Items In Domain Research Articles

Development of a behaviour change intervention for improving physical activity amongst stroke survivors with physical disabilities: a co-design approach

BackgroundStroke survivors face many barriers to physical activity (PA). Solving physical inactivity after stroke requires a “systems-based” approach. We aimed to develop a complex intervention targeted at improving PA after stroke in Singapore using behaviour change theory and a co-design approach involving multiple stakeholders.MethodsWe carried out the intervention development in three phases: i. preparation phase, ii. co-design phase, and iii. intervention refinement phase. During the preparation phase, we conducted surveys (n = 38 stroke survivors, 71 physiotherapists and 35 exercise professionals) and interviews (n = 19 stroke survivors) to understand the factors influencing PA after stroke. The co-design phase consisted of two-co-design workshops held in August 2022 and were attended by 13 stroke survivors and 4 caregivers. Relevant domains of the Theoretical Domains Framework (TDF) and items in the Template for Intervention Description and Replication (TIDieR) checklist guided the discussion topics in the first co-design workshop. Solution prototypes such as exercise videos, arm and leg straps and information resources were shown in the second co-design workshop to gather feedback. In the intervention refinement phase, eight healthcare professionals from various sectors participated in two virtual Zoom meetings in August 2023, and used the Acceptability, Practicability, Effectiveness, Affordability, Spillover effects and Equity (APEASE) grid to rate the active ingredients in the complex intervention by considering the current healthcare landscape in terms of resources and manpower.ResultsStroke survivors and caregivers want a personalised PA program, stroke-specific PA opportunities and information resources, medical clearance, advice and help from healthcare professionals skilled in stroke care, face-to-face sessions at preferred exercise spaces, and access to adaptive equipment. A complex intervention consisting of 21 behaviour change techniques, 6 intervention functions and 8 options was developed.ConclusionsUsing behaviour change theory and a co-design approach involving multiple stakeholders, a complex intervention was developed to target physical inactivity after stroke. The intervention titled MOTIVATE is currently being tested in a type 1 hybrid effectiveness-implementation trial.

Urban-Rural Disparities in Community Participation after Spinal Cord Injury in Ontario.

Personal, social, and environmental factors may influence self-efficacy and social reintegration among people living with spinal cord injury or disease (SCI/D) in urban and rural areas. Novel data collection methods have the potential to characterize community participation (CP) in diverse settings. The objectives were (1) to describe and compare self-reported community participation (Reintegration to Normal Living Index (RNLI) and Moorong Self-Efficacy Scale (MSES)) levels of individuals with SCI/D living in urban or rural Ontario, Canada; and (2) to determine the accuracy of an artificial intelligence (AI) optical mark recognition tool for extracting data from CP surveys conducted among participants after transitioning from inpatient rehabilitation to home and residing in the community. We partnered with SCI Ontario staff to collect MSES and RNLI survey data from adults with motor complete (e.g., AIS A-B) and incomplete (AIS C-D) SCI/D living in urban or rural Ontario, Canada, between January and October 2022. The Rurality Index of Ontario (RIO) from the postal code determined urban or rural residency. Optical mark recognition (OMR) software was used for survey data extraction. A Research Associate validated the extracted survey responses. Descriptive statistics, correlation analysis, and non-parametric statistics were used to describe the participants, their impairments, and their reported CP levels across urban and rural settings. Eighty-five individuals with SCI/D (mean age 53.7 years, 36.5% female) completed the survey. Most of the participants resided in major urban areas (69.4%) and had traumatic injuries (64.7%). The mean total MSES score for Ontarians with SCI/D was 87.96 (95% confidence interval [CI]: 84.45, 91.47), while the mean total RNLI score for the same individuals was 75.61 (95% CI: 71.85, 79.37). Among the MSES domains, the lowest score was observed in response to sexual satisfaction (mean: 4.012, 95% CI: 3.527, 4.497), while the lowest RNLI domain item score was associated with the ability to travel out of town (mean: 5.965, 95% CI: 5.252, 6.678). Individuals with incomplete injuries in rural areas reported lower MSES and RNLI scores than those with complete motor injuries, whereas no significant differences were found in MSES and RNLI scores among urban residents based on impairment. These findings suggest that, depending on the environmental context (e.g., rural vs. urban areas), AIS categories may influence the perception of CP among people living with SCI/D. The OMR tool had 97.4% accuracy in extracting data from the surveys. The CP (MSES and RNLI) scores reported by individuals with SCI/D differ based on their living setting. In rural Ontario, individuals with greater functional ability reported lower CP than their counterparts living in urban settings. Although CP remains a challenge, the needs of individuals with motor incomplete SCI/D and heterogeneous levels of mobility residing in rural areas require exploration and targeted interventions. The OMR tool facilitates accurate data extraction from surveys across settings.

Teamwork in Rural Emergency Health Care: A Simulation-Based Cross-over Study of Co-located and Distributed Teams.

Despite the increasing use of distributed healthcare teams, performance evaluation is largely lacking. This study examined rural emergency health care in Sweden to determine the effect of teams being either co-located or distributed with remote physicians accessible via telemedicine. In this crossover study, 17 three-person teams were video recorded during co-located and distributed simulated scenarios. Team performance in the video recordings was evaluated using the TEAM instrument. Co-located scenarios had significantly higher Total ratings for the instrument (items 1-11), in the teamwork domain (items 3-9), and in overall performance (item 12) compared with distributed scenarios (P < 0.005). Item-level analysis revealed that co-located teams were better at completing tasks on time (item 4) and showed greater adaptability to changing situations (item 7). The higher rating of the performance of co-located teams underscores the challenges facing distributed teams. Given that distributed healthcare teams are a reality in rural areas in northern Sweden, education and training must be adapted to address these challenges. This adaptation is crucial for ensuring high-quality patient care by distributed teams.

Rasch analysis of quality of life in children with vernal keratoconjunctivitis (QUICK) questionnaire

ABSTRACT Clinical relevance A validated questionnaire measures the construct accurately, helps clinician to support decision making, facilitates assessment and monitoring of patients, guides clinical trial and promotes patient-centred care. Background To assess the psychometric properties of the Quality of Life in Children with Vernal Keratoconjunctivitis (QUICK) questionnaire among Indian children with Vernal Keratoconjuntivitis (VKC) using Rasch analysis. Methods This study used a questionnaire validation study design. The QUICK questionnaire for VKC was translated to two local languages using back translation process and administered to the Indian children (aged 5–15 years) diagnosed with VKC between June 2021 and March 2022. The study took place at a tertiary eye care hospital in Chennai, India. The psychometric properties were assessed based on six indicators namely rating scale behaviour, measurement precision, item fit, unidimensionality, targeting and Differential Item Functioning (DIF). Results Fifty six children with VKC (mean age 10.5 years and 77.8% males) filled the questionnaire. The analysis of overall QUICK questionnaire (16 items) revealed an ordered threshold for the rating scale, no noticeable DIF and excellent person-item targeting (0.15). However, the questionnaire showed inadequate person separation (PSI 1.82 and PSR 0.77), four misfit items and lack of unidimensionality (eigenvalue 2.80). Eliminating misfit items and contrasting items resolved multidimensionality, leaving nine items related to the symptoms domain in the questionnaire. However, the person separation (PSI 1.52 and PSR 0.70) remained below 2.0. Conclusion The resultant 9-item QUICK questionnaire discriminates only low and high performers among VKC patients. Thus, it may be used solely to assess the symptoms domain in Health Related Quality of Life (HRQoL). This questionnaire requires addition of items in other domains pertaining to HRQoL to make it holistic.

Verification of five-factor models and reference scores for personality dysfunction and trait domains of the Personality Assessment Questionnaire for ICD-11 (PAQ-11), revised version.

A brief self-reported measure of the Personality Assessment Questionnaire for the 11th edition of the World Health Organization's International Classification of Disease (ICD-11) (PAQ-11) was developed to evaluate ICD-11 personality traits. The aim of this study was to investigate the validity of the revised PAQ-11 version (PAQ-11R) with an additional item in the Dissociality domain and thresholds for the severity of personality dysfunction and domains. Study 1 examined the construct validity of the PAQ-11R in 192 university students in Korea. Study 2 estimated tentative reference scores of personality dysfunction and domains of the PAQ-11R in 91 patients in Korea. In study 1, the PAQ-11R had a five-factor structure and the revised Dissociality scale had better convergent and discriminant validities than the previous version. In study 2, the receiver operating characteristic (ROC) curve of the PAQ-11R identified a threshold score of 35. Reference scores for domains were estimated as 15 for Negative Affectivity, 10 for Detachment, 8 for Anankastia, and 5 each for Disinhibition and Dissociality. These scores contribute to severity of personality disturbance but remain qualifiers only; they are not diagnostic. The results suggest that the PAQ-11R is useful as a quick assessment tool for identifying the domains of personality dysfunction in clinical practice in harmony with the ICD-11 guidelines.

Critical Evaluation of the 2016 SOSORT Clinical Guidelines on the Detection and Clinical Management of Adolescent Idiopathic Scoliosis Using the AGREE II Tool: A Chiropractic Perspective

ObjectiveThe objective of this study is to assess the methodological quality of the 2016 Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) guidelines for the detection and management of adolescent idiopathic scoliosis. MethodsA diverse group of experts, including practicing chiropractors, chiropractors with a Diplomate by the American Chiropractic Board of Radiology, chiropractors with PhD degrees, and chiropractors involved in teaching within chiropractic programs was invited to participate in the study. Experts independently evaluated the guidelines using the Appraisal of Guidelines for Research and Evaluation II tool. Individual scaled scores were calculated for each item and the 6 domains, with methodological quality considered good if the score was equal to or greater than 70%. ResultsThe 19 experts, including 6 clinicians, 4 chiropractic radiologists, 6 researchers, and 3 lecturers, represented Canada (n = 3), United states (n = 4), France (n = 2), Australia (n = 1), United Kingdom (n = 1), Switzerland (n = 1), Sweden (n = 3), Denmark (n = 2), China (n = 1), and Côte d'Ivoire (n = 1). Domain scaled scores ranged from 38% to 90%. The 4 items of the applicability domain scored between 26% and 45%. The experts made suggestions for improving the applicability of the guidelines’ recommendations. ConclusionThe methodological quality of the 2016 SOSORT clinical practice guidelines was deemed good. However, strategies should be devised to improve their applicability. This could be achieved by involving a more diverse representation of healthcare professions in the development of future guidelines.

Disparities in patient-reported distress in head and neck cancer.

257 Background: Distress is common among cancer patients, and impacts morbidity and mortality. Head and neck cancer (HNC) is considered one of the most emotionally distressing of all cancers, and given the stark racial disparities in HNC outcomes, we sought to examine racial and sociodemographic factors associated with clinically meaningful distress in a cohort of patients with HNC. Methods: We built a retrospective cohort of patients at a semi-urban, academic, National Cancer Institute (NCI)-designated comprehensive cancer center in the Southeastern United States. Cohort included patients with a diagnosis of HNC who received care from the Radiation Oncology department 5 weeks or less of initial diagnosis, from 2017 to 2022. Outcome of interest was clinically meaningful distress, a binary variable defined as a score of ≥4 on the distress thermometer (DT), a validated tool measuring distress, with scores ranging from 0-10. Main independent variables were sociodemographic factors (race/ethnicity, age, sex, marital status, and health insurance status). We further adjusted for clinical variables (stage of presentation, anatomical subsites, smoking and alcohol history), and problem list domain items. Using chi-square tests and multinomial regression analysis, we estimated differences in distress and odds of meaningful distress by sociodemographic factors, adjusting for clinical factors and problem list domains. Results: From a primary sample of 1,167 patients, 507 patients met our inclusion criteria. Nearly half (45.8%) of our sample had clinically meaningful distress, with a median DT score of 3 (IQR, 0-6). Total number of problem list items and physical concerns showed significant racial differences ( p &lt; 0.05); however, in our final models, race was not significantly associated with clinically meaningful distress. Compared to those unmarried, married patients were significantly less likely to report distress (aOR = 0.62; 95% CI: 0.40, 0.95). Also, patients with emotional problems had double the odds of reporting clinically meaningful distress (aOR = 2.03; 95% CI: 1.02, 4.08). Other factors associated with significant clinical distress included tobacco history, and reported practical problems. Conclusions: Marital status and reported emotional problems are significantly associated with clinically meaningful distress in patients with HNC. Our study underscores the need for social support in mitigating distress and optimizing mental healthcare in our patient population. Further studies will explore distress trajectories across the HNC continuum and impact on HNC outcomes.

The Pattern of Dissociative Symptoms Differs between Post-Traumatic Stress Disorder and First Esketamine Administration for Treatment-Resistant Depression

Abstract Objective Dissociative symptoms are commonly observed during the first administration of esketamine for the treatment of Treatment-Resistant Depression (TRD) and in a substantial minority of patients with Post-Traumatic Stress Disorder (PTSD). We examine differences in the number and pattern of dissociative symptoms (depersonalization, derealization, dissociative amnesia, identity fragmentation) reported by these two groups. Data Selection Data for patients diagnosed with PTSD (N = 134) were drawn from studies of individuals with exposure to civilian traumas, childhood abuse or combat trauma. Data for patients with TRD undergoing their first treatment session with ESK (N = 759) were drawn from published results detailing the presentation of dissociative symptoms during FDA registration trials. Data Synthesis Dissociative symptoms in general were more prevalent in the ESK group (P &amp;lt; 0.01). However, a significant (p &amp;lt; 0.0001) Group x Item Domain interaction revealed that dissociative amnesia and identity fragmentation were endorsed more frequently relative to the other domains in the PTSD group relative to the ESK group. Depersonalization and derealization were the most prominent dissociative symptoms endorsed by the ESK group, whereas items from the dissociative amnesia domain were endorsed most frequently in the PTSD group. Conclusions The pattern of dissociative symptoms endorsed by patients with PTSD differs from that reported by patients with TRD receiving esketamine for the first time, suggesting the possibility that the etiology of “dissociative symptoms” may vary to some degree across therapeutic conditions.

IDC-CDR: Cross-domain Recommendation based on Intent Disentanglement and Contrast Learning

Using the user’s past activity across different domains, the cross-domain recommendation (CDR) predicts the items that users are likely to click. Most recent studies on CDR model user interests at the item level. However because items in other domains are inherently heterogeneous, direct modeling of past interactions from other domains to augment user representation in the target domain may limit the effectiveness of recommendation. Thus, in order to enhance the performance of cross-domain recommendation, we present a model called Cross-domain Recommendation based on Intent Disentanglement and Contrast Learning (IDC-CDR) that performs contrastive learning at the intent level between domains and disentangles user interaction intents in various domains. Initially, user–item interaction graphs were created for both single-domain and cross-domain scenarios. Then, by modeling the intention distribution of each user–item interaction, the interaction intention graph and its representation were updated repeatedly. The comprehensive local intent is then obtained by fusing the local domain intents of the source domain and the target domain using the attention technique. In order to enhance representation learning and knowledge transfer, we ultimately develop a cross-domain intention contrastive learning method. Using three pairs of cross-domain scenarios from Amazon and the KuaiRand dataset, we carry out comprehensive experiments. The experimental findings demonstrate that the recommendation performance can be greatly enhanced by IDC-CDR, with an average improvement of 20.62% and 25.32% for HR and NDCG metrics, respectively.

Preferences for Text Messaging Supports During Youth Transition to Adult Mental Health Services: Theory-Informed Modified e-Delphi Study.

For many young people, the transition from child to adult mental health services is a vulnerable time associated with treatment disengagement and illness progression. Providing service information and options to youth, appealing to them, and tailoring to their needs during this period could help overcome systematic barriers to a successful transition. We know little about how SMS text message-based interventions might be leveraged to support the motivational, informational, and behavioral needs of youth during this time. Ascertaining youth preferences for the content and functionality of an SMS text message service could inform prototype development. This study investigated consensus preferences among youth on important content, technology features, and engagement supports to inform a transition-focused SMS text message service. A modified e-Delphi survey design was used to collect demographics, current levels of technology use, importance ratings on message content, preferred technical features, and barriers and enablers to engagement for youth in Canada aged 16-26 years who have accessed mental health services within the past 5 years. Survey items on content were categorized according to the information-motivation-behavioral skills (IMB) model. Survey items on technical features were categorized according to the persuasive system design (PSD) model. A predefined consensus rating matrix and descriptive statistics were used to characterize the sample. The high consensus threshold was 70%. A total of 100 participants, predominantly non-White (n=47, 47%), aged 20-26 years (n=59, 59%), and who had first accessed mental health services between the ages of 13 and 19 years (n=60, 60%), were selected. The majority (n=90, 90%) identified as daily SMS text message users. A high level of consensus on importance ratings was reported in 45% (9/20) of content items based on the IMB model. There were higher levels of consensus on importance ratings related to behavior domain items (3/3, 100%) than information domain items (4/9, 44%) or motivation domain items (2/8, 25%). A high level of consensus on importance ratings was reported in only 19% (4/21) of feature and functionality items based on the PSD model. Among PSD model categories, there was a high level of consensus on importance ratings in 8% (1/12) of the primary task support domain items and 100% (3/3) of the system credibility support domain items. None of the dialogue-support and social-support domain items met the high level of consensus thresholds. In total, 27% (27/100) of youth indicated that the most significant enabler for engaging with a transition-focused SMS text message intervention was the personalization of text messages. Scientists developing next-generation SMS text messaging interventions for this population need to consider how levels of consensus on different features may impact feasibility and personalization efforts. Youth can (and should) play an integral role in the development of these interventions.

Conceptual Framework of Upper Cross Syndrome: A Delphi Study.

Upper cross syndrome (UCS) is one of the most common postural dysfunctions due to prolonged flexed attitude. Good posture plays an important role in maintaining musculoskeletal balance and protecting it from further injury. Conducting research on the conceptual framework will help clinicians to identify and plan treatment strategies for the correction of this syndrome and prevent secondary complications. Thus, the aim of this study was to develop a conceptual framework for UCS. The Delphi method was used to conduct the study and develop a conceptual framework. A total of 30 multidisciplinary experts participated in the study, and a list of 41 items was finalized after an extensive literature review. A cover letter along with all the items was mailed to the experts to obtain their input. Three rounds of Delphi were conducted until a consensus was reached. The following parameters were used to determine consensus: moderate Kendall's coefficient of concordance (Kendall's W), agreement greater than 51.0%, interquartile range (IQR) below 1.5, and standard deviation (SD) below 1. By the end of the third round, 37 items were finalized. The conceptual framework consisted of four items in postural alignment, eight items in muscular imbalance, 20 items in functional limitation, and five items in the psychosocial domain. We successfully developed a conceptual framework for UCS. Four domains, including postural alignment, muscular imbalance, functional limitation, and psychosocial, were identified. This will lead to a deeper comprehension of UCS, which will facilitate its early detection and treatment. The multidimensional approach of the study will provide a better scope for the clinicians to educate the patient about good posture, which not only will impact physical performance but also improve quality of life. The development of this framework will help to prevent, monitor the progress, and correct UCS.

Evidence for separate backward recall and n-back working memory factors: a large-scale latent variable analysis

ABSTRACT Multiple studies have explored the factor structure of working memory (WM) tasks, yet few have done so controlling for both the domain and category of the memory items in a single study. In the current pre-registered study, we conducted a large-scale latent variable analysis using variant forms of n-back and backward recall tasks to test whether they measured a single underlying construct, or were distinguished by stimuli-, domain-, or paradigm-specific factors. Exploratory analyses investigated how the resulting WM factor(s) were linked to fluid intelligence. Participants (N = 703) completed a fluid reasoning test and multiple n-back and backward recall tasks containing memoranda that varied across (spatial or verbal material) and within (verbal digits or letters) domain, allowing the variance specific to task content and paradigm to be assessed. Two distinct but related backward recall and n-back constructs best captured the data, in comparison to other plausible model constructions (single WM factor, two-factor domain, and three-factor materials models). Common variance associated with WM was a stronger predictor of fluid reasoning than a residual n-back factor, but the backward recall factor predicted fluid reasoning as strongly as the common WM factor. These data emphasise the distinctiveness between backward recall and n-back tasks.

Development of Valid and Reliable Questionnaire to Evaluate Knowledge, Attitude, and Practices (KAP) of Lifestyle Medicine Domains.

To develop and test the validity and reliability of a questionnaire that measures the level of knowledge, attitude, and practice (KAP) of LM domains among medical trainees through practicing physicians. The KAP questionnaire sections covered the nine domains of LM. The validation process included face and content validity. A total of 151 individuals from the medical field residing in Saudi Arabia were recruited through a convenient sampling technique to participate in the study. Item response theory (IRT) was applied to validate the knowledge domain, while exploratory factor analysis (EFA) was used to assess attitude and practice. Cronbach's alpha was performed to test the reliability of the three sections. The questionnaire contained 37 items of knowledge, 45 attitudes, and 28 practice items. According to the IRT analysis, 27 items of knowledge were within the acceptable range of difficulty and discrimination. The EFA analysis resulted in 6 factors, including all the items in the attitude domain, and 4 factors, for a total of 27 items in the practice domain, with satisfactory factor loading (>0.4). The Cronbach's alpha for the three domains was very high (≥0.88). The KAP questionnaire for LM is valid and reliable across a spectrum, from medical trainees to practicing physicians. This tool could serve as an instrument to evaluate and develop adequate educational programs for medical doctors.

Development of the 2023 ACR/EULAR Antiphospholipid Syndrome Classification Criteria, Phase III-D Report: Multicriteria Decision Analysis.

The 2023 American College of Rheumatology/EULAR antiphospholipid syndrome (APS) classification criteria development, which aimed to identify patients with high likelihood of APS for research, employed a four-phase methodology. Phase I and II resulted in 27 proposed candidate criteria, which are organized into laboratory and clinical domains. Here, we summarize the last stage of phase III efforts, employing a consensus-based multicriteria decision analysis (MCDA) to weigh candidate criteria and identify an APS classification threshold score. We evaluated 192 unique, international real-world patients referred for "suspected APS" with a wide range of APS manifestations. Using proposed candidate criteria, subcommittee members rank ordered 20 representative patients from highly unlikely to highly likely to have APS. During an in-person meeting, the subcommittee refined definitions and participated in an MCDA exercise to identify relative weights of candidate criteria. Using consensus decisions and pairwise criteria comparisons, 1000Minds software assigned criteria weights, and we rank ordered 192 patients by their additive scores. A consensus-based threshold score for APS classification was set. Premeeting evaluation of 20 representative patients demonstrated variability in APS assessment. MCDA resolved 81 pairwise decisions; relative weights identified domain item hierarchy. After assessing 192 patients by weights and additive scores, the Steering Committee reached consensus that APS classification should require separate clinical and laboratory scores, rather than a single-aggregate score, to ensure high specificity. Using MCDA, candidate criteria preliminary weights were determined. Unlike other disease classification systems using a single-aggregate threshold score, separate clinical and laboratory domain thresholds were incorporated into the new APS classification criteria.

Factor Structures in the Depressive Symptoms Domains in the 9Q for Northern Thai Adults and Their Association with Chronic Diseases.

Most of the common models to examine depression are one-factor models; however, previous studies provided several-factor structure models on each depressive symptom using the Patient Health Questionnaire-9 (PHQ-9). The Nine-Questions Depression-Rating Scale (9Q) is an alternative assessment tool that was developed for assessing the severity of depressive symptoms in Thai adults. This study aimed to examine the factor structure of this tool based on the factor structure models for the PHQ-9 provided in previous studies using confirmatory factor analysis (CFA). We also examined the association of chronic diseases and depressive symptoms using the Multiple Indicators Multiple Causes model among 1346 participants aged 19 years old or more without psychiatric disorders. The results show that the two-factor CFA model with six items in the cognitive-affective domain and three items in the somatic domain provided the best fit for depressive symptoms in the study population (RMSEA = 0.077, CFI = 0.953, TLI = 0.936). Dyslipidemia was positively associated with both cognitive-affective symptoms (β = 0.120) and somatic depressive symptoms (β = 0.080). Allergies were associated with a higher level of cognitive-affective depressive symptoms (β = 0.087), while migraine (β = 0.114) and peptic ulcer disease (β = 0.062) were associated with a higher level of somatic symptoms. Increased age was associated with a lower level of somatic symptoms (β = -0.088). Our findings suggested that considering depressive symptoms as two dimensions yields a better fit for depressive symptoms. The co-occurrence of chronic diseases associated with depressive symptoms should be monitored.

Modification of a parent-report sleep scale for individuals with CDKL5 deficiency disorder: a psychometric study.

Sleep difficulties are common in CDKL5 deficiency disorder (CDD), a developmental and epileptic encephalopathy (DEE). This study evaluated the factor structure of the Disorders of Initiating and Maintaining Sleep (DIMS), Disorders of Excessive Daytime Somnolence (DOES) and Sleep Breathing Disorders (SBD) domains of the Sleep Disturbance Scale for Children (SDSC) for CDD. A cross-sectional psychometric study design was used. Data were collected for 125 individuals aged 3 years or older who attended a US Centers of Excellence clinic or registered with the International CDKL5 Disorder Database. The median age was 10.3 years (range 3.2 - 40.7 years) and 105 (84%) were female. Two of the three SBD items related were not observed by most respondents and analysis was restricted to the DIMS and DOES domains. Using all items in the initial confirmatory factor analysis, two items in the DIMS domain and one item in the DOES domain loaded poorly. After deleting these items and repeating the analysis, item loading (0.524-0.814) and internal consistency (DIMS: 0.78, DOES: 0.76) statistics were good. The square of the inter-domain correlation coefficient was 0.17, less than Average Variance Extracted values for both domains and indicating good discriminant validity. The Tucker-Lewis and Comparative Fit indices were slightly lower than the threshold of >0.9 for establishing goodness of fit. The modified DIMS and DOES domains from the SDSC could be suitable clinical outcome assessments of insomnia and related impairments in CDD and potentially other DEE conditions.

Adherence of SARS-CoV-2 Seroepidemiologic Studies to the ROSES-S Reporting Guideline During the COVID-19 Pandemic.

Complete reporting of seroepidemiologic studies is critical to their utility in evidence synthesis and public health decision making. The Reporting of Seroepidemiologic studies-SARS-CoV-2 (ROSES-S) guideline is a checklist that aims to improve reporting in SARS-CoV-2 seroepidemiologic studies. Adherence to the ROSES-S guideline has not yet been evaluated. This study aims to evaluate the completeness of SARS-CoV-2 seroepidemiologic study reporting by the ROSES-S guideline during the COVID-19 pandemic, determine whether guideline publication was associated with reporting completeness, and identify study characteristics associated with reporting completeness. A random sample from the SeroTracker living systematic review database was evaluated. For each reporting item in the guideline, the percentage of studies that were adherent was calculated, as well as median and interquartile range (IQR) adherence across all items and by item domain. Beta regression analyses were used to evaluate predictors of adherence to ROSES-S. One hundred and ninety-nine studies were analyzed. Median adherence was 48.1% (IQR 40.0%-55.2%) per study, with overall adherence ranging from 8.8% to 72.7%. The laboratory methods domain had the lowest median adherence (33.3% [IQR 25.0%-41.7%]). The discussion domain had the highest median adherence (75.0% [IQR 50.0%-100.0%]). Reporting adherence to ROSES-S before and after guideline publication did not significantly change. Publication source (p < 0.001), study risk of bias (p = 0.001), and sampling method (p = 0.004) were significantly associated with adherence. Completeness of reporting in SARS-CoV-2 seroepidemiologic studies was suboptimal. Publication of the ROSES-S guideline was not associated with changes in reporting practices. Authors should improve adherence to the ROSES-S guideline with support from stakeholders.

The Degree of Availability of a Creativity Culture among Kindergarten Teachers in the Capital Amman from the Female Kindergarten Principals Point of View

The study aimed at revealing the degree of Availability of a Creativity culture among kindergarten teachers in the capital Amman from of a Female Kindergarten principals point of view. The descriptive survey methodology was used, the study sample consisted of (341) female principals, and the questionnaire was used as a study tool which, distributed over four domains of (26) items, and the domains were (the domain of originality and intellectual fluency, the domain of mental flexibility and the ability to analyze, the domain of focus and sensitivity to problems, and domain of tendency to experiment). Its validity and reliability were confirmed. The most important results of the study indicated that the degree of availability creativity culture among kindergarten teachers in Amman from the viewpoint of the female kindergarten principals came to a high degree at the total level and at the level of domains. The results showed that there were statistically significant differences in the availability degree of a culture of creativity among kindergarten teachers in the capital, Amman, due to the variable of experience and in favor of the category of 10 years or more. The researcher recommends maintaining this level of creativity culture to enable teachers to become kindergarten leaders and work to adopt creative children and determine their future paths to work as inventive leaders who keep pace with the local, regional and global labor market. Finally, there were no significant differences due to the educational qualification.

Health App Review Tool (HART): content validation through expert panel review

ABSTRACT The Health App Review Tool (HART) is an evaluation tool that is designed to help the users in evaluation of the health apps for Alzheimer’s Disease and Related Dementias (ADRD) population. As the development of the HART continues, the domain items that HART addresses require evaluation to determine if they meet the intended required criteria for the users.To complete content validation of the HART 10 health care professions provided content validation of the HART via a content validation form. Specifically, data collection took place virtually through Microsoft Teams and Qualtrics-based content validity index. Following, revisions were made through a consensus process involving 3 rehabilitation experts, minimizing potential conflicts.Findings indicate 76 of 109 items were considered acceptable, 19 items were in need of review and 14 items in need of revision. In sum 30% of the total HART items required either review or revision to improve HART validity. The changes were implemented through consensus revisions.

Exploring the Potential Impact of Training on Short-Term Quality of Life and Stress of Parents of Children with Autism: The Integrative Parents' Autism Training Module.

Parents of autistic children experience high levels of parental stress and low quality of life related to the demanding child caring burden they experience. Parent education and training programs are acknowledged to improve parental well-being and reduce parenting stress. In the framework of the Erasmus+ Integrative Autism Parents Training Project (IPAT), we developed the IPAT Training Module based on parents' expressed needs, in order to improve parental quality of life (QoL) and decrease their perceived stress. Sixty-two parents from four countries participated in the IPAT Module Training activity. We used WHOQOL-BREF and Perceived Stress Scale (PSS-10 version) for QoL and stress, respectively, before and after training and a study-specific questionnaire to assess participants' satisfaction. Parents' QoL improved significantly in the environment domain and specific items, while stress levels remained unmodified. Training appeared more advantageous for parents with lower initial QoL and those whose child had been enrolled in a special education program for an extended duration. Parents were quite satisfied, in particular those with lower initial social relationships QoL. Larger studies including a control group are necessary to support preliminary evidence provided by this study, identify additional effect moderators, and disentangle the contribution of different components of the training.