Key Domains Research Articles

Administrators’ perspectives on teachers breaking contract at international schools

This study on breaking contract at international schools provides insights from interviews with 13 international school administrators. Through an examination of the reasons for, and impacts of, breaking contract, five types of international school contract non-completion are identified. In addition to a typology for future studies of this phenomenon, the study outlines five impacts of contract non-completion and four key domains for school leaders to consider in relation to contract non-completion at international schools.

The Tardive Dyskinesia Impact Scale (TDIS), a novel patient-reported outcome measure in tardive dyskinesia: development and psychometric validation

BackgroundTardive dyskinesia (TD), a movement disorder in which patients experience abnormal involuntary movements, can have profound negative impacts on physical, cognitive, and psychosocial functioning. The Abnormal Involuntary Movement Scale (AIMS), a clinician-rated outcome, is considered the gold standard for evaluating treatment efficacy in TD clinical trials. However, it provides little information about the impacts of uncontrolled movements from a patient perspective and can be cumbersome to administer in clinical settings. The Tardive Dyskinesia Impact Scale (TDIS) was developed as a patient-reported outcome measure to fulfill the need for a disease-specific impact assessment in TD. The objective of the present study was to develop and evaluate the psychometric properties of the TDIS to determine whether it is fit-for-purpose to measure TD impact.MethodsData from qualitative studies and phase 3 trials of a VMAT2 inhibitor for the treatment of TD (KINECT3 and KINECT4) were used to determine the psychometric properties of the TDIS. Qualitative research included concept elicitation and cognitive debriefing interviews with TD patients and their caregivers in order to assess how well the TDIS captured key domains of TD impact. Quantitative analyses to examine the psychometric properties of the TDIS included assessing construct validity (factor structure, known groups, and predictive validity) and responsiveness to change.ResultsQualitative results showed that the TDIS captures the key TD impacts reported by patients and caregivers and that the TDIS was interpreted as intended and relevant to patients’ experiences. Quantitative results found evidence of 2 underlying domains of the TDIS: physical and socioemotional (Comparative Fit Index > 0.9). Known groups and predictive validity indicated that, compared with the AIMS, the TDIS captures unique content (correlation between AIMS and TDIS = 0.2–0.28). The TDIS showed responsiveness to change in treatment, with TDIS scores improving over 48 weeks in the 2 phase 3 trials.ConclusionsThe TDIS captures relevant information about the impact of TD and is easily administered in a clinician’s office or patient’s home. It may be used longitudinally to show changes in TD burden over time. The TDIS complements the AIMS; using these assessments together provides a more holistic assessment of TD.

The role of specialty palliative care interdisciplinary team members in acute care decision support: a qualitative study protocol

BackgroundSpecialty palliative care interdisciplinary teams (IDT) can play an important role in supporting patients and family members during acute care decision-making. Despite guidelines and evidence emphasizing decision-making support as a key domain of specialty palliative care, little is known about how decision-making support is actually implemented by specialty palliative care IDTs. This study aims to (1) describe the structure and processes of inpatient decision-making support delivered by specialty palliative care IDT, and (2) examine the perspectives of IDT members on their role in this decision-support.MethodsA team of clinician and non-clinician researchers will conduct non-participant observation ethnography at a single medical center in northern New England. The ethnography will focus on the work of IDT members in supporting decision making, particularly elements of specialty palliative care that have limited descriptions in the literature (e.g. systems and processes of care). Observations of formal and informal interactions between IDT members and clinical encounters will be conducted at one site over four months. Participants include patients, care partners, non-specialty palliative care providers, and specialty palliative care IDT members. Additionally, we will conduct semi-structured interviews with IDT members across three geographically diverse specialty palliative care teams across the United States to explore providers’ first-person perspective on their roles and function in decision-making support for hospitalized patients. Field notes and transcripts from observation and interviews will be uploaded to Dedoose software for management and thematic analysis following an inductive approach.DiscussionTo our knowledge, this will be the first observational study of the roles of interdisciplinary specialty palliative care teams. Results from this research will support further investigation into implementation of decision-making support across different types of medical teams.

Gender and Parental Income Disparities in Secondary School Students' Hard Skills Levels: A Study in Sri Lanka

Aims: This research investigates the intricate interplay between gender and parental income as pivotal determinants influencing hard skills proficiency among secondary school students in Sri Lanka. Positioned within the dynamic landscape of secondary education, the study aims to unravel the nuanced factors that contribute to educational disparities.
 Study Design: Methodologically, a quantitative research design was employed, utilising a survey-based approach to gather data from a diverse sample of 1350 secondary school students in Sri Lanka. The sampling strategy employed was stratified random sampling, ensuring representation across various socio-economic strata. The study used rigorous measures to guarantee the questionnaire's validity and reliability, enhancing the findings' robustness.
 Place and Duration of Study: Situated within the diverse socio-economic landscape of Sri Lanka, the research spans secondary schools in different regions of the country. The study duration encompassed a specific timeframe, providing a snapshot of the current state of affairs within the evolving educational system of Sri Lanka
 Methodology: The findings revealed moderately high overall hard skills proficiency levels among secondary school students, with notable variations in language skills and project contribution. Significant gender-based disparities and parental income variations were identified, underscoring the necessity for targeted interventions. The study's contribution to the discourse on educational equity and social justice is evident, emphasising the broader societal and economic contexts.
 Results: The research findings highlight gender-based differences and parental income disparities, shedding light on specific areas where interventions are urgently needed. Language skills and project contribution emerged as key domains where variations were pronounced, providing actionable insights for policymakers and educators
 Conclusion: This research highlights the urgency of implementing gender-sensitive educational interventions, initiatives to enhance computer skills, and targeted support for low-income families in Sri Lanka. Emphasising the necessity for policy changes prioritizing educational equity and advocating for community engagement initiatives, the successful application of these recommendations in Sri Lanka could serve as a blueprint for fostering inclusive and equitable learning environments globally.

A Pediatric-Focused Self-Assessment Tool on Vulnerabilities to Aid Regional Disaster Planning.

A significant number of disaster and emergency victims are children. Yet, many hospitals are ill-prepared to care for these patients during disasters, as identified by the National Pediatric Readiness Project's survey of hospital pediatric disaster plans. The Region V for Kids Center of Excellence created a self-assessment tool to help regions identify vulnerabilities and ways to enhance care for vulnerable children and families. Region V for Kids identified 9 key domains (eg, infrastructures and support mechanisms) that are important to safeguard children's and families' care during disasters. A self-assessment tool to assess these domains was distributed to 24 regional health care coalitions along with a 9-question usefulness survey. The self-assessment tool addressed 3 of the original domains, which have regional or national open-source databases and datapoints that health care coalitions can access for their responses. The survey received a 50% response rate. Approximately 40% of respondents indicated they were "somewhat likely" to make changes based on data gathered by the tool. The original self-assessment tool was revised to create an expanded web-based version. Health care coalitions and localities can use this tool to evaluate pediatric preparedness, identify needed improvements, and improve outcomes for children, families, and communities.

The dynamic role of business intelligence in developing effective planning strategies through analyzing data as an influential variable: Case of engineering the pharmaceutical sector in Jordan

In the current pharmaceutical context of Jordan, the significance of Business Intelligence (BI) has emerged as a crucial factor in designing efficient planning methods. This research investigates the transformative impact of business intelligence (BI) in four key domains: drug development enhancement, operational optimization, compliance assurance, and market dynamics comprehension. The research highlights the need to utilize a data-driven methodology to emphasize the value of business intelligence (BI) tools in extracting valuable insights, facilitating strategic decision-making, and promoting operational efficiency. The results indicate that pharmaceutical organizations that utilize business intelligence (BI) can uncover concealed patterns, recognize chances for growth, and make well-informed decisions. Additionally, the capacity of business intelligence (BI) to integrate novel data has accelerated the development of resilient technical frameworks, thereby reinforcing its essential position within the pharmaceutical sector in Jordan. This research serves as evidence of the potential of business intelligence (BI) in facilitating innovation, surmounting obstacles, and eventually improving patient outcomes.

Role matters in understanding ‘quality’ in palliative care: a qualitative analysis of patient, caregiver and practitioner perspectives

ObjectivesTo compare the discussions from two panels on the concept of palliative care quality for patients with advanced cancer, exploring the priorities reflected in each group’s perspectives.DesignWe convened two RAND-UCLA...

Beneficiaries’ Perception on the Education Extension Programs of De La Salle University-Dasmariñas

Education extension programs of De La Salle University-Dasmarinas (DLSU-D) greatly adhere to the Lasallian mission and to its vision and mission in promoting a Christian and humane society. The university implements community development programs basically to uplift the lives of the underprivileged and to provide accessible education extension programs for the youth-at-risk through the Hatid-Aral, Balik-Aral, and Night College Programs. As the university’s lead unit for extension services, the Lasallian Community Development Center conducted this impact study to examine the adequacy and effectiveness of the university’s implemented education extension programs based on the perceptions of the programs’ beneficiaries. A survey questionnaire was used as primary data collection tool designed to focus on key areas or domains of assessment that measure the adequacy and effectiveness of the programs. The overall results of the study show that the respondents have a strong satisfaction on the overall performance of DLSU-D’s Education Extension Programs with a strong agreement to their effectiveness and agreement to their adequacy. Therefore, the overall combined result of the study revealed that the respondents have a strong or high recognition of the adequacy and effectiveness of DLSU-D’s Education Extension Programs.

Exploring Frontiers: Interdisciplinary Insights into Human Space Flight Advancements

This review article comprehensively examines the multifaceted landscape of human space flight, focusing on the transformative role of the International Space Station (ISS) and the evolving challenges and opportunities associated with deep space exploration. Anchored in the synergy between space science, engineering, and human physiology, our exploration unfolds across key domains, shedding light on the scientific, technological, and psychological dimensions of human space missions.

The Impact of Artificial Intelligence Militarization on South Asian Deterrence Dynamics

The rapid advancement of artificial intelligence in recent years has significantly altered the strategic landscape and character of warfare. Military institutions are extensively exploring various aspects to fortify security, recognizing AI as a pivotal technology reshaping the nature of confrontations. Within the Indian defense sector, there's been proactive involvement in assimilating artificial intelligence. This strategic incorporation of AI within India's military framework will distinctly influence Pakistan's assessment of potential threats thereby impacting deterrence dynamics at both conventional and nuclear level. The paper applies the Deterrence Theory. This theory posits that the possession of superior military capabilities can dissuade adversaries from initiating conflict. In the context of AI integration, the paper aims to explore how advancements in AI bolster India's deterrence posture vis-à-vis Pakistan and militarization of AI by India will impact the deterrence equation and stability dynamics in the region. Moreover, this also might disturb the equilibrium enhancing the likelihood of conflict between two states. By exploring the possible impact of militarization of AI by Indian defense sector, the paper founds that AI militarization can alter the balance of power dynamics impacting the strategic stability and stability-instability paradox between India and Pakistan. Qualitative research methodology has been used for comprehensive analysis of existing literature on AI's role in modern warfare, coupled with an examination of research work on militarization of AI in South Asia. The aim is to delineate the repercussions of Indian AI militarization on the power dynamics of South Asia and deterrence equation. Thus, by examining the key domains of Indian AI militarization, this paper suggests that to keep pace with India’s technological advancement, Pakistan should undertake the policy of quid-pro-quo since it cannot afford to delay the integration of AI in its defense sector contemplating it as a national security concern for Pakistan.

The Role of Cytokine IL-2 In Cancer Immunotherapy

Cancer remains a leading global cause of mortality, distinguished by its propensity for rapid proliferation, metastatic potential, and the ability to affect various organs with ease. If left untreated, it may lead to nerve compression, rupture of blood vessels, multi-organ failure, and may ultimately lead to the patient's death. The ability of immunotherapy to block signaling pathways that inhibit immune cell activation, enhance and amplify anti-tumor responses, or increase the amount of anti-tumor response cells makes it an important weapon in the fight against cancer. Among the key domains of cancer immunotherapy research, harnessing cytokines to invigorate anti-tumor reactions in cancer patients ranks as one of the foremost areas, given cytokines' capacity to regulate the host's immune reaction against cancer cells. Interleukin-2 (IL-2) is a recognized T-cell growth factor that has been used to treat metastatic melanoma. While extensive research has substantiated IL-2's potential in cancer therapy by impacting the immune system, its practical utility has encountered several constraints. This review centers on the diverse applications of IL-2-based cancer therapy, their underlying mechanisms, the associated limitations, and prospects for the future of IL-2 in the realm of cancer immunotherapy.

Healthy Age Friendly Homes Programme: Evaluation of a Multi Stakeholder Intervention to Ageing in Place

Introduction: Healthy Age Friendly Homes (HAFH) Phase 1 Pilot is a pilot programme aimed at creating a service to identify older people living at home and supporting them to age in place. It is a multi-stakeholder project, evaluated by Maynooth University and funded by Sláintecare, with the programme being delivered by Age Friendly Ireland hosted by Meath County Council. 
 There were 768,900 persons living in Ireland aged 65 and over in April 2022, an increase of 139,100 older people since 2016. With an increasing population of older people; increased supports and services are required to adapt to this change. The aim of this programme was to take a multi-pronged approach encompassing health, housing, community and social supports, and technology, to support older people to remain independent at home, for as long as possible. 
 Recruitment: A sample of convenience was sought across 9 counties. A National Manager and 9 Local Co-ordinators were appointed by Age Friendly Ireland, who conducted a series of awareness campaigns to encourage older people to self-refer into the programme. In addition, a multi stakeholder recruitment approach was utilised, working with services such as personnel in local government, health services, transport, community and voluntary groups, Gardaí, elected members and others, to identify those in communities who may benefit from the programme. 
 Methods: Participants received a home visit from one of 9 Local Co-ordinators who conducted a personal assessment with each individual, covering the four key domains of health, housing, community/social and technology needs. Work orders were prepared based on individual needs assessments including referral to services such as befriending teams, health practitioners and assistance with completion of documentation relating to housing grants, and other opportunities available to older people such as rightsizing. 
 Consenting research participants received two phone calls, at the beginning of the intervention and at 6 months post intervention. Data was collected on; Health Status (EQ-5D), Social Supports - The Oslo Social Support Scale (OSSS-3), Quality of Life - The CASP-12, Loneliness - The UCLA and on Self-Efficacy - The GSE scale. A randomised sample was chosen from each geographical region to undertake a qualitative interview, recording perceptions of the programme. The topic guide was created in line with the RE-AIM framework for intervention studies. 
 Results: To date, 169 participants have taken part in the research evaluation presented. At baseline, 23% reported that their house does not meet their needs. Less than one quarter (24%) had previously applied for a housing adaptation grant. 21% of participants reported moderate problems with mobility, 25% reported moderate problems with pain/discomfort, and 16% reported slight problems with anxiety or depression. 18% of participants reported poor social support and a mean score of 27.24 was reported on the CASP-12. The programme was positively received by participants; one of the most positive aspects reported was the social interaction gained. 
 Conclusion: The HAFH programme has been well received by participants and demonstrates how partnerships between local government, community and health services, can positively enhance the lives of older people living in the community.

WORK-LIFE BALANCE: CONCEPTUAL FIELD OF INTERPRETATIONS

In their legislative actions and political strategies, the EU’s countries integrate the promotion of sustainable economic and social development, justice, and equality policies with efforts to address worklife balance and personal life matters. Modern corporations, driven by a focus on economic success, are developing and implementing their work-life balance strategies for employees. Studies by European- American researchers define the balance between work and personal life as a significant component both of social quality of life and decent work. Nevertheless, in Ukraine, aspiring for European integration, the matter of preserving work-life balance still warrants attention from scientists, policymakers, and managers. This article's purpose is to explore the various definitions and interpretations of the key concept 'work-life balance' found in contemporary scientific literature. It aims to identify the range of attributes inherent in the phenomenon referred to as 'work-life balance.' The article conducts a classification of conceptual approaches for interpreting this concept, outlines its fundamental characteristics based on a comprehensive review of the specialized literature, and highlights the cognitive potential and limitations of specific conceptual models. The authors categorize conceptual models of work-life balance into two distinct clusters: 1) Attributive models, which place emphasis on either subjective or objective characteristics of balancing work and personal life; 2) Relational models, which aim to illustrate the connections between different life spheres. The second cluster comprises concepts that vary in their focus on segmenting or exploring the mutual influences between key life domains, highlighting the nature of these influences in terms of balance or conflict. Heuristic perspectives in the conceptualization of the work-life balance concept are evident in synthetic models capable of encompassing both objective and subjective aspects of the phenomenon. These models recognize the intricate relationships between various life domains, extending beyond the simple dichotomy of harmony vs. conflict. They also consider the potential for synergistic effects, such as compensation, mutual reinforcement, and the transfer of effects. This work contributes to the advancement of the work-life balance concept and its potential empirical application in sociological studies related to quality of life, decent work, and the evaluation of socially oriented development strategies for both states and corporations.

The lysine 2-hydroxyisobutyrylome of Helicobacter pylori: Indicating potential roles of lysine 2-hydroxyisobutyrylation in the bacterial metabolism

Helicobacter pylori (H. pylori) is a pathogen which colonizes the stomach, causing ulcers, chronic gastritis and other related diseases. Protein post-translational modifications (PTMs) in bacteria mainly include glycosylation, ubiquitination, nitrosylation, methylation, phosphorylation and acetylation, all of which have divergent functions in the physiology and pathology of the bacterium. Lysine 2-hydroxyisobutyrylation (Khib) is a newly discovered type of PTM in recent years in some kinds of organisms, and this PTM is involved in the regulation of a variety of metabolic process, such as bacterial glucose metabolism, lipid metabolism and protein synthesis. This study performed the first qualitative lysine 2-hydroxyisobutyrylome in H. pylori, and a total of 4419 Khib sites in 812 proteins were identified. The results show that Khib sites are mainly located in the key functional regions or active domains of proteins involved in nickel-trafficking, energy production, virulence factors, anti-oxidation, metal resistance, and ribosome biosynthesis in H. pylori. The study presented here provides new hints in the metabolism and pathology of H. pylori and the proteins with Khib modification may be potentially promising targets for the further development of antibiotics, especially considering the high occurrence of treatment failure of H. pylori failure due to development of antibiotics-resistance.

ORAL HEALTH EQUITY, BELIEFS, PRACTICES, PERCEPTIONS AMONG OLDER DETROIT RESIDENTS

Abstract Oral health disparities are widespread among older and disadvantaged Detroit residents. While preventable, poor oral health is strongly associated with adverse health and social outcomes and increased risk of cognitive impairments. To address limitations in access and knowledge among older Detroit persons, the University of Detroit Mercy Oral Health Equity project is providing free drop-in clinics offering screenings and basic care at multiple local community centers. However, we need person-centered knowledge about the reasons for an individual’s current oral health status and to inform strategies to increase service uptake. We conducted interviews with attendees onsite after their services to learn oral health perceptions, wants, and practices. Findings are reported from a sample, n=62, of predominantly African American, median age 81, female 69%, 50% over two years without a dental visit, and 61% fair to poor self-reported oral health. Analyses used topic, theme, pattern, and critical case content analytic methods. Constructs comprising four key domains were identified: (a) Oral health care exists at the intersection of forces featuring societal, political, historical, local urban place, and economic dimensions beyond individual-level health and behaviors; (b) lifespan pathways into current oral health and care practices, including wishes for future oral health status; (c) barriers and resources to oral health care access and practices; and (d) personal knowledge gaps regarding signs and mechanisms of oral health. Discussion will focus on strategies to reduce disparities and increase utilization, community and person-level knowledge gaps, and training dental students to engage older disadvantaged persons effectively.

A novel SMARCC1 BAFopathy implicates neural progenitor epigenetic dysregulation in human hydrocephalus.

Hydrocephalus, characterized by cerebral ventriculomegaly, is the most common disorder requiring brain surgery in children. Recent studies have implicated SMARCC1, a component of the BRG1-associated factor (BAF) chromatin remodelling complex, as a candidate congenital hydrocephalus gene. However, SMARCC1 variants have not been systematically examined in a large patient cohort or conclusively linked with a human syndrome. Moreover, congenital hydrocephalus-associated SMARCC1 variants have not been functionally validated or mechanistically studied in vivo. Here, we aimed to assess the prevalence of SMARCC1 variants in an expanded patient cohort, describe associated clinical and radiographic phenotypes, and assess the impact of Smarcc1 depletion in a novel Xenopus tropicalis model of congenital hydrocephalus. To do this, we performed a genetic association study using whole-exome sequencing from a cohort consisting of 2697 total ventriculomegalic trios, including patients with neurosurgically-treated congenital hydrocephalus, that total 8091 exomes collected over 7 years (2016-23). A comparison control cohort consisted of 1798 exomes from unaffected siblings of patients with autism spectrum disorder and their unaffected parents were sourced from the Simons Simplex Collection. Enrichment and impact on protein structure were assessed in identified variants. Effects on the human fetal brain transcriptome were examined with RNA-sequencing and Smarcc1 knockdowns were generated in Xenopus and studied using optical coherence tomography imaging, in situ hybridization and immunofluorescence. SMARCC1 surpassed genome-wide significance thresholds, yielding six rare, protein-altering de novo variants localized to highly conserved residues in key functional domains. Patients exhibited hydrocephalus with aqueductal stenosis; corpus callosum abnormalities, developmental delay, and cardiac defects were also common. Xenopus knockdowns recapitulated both aqueductal stenosis and cardiac defects and were rescued by wild-type but not patient-specific variant SMARCC1. Hydrocephalic SMARCC1-variant human fetal brain and Smarcc1-variant Xenopus brain exhibited a similarly altered expression of key genes linked to midgestational neurogenesis, including the transcription factors NEUROD2 and MAB21L2. These results suggest de novo variants in SMARCC1 cause a novel human BAFopathy we term 'SMARCC1-associated developmental dysgenesis syndrome', characterized by variable presence of cerebral ventriculomegaly, aqueductal stenosis, developmental delay and a variety of structural brain or cardiac defects. These data underscore the importance of SMARCC1 and the BAF chromatin remodelling complex for human brain morphogenesis and provide evidence for a 'neural stem cell' paradigm of congenital hydrocephalus pathogenesis. These results highlight utility of trio-based whole-exome sequencing for identifying pathogenic variants in sporadic congenital structural brain disorders and suggest whole-exome sequencing may be a valuable adjunct in clinical management of congenital hydrocephalus patients.

LONGITUDINAL METHODS FOR ASSESSING PROGRESSION OF MULTIMORBIDITY AND RELATED HEALTH OUTCOMES

Abstract The growing body of longitudinal research on multimorbidity (≥ 2 chronic conditions) has identified that multimorbidity progression in mid and late life is associated with change in other health domains (e.g., mobility limitations) and can have far-reaching effects on person-centered outcomes such as health-related quality of life. Several increasingly accessible quantitative methods can be applied to the longitudinal study of multimorbidity and related health outcomes, but there has been relatively little work describing and synthesizing the merits and limitations of methods available for this purpose. We will discuss the application and limitations of popular longitudinal methods that can be applied to the study of change in multimorbidity and associated health outcomes. We will consider overarching issues in the longitudinal study of multimorbidity including operationalizing multimorbidity, data-related concerns such as measurement invariance, and choice of time scale (i.e., change in age or calendar time). We will then cover methods aligned to four specific research objectives: 1) examining individual change in multimorbidity, 2) identifying population sub-groups that follow similar trajectories of multimorbidity progression, 3) understanding when, how, and why individuals/groups shift to more advanced stages of multimorbidity, and 4) examining the co-progression of multimorbidity with key health domains over time. This work will help establish a common language for assessing longitudinal changes in multimorbidity, inform research that can fill gaps in our knowledge regarding multimorbidity progression and critical periods of change, and support the identification of groups that experience divergent rates and etiological pathways of disease progression.

EFFECTS OF GAMIFIED COGNITIVE TRAINING TO DETER THE PROGRESSION OF MILD COGNITIVE IMPAIRMENT

Abstract Mild cognitive impairment (MCI) is highly prevalent condition among older adults, and has a greater risk of progression to dementia. Even cognitive training has great efficacy to delay the onset of dementia, its time-limited offer by professional members reduces its availability. Whereas ‘gamification’ evolves as important concept to enhance treatment engagement, we developed an innovative Sudoku solving algorithm titled ‘T-code’ to assimilates the key domains of cognitive training on attention, logical and deductive reasoning. A single-blinded RCT randomized 288 older adults with MCI to receive the 24-week Sudoku Mind Activation and Revitalizing Training (SMART) Program (n=157) or the usual care (n = 131). A battery of cognitive assessments, the Memory Inventory for Chinese, the Short Form-36 were evaluated at baseline, immediately after the 12-week Sudoku training and after the 12-week home-based self-practice. Focus group interview was conducted to explore subjects’ experience and reasons for its therapeutic effects if any. The results indicated that participants in the SMART Program had greater improvements in global cognitive function, working memory, language, short- and long-term delay recalls, recognition memory, CTT 1 and subjective memory complaints immediately after the 12-week training than the control. These effects, together with executive function, were sustained till the end of the programme. The qualitative findings converged with the outcome evaluation, and improved self-confidence, more active life engagement, and enhanced mood status might sustain the cognitive benefits. This game-based cognitive training is a treatment option of high accessibility, availability and acceptance to prevent MCI from progressing to dementia.

THE ROLE OF CONTEXTUAL FACTORS IN ADULT DEVELOPMENT AND AGING

Abstract Individual development is embedded in multiple environmental systems, ranging from broader distal cultural and historical contexts to more proximal residential, family, and partnership contexts. The goal of this symposium is to showcase research studying the role of distal and proximal contextual factors in the development and aging of key domains, including health, cognitive function, social relationships, and emotional experiences. Nakagawa et al. examine cultural differences in the associations of positive affect and loneliness with longevity using data from prospective surveys in the United States (1986–2005) and Japan (1987–2006). Hülür et al. use 35-year longitudinal data (1977-2012) from 3,482 participants of the Seattle Longitudinal Study to examine associations between perceived residential neighborhood characteristics and trajectories of cognitive aging. Kobayashi et al. study cohort and gender differences in trajectories of social contact and social participation and the effects of being married and living with a child using data from the National Survey of the Japanese Elderly (1987-2021). Meier et al. will present data from a study on emotional co-regulation in younger and older couples’ daily lives focusing on situational factors (e.g., psychological availability) within romantic relationships that can shape daily emotional experiences and relationship quality. The discussion by Hans-Werner Wahl will focus on how these approaches contribute to our understanding of processes of context dynamics and how they can be utilized to promote the maintenance of health and function in aging.

Can the electronic medical record provide reliable indicators of primary care behavioral health fidelity? Comparison of accessibility and productivity indicators assessed through observational coding.

The primary care behavioral health (PCBH) model is one of the most widely implemented integrated care approaches. However, research on the model has been limited by inconsistent measurement and reporting of model fidelity. One way of making measurement of PCBH model fidelity more routine is to incorporate fidelity indicators into the electronic medical record (EMR), though research regarding the accuracy of EMR data is mixed. In this study, we aimed to assess the reliability of EMR data as a PCBH fidelity measurement tool by comparing key EMR indicators of PCBH fidelity to those recorded by an observational coder. Over an 8-month period (October 2021-May 2022), 12 behavioral health consultants (BHCs; 92% White, 75% female) across five primary care clinics recorded indicators of PCBH fidelity in the EMR as part of their routine charting of behavioral health visits. During that same period, one observational coder completed seven 4-hr visits per clinic to obtain multiple samples of data from each over time and recorded the same variables (i.e., percentage of visits prompted by warm handoffs, number of warm handoffs, and number of patient visits). We used bivariate correlations to test the associations between the EMR variables and the observer-coded variables. Correlations between EMR and observer-coded variables were moderate to strong, ranging from r = .46 to r = .97. Leveraging EMR data appears to be a fairly reliable approach to capturing indicators of PCBH model fidelity in the key domains of accessibility and high productivity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).