois, US. This study had 4 phases: (1) tool revision, (2) pilot testing, (3) content validity assessment, and (4) interrater and test-retest reliability assessment. The original Nutrition Environment Food Pantry Assessment Tool (NEFPAT) was revised to incorporate evidence from updated guidelines and evidence. The NEFPAT+ was pilot-tested by 9 professionals at 5 food pantries. After revisions, 18 experts rated the content validity. Interrater and test-retest reliability was based on 2–4 professionals completing independent evaluations at 21 food pantries twice, 1 month apart. Content validity indices and intraclass correlation (ICC) coefficients for reliability estimates were compared with established thresholds. The NEFPAT+ was rated content valid by 94% of experts. The ICC for NEFPAT+ scores indicated excellent interrater reliability (ICC, 0.96; 99% confidence interval, 0.75–0.97) and good test-retest reliability (ICC: 0.80; 99% confidence interval, 0.60–0.92). Evidence supports the content validity, interrater reliability, and test-retest reliability of the NEFPAT+. Future studies can assess how NEFPAT+ scores relate to intervention outcomes and dietary behaviors. [ABSTRACT FROM AUTHOR]

Background/Aims: Evidence-based standards are an important means for ensuring safe and effective care for birthing women. The provision of one-to-one care for women in labour is one such standard, which should be the norm in Dutch maternity care. However, no audit measures of this standard are available. This study examined the use of Birthrate Plus, a validated instrument for the measurement of patient acuity. This tool has the added benefit of allowing measurement of birth characteristics in relation to staffing numbers, providing a basis for auditing the standard of one-to-one care for women in labour in hospitals in the Netherlands. Methods: This pilot study used the Birthrate Plus tool to retrospectively examine birth characteristics and staffing levels in a 4-month period, in five hospitals in the Netherlands. Results: The review of 11 582 patient cases found that most births in the sample were classified as occurring in the higher acuity levels of Birthrate+ tool. Examination of staffing levels showed that when comparing actual staffing levels with recommended levels, hospitals had a shortfall of between 47% and 64%. Conclusions: The Birthrate Plus tool could be useful in auditing staffing levels in Dutch maternity care. Analysis of the data provided by hospitals in the sample showed that none were able to meet the Dutch standard of providing consistent one-one-one care. [ABSTRACT FROM AUTHOR]

Teaching is one of the most stressful occupations in the United States. This is especially true for teachers who are responsible for meeting the complex needs of students with disabilities, particularly those with emotional and behavioral disorders (EBD). In fact, EBD teachers have a higher risk of experiencing burnout than their special education and general education colleagues. This burnout leads EBD teachers to leave the specialization of EBD, leave the field of special education, or leave the teaching profession as a whole. One way to mitigate this exodus of EBD teachers is to provide a broader pedagogical opportunity. Project-based learning (PBL) is a pedagogical methodology that is not often used by EBD teachers. The current study examines the use of PBL teaching to support students behaviorally and its impact on EBD teacher stress and job satisfaction. PBL was shown to improve student classroom and personal behaviors as well as increase job satisfaction for EBD teachers. [ABSTRACT FROM AUTHOR]

An observational methodology system has been designed which allows the observation and analysis of the technical-tactical behaviour and interaction of judokas during competition. The observation instrument (JUTACTIC) is composed of 8 fixed criteria that provide information related to the competition and the competitors and 13 variable criteria that, throughout the intrasessional monitoring of each combat, allow the behaviour displayed by both judokas and their interaction to be recorded. From an observational sample consisting of matches from the Rio 2016 Olympic champions and the corresponding samples made using the LINCE PLUS software, evidence of validity, reliability, generalizability and applicability of the observation system is provided. The content validity of the observation instrument has been endorsed by a panel of experts (n = 11). Intra and inter-observer reliability has been guaranteed from the results obtained in the Fleiss Kappa and the Krippendorff Alpha. The generalizability analysis with the design structure [Category] [Participants] / [Matches] has confirmed that around seven matches are needed to accurately analyse the behaviour of the competitor under study. The practical application possibilities of the observation instrument has been shown with an example of the results obtained and the regular behaviour structures detected (T-patterns) using the THEME software. [ABSTRACT FROM AUTHOR]

Background: A variety of measurement methods and imaging modalities are in use to quantify the morphology of lateral femoral condyle (LFC), but the most reliable method remains elusive in patients with lateral patellar dislocation (LPD). The purpose of this study was to determine the intra- and inter-observer reliability of different measurement methods for evaluating the morphology of LFC on different imaging modalities in patients with LPD. Methods: Seventy-three patients with LPD were included. Four parameters for quantifying the morphology of LFC were retrospectively measured by three observers on MRI, sagittal CT image, conventional radiograph (CR), and three-dimensional CT (3D–CT). The intra-class correlation coefficient was calculated to determine the intra- and inter-observer reliability. Bland–Altman analysis was conducted to identify the bias between observers. Results: The lateral femoral condyle index (LFCI) showed better intra- and inter-observer reliability on MRI and 3D–CT than on CR and sagittal CT images. The mean difference in the LFCI between observers was lowest on 3D–CT (0.047), higher on MRI (0.053), and highest on sagittal CT images (0.062). The LFCI was associated with the lateral femoral condyle ratio (ρ = 0.422, P = 0.022), lateral condyle index (r = 0.413, P = 0.037), and lateral femoral condyle distance (r = 0.459, P = 0.014). The LFCI could be reliably measured by MRI and 3D–CT. Conclusion: The LFCI could be reliably measured by MRI and 3D–CT. The LFCI was associated with both the height and length of LFC and could serve as a comprehensive parameter for quantifying the morphology of LFC in patients with LPD. [ABSTRACT FROM AUTHOR]

Background: The effects of antipsychotic (AP) medications on cognitive functions in individuals at clinical high-risk (CHR) of psychosis are poorly understood. This study compared the effects of AP treatment on cognitive improvement in CHR adolescents and adults. Methods: A total of 327 CHR participants, with an age range of 13 to 45 years, who underwent baseline neuropsychological assessments and a 1-year clinical follow-up were included. Participants with CHR were categorized into four groups based on their age: adolescents (aged < 18) and adults (aged ≥ 18), as well as their antipsychotic medication status (AP+ or AP−). Therefore, the four groups were defined as Adolescent-AP−, Adolescent-AP+, Adult-AP−, and Adult-AP+. Results: During the follow-up, 231 CHR patients received AP treatment, 94 converted to psychosis, and 161 completed the 1-year follow-up. The Adolescent-AP+ group had more positive symptoms, lower general functions, and cognitive impairments than the Adolescent-AP− group at baseline, but no significant differences were observed among adults. The Adolescent-AP+ group showed a significant increase in the risk of conversion to psychosis (p < 0.001) compared to the Adolescent-AP− group. The Adult-AP+ group showed a decreasing trend in the risk of conversion (p = 0.088) compared to the Adult-AP− group. The Adolescent-AP− group had greater improvement in general functions (p < 0.001), neuropsychological assessment battery mazes (p = 0.025), and brief visuospatial memory test-revised (p = 0.020), as well as a greater decrease in positive symptoms (p < 0.001) at follow-up compared to the Adolescent-AP+ group. No significant differences were observed among adults. Conclusions: Early use of AP was not associated with a positive effect on cognitive function in CHR adolescents. Instead, the absence of AP treatment was associated with better cognitive recovery, suggesting that AP exposure might not be the preferred choice for cognitive recovery in CHR adolescents, but may be more reasonable for use in adults. [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to investigate whether morphometric variables of the knee can predict isolated meniscal bucket-handle tears and identify the risk factors. Methods: The study included 146 participants with a mean age of 36.547 ± 12.279 years. They included two groups of 73 patients each: one group with isolated meniscal bucket-handle tears and another with no knee injury (control group). Magnetic resonance imaging findings of the participants were retrospectively assessed. A few morphometric variables associated with distal femur, proximal tibia, and cruciate ligaments were measured. Results: Cruciate ligament tensity (CLT), medial femoral condylar height (MFCH), and lateral meniscal bone angle (LMBA) were found to be 12.7 ± 0.3, 30.1 ± 2.5 mm, and 21.2° ± 3.4°, respectively, in patients with meniscal bucket-handle tear, compared with 11.9 ± 0.2, 28.3 ± 2.7 mm, and 26.5° ± 3.7° in the control group, respectively. Based on multivariate Firth's logistic regression analysis, CLT (Odds ratio [OR]: 456.533; 95% confidence interval [CI]: 27.582 to > 999.999), MFCH (OR: 1.603; 95% CI: 1.023–2.513), and LMBA (OR: 0.780; 95% CI: 0.624–0.975) could distinguish between meniscal bucket-handle tears and knees without meniscus tears (p < 0.05). Based on the multicategorical multinominal regression model, CLT (OR: > 999.999; 95% CI: 49.937 to > 999.999) and MFCH (OR: 1.903; 95% CI: 1.005–3.606) were the determinant variables in differentiating medial meniscal bucket-handle tears from knees without meniscus tears (p < 0.05). Conclusion: Large CLT, high medial condyle, and small LMBA were revealed as the morphometric risk factors for meniscal bucket-handle tear. [ABSTRACT FROM AUTHOR]

Objective The Staged Approach for Rehabilitation Classification for the Shoulder (STAR-Shoulder) has been proposed as a model to guide management and improve outcomes for patients with shoulder pain; however, the effect of its utilization on patient outcomes has not been established. Therefore, the primary purpose of this study was to determine whether patient outcomes were improved if care was matched to the STAR-Shoulder system compared with unmatched care. Methods Collected and reviewed demographic, examination, and intervention data for all patients receiving physical therapist treatment for shoulder pain during a 1-year period within a single health care system. Outcome variables included the numeric pain rating scale, the Quick Disabilities of the Arm, Shoulder and Hand Questionnaire (QuickDASH), and the number of visits. Clinical records from patients receiving care at the discretion of the therapist were systematically audited to determine whether care provided was considered matched or unmatched. Results A total of 692 patient records were examined. The interrater reliability of classifying care as matched or unmatched was substantial (κ = 0.6; 95% CI = 0.4 to 0.9), with 82% agreement. Changes in patient outcome scores were significantly better for those patients whose care matched the STAR-Shoulder system for pain changes (mean difference = −1.2; 95% CI = 0.8 to 1.6; effect size [ d ] = 0.5) and QuickDASH score (mean difference = 12.7; 95% CI = 9.9 to 15.5; d  = 0.7). No difference was noted for number of visits. Conclusion The STAR-Shoulder system appears to be a meaningful way to classify patients and guide intervention to improve patient outcomes. Impact Application of the STAR-Shoulder system to help align physical therapist interventions more closely with tissue irritability and physical impairments appears to improve patient outcomes. These findings support this model as a promising approach to advance evidence-based practice for shoulder pain. [ABSTRACT FROM AUTHOR]

Young refugee populations continue to grow. This scoping review aims to identify and summarize studies of programs that provide linguistically responsive practices for children who are refugees. Secondary aims of this review are: (a) to identify the gaps in the literature, and (b) to suggest future research and policy directions. By studying key features of linguistically responsive practices for children who are refugees, we can better understand the important components of a high-quality inclusive and equitable environment for all children, including those with minority language backgrounds. We conducted an electronic database search and identified 14 studies. Studies varied in location, country of origin, and language support. The findings from this review revealed a critical need to develop, implement, and study linguistically responsive programs for children who are refugees in host countries. [ABSTRACT FROM AUTHOR]

Background: Pre-treatment stratification and outcomes of neuroblastoma patients often depend on the assessment of image-defined risk factors (IDRFs) on MR Imaging, usually using Gadolinium-contrast materials which are cautioned in pediatrics. We aimed to address whether gadolinium contrast-enhanced sequences are necessary to identify the presence/absence of IDRFs. Methods: Patients with neuroblastoma with MR imaging were retrospectively identified from 2005 to 2021. Ninety confirmed IDRFs were evaluated in 23 patients. Corresponding MR studies were anonymized, randomized, and independently evaluated by 3 fellowship-trained pediatric radiologists. Each radiologist assessed the studies twice. At the first reading, all enhanced sequences were omitted, while in the second reading, the full study with enhanced sequences were included. Consensus reading was obtained among readers. Inter- and intra-rater agreements using Kappa statistics (κ) as well as the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of non-enhanced MR in assessing IDRFs with respect to enhanced MR were calculated. Results: There were substantial (ĸ: 0.64-0.73) intra-reader agreements, and moderate to substantial (ĸ: 0.57-0.62) inter-reader agreements among radiologists in identifying IDRFs using non-enhanced MR. Non-enhanced MR had a sensitivity of 87.8% (95% CI [79-94]), specificity of 93% (89-96), PPV of 82.3 (73-89), NPV of 95.4 (92-98), and accuracy of 91.6 (88-94) in identifying IDRFs. However, 5/23 patients (21.7%) had a change in staging with the inclusion of contrast sequences. Conclusion: Although contrast sequences have a role in IDRF assessment, the majority can be adequately assessed on MR without gadolinium-contrast enhancement. Validation in a larger cohort is an important next step. [ABSTRACT FROM AUTHOR]

Introduction: Reporting of aromatherapy-focused research often lacks sufficient quality and detail for replication and subsequent application of results. To our knowledge currently, no quality appraisal tool exists for aromatherapy research reporting. To address this gap, the Aromatic Research Quality Appraisal Taskforce (ARQAT) composed of aromatherapy professionals with varied expert backgrounds came together. Presented here is the Transparent Reporting for Essential oil and Aroma Therapeutic Studies (TREATS) checklist, which is a result of this collaborative effort. Methods: Creation of TREATS followed a three-stage process, including determination of interest/need, development, and dissemination. The shortcomings of existing aromatherapy research reporting quality were evaluated and responses to address these shortcomings were used to create checklist items that were then grouped into sections. Items for each section were brain-stormed with reference to the aromatherapy literature and ARQAT's expert knowledge, and the development of each section followed an iterative process until agreement was reached. An explanatory document was also created to assist more accurate use of the tool; it and the checklist were reviewed by a group of aromatherapy experts. Results: The TREATS checklist with 38 items in four sections was developed along with the explanatory document. The ARQAT and a global group of aromatherapy experts reviewed the TREATS. Their results and comments assisted development of the current version. The TREATS identifies key components of research involving essential oils, their application, and olfactory considerations that ARQAT considers the minimum necessary for high-quality aromatherapy research. Conclusion: The TREATS, explanatory document, and associated website (www.arqat.org) contribute to thorough aromatherapy research critique. The TREATS checklist aids appraisal of quality and can be used with any study design. It lays the foundation for the future development of aromatic research reporting guidelines. [ABSTRACT FROM AUTHOR]

Our aim was to adapt the Clinical Institute of Withdrawal Assessment for Alcohol scale (CIWA-Ar) into Estonian and test its reliability and validity. A total of 72 patients with alcohol withdrawal syndrome participated in the study. In order to assess the interrater reliability, at first assessment the CIWA-Ar was simultaneously completed by two nurses. In order to assess the sensitivity of the CIWA-Ar to the changes in the severity of the withdrawal syndrome, as well as its correlations to several indices characterizing the subjects' current condition, the CIWA-Ar, the Clinical Global Impression Severity subscale (CGI-S), the visual analogue scales for the assessment of the general feeling of malaise, anxiety and depression were filled in and the vital signs were measured at inclusion, in 4 h and after the withdrawal syndrome had been resolved. The intraclass correlation coefficient (ICC) for the Estonian version of the CIWA-Ar total score, used as an indicator of interrater reliability, was excellent. The CIWA-Ar had significant correlations with the psychiatrists' CGI-S ratings of the severity of the patient's condition at all assessment points. Significant correlations were also found between CIWA-Ar and patients' self-ratings, the highest correlations found with self-rated anxiety and general feeling of malaise. CIWA-Ar total score did not correlate with simultaneously measured heart rate, systolic and diastolic blood pressure at the first assessment. At the second assessment, heart rate had a significant correlation with the CIWA-Ar total score. Our study provides confirmation that the CIWA-Ar tool is well applicable in the Estonian language and culture setting. [ABSTRACT FROM AUTHOR]

Connected speech is often used to assess many aspects of an individual's language abilities after stroke. However, it is unknown the degree to which elicitation methods differ in generating structural and syntactic aspects of connected speech, two critical components of successful communication. Quantifying the degree to which elicitation methods differ in eliciting structurally, syntactically, and lexically complex connected speech at the earliest stage of stroke before reorganization and rehabilitation of function independent of clinical diagnosis of aphasia has not been examined to date. Addressing this gap has implications for early clinical intervention as well as empirical studies of connected speech production. We compared two common elicitation methods, picture description and storytelling on lexical, structural, and syntactic measures of connected speech in speakers during the acute stage of left hemisphere stroke. We measured connected speech using an automated quantitative production analysis approach (Fromm et al., 2021) in 71 native-English speaking participants (27 female; 59 ± 13 years) within an average 3.9 days from left hemisphere stroke onset. We tested the degree of agreement and consistency between elicitation methods for lexical, structural, and syntactic measures of connected speech, as well as the degree of concordance in classifying deficits across individuals. Storytelling elicited significantly more words and more structurally complex, lexically diverse, and syntactically accurate speech in comparison to picture description. Elicitation methods differed in measuring outcomes across participants for the lexical and syntactic, but not structural complexity aspects of connected speech where storytelling classified more participants with impairments in comparison to picture description. These differences suggest storytelling provides assessment of connected speech abilities more reflective of real-world abilities where its use is particularly critical for examining individual differences and providing diagnoses of acute stroke language deficits. As a result, using storytelling as a connected speech elicitation method more effectively captures a patient's language capabilities after stroke, consequently informing clinical diagnosis and treatment. [ABSTRACT FROM AUTHOR]

In healthcare, effective communication and teamwork are pivotal in reducing medical errors. Integrating team training into health professions education is crucial. Accurate measurement of team performance during training requires reliable assessment tools. The TeamSTEPPS® Team Performance Observation Tool (TPOT), recently updated by the Agency for Healthcare Research and Quality, serves this purpose. However, it had not been translated and validated for use in Thailand. We aimed to translate and assess the psychometric properties of the Thai version of TPOT. Employing a back-translation process, TPOT was adapted to the Thai context. The resulting Thai TPOT instrument was administered to 518 healthcare professionals who had undergone TeamSTEPPS® training. Participants were asked to evaluate two prerecorded, 7-minute simulated team emergency scenarios using the Thai TPOT instrument. Results exhibited high internal consistency (Cronbach's alpha =.96) and inter-rater reliability (ICC =.98). Confirmatory factor analysis affirmed the construct validity of the Thai TPOT. These findings establish the Thai TPOT as useful for evaluating teamwork within healthcare teams. [ABSTRACT FROM AUTHOR]

The infusion of multicultural factors into all aspects of training, research, and service is an expected competency for professionals in health service psychology. This includes skills in multicultural case conceptualization, the basis upon which diagnoses, and treatment interventions are selected. However, there is a paucity of research on the effects of training on multicultural case conceptualization ability and limited evidence of its effectiveness. Using a single-case research design, this study addressed this inadequacy by training doctoral students to interpret and integrate multicultural factors in their case conceptualizations. Results indicated no functional relationship between the training intervention and multicultural case conceptualization skills. A combination of statistical and visual analyses indicated weak effects of the intervention for two participants and a counter to the intended direction of effect for one participant. The limitations of the study and valuable insights are discussed, raising important implications for future research and training. [ABSTRACT FROM AUTHOR]

Purpose: Whether photographs included in the operative report of knee arthroscopies can make the surgeon liable in the event of a legal investigation remains unknown. The main objective of this study was to establish inter-observer reliability in determining the presence or absence of lesions of the cartilage, meniscus and anterior cruciate ligament (ACL). Secondary objective was to assess the inter-observer reliability in classifying lesions. Method: A retrospective observational study was conducted in a continuous serie of 60 patients who underwent knee arthroscopy from the same operator. The photographs of each patient's operative report were presented separately to three experts, blinded to each other. Each expert had to decide on the presence or absence of injuries to the following structures: meniscal, cartilage and ACL and then, classify it. Primary and secondary endpoints were evaluated using the Fleiss' kappa index. Results: Inter-observer reliability for lesion detection was between 0.4 and 0.61 for all structures with three exceptions: for cartilage, it was low (0.15) at the lateral tibial plateau and poor (-0.01) at the external condyle. On the contrary, the concordance was almost perfect (0.8) for the ACL. For classifying cartilaginous and meniscal lesions, inter-observer reliability was poor (from 0.03 to 0.14), except for at the lateral meniscus (0.65). Conclusion: Inter-observer reliability of arthroscopic knee diagnoses is poor when photographs alone are used. In the event of a legal investigation following knee arthroscopy, the photographs included in the operative report should not be used alone to hold the surgeon liable. [ABSTRACT FROM AUTHOR]

Background: Children with phonological impairment present with pattern‐based errors in their speech production. While some children have difficulties with speech perception and/or the establishment of robust underlying phonological representations, the nature of phonological impairment in children is still not well understood. Given that phonological and lexical development are closely linked, one way to better understand the nature of the problem in phonological impairment is to examine word learning abilities in children. Aims: To examine word learning and its relationship with speech perception, speech production and vocabulary knowledge in children aged 4–5 years. There were two variables of interest: speech production abilities ranging from phonological impairment to typical speech; and vocabulary abilities ranging from typical to above average ('lexically precocious'). Methods & Procedures: Participants were 49 Australian‐English‐speaking children aged 48–69 months. Children were each taught four novel non‐words (out of a selection of eight) through stories, and word learning was assessed at 1 week post‐initial exposure. Word learning was assessed using two measures: confrontation naming and story retell naming. Data were analysed by group using independent‐samples t‐tests and Mann–Whitney U‐tests, and continuously using multiple linear regression. Outcomes & Results: There was no significant difference in word learning ability of children with and without phonological impairment, but regardless of speech group, children with above average vocabulary had significantly better word learning abilities than children with average vocabulary. In multiple linear regression, vocabulary was the only significant predictor of variance in word learning ability. Conclusions & Implications: Children with phonological impairment can be lexically precocious and learn new words like their peers without phonological impairment. Contrary to expectations, vocabulary knowledge rather than expressive phonological ability explained variance in measures of word learning. These findings question an assumption that children with phonological impairment have underspecified phonological representations. They also highlight the heterogeneity among children with phonological impairment and the need to better understand the nature of their difficulty learning the phonological system of the ambient language. WHAT THIS PAPER ADDS: What is already known on the subject: There is limited research examining the word learning abilities of children with phonological impairment. Most previous research focuses on word properties such as phonotactic probability and neighbourhood density. Within the existing literature there are different reports and conclusions regarding the word learning abilities of children with phonological impairment and whether their word learning differs from that of children with typically developing speech. What this study adds to existing knowledge: This study found that vocabulary was the strongest predictor of word learning across children with and without phonological impairment. There was no significant difference in word learning ability between children with and without phonological impairment. However, children with lexically precocious vocabulary abilities were significantly better at word learning than children with average vocabulary abilities. What are the potential or actual clinical implications of this work?: Findings from this study support the importance of assessing and considering measures of word learning—including vocabulary—when working with children with phonological impairment. This study indicates that it is possible to use stories coupled with measures of confrontation naming and story retell to gain deeper insight into children's word learning abilities. [ABSTRACT FROM AUTHOR]

Background: The complexity of communication presents challenges for clinical assessment, outcome measurement and intervention for people with acquired brain injury. For the purposes of assessment or treatment, this complexity is usually managed by isolating specific linguistic functions or speech acts from the interactional context. Separating linguistic functions from their interactional context can lead to discourse being viewed as a static entity comprised of discrete features, rather than as a dynamic process of co‐constructing meaning. The ecological validity of discourse assessments which rely on the deconstruction of linguistic functions is unclear. Previous studies have reported assessment tasks that preserve some of the dialogic features of communication, but as yet, these tasks have not been identified as a distinct genre of assessment. We suggest the term 'co‐constructed communication' to describe tasks which are specifically designed to capture the dynamic, jointly produced nature of communication within a replicable assessment task. Aims: To identify and summarize how co‐constructed communication has been assessed with individuals with non‐progressive acquired communication disability regarding task design, measures and psychometric robustness. Methods: A scoping review methodology was used to identity relevant studies. Systematic database searches were conducted on studies published before July 2021. Studies in the yield were assessed against eligibility criteria, with 37 studies identified as eligible for inclusion. Main contribution: This is the first time that co‐constructed communication has been defined as a genre of discourse assessment for stroke and traumatic brain injury populations. Co‐constructed communication has been assessed for 144 individuals with aphasia and 111 with cognitive–communication disability. Five categories of co‐constructed communication tasks were identified, ranging in complexity. Variability exists in how these assessment tasks are labelled and measured. Assessment measures require further psychometric profiling, specifically regarding test–retest reliability and validity. Conclusions: Co‐constructed communication is a discourse genre which offers researchers and clinicians a replicable method to assess language and communication in an experimentally rigorous way, within an ecologically valid context, bridging the gap between experimental and ecological assessment approaches. What this paper adds: What is already known on this subject: Standardized assessments of language skills and monologue offer reliable, replicable ways to measure language. However, isolating language from an interactional context fundamentally changes the behaviour under study. This raises questions about the ecological validity of the measures we routinely use to determine diagnoses, guide treatment planning and measure the success of treatment. What this study adds to the existing knowledge: This review highlights studies that conceptualize, and often quantify, interaction by combining experimental rigour and aspects of everyday dialogue. This is the first time this genre of discourse assessment has been identified. We propose the term 'co‐constructed communication' to describe this genre and provide an operational definition for the term. What are the practical and clinical implications of this study?: Co‐constructed communication assessment tasks require refinement, particularly regarding aspects of psychometric robustness. In the future, these tasks offer pragmatic, meaningful ways to capture the effect and impact of aphasia and cognitive–communication disability within interaction. [ABSTRACT FROM AUTHOR]

We describe the development of an observational video coding tool, the Rehabilitation Observation Measure of Engagement (ROME), to quantify engagement in rehabilitative settings at the person (internal state of an individual) and between-system (interaction between individuals) level. Forty-nine children with unilateral spastic cerebral palsy (29 males; Age: M = 9.28 yrs, SD = 3.08 yrs) and their interventionists were videotaped during different activities. Construct validity was examined by correlating the ROME with the Engagement vs. Disaffection with Learning Survey and the Pediatric Rehabilitation Intervention Measure of Engagement – Observation questionnaire. Inter- and intra-rater reliability were examined using two independent raters. The ROME's responsiveness to change was examined by comparing scores across activities. For construct validity, results showed a positive correlation for person-level engagement (r = 0.444, p = 0.003). No relationship was found between-system-level engagement. High intrarater (91.8%) and interrater (96.1%) reliability was found. The ROME's responsiveness to change was supported by children exhibiting lower engagement scores during repetitive shaping activities. These findings provide evidence that the ROME is a reliable tool to objectively examine the construct of engagement within rehabilitation and is valid for quantifying person-level engagement. It provides information that cannot be extracted from questionnaires and can help guide intervention decisions. Behavioral characteristics, including engagement, of the agents involved in rehabilitation are largely unstudied, although engagement is expected to benefit motor learning. The Rehabilitation Observation Measure of Engagement (ROME) is an observation measure that uses predefined codes and can be used universally, as it is not limited to specific language or cognitive levels. The ROME is a reliable tool for objectively measuring the role of the construct of behavioral engagement during rehabilitation and valid for examining person-level engagement. The ROME may be used as a measure of client and service provider process, of intervention quality, or as a decision guide. [ABSTRACT FROM AUTHOR]

Computer-supported collaborative learning (CSCL) seeks to improve students' learning with the support of technology. Although CSCL facilitates an enriching environment for cooperation, CSCL activities might be affected by asymmetrical participation. Group awareness tools have proven to enhance learners' interactions, balancing the levels of participation and increasing the learning outcomes. This study investigates the effect of a group awareness tool (GAT) on participation within synchronous CSCL activities in the context of extracurricular activities. We designed a quasi-experimental within-subject study (GAT exposure and control condition) and tested an ad hoc GAT in a web-based CSCL platform with high school students (N = 140). The measured variables included the effect of the GAT on students' participation and the quality of discussion. A complementary analysis evaluated students' perceptions of the tool. Results revealed that the implementation of a GAT encourages students to take part in CSCL discussions without explicitly hindering its quality. Even so, the balance of participation was not significantly affected. Students further reported that they found the GAT useful to regulate collaboration. The results from the study provide further knowledge of the functioning of group awareness tools in secondary education and share an insight into how students perceive them. [ABSTRACT FROM AUTHOR]