Development Of Assessment Tool Research Articles

8.M. Skills building seminar: Mental health and substance use in Europe

Abstract The impact of social factors on individual and population mental health are well established (Kirkbride, et al., 2024). The same social factors may trigger the substance use behavior developing into substance use disorders. Mental health disorders can contribute to the substance use and substance use disorders with worsening effects over time (EMCDDA, 2016). This association between substance use, substance use disorders and mental health disorders is a key objective for the scientific consideration and policy development. Respective phenomena are universal and a broader perspective would be useful for a better understanding of how the issue of comorbidities of substance use and mental disorders are addressed on a European level. Identification of the substance use problem, especially among populations in vulnerable situations, like migrants, becomes utterly important. Heterogenous systematic reviews show that there is a need for socially and culturally refugee sensitive instruments to measure the substance use in migrants. Oftentimes substance use is followed by the substance use disorders and drug use related infections. Injecting drug use is also a risk factor for having drug use related infections, such as hepatitis B and C, HIV, tuberculosis. Assessment of risk behaviour patterns among people who inject drugs may contribute to a higher participation in treatment and health programmes, reduce the burden of substance use and tackle comorbidities of substance use and mental health disorders. The skill building seminar aims to increase the knowledge and capacities on substance use and comorbidities, applied methodological approaches and tools in different European contexts. This workshop will support researchers, policy makers, public health planners by providing evidence base to address substance use and mental health issues. The added value of this workshop is based on the structure, content and mode of presentations - presentations will be followed by questions from participants and short discussions. The workshop will start with the general introduction to the topic of comorbidities of substance use and mental health disorders (EUPHA-PMH and EUDA). Then the European level perspective on comorbidities of substance use and mental health disorders will be presented including recent policy developments (1 presentation by Linda Montanari, EUDA). It will be supported with research results from the study conducted in Germany on substance use assessment tool development in migrant population (2 presentation by Kim-Julian Behr, Germany) and behavioural risk factor assessment study among people who inject drugs in Lithuania (3 presentation by Marija Jakubauskiene, Lithuania). Key messages • Participatory approach is useful to address the substance use problem in assessment tool development and further monitoring. • Better understanding of comorbidity of substance use and mental disorders leads to a more effective prevention.

Development of a welfare assessment tool for tourist camp elephants in Asia

Background Approximately one-third of Asian elephants are managed under human care, participating in educational, cultural, religious, and tourist activities. Management conditions vary considerably among venues, raising questions about whether welfare needs are consistently being met, particularly for Asian tourist camp elephants. To evaluate the well-being of elephants engaged in tourist activities, an evidence-based tool is needed for routine assessments to identify potential welfare risks, aid in the development of better camp standards, and enable caretakers to address specific concerns. While many animal welfare tools exist, none have been designed to consider specific environments and management practices faced by elephants living and working in tourist camps. Methods Using direct observations and interviews, the Elephant Welfare Assessment Tool (EWAT) was developed for tourist camp elephants using the Five Domains Model as a framework. Measures were selected based on peer-reviewed literature, existing standards and guidelines, and opinions from animal welfare experts working with zoo and tourist camp elephants. The EWAT differs from existing tools by including criteria on work activities and restraint methods (e.g., chaining and ankus use), factors common in Asia but not often encountered by western zoo elephants. Measures were scored using a 0–2 Likert Scale. The tool was tested in Thailand and determined by calculating a content validity index (CVI) and conducting inter-rater and test-retest reliability tests. Results The initial tool included 18 animal-based and 21 resource-based measures across four domains: Nutrition (n = 5), Environment (n = 14), Health (n = 10), and Behavior and Mental State (n = 10). Index scores of content validity (CVI) (Item CVI (0.83), Scale CVI/Average (0.98), and Scale CVI/Universal (0.89)) were high. Measures scoring less than 0.83 were removed: the opportunity to mate, the mahout-elephant relationship, and mahout job satisfaction. The final tool consisted of 42 questions related to 36 measures, including 18 animal-based and 18 resource-based measures within the Nutrition (n = 5), Environment (n = 11), Health (n = 10), and Behavior and Mental State (n = 10) domains. Intraclass correlation coefficients (ICC) for inter-rater reliability (0.78–0.90, p < 0.05) and test-retest (0.77–0.91, p < 0.05) analyses conducted at two camps showed good agreement. Conclusions This new assessment tool (EWAT) is a context-specific, holistic method designed to offer a practical means of conducting individual and institutional-level assessments of elephant welfare in tourist camps. It is based on the Five Domains Model using reliable and validated animal- and resource-based measures, data collection through direct observation and interviews, and a numerical scoring system. The tool includes several criteria applicable to tourist rather than zoo venues to make it more relevant to the challenges faced by working elephants in Asia.

A Theoretical Model for Measuring Upper Primary School Learners’ Scientific Reasoning Abilities in Science

One agenda of science instruction in primary schools is to develop learners’ scientific reasoning abilities and to equip them with the necessary twenty-first-century skills. Few studies have been conducted to develop measurement tools that aspire to assess primary school learners’ scientific reasoning. Most of these studies lack a theoretical model backing the development of these assessment tools. This paper introduces the model for measuring scientific reasoning (MMSR) as a theoretical model for guiding the development of assessment tools in the context of measuring upper primary school learners’ scientific reasoning. We first conceptualise scientific reasoning using a review of the literature and then present evidence to justify and validate this model for use in measuring primary school learners’ scientific reasoning abilities. Furthermore, using research in history and philosophy of science and science education, the MMSR model supports the development of assessment tools measuring learners’ patterns of scientific reasoning and also considering the nature of science across different contextual settings.

Write here write now. What can we learn from the writing goals of people with aphasia?

ABSTRACT Background People with aphasia commonly have difficulties with producing written language (dysgraphia). Greater understanding of people with aphasia’s rehabilitation goals for writing can inform development of evidence-based assessment and management tools. Aims This qualitative study aimed to explore the nature of writing goals of people with aphasia who attended an intensive speech and language therapy (SLT) centre. Methods and Procedures Qualitative data was obtained from five years-worth of client SLT reports from an intensive aphasia centre. Using qualitative content analysis, a deductive coding framework was used to identify any description of writing goals; coding incorporated iterative refinement and agreement among authors. Themes were then constructed to reflect clients’ goals to inform writing assessment and therapies. Outcomes and Results Qualitative analysis focused on content describing 66 goals on writing from 87 reports. There were two dominant interrelated themes: Supporting Communication (33 goals) and Technology (25 goals). Technology included subthemes on Emailing, Texting, Social Media, and Assistive Technology. Two smaller themes were Impairment Focused (4 goals), where goals did not have a clear functional direction, and Other (4 goals), where goals targeted specific writing activities, e.g. crosswords. Conclusions These thematic findings demonstrate the varied real-life goals for writing among attendees at an aphasia centre. They highlight the nature of relatively early-stage rehabilitation goals for individuals with aphasia, focusing on supporting communication and returning to valued activities. The results provide a context within which we can scrutinise the adequacy of current clinical tools to support goal setting, assess functional writing and design interventions for acquired writing difficulties. Further guidance is needed on assessment of writing as a supportive communication strategy and therapy towards improving this skill. There are also gaps in supporting the personal goals of people with aphasia who wish to produce written language via technology or in online environments. Future research should recognise these priorities and work together with people with aphasia, clinicians, and technology specialists to address an area of clinical need.

Exploring predictors of interaction among low-birth-weight infants and their caregivers: a machine learning–based random forest approach

BackgroundQuality caregiver-infant interaction is crucial for infant growth, health, and development. Traditional methods for evaluating the quality of caregiver-infant interaction have predominantly relied on rating scales or observational techniques. However, rating scales are prone to inaccuracies, while observational techniques are resource-intensive. The utilization of easily collected medical records in conjunction with machine learning techniques offers a promising and viable strategy for accurate and efficient assessment of caregiver-infant interaction quality.MethodsThis study was conducted at a follow-up outpatient clinic at two tertiary maternal and infant health centers located in Shanghai, China. 68 caregivers and their 3-15-month-old infants were videotaped for 3–5 min during playing interactions in non-threatening environment. Two trained experts utilized the Infant CARE-Index (ICI) procedure to assess whether the caregivers were sensitive or not in a dyadic context. This served as the gold standard. Predictors were collected through Health Information Systems (HIS) and questionnaires, which included accessible features such as demographic information, parental coping ability, infant neuropsychological development, maternal depression, parent-infant interaction, and infant temperament. Four classification models with fivefold cross-validation and grid search hyperparameter tuning techniques were employed to yield prediction metrics. Interpretable analyses were conducted to explain the results.ResultsThe score of sensitive caregiver-infant interaction was 6.34 ± 2.62. The Random Forest model gave the best accuracy (83.85%±6.93%). Convergent findings identified infant age, care skills of infants, mother age, infant temperament-regulatory capacity, birth weight, positive coping, health-care-knowledge-of-infants, type of caregiver, MABIS-bonding issues, ASQ-Fine Motor as the strongest predictors of interaction sensitivity between infants and their caregiver.ConclusionsThe proposed method presents a promising and efficient approach that synergistically combines rating scales and artificial technology to detect important features of caregiver-infant interactions. This novel approach holds several implications for the development of automatic computational assessment tools in the field of nursing studies.

Development and psychometric validation of an age-friendly health system assessment tool in the Iranian context

Evaluating health system interventions for elderly care necessitates a context-specific, credible and dependable instrument. This research was dedicated to creating and validating a tool to assess the health system’s age-friendliness. The study unfolded in two pivotal stages: the generation of items utilizing a hybrid model and the psychometric appraisal of the tool, encompassing both validity and reliability assessments. From an initial pool of 522 items derived from a systematic scoping review and qualitative analysis, a concise assessment tool emerged, featuring 52 items across 6 domains: governance, information, resources, service delivery, community engagement and outcomes. The 52-item tool offers a straightforward, substantiated and robust means to gauge age-friendliness, pinpoint health system deficiencies and facilitate strategic planning on the basis of its insights.

Development of an Ergonomics Risk Assessment Tool for Pushing and Pulling (PUSHPULL) Activities at the Workplace

The observational method remains the most widely utilized for assessing the risk factor of Work-related Musculoskeletal Disorders (WMSDs) as it is inexpensive, quick and practical in field data collection. However, there is some limitation with the current risk assessment on Pushing and Pulling (PP), such as the need to use expensive force measuring equipment, limited coverage of critical variables for assessing the risk and psychometric properties for the method, which is not adequately established. This study aims to develop a new method for assessing the PP of wheeled equipment called the PUSHPULL method and establish the reliability and validity of the PUSHPULL method. Two stages are involved in developing the PUSHPULL method: i) development of PUSHPULL specification and ii) psychometric properties evaluation. Selection of variables for inclusion in the PUSHPULL method employed three strategies: i) literature review, ii) expert panel review, and iii) survey among Occupational Safety and Health (OSH) practitioners. Current assessment methods were also reviewed to assist in assigning rating scores. Psychometric properties evaluation was performed for content validity (representative, relevance and clarity) and inter and intra-rater reliability testing. Consequently, content validity was performed by six experts. The results of content validity (S-CVI/Ave) were discovered to be in the acceptable range of 0.97, 0.98 and 0.82, respectively, for representativeness, relevance and clarity. Based on the inputs from the expert panel, improvements were made, and prototype 2 was generated. Prototype 2 underwent reliability testing, and Gwet AC1 was discovered to be 0.596 (moderate) and 0.77 (good), respectively, for inter and intra-rater reliability. The PUSHPULL method was developed based on empirical data from a literature review, expert panel review and inputs from OSH practitioners. The method covers all the significant variables related to the risk of PP. Moreover, the reliability and validity of the PUSHPULL method were clarified during the development stage. The tool can determine the risk level and prioritize the intervention.

BrainQCNet: A Deep Learning attention-based model for the automated detection of artifacts in brain structural MRI scans

Abstract Analyses of structural MRI (sMRI) data depend on robust upstream data quality control (QC). It is also crucial that researchers seek to retain maximal amounts of data to ensure reproducible, generalizable models and to avoid wasted effort, including that of participants. The time-consuming and difficult task of manual QC evaluation has prompted the development of tools for the automatic assessment of brain sMRI scans. Existing tools have proved particularly valuable in this age of Big Data; as datasets continue to grow, reducing execution time for QC evaluation will be of considerable benefit. The development of Deep Learning (DL) models for artifact detection in structural MRI scans offers a promising avenue toward fast, accurate QC evaluation. In this study, we trained an interpretable Deep Learning model, ProtoPNet, to classify minimally preprocessed 2D slices of scans that had been manually annotated with a refined quality assessment (ABIDE 1; n = 980 scans). To evaluate the best model, we applied it to 2141 ABCD T1-weighted MRI scans for which gold-standard manual QC annotations were available. We obtained excellent accuracy: 82.4% for good quality scans (Pass), 91.4% for medium to low quality scans (Fail). Further validation using 799 T1w MRI scans from ABIDE 2 and 750 T1w MRI scans from ADHD-200 confirmed the reliability of our model. Accuracy was comparable to or exceeded that of existing ML models, with fast processing and prediction time (1 minute per scan, GPU machine, CUDA-compatible). Our attention model also performs better than traditional DL (i.e., convolutional neural network models) in detecting poor quality scans. To facilitate faster and more accurate QC prediction for the neuroimaging community, we have shared the model that returned the most reliable global quality scores as a BIDS-app (https://github.com/garciaml/BrainQCNet).

Development of a web-based ecological momentary assessment tool to measure day-to-day variability of the symptoms in patients with Sjögren’s disease

ObjectivesTo develop and validate a web-based ecological momentary assessment (EMA) tool to enhance symptoms monitoring among patients with Sjögren’s disease (SjD).MethodsConsecutive adults with SjD were enrolled in this pilot observational...

Traditional Chinese Medicine in the treatment of recurrent respiratory tract infections in children: an overview of systematic reviews and Meta-analyses.

To evaluate and summarise the evidence from published Meta-analyses/systematic reviews (MAs/SRs) of Traditional Chinese Medicine (TCM) in the treatment of recurrent respiratory tract infections (RRTIs) and to provide a scientific basis for the clinical treatment of RRTIs with TCM. Studies were retrieved from Chinese and English databases including the China National Knowledge Infrastructure, Wanfang database, China Science and Technology Journal Database, SinoMed, PubMed, Web of Science, the Cochrane Library and EMbase from their establishment date to March 2023. Involved studies were screened, extracted, and evaluated for quality by two researchers independently. The a measurement tool to assess systematic reviews (AMSTAR) 2 scale was used for methodological quality evaluation, as well as the preferred reporting items for systematic reviews and Meta-analyses (PRISMA) 2020 statement for report quality evaluation, the risk of bias in systematic reviews (ROBIS) tool for risk of bias, and the grading of recommendations, assessment, development and evaluation (GRADE) quality assessment tool for evidence quality. Twenty MAs/SRs studies were included, including analyses of 274 original studies involving 38 335 patients with RRTIs. The AMSTAR 2 scale evaluation results showed that 19 studies were of very low quality and one of moderate quality. The ROBIS evaluation results showed that 11 MAs/SRs were at high risk and nine at low risk of bias. The PRISMA 2020 report quality showed the included studies had scores between 23.5 and 35.5, among them one with high quality, 17 with moderate quality and two with low quality. The GRADE system results showed that among 126 outcome indicators, only 17 had moderate quality of evidence, 27 had low quality, 82 had very low quality, and none had high quality. The MAs/SRs methodological quality of using TCM for treatment RRTIs is generally poor, the quality of reports as well as of evidence is generally low, and the risk of bias is high; therefore we should treat these results with caution.

Sociodemographic Characteristics Of Rural And Urban School-Going Children With Behavioral And Emotional Disorders

Background: The prevalence of behavioral and emotional disorders among school-going children is a significant public health concern, particularly in developing countries like Bangladesh. This study aimed to explore the socio-demographic characteristics influencing these disorders in rural and urban settings in the Meherpur District of Bangladesh. Methods: This cross-sectional, descriptive, and analytical study was conducted from January 2007 to December 2009, involving 435 school-going children aged 5 to 18 years from both rural (n=214) and urban (n=221) areas of Meherpur District. Participants were selected through purposive sampling, and data were collected using the Development and Well-being Assessment (DAWBA) tool, validated in Bangla, to diagnose emotional and behavioral disorders based on ICD-10 criteria. Results: The study found significant disparities in socio-demographic factors between rural and urban groups. Rural children were more likely to have illiterate parents, with 37.85% of fathers and 61.21% of mothers being illiterate. Family income was significantly lower in rural areas, with 94.86% of rural families earning less than 10,000 Tk per month. The prevalence of psychiatric disorders was slightly higher in rural areas (15.89%) compared to urban areas (14.03%). Major depressive disorder was the most common emotional disorder, while hyperkinetic disorder was the most prevalent behavioral disorder, with no significant differences between rural and urban groups. Conclusion: The study highlights the critical role of socio-demographic factors in the prevalence of behavioral and emotional disorders among children in Bangladesh. The findings suggest a need for targeted interventions in rural areas to address educational and mental health disparities, contributing to more equitable health outcomes.

Sperm Metabolism.

Bioenergetics plays a crucial role in sperm functions, including motility, capacitation-related protein modifications, oocyte recognition and interaction, all of which are essential for fertilization. Sperm metabolism is recognized as flexible, responding to environmental cues and energetic demands during ejaculation, the journey along the female tract, and until fertilization. Recent studies suggest that sperm metabolic functions are relevant beyond fertilization and may influence zygote and embryo development, impacting paternal-derived effects on offspring development and health. In recent years, sperm metabolic functions and homeostasis have gained increasing interest in male reproduction research. Given the crucial implications of sperm metabolism on fertility-related processes, this field is of interest not only in human male fertility but also in livestock research, semen conservation, and assisted reproductive techniques. Newly developed assessment tools are allowing a better understanding of sperm metabolism under different conditions and identifying species-specific peculiarities. This review aims to discuss the current knowledge of mammalian sperm metabolism, focusing on species-specific features, changes during the sperm journey, and potential contributions to translational research and reproductive biotechnologies. Furthermore, we propose future perspectives on sperm bioenergetics research.

Development and demonstration of a social sustainability assessment tool for the construction project life cycle

Purpose This research paper aims to address the scarcity of social sustainability (SS) in construction by developing a Social Sustainability Assessment Tool (SocSAT), further demonstrating the tool's applicability in measuring SS practices across the construction project life cycle. Design/methodology/approach Various research methods were used to establish the assessment criteria, including literature review, focused group discussions and structured interviews. Subsequently, the SocSAT was developed using proprietary spreadsheet software, which was further demonstrated its applicability and validity using ten project case studies. Findings The SocSAT was built on 19 indicators for pre-construction, 25 indicators for construction, and 4 indicators for post-construction phases. The SocSAT offers a comprehensive means for practitioners to assess and monitor SS practices across project phases. The findings indicate that the SocSAT is a straightforward and user-friendly assessment tool that enables practitioners to self-diagnose and better comprehend the present SS practices across the project life cycle. Research limitations/implications Limitations include the context-specific nature of validating the SocSAT. Practical implications SocSAT enables construction practitioners to monitor and improve their SS practices effectively, facilitating informed decision-making and promoting sustainable construction. The tool is a valuable guide for stakeholders to incorporate SS considerations, ensuring transparent communication and project success. Originality/value This research fills a gap in SS research within the construction industry. The SocSAT offers theoretical advancements with practical value, providing a standardized approach to objectively measure the SS dimension across construction project life cycles.

Teachers’ professional ideas on the characteristics of evaluation of educational results of students with limited health abilities on lessons of physics and mathematics

Introduction. The article is dedicated to the problem of evaluating educational achievements of students with limited health abilities in the classes of physics and mathematics. The results of the research aimed at the study of professional views of the teachers on the issues of conducting interim certification of students at the level of basic general education are presented in this work. The actuality of the study is determined by the need to improve the quality of general education of students with OHS, which is directly related to the assessment of their educational results. Materials and Methods. The study was conducted among physics and mathematics teachers using an online questionnaire, consisting of problems, the answers to which characterize the professional positions of teachers in terms of defining goals, developing assessment tools, using a differentiated approach and creating special conditions when conducting midterm assessment and assessing the educational results of students with special educational needs. Results. The results of the study showed a fairly wide variability of the views of the teachers on the subject studied. The majority of respondents point to the need to modify and differentiate the ratings by the degree of complexity, allowing to provide different types of assistance to students, and consider it necessary to create special conditions. At the same time, in practice, part of the teachers address the problem quite formally, and in some cases the special educational needs of the students are ignored. Discussion and Conclusions. According to the results of the study, the author, on the one hand, notes the insufficient scientific development of the problem, on the other hand, he identifies some professional deficits of physics and mathematics teachers in terms of competencies related to the assessment of educational results. These deficits, according to the author, can be overcome by developing and including in the content of the main and additional professional educational programs sections related to the study of the special educational needs of different categories of students with disabilities, which determine the features of assessing their educational achievements, including the features of adapting assessment tools and assessment procedures, creating special conditions.

From the Bio-Psycho-Social Model to the Development of a Clinical-Forensic Assessment Tool for Chronic Pain in Victims of Violence: A Research Protocol.

Violence against women impacts a minimum of 35% of the global female population, encompassing sexual, physical, and psychological forms. Perpetrators of this violence include partners, family members, or strangers. Its ramifications are substantial, evident in the prevalence of chronic pain reported by between 48% and 84% of women who have experienced abuse, with an odds ratio of 2.08. Notably associated diagnoses include pelvic/vaginal pain, fibromyalgia, irritable bowel syndrome/bowel symptoms, abdominal pain, migraine/headache, and back and neck pain. These diagnoses significantly limit a woman's ability to participate in daily activities, such as exercising or working, leading to genuine disability. Despite substantial evidence, the precise cause and etiology of these conditions remain unclear. Adhering to the bio-psycho-social model, it is conceivable that chronic pain in victims of violence cannot be attributed to a single factor alone, but rather to a combination of all three: biological, psychological, and social factors. Uncovering these factors could have significant clinical and legal implications. On one hand, it would be possible to conduct screenings to avoid developing chronic pain. and guide individuals toward the correct treatment. On the other hand, victims could seek compensation for chronic pain resulting from violence. Considering the limited knowledge about the causes of chronic pain and the absence of tools to identify risk factors or a set of tests for evaluating victims of violence, the goal of the research described in this project protocol is to pinpoint the specific contributing factors for chronic pain due to violence victimization. Additionally, it aims to devise a comprehensive protocol for assessing these factors in forensic science.

The Development of a Quantitative Disability Assessment Tool in Patients with Idiopathic Parkinson's Disease.

Background/Objectives: The objective of this study was to develop a novel quantitative disability assessment tool for patients with idiopathic Parkinson's disease (IPD). Methods: A total of 47 patients with IPD were recruited from two hospitals. A specialist in Rehabilitation Medicine utilized the modified Schwab and England Activities of Daily Living Scale (mSEADL) as a reference, conducting a comprehensive medical chart review and an in-depth interview. The novel-developed disability measurement was calculated as ((mSEADL during the on-state) × (time of on-state)) + ((mSEADL during the off-state) × (time of off-state))/(waking time). Additionally, the degree of disability was assessed using the Korean version of the Modified Barthel Index during the on-state. Results: Twenty-four participants (51.1%) exhibited the off-state during waking hours. In patients exhibiting an off-state, the mSEADL score was significantly lower during the off-state than during the on-state (p < 0.05). The novel-developed disability measurement demonstrated a higher correlation coefficient with the reference mSEADL (0.960) than with the K-MBI (0.808), with statistical significance (p < 0.05). Conclusions: The results demonstrated that larger IPD patients exhibited an on-off phenomenon with greater dependency during the off-state. Therefore, the on-off phenomenon should be considered when evaluating disability in patients with IPD, with methods such as the novel-developed disability measurement tool in this study.

Progress of Applied Research on Patient-reported Outcomes in Adolescent Idiopathic Scoliosis

This paper mainly reviews patient-reported outcome assessment tools for adolescent idiopathic scoliosis at home and abroad and their application status in the field of adolescent idiopathic scoliosis, aiming to provide references for further development of patient-reported outcome assessment tools for adolescent idiopathic scoliosis in China and selection of appropriate assessment tools for clinical staff.

Mental Health Practitioners’ Training Needs and Preferences for Addressing Online Use with Children and Young People

ABSTRACT Background Digital technology use by children and young people (CYP) has been linked to mental health issues. Currently, mental health professionals (MHPs) lack clear guidance on addressing the impact of digital use on CYP mental health. Objectives This study aimed to identify the training needs and preferences of MHPs, in having these discussions with CYP. Method We conducted an online survey of MHPs from the UK and Ireland. The survey covered topics including, barriers encountered during discussions, and MHP training and resource needs. Descriptive statistics were used to analyze quantitative data, and content analysis was used to explore qualitative responses. Results A total of 133 MHPs responded: primarily female (79.7%), white (90.8%), working in secondary care services (69.2%), with extensive experience working with CYP (47.4% 10+yrs). Although nearly half reported frequently discussing online activity with CYP, the majority lacked adequate training and resources. Barriers included concerns about relevance, limited knowledge, and practical limitations. MHPs expressed interest in training on communication strategies and enhancing understanding of online risks. Additionally, they preferred resources co-created with CYP, featuring real-life examples and perspectives. Conclusions Gaps in MHPs’ readiness to address digital aspects of CYP mental health highlight the necessity for organizational-level changes and tailored training initiatives. Emphasizing collaborative efforts with CYP in resource development is crucial to create accessible and inclusive materials, that MHPs want to engage with. Further, MHPs prioritize the development of assessment tools, evidence-based interventions, and best practice guidelines to enhance approaches to these discussions, and limit disparities in quality of care.

Adapting Child Development Assessment Tools to the Rural Indian Context.

Child development assessment tests serve many purposes, including educational placement, identifying cognitive weaknesses, and initiating early interventions. Much of the research associated with developmental testing has been conducted in high-income countries, offering limited guidance on adapting these tests to other settings. As part of the first phase of a study exploring the impact of childhood vaccines on cognition and school attainment, we aimed to assess the feasibility of enrolling children from the community, documenting immunization, and conducting child development assessments for children between 18 months and 8 years of age in a rural setting in Haryana, India. To ensure assessments are optimally tailored to the context, child development assessment tests require valid translation and cultural adaptation. This report describes the rigorous seven-step adaptation process we designed for the contextually appropriate adaptation of the following three child development assessment tests: the Bayley Scales of Infant Development-IV, the Stanford Binet Intelligence Scale Fifth Ed. for Early Childhood, and the Wechsler Intelligence Scale for Children IV. This process involved translating tests into the local language, back-translating them for accuracy, adapting them to the rural context via several iterations, and field-testing to refine and validate adaptation quality. This adaptation process may be beneficial for other researchers involved in adapting child development assessment tests to other settings. Further, this adaptation process may inform other researchers involved in adapting tests for diverse settings.

The hidden costs of informal caregiving: a concept analysis

Background“The hidden costs of informal caregiving” is an interdisciplinary concept. While caregivers make a significant contribution to the process of caregiving, they sacrifice their leisure time, and incur risks of dropping out of the job, impaired mental and physical health, and decreased well-being within the context of caregiving. Those invisible sacrifices are often overlooked and described as hidden costs of informal caregiving. However, the conceptualisation of hidden costs of informal caregiving has not yet been clarified and scientifically assessed. The research aimed to clarify the concept of hidden costs of informal caregiving and develop an operational definition.MethodsWalker and Avant’s concept analysis was conducted. Databases of CBM, CNKI, WanFang, VIP, PubMed, Embase, CINAHL, Web of Science, MEDLINE, Cochrane Library, Econlit, CINAHL and ProQuest were searched with the term “hidden costs of informal caregiving”. Information about the uses of the concept, defining attributes, model cases, antecedents, consequences and empirical referents of hidden costs of informal caregiving was extracted and synthesized.ResultsA total of 25 articles were included. The six defining attributes of hidden costs of informal caregiving were identified as including “undertaken by informal caregivers”, “the time costs of caregiving”, “costs of career development” “physical well-being costs”, “mental well-being costs” and “social relationship costs”. Personal characteristics of the caregivers and care recipients, along with caregiving attributes, were among the antecedents. The consequences of hidden costs of informal caregiving resulted in negative influences which included poor quality of life, life-altering decisions, options for the type of care, some degree of economic hardship, decreased compliance with treatment plans and monetary value informal caregivers are willing to pay to be replaced.ConclusionThis concept analysis decisively illuminated the hitherto nebulous concept and expanded the contents of hidden costs of informal caregiving, which will foster a deeper appreciation of the invisible cost of caregivers. Moreover, it will provide a reference for the study of the hidden costs of informal caregiving in future, contribute to the development of assessment tools and theoretical models of hidden costs of informal caregiving, and create a basis for designing an evidence-based care program.