Behavior Observation Scale Research Articles

Behavioral Problems and Self-Feeding Independence Among Patients With Acute Stroke: A Single-Center Study.

Self-feeding independence is often the first goal in acute stroke rehabilitation. Attention deficits appear frequently after stroke, but neuropsychological tests may be difficult to perform in the acute phase, and the effect on self-feeding activities may be difficult to detect. Therefore, we aimed to clarify behavioral problems with self-feeding using the Moss Attention Rating Scale (MARS), a behavioral observational rating scale of attentional function, for a better understanding of the effects of self-feeding. To identify behavioral problems caused by attention deficits among patients with acute stroke who need assistance in self-feeding, using the MARS. Cross-sectional single-center study. St. Marianna University Yokohama Seibu Hospital, Kanagawa, Japan. A total of 96 patients (42 women and 54 men) were admitted to the hospital for stroke treatment. Patients' median age was 75.0 yr. The date of evaluation was a median of 3.0 days from admission. The primary outcome was the FIM® eating subscore. The secondary outcome was the MARS score. Significant differences were noted in the total raw MARS, logit, and three-factor scores for self-feeding independence (p < .01). The effect size of the consistent or sustained factor on independence was large (r = .83). Behavioral problems related to self-feeding dependence include the inability for sustained attention. Our results suggest that sustained concentration during self-feeding is necessary for eating independence. Rehabilitation focused on sustained attention is important for independent self-feeding. Plain-Language Summary: A patient's self-feeding independence is often the first goal in acute stroke rehabilitation. Patients frequently experience attention deficits after a stroke, but neuropsychological tests may be difficult to perform in the acute phase of rehabilitation, and the effect of attention deficits on self-feeding may be difficult to identify. To have a better understanding of the effects on self-feeding, this study aimed to identify behavioral problems using the Moss Attention Rating Scale (MARS). The study found that the MARS can be used to identify behavioral problems related to self-feeding independence, which can help occupational therapists to develop rehabilitation programs for their clients who have experienced a stroke.

Remote family education and support program for parents of patients with adolescent and early adulthood eating disorders based on interpersonal psychotherapy: study protocol for a pilot randomized controlled trial.

In cases of adolescent and early adulthood eating disorders, despite the importance of the patients' relationship with their parents, conflict and confusion frequently occur among them. Interpersonal psychotherapy (IPT) is a present-focused psychotherapy that emphasizes the interpersonal context of symptoms. We developed a remote family education and support program exclusively for parents of patients with eating disorders, based on the principle of IPT. The use of IPT is expected to reduce conflicts in the patient-parent relationship. Consequently, parents will be better able to listen to patients, and patients will be better able to express their thoughts and desires. In this study, we describe the protocol for a randomized controlled trial designed to examine the effectiveness of this program in promoting effective communication in their home based on active listening skills of parents of patients with adolescent and early adulthood eating disorders. Participants will be parents of patients aged 12-29years with adolescent and early adulthood eating disorders. Individually randomized, parallel-group trial design will be employed. Seventy participants will be allocated to one of two treatment conditions: (1) remote family education and support program (four, 150min weekly group sessions) for parents plus treatment-as-usual for patients (consultation by physicians or no treatment), or (2) waiting for the control condition (parents will wait to start the program for 8weeks) plus treatment-as-usual for patients. The primary outcome measure will be parents' active listening ability as measured by the Active Listening Attitude Scale at 8weeks after randomization. Additionally, perception of social support (Social Provision Scale-10 item), loneliness (UCLA Loneliness Scale), mental health status (K6), family function (Family Assessment Device), and parent-evaluated eating disorder symptoms (Anorectic Behavior Observation Scale) will be assessed. Data from the intention-to-treat sample will be analyzed 8weeks after randomization. This is the first study to evaluate the effectiveness of a family education and support program for parents of patients with adolescent and early adulthood eating disorders based on IPT. If this type of intervention is effective, although indirect, it could be a new support method for this patient population. Clinical Trials. gov ID NCT05840614.

Individualized peer support needs assessment for families with eating disorders

BackgroundPeer support among family members is important in cases of mental illness, but there has been limited practice or research on individual peer support specific to families taking care of patients with eating disorders (EDs). To conduct peer support activities, it is necessary to clarify the needs of families.ObjectivesThe objective of this study are to identify the needs for group and individual peer support and the characteristics of family members with EDs who are willing to receive and provide individual peer support.MethodA cross-sectional questionnaire survey was conducted for family members with EDs recruited via the Internet. The questionnaires included demographic information on respondents and their patients, questions about the need for family peer support, interest in offering peer support, and social resources. All participants were given the General Health Questionnaire (GHQ-12), the Zarit Caregiver Burden Interview (J-ZBI_8), and the Anorectic Behavior Observation Scale (ABOS).ResultsOut of 314 respondents, 87.3% believed that a group peer support system was necessary, whereas 56.7% believed that an individual peer support system was necessary. As to whether they want to use individual peer support, 70 (22.4%) stated “Extremely YES” and 99 (31.7%) stated “Moderately YES.” Family members who were willing to receive individual peer support used more social resources and had higher scores on the GHQ and J-ZBI_8. Regarding the provision of peer support, 38 (12.2%) responded “very interested and willing to provide it if possible” and 87 (27.9%) responded “interested and willing to study.” Those with a high willingness to provide peer support used more social resources and had lower ABOS scores; however, 38 respondents (45.7%) exceeded the GHQ mental health screening cutoff (3/4).ConclusionFamily members with ED had a strong need for family peer support Those willing to receive individual peer support suffered from poor mental health and high burden of care. Family members willing to provide peer support tended to have patients whose EDs symptoms had already improved, but their own mental health was not necessarily good. Training for potential peer supporters is needed to implement peer support.

Effects of artificial intelligence aibo intervention on alleviating distress and fear in children

BackgroundProcedures and actions such as injections and immobilization cause distress to children. In the pediatric field, there is a need for interventions and support to alleviate the pain and distress caused by such medical procedures. In recent years, the introduction of robots as a means of distraction has begun to be attempted.MethodsIn this study, we conducted a non-randomized controlled trial to examine the effect of intervention using ‘aibo’, a dog-like robot which has artificial intelligence (AI), to promote distraction in children after vaccination. Children between the ages of 3 and 12 years old eligible for the Japanese encephalitis vaccine, and their caregivers were assigned to intervention group or control group. Then, children evaluated their pain and children’s behavior were observed by observer. The mean values of Faces pain rating scale scores and observer pain scale scores were compared between groups using an unpaired t-test.ResultsFifty-seven children (32 in the intervention group) participated in the study. Results of a t-test with the control group showed that the intervention group using aibo had significantly less pain following the post-vaccination intervention than the control group using stuffed dog (Face Scale, t(55) = 2.582, p = .0125; Behavioral Observation Scale, t(55) = 2.772, p = .00759). The results support the hypothesis that the aibo intervention group will be less distressed and able to calm down more quickly after vaccination than the control group.ConclusionInteractive communicative play intervention by an artificially intelligent aibo before and after painful and frightening medical procedures may alleviate fear and anxiety and prevent medical trauma in children.

Factorial Structure of the EOCL-1 Scale to Assess Executive Functions.

The process of assessing executive functions through behavioral observation scales is still under theoretical and empirical construction. This article reports on the analysis of the factorial structure of the EOCL-1 scale that assesses executive functions, as proposed by the theory developed by Luria, which has not been previously considered in this type of evaluation. In this scale, the executive functions taken into account are error correction, internal behavioral and cognition regulatory language, limbic system conscious regulation, decision making, future consideration of consequences of actions, goal-directed behavior, inhibitory control of automatic responses, creation of new behavioral repertoires, and cognitive–behavioral activity verification. A variety of validity and reliability analyses were carried out, with the following results: (a) an adequate internal consistency level of executive functions between α = 0.70 and α = 0.83, (b) significant convergent validity with a scale that assesses frontal deficits between r = −0.07 and r = 0.28, and (c) the scale’s construct validity that proposes a model with an executive central factor comparative fit index (CFI) = 0.93, root mean square error of approximation (RMSEA) = 0.04 (LO.04 and HI.04), standardized root mean square residual (SRMR) = 0.04, and x2(312) = 789.29, p = 0.001. The findings are discussed based on previous literature reports and in terms of the benefits of using a scale to assess the proposed executive functions.

The effect of omega-3 long\xa0chain polyunsaturated fatty acids on aggressive behaviour in adult male prisoners: a structured study protocol for a multi-centre, double-blind, randomised placebo-controlled trial and translation into policy and practice

BackgroundInterventions to better manage aggressive behaviour and reduce recidivism are a primary concern for corrective services. Nutritional interventions to correct prisoner behaviour have been largely overlooked in the literature. Emerging evidence suggests that dietary intake influences aggressive behaviours and that nutritional supplementation with omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA) could attenuate both the severity and frequency of aggressive behaviour.MethodsAdult male prisoners who have a history of aggressive behaviour (n = 600) will be recruited from at least 6 Correctional Centres and randomised to receive either n-3 LCPUFA or placebo supplementation for a 16-week duration. Treatment will be with either 1 g/day of n-3 LCPUFA (694 mg DHA and 397 mg EPA) or placebo capsules, which are a corn/soy oil blend and are identical in size and colour.The primary outcome measure is the Inmate Behavioural Observation Scale (IBOS): an objective measure of aggressive behaviour. Secondary outcome measures include questionnaires (including aggression, attention deficit disorder, impulsivity, depression/anxiety/stress scales), engagement in programmes, recidivism and quality of life. Baseline and post-intervention assessments include the IBOS, questionnaires and blood to measure the levels of n-3 LCPUFA.DiscussionTo conclusively test the potential that increasing n-3 LCPUFA intakes can improve rates of prisoner aggression and associated mental health and violence-related social system management costs, we propose an adequately powered multi-centre, double-blind, randomised controlled trial, examining the effects of n-3 LCPUFA supplementation on aggressive behaviour in adult male prisoners. If successful, this study will inform prisoner policy with respect to nutrition and by inference contribute to a broader community approach to preventative mental health practices.Trial registrationAustralian New Zealand Clinical Trial Registry (ANZCTR) ACTRN12618001665224. Registered on 10 October 2018.

The Effect of Dietary Supplementation on Aggressive Behaviour in Australian Adult Male Prisoners: A Feasibility and Pilot Study for a Randomised, Double Blind Placebo Controlled Trial.

This study aimed to assess the feasibility of conducting a nutrition trial in adult male prisoners. Adult male prisoners were recruited for a 16-week randomised control trial comparing the effect of ingestion of omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA) and multivitamin supplements versus placebo on aggressive behaviour. The baseline and post-intervention assessments from the participant blood samples were the erythrocyte n-3 LCPUFA levels as well as measures of aggressive behaviour determined through institutional records of misconduct (IRM), the Inmate Behaviour Observation Scale (IBOS), and questionnaires. A total of 136 adult male prisoners consented to the study with a retention rate of 60%, and 93% of blood samples were successfully collected. The IRM and IBOS scores were collected for 100% of participants, whilst 82–97% of participants completed the questionnaires. From the baseline data, the Odds Ratio shows that prisoners are 4.3 times more likely to have an IBOS >2 if they are below the 6% cut off on the omega-3 index. Both groups improved across all outcome measures and, at the current sample size, no significant differences were seen between them. A power calculation suggests a total sample size of 600 participants is required to detect the effects of this dietary supplementation, and that this supplementation study is feasible in a Correctional Centre. Important criteria for the exclusion and consideration of logistics and compliance are presented.

A Template for Curriculum Development to Teach Complex Surgical or Endoscopic Techniques With Logistical Challenges

The current, unprecedented pace of change in medicine challenges healthcare professionals to stay up-to-date. To more effectively disseminate new surgical or endoscopic techniques a modern paradigm of training is required. Our aim was to develop a curricular framework for complex techniques that provide logistical challenges to training in order to increase safe, effective use. We use colonic endoscopic submucosal dissection (cESD) as an example. Curriculum development followed a multistep process representing best practice in training and education. First, a Clinical Needs Assessment established the demand for/sustainability of training. A Training Needs Analysis then identified the knowledge, skills, and attitudes required to perform cESD. A modified Delphi process defined desired learner characteristics, identified indications/contraindications to cESD, and developed a procedural task list. A pilot simulation program gathered feedback from cESD faculty experts and learners. Finally, a Behavioral Observation Scale was developed as a clinical assessment tool to assess procedural performance. The Houston Methodist Institute for Technology, Innovation and Education. The first Curriculum Design Summit engaged 11 clinical SMEs, 4 education and training SMEs, 3 market development SMEs, and 1 medical device research and design engineer. The second Curriculum Design Summit engaged 10 clinical SMEs, 4 education and training SMEs, and 4 market development SMEs. We also engaged 12 Learner SMEs at both hands-on pilot courses who currently are training to perform cESD. Desired learner criteria were defined (e.g., in practice >2 years, available case volume ≥25/year) to ensure ability and motivation of learners. Lesions were classified by (1) suitability for cESD (Clinical T1N0M0, Paris 0-IIa +1s > 2 cm, 0-IIc + IIa, 0-IIc), and (2) suitability for trainee experience level. A comprehensive cESD task list was constructed and an assessment tool created based on SME review of key characteristics (e.g., comprehensiveness and usability). We describe a comprehensive framework to develop educational curricula for complex surgical/endoscopic techniques with logistical challenges. To illustrate the sustainability of this training model and impact on patient outcomes, we plan to further develop and implement this program nationally.

Evidencia de sobrediagnóstico en el TDAH en base a evaluación neuropsicológica: un estudio en escolares chilenos

Objetivo: El Trastorno por Déficit de Atención con Hiperactividad/impulsividad (TDAH) es una de lasdificultades de aprendizaje más comunes en las escuelas chilenas. Se caracteriza por un patrón defuncionamiento atípico en atención e inhibición, con fuerte compromiso de otras funciones ejecutivas.Uno de los desafíos que plantea este trastorno está referido al proceso de diagnosis, el cual no sueleser suficientemente preciso. Se pretende explorar las diferencias en la distribución de dos muestrasde estudiantes con y sin TDAH diagnosticadas con una escala de observación conductual a través de laevaluación de las funciones ejecutivas de atención, inhibición y flexibilidad cognitiva.&#x0D; Método: En este estudio se evaluó a 132 escolares, 66 con TDAH y 66 sin TDAH, en las variables deatención, inhibición y flexibilidad cognitiva de un colegio de la ciudad de Concepción en Chile. Secontrastó el rendimiento cognitivo con los diagnósticos y se reagrupó a los estudiantes en los subtiposconocidos del trastorno.&#x0D; Resultados: La evaluación neuropsicológica mostró que en el grupo con TDAH había alumnos queno cumplían los criterios diagnósticos para estar incluidos en él. En el grupo sin TDAH se observó unfenómeno semejante. En ambos grupos la evaluación neuropsicológica de la atención y la inhibiciónresultaron útiles para diagnosticar con mayor certeza y para determinar el subtipo al que pertenecíacada estudiante con TDAH detectado. La flexibilidad cognitiva solo permitió diferenciar a los sujetos cony sin TDAH.&#x0D; Conclusiones: En ambos grupos estudiados fue posible encontrar sujetos mal diagnosticados; el sobrediagnóstico fue de 43,93 % en el grupo con TDAH, mientras que el infradiagnóstico fue de 42,42 % enel grupo sin TDAH.

Effects of Shantala massage combined with Sherborne Developmental Movement method

Summary Study aim: The aim of the study was to evaluate the effectiveness of Shantala massage during the classes conducted using the Developmental Movement method in improving the “with” relationship in healthy children aged 3 to 4 years. Material and methods: The study involved 12 healthy children aged 3 to 4 years participating in SDM classes with their parents. The participants were divided into two groups. In the experimental group, Shantala massage was used during play based on the “with” relationship, whereas the massage proposed by Veronica Sherborne was performed in the control group. The Child Behaviour Observation Scale (SOZ-D) was employed to assess the improvements of psychomotor development. The study was a two-stage study, before the Sherborne Developmental Movement Method programme (initial observation) and after six months of classes (post-observation). The duration of the programme was 6 months. Classes were conducted once a week for 40 minutes. Results: It was found based on the analysis of the results that the introduction of Shantala massage led to a significant increase in the assessment of child development on the subscale of emotional development. Conclusions: The use of Shantala massage during SDM classes has a positive effect on emotional development of healthy children aged 3 to 4 years.

Do parents perceive the abnormal eating attitudes of their adolescent children with anorexia nervosa?

Parents are often the first to detect the initial signs of anorexia nervosa (AN) and take necessary measures to ensure that their children receive appropriate treatment. The evaluation of AN in adolescence is complicated by taking into account the tendency to minimize and deny the symptoms by adolescents, and the difficulty of parents in detecting the main symptoms. We compared the adolescent and parent scores on measures of disordered eating at initial presentation. The sample consisted of 62 adolescents diagnosed with AN, who attended an eating disorder children's unit. Adolescents completed the Eating Attitudes Test (EAT-40) and their parents the Anorectic Behavior Observation Scale (ABOS). The questionnaire data were collected as part of the routine clinical practice and were obtained from clinical notes. The findings indicate no significant correlations between the EAT-40 and ABOS scores, or between AN subtypes according to parent observation of symptoms. There were significant differences between parents, with mothers reporting higher scores than fathers. This study highlights the importance of psychoeducation for parents on the early signs of AN, in order to improve recognition and diagnosis at initial assessment of their adolescent children in the early phases.

How incremental video training did not guarantee implementation due to fluctuating population prevalence

Patients with stroke admitted at the neurology/neurosurgery ward of the Academic Medical Centre in Amsterdam, The Netherlands, may experience problems in communication, such as aphasia, severe confusion/delirium or severe language...

Peculiarities of strategic management implementation of human resources at the enterprise

The paper argues that reward systems provide incentives and reinforce workforce behaviors and facilitate the implementation of strategies, while development systems provide the workforce skills required to implement them. Emphasis is placed on the need to consider the performance measurement systems they use to gather the information needed to share rewards and identify development needs. The purpose of the work is to investigate the peculiarities of implementing a strategic human resource management based on the organization of an effective remuneration system. The object of the study is the strategic management of human resources. There are different approaches to measuring performance that help assess the extent to which employee behavior at all organizational levels contributes to the implementation of strategies. Measures for the effectiveness of such work are implemented by remuneration systems. All methods of measuring and evaluating performance are potentially useful tools for providing feedback on the extent to which behavior is consistent with organizational strategies. In addition, they are all potentially useful tools for informing the remuneration system about how much employees deserve higher compensation, recognition, and more. It should be emphasized that they are all potentially significant sources of guidance for future development efforts. The study uses system-structural analysis; systematic approach, systematization, abstract-logical approach – at generalization of results of research and formulation of conclusions. The role of reward and development systems in strategy implementation is substantiated. The article points out that a number of assessment approaches have traditionally been used to measure performance. One of the most common is goal management, graphical rating scales, and stories. The most up-to-date performance appraisal systems are those that use the behavioral rating scale. The article discusses the goal-management approach that is widely applied to performance appraisal. In the case of goal management, it is easy to set strategy implementation, as goals can be defined as outcomes or milestones in the strategy implementation process. It is emphasized that goal management usually begins with the initial phase, in which the subordinate forms the goals or objectives to be achieved within the next period of time. As part of this process, the subordinate identifies the measures that will determine the achievement of such goals and outlines the plans of action he or she will use to achieve them. It is emphasized that, as with all approaches to performance evaluation, goal management has drawbacks. Goals for some jobs are harder to write, such as for staffing, and problems arise when goals are not well thought out. In addition, this process may be perceived with cynicism if senior executives are not evaluated by goal management. The article describes the reward systems that are used by leading businesses: goal management, graphical rating scales, performance descriptions, behavioral ratings, behavioral observation scales, and 360-degree feedback systems. The lack of performance evaluation at the executive level is emphasized. Suggestions are made for the wider application of management evaluation. After discussing measuring the effectiveness of the system, rewards were considered in terms of compensation. Traditional work-based pay systems are described and their inability to provide the flexibility needed in today’s competitive environment is discussed. The importance of an appropriate system of rewards in the implementation of the human resources management strategy has been proved. Because of the critical role of compensation in several work systems, organizational processes, and organizational structures, several innovative approaches to compensation have been discussed. Because highly competitive human resources will be required to gain future competitive advantage, reconciling rewards with skills can be critical to successful strategy implementation. A new broadband compensation approach was also explored. They also discussed team remuneration, which rewards joint efforts, and discussed variable compensation. Variable compensation is becoming more widespread as it helps to create a sense of common purpose among all employees. Variable compensation can also help to secure employment. The role and current status of compensation to performers were also examined.

Postoperative stress and pain response applying fast-track protocol in patients undergoing hepatectomy

Aim To assess the clinical parameters and compare the stress and pain response between fast-track recovery protocol and conventional treatment in patients undergoing major liver resection. Methods Eighty-eight patients suffering from malignant liver tumours were surgically treated from May 2012 to March 2015. After randomisation, they were prospectively divided into two groups: group fast-track patients (n = 46) and group conventional treatment patients (n = 42). Demographic and clinical data were collected and patients were assessed with pain scale (behavioural observation scale and visual analog scale), while depression levels were evaluated with Zung self-rating depression scale and three Numeric Analog Scale self-reported questions. Peripheral blood samples were collected at time points: T1 on the admission day, T2 on the day of surgery and T3 on the day of discharge examining serum levels of adrenocorticotropic hormone and cortisol. Conclusion Fast-track recovery protocols seem to be associated with improvement in several clinical parameters, without compromising, biologic or emotional stress in patients undergoing major liver resection.

Projector-based virtual reality dome environment for procedural pain and anxiety in young children with burn injuries: a pilot study.

BackgroundVirtual reality (VR) is a non-pharmacological method to distract from pain during painful procedures. However, it was never tested in young children with burn injuries undergoing wound care.AimWe aimed to assess the feasibility and acceptability of the study process and the use of VR for procedural pain management.MethodsFrom June 2016 to January 2017, we recruited children from 2 months to 10 years of age with burn injuries requiring a hydrotherapy session in a pediatric university teaching hospital in Montreal. Each child received the projector-based VR intervention in addition to the standard pharmacological treatment. Data on intervention and study feasibility and acceptability in addition to measures on pain (Face, Legs, Activity, Cry, Consolability scale), baseline (Modified Smith Scale) and procedural (Procedure Behavior Check List) anxiety, comfort (OCCEB-BECCO [behavioral observational scale of comfort level for child burn victims]), and sedation (Ramsay Sedation Scale) were collected before, during, and after the procedure. Data analyses included descriptive and non-parametric inferential statistics.ResultsWe recruited 15 children with a mean age of 2.2±2.1 years and a mean total body surface area of 5% (±4). Mean pain score during the procedure was low (2.9/10, ±3), as was the discomfort level (2.9/10, ±2.8). Most children were cooperative, oriented, and calm. Assessing anxiety was not feasible with our sample of participants. The prototype did not interfere with the procedure and was considered useful for procedural pain management by most health care professionals.ConclusionThe projector-based VR is a feasible and acceptable intervention for procedural pain management in young children with burn injuries. A larger trial with a control group is required to assess its efficacy.

A Study to Assess the Effectiveness of Kaleidoscope in Reducing Physical Stress during Venipuncture Procedure among Hospitalized Pre-School Children at Selected Hospital of Ahmadabad City, Gujarat State.

A study to assess the effectiveness of kaleidoscope in reducing physical stress during venipuncture procedure among hospitalized pre-school children at selected hospital of ahmedabad city, gujarat state. Objectives of the study: To assess physical stress among hospitalized preschool children (experimental group) with kaleidoscope during venipuncture procedure. To assess physical stress among hospitalized preschool children (control group) without kaleidoscope during venipuncture procedure. To assess the effectiveness of kaleidoscope in reducing physical stress by comparing experimental group and control group score. It included the true experimental research approach, post only design, variables under study were kaleidoscope as independent variable, reducing physical stress among hospitalized preschool children as dependent variable. Research is based On Imogene king's goal attainment model selected Hospital of Ahmedabad city as research setting, total 40 samples, and non probability sampling techniques was used. The instrument used for this study was kaleidoscope and tool used for data collection were demographic data, Hospitalization profile and modified observational behavioral pain scale. The data obtained were analyzed and interpreted in the light of objectives and hypothesis using both descriptive and inferential statistical in terms of frequency, percentage and chi-square. The calculated chi-square value (10.141) is greater than the tabulated chi-square value (7.815). Therefore the null hypothesis H0 was rejected and research hypothesis H1 was accepted and it revealed that the modified behavioral observational pain scale was effective in terms of physical stress among the sample. Association between post test score of experimental and control group with selected variables among that the duration of venipuncture procedure, Child past experience to immunization/injection, child's reaction towards health personnel were found to be significant at 0.05 level of significance in experimental group and duration of venipuncture procedure, child's reaction towards health personnel were found to be significant at 0.05 level of significance in control group. In the overall and specific content area, the calculated chi-square value is greater than the tabulated chi-square value. The findings indicate that the kaleidoscope was an effective method of distraction technique during venipuncture procedure. Based on the findings, the following recommendations were offered for future research. The study can be replicated on a large sample, thereby; findings can be generalized for a large population. A similar study can be conducted on children undergoing invasive Pediatric procedures other than the selected one (access to IV line). The study can be replicated in other settings (e.g.: private settings) which might allow comparisons. A comparative study can be conducted to see the effect of distraction techniques during different developmental stages. It was concluded that kaleidoscope reduced physical stress of hospitalized preschool children during venipuncture procedure.

Model Penilaian Kinerja di Madrasah

Teacher performance assessment is an important factor for improving teacher performance. Teacher who have good performance will affect the academic results of students and madrasah. One of the factors influencing teacher performance appraisal is head of madrasah. The assessment model used depends on the experience of the head of the madrasah. The purpose of this study is to investigate how the head of the madrasah in assessing teacher performance and describing the use of teacher performance appraisal model. The research was conducted at Madrasah Aliyah Al-Ikhsan Beji Purwokerto with qualitative research method and descriptive approach. Data were collected by interview, observation, and documentation techniques. The analysis used is qualitative approach with Miles and Huberman model. The result showed that the practice of performance appraisal in Madrasah Aliyah Al-Ikhsan Beji not yet maximal, as for factors that influence the lack of appraiser, assessment aspect, utilization of teacher performance appraisal result. While the model used is Behavior Observation Scale (BOS) and Field Review model.

Enhancing clinical communication assessments using an audiovisual BCI for patients with disorders of consciousness

Objective. The JFK coma recovery scale-revised (JFK CRS-R), a behavioral observation scale, is widely used in the clinical diagnosis/assessment of patients with disorders of consciousness (DOC). However, the JFK CRS-R is associated with a high rate of misdiagnosis (approximately 40%) because DOC patients cannot provide sufficient behavioral responses. A brain–computer interface (BCI) that detects command/intention-specific changes in electroencephalography (EEG) signals without the need for behavioral expression may provide an alternative method. Approach. In this paper, we proposed an audiovisual BCI communication system based on audiovisual ‘yes’ and ‘no’ stimuli to supplement the JFK CRS-R for assessing the communication ability of DOC patients. Specifically, patients were given situation-orientation questions as in the JFK CRS-R and instructed to select the answers using the BCI. Main results. Thirteen patients (eight vegetative state (VS) and five minimally conscious state (MCS)) participated in our experiments involving both the BCI- and JFK CRS-R-based assessments. One MCS patient who received a score of 1 in the JFK CRS-R achieved an accuracy of 86.5% in the BCI-based assessment. Seven patients (four VS and three MCS) obtained unresponsive results in the JFK CRS-R-based assessment but responsive results in the BCI-based assessment, and 4 of those later improved scores in the JFK CRS-R-based assessment. Five patients (four VS and one MCS) obtained usresponsive results in both assessments. Significance. The experimental results indicated that the audiovisual BCI could provide more sensitive results than the JFK CRS-R and therefore supplement the JFK CRS-R.

Validation of the Behavioural Observation Scale 3 for the evaluation of pain in adults.

Many behavioural scales are available to assess pain but none are suitable for a quick evaluation of non-sedated and non-geriatric adults. The Behavioural Observation Scale 3 (BOS-3) is short, composed of five items. This study examined its feasibility and diagnostic performances. Adult patients were included from medical and surgical departments of the University Hospital of Bordeaux. In a cross-sectional study, BOS-3 was compared to Numerical Rate Scale (NRS) with communicating patients (CP) and Behavioural Scale for the Elderly Person (ECPA2) with non-communicating patients (NCP). Each time, BOS-3 and reference scale were performed by an internal caregiver and an external expert. We included 447 patients: 395 communicating and 52 non-communicating. All patients were assessed by the BOS-3 and the reference test. All BOS-3 were carried out in less than one minute with only four missing data. Its reproducibility (ICC=0.77 [95% CI 0.73-0.81] with CP and 0.93 [95% CI 0.89-0.97] with NCP) and its internal consistency (Cronbach α=0.67 with CP and 0.70 with NCP) were good. In non-communicating patients, ROC analysis set a threshold at 3 on 10. Sensitivity was 0.87 [95% CI 0.77-0.96], specificity 0.97 [95% CI 0.93-1.00], positive predictive value 0.93 [95% CI 0.86-0.99] and negative predictive value 0.95 [95% CI 0.89-1.00]. In communicating patients, sensitivity decreased to 0.34 [95% CI 0.28-0.38] but specificity reached 0.96 [95% CI 0.94-0.98] and positive predictive value 0.75 [95% CI 0.70-0.79]. BOS-3 had good metrological properties in non-communicating adults. With communicating patients, a positive BOS-3 could be an additional tool to confirm pain, when underestimated on the NRS. This study describes the diagnostic performances of a behavioral pain assessment scale designed for non-geriatric and non-sedated adults. The results show its validity in non-communicating patients and suggest its usefulness as an ancillary tool in communicating patients in whom simple numerical scales are often insufficient.

The effect of self-evaluation on the principals’ transformational leadership, teachers’ work motivation, teamwork effectiveness, and school improvement

The principals’ leadership is the most important factor in determining the development of schools. In order to improve education quality, the principals’ leadership competences should be improved. The aim of this study is to test the effect of self-evaluation as the technique of the self-development of the principals’ transformational leadership and its effect on teachers’ work motivation, teamwork effectiveness and school improvement. The study was conducted in Malang, Indonesia. It used quasi-experimental research design with non-equivalent comparative group. The subjects of the study were 40 principals and 240 teachers for each experimental groups, and 40 principals and 240 teachers for the controlled group. They were chosen using cluster quota random sampling. The instrument used to collect the data was questionnaires including behaviour observation scale, numerical scale and summated rating, while the data analysis techniques were statistic descriptive, univariate and multivariate analysies of variance. Based on the data analysis, it could be concluded that the self-evaluation technique was effectively proven in improving transformational leadership, teachers’ work motivation, teamwork effectiveness and school improvement. The model of self-evaluation with feedback has a stronger effect compared to self-evaluation without feedback.