Acceptable Measurement Research Articles

Postoperative accuracy quantification of corrective osteotomies: standardisation of Q3D-CT methodology

PurposeCurrently, no gold standard exists for 3D analysis of virtually planned surgery accuracy postoperatively. The aim of this study was to present a new, validated and standardised methodology for 3D postoperative assessment of surgical accuracy in patients undergoing 3D virtually planned and guided corrective osteotomies.MethodsAll patients who underwent 3D planned corrective osteotomy in 2021–2022 at our center with a postoperative CT were included. Postoperative surgical outcome was analysed with a postoperative CT and compared to the preoperative virtual surgical planning to determine achieved accuracy. Validation of the analysis was performed by evaluating the individual assessment of six experienced observers. A postoperative quantification was performed according to the proposed innovative methodology based on rotation axes of a virtual postoperative bone model aligned to the virtual preoperative bone model and virtual surgical planned bone model. To evaluate the intra-observer variability, one observer performed the assessment twice.ResultsQuantification of 13 patients according resulted in measurements with a median range (and its interquartile range) for 3D translation of: 2.43 mm (3.17), for the angle deviations: 3D rotation, 2D coronal, 2D sagittal and 2D axial were: 0.66° (1.66°), 0.74° (0.44°), 0.99° (1.27°), 2.37° (5.00°), respectively. The inter- and intraobserver reliability established with the Intraclass correlation coefficient was for all measurements excellent (> 0.76).ConclusionThe proposed 3D CT technique provides an significant more accurate and objective method for assessment of surgical outcome of a guided corrective osteotomy. The present proposed novel methodology showed excellent inter- and intra-observer reliability with clinically acceptable absolute surgical outcome measurements.

Acceptability and preliminary outcomes of the Enhanced Assess, Acknowledge, and Act Sexual Assault Resistance Education Program for women who use alcohol and cannabis (EAAA+): Findings from an open pilot trial.

One in five college women experiences sexual assault (SA). Feminist scholars have called for the use of programming that empowers women by increasing their ability to recognize and resist SA. One such program, the Enhanced Assess, Acknowledge, Act SA Resistance Education Program (EAAA), has demonstrated lower rates of SA up to 24 months (Senn et al., 2015, 2017). EAAA could be further enhanced by directly targeting women's risky alcohol and cannabis use, two known risk factors for SA, within an integrated framework. This study evaluated the acceptability and preliminary efficacy of an integrated version of EAAA with enhanced alcohol and new cannabis content. College women (n=14) aged 18-24 who reported engaging in past-month heavy alcohol use, cannabis use, and simultaneous alcohol and cannabis use participated in the adapted program. Women completed a baseline assessment, measures of acceptability at strategic points during the program, and a post-program assessment. Women rated the program very high in likability, quality, organization, relevance, and usefulness and were likely to recommend it to other women. Overall, acceptability and usability ratings for EAAA+ were high. Content analysis of open-ended questions indicated that some women wanted more cannabis and/or alcohol content included. Results indicate that the adapted content is acceptable for the target population and has promising pre-post changes on alcohol, cannabis, and SA-related outcomes.

Czech Version of the Multidimensional Assessment of Interoceptive Awareness (MAIA): Psychometric Evaluation and Network Model

Abstract Objectives Interoceptive awareness is crucial in mental health research, yet the psychometric characteristics of the most commonly used tool to measure it, the Multidimensional Assessment of Interoceptive Awareness (MAIA), have been underexplored, as the results of previous studies have been inconclusive. This study aimed to evaluate the psychometric characteristics of the Czech version of the tool (MAIACZ). Method Participants were sampled from seven clinical sites in the Czech Republic and the final sample consisted of 431 Czech clinical patients (75% women, M age = 39.20 ± 11.04 years), suffering from various psychiatric diagnoses. Patients were measured weekly across 8 weeks. A combination of factor analysis and network models was employed. Results Confirmatory factor analysis (CFA) supported the commonly used eight-factor structure of the MAIA, consistent with the original English version, though subscales Not distracting, Not worrying, and Noticing showed poor internal consistency. Invariance across gender, age, and measurement waves was confirmed using multigroup CFA. Convergence validity was established through correlations between MAIACZ subscales and measures of anxiety, depression, alexithymia, and symptom acceptance. A bootstrapped dynamic network model, conducted over 8 weekly measurement waves, showed the dynamic associations between MAIA subscales and its relation to wellbeing. Conclusions Contrary to the theoretical model, the temporal graph revealed that the main source nodes were related to the subjective mindset towards interoception, such as the tendency not to worry or distract from bodily signals, rather than the neutral perception of interoceptive stimuli. Well-being was also a prerequisite rather than a consequence of interoceptive awareness-related mechanisms. The Trusting subscale, which has received significant support for its predictive effects in previous literature, was found to be related to wellbeing primarily at the between-person level.

A multiresolution approach with method-informed statistical analysis for quantifying lymphatic pumping dynamics

Despite significant strides in lymphatic system imaging, the timely diagnosis of lymphatic disorders remains elusive. This is driven by the absence of standardized, non-invasive, reliable, quantitative methods for real-time functional analysis of lymphatic contractility with adequate spatial and temporal resolution. Here, we address this unmet need by integrating near-infrared fluorescence lymphangiography imaging with an innovative analytical workflow that combines data acquisition, signal processing, and statistical analysis to integrate traditional peak-and-valley analysis with advanced wavelet time-frequency analyses. Variance component analysis was used to evaluate the drivers of variance attributable to each experimental variable for each lymphangiography measurement type. Generalizability studies were used to assess the reliability of measured parameters and how reliability improves as the number of repeat measurements per subject increases. This allowed us to determine the minimum number of repeat measurements needed per subject for acceptable measurement reliability. This approach not only offers detailed insights into lymphatic pumping behaviors across species, sex and age, but also significantly boosts the reliability of these measurements by incorporating multiple regions of interest and evaluating the lymphatic system under various gravitational loads. For example, the reliability of the peak-and-valley analysis of human lymphatic vessels was increased 3-fold using the described approach. By addressing the critical need for improved imaging and quantification methods, our study offers a new standard approach for the imaging and analysis of lymphatic function that can improve our understanding, diagnosis, and treatment of lymphatic diseases. The results highlight the importance of comprehensive data acquisition strategies to fully capture the dynamic behavior of the lymphatic system.

EXamining the feasibility of exerCisE to manage symptoms of Lupus (EXCEL): a protocol for a randomised controlled pilot study

IntroductionSLE is a chronic autoimmune disease that results in sustained hyperactivation of innate and adaptive immune cells and widespread inflammatory damage. Regular exercise reduces SLE symptoms including fatigue and joint...

Acceptance, Safety, and Effect Sizes in Online Dialectical Behavior Therapy for Borderline Personality Disorder: Interventional Pilot Study.

The potential of telehealth psychotherapy (ie, the online delivery of treatment via a video web-based platform) is gaining increased attention. However, there is skepticism about its acceptance, safety, and efficacy for patients with high emotional and behavioral dysregulation. This study aims to provide initial effect size estimates of symptom change from pre- to post treatment, and the acceptance and safety of telehealth dialectical behavior therapy (DBT) for individuals diagnosed with borderline personality disorder (BPD). A total of 39 individuals meeting the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition]) criteria for BPD received 1 year of outpatient telehealth DBT at 3 sites in Germany and Canada. Effect size estimates were assessed using pre-post measures of BPD symptoms, dissociation, and quality of life. Safety was evaluated by analyzing suicide attempts and self-harm. Additionally, acceptance and feasibility, satisfaction with treatment, useability of the telehealth format, and the quality of the therapeutic alliance were assessed from both therapists' and patients' perspectives. All analyses were conducted on both the intention-to-treat (ITT) and according-to-protocol (ATP) samples. Analyses showed significant and large pre-post effect sizes for BPD symptoms (d=1.13 in the ITT sample and d=1.44 in the ATP sample; P<.001) and for quality of life (d=0.65 in the ITT sample and d=1.24 in the ATP sample). Dissociative symptoms showed small to nonsignificant reductions. Self-harm behaviors decreased significantly from 80% to 28% of all patients showing at least 1 self-harm behavior in the last 10 weeks (risk ratio 0.35). A high dropout rate of 38% was observed. One low-lethality suicide attempt was reported. Acceptance, feasibility, and satisfaction measures were high, although therapists reported only moderate useability of the telehealth format. Telehealth DBT for BPD showed large pre-post effect sizes for BPD symptoms and quality of life. While the telehealth format appeared feasible and well-accepted, the dropout rate was relatively high. Future research should compare the efficacy of telehealth DBT with in-person formats in randomized controlled trials. Overall, telehealth DBT might offer a potentially effective alternative treatment option, enhancing treatment accessibility. However, strategies for decreasing drop-out should be considered. German Clinical Trials Register DRKS00027824; https://drks.de/search/en/trial/DRKS00027824.

Assessing the Risks and Cultural Relativity of Diabetes in Black Individuals of African Caribbean Ancestry (ACB) Aged 18-39 Years in Toronto.

Context: Diabetes rates are high in Black and some other ethnic communities, often leading to more severe complications. We conducted a study to identify the prevalence and risk of diabetes among African Caribbean Black (ACB) individuals aged 18-39 and to assess the sensitivity of glycated hemoglobin (HbA1c) compared to an oral glucose tolerance test (OGTT) to diagnose diabetes. Methods: In this mixed-methods study, maximum variation sampling was used to recruit 272 ACB participants from fourteen African and five Caribbean countries from Toronto. Participants' height, weight, waist circumference, HbA1c, OGTT, demographic, and behavioural data were collected. SPSS was used to analyze the quantitative data. This study used descriptive statistics for frequency distribution and cross-tabulation while inferential statistics (regression, ANOVA, factor analysis, etc.) were used for relational analysis. Because of the small sample size, qualitative data were analyzed manually using the charting technique. Results: This study found that 1.5% of participants had diabetes, 9.2% had prediabetes, and 44.9% were at risk of developing diabetes. The mean value of HbA1c, FBS, and 2hPG was 5.5%, 4.8 mmol/L, and 5.7 mmol/L, respectively. The mean BMI was 28.2 kg/m2, and the waist circumference was 85.8 cm. This study found a correlation between glucose intolerance and increasing body mass index (BMI) and waist circumference (WC). Dietary habits, physical inactivity, and mental health challenges were risk factors among the participants. HbA1c was found to be a more sensitive and culturally acceptable screening measure than OGTT in diagnosing diabetes. Conclusions: ACB individuals are at high risk of having diabetes, requiring culturally tailored peer-based health promotion strategies to reduce diabetes prevalence and risk. HbA1c is a culturally acceptable and statistically more capable measure than OGTT in identifying individuals with prediabetes. Further longitudinal research is needed.

Supporting the Individualized Use of Digital Tools in Community Mental Health: The Technology Specialist Pilot Study.

This pilot study evaluated the feasibility of the technology specialist intervention, which assists clients in achieving mental health recovery and well-being goals via existing digital tools in a real-world community mental health setting. Thirteen adult clients with serious mental illness and their providers completed baseline, 3-, and 6-month assessments, including goal setting, self-efficacy, activation, and acceptability measures, along with weekly ecological momentary assessments. Clients selected goals and corresponding tools, used the tools steadily, and showed improvement in activation and self-efficacy. Most participating clients (82%, n = 9) and providers (80%, n = 8) found the intervention acceptable. These preliminary findings show that the technology specialist intervention is promising and warrants further testing.

Quantitative Neuroanatomical Measurement on Photogrammetric Model: Validation Study.

To examine and compare the accuracy of measurements obtained from photogrammetric models versus direct measurements taken on dry skulls, with the aim to verify the feasibility of photogrammetry for quantitative analysis in microsurgical neuroanatomy. Two dry human skulls were used. Each was scanned using the dual camera system of a smartphone The selected photos were separately processed using 2 different softwares to create three-dimensional models. Subsequently, 41 anatomical measurements (both linear and curvilinear) based on common anatomical landmarks were taken both directly on dry skulls and on photogrammetric models and compared. Analyzed factors included measurement error, intrarater and interrater reliability, and intermodality agreement. Four photogrammetric models were created. Analysis revealed similar errors when comparing photogrammetric and direct measurements. Measurements from digital models exhibited robust reliability among repeated measures and different observers, supported by very high intraclass correlation coefficient values. Mean measurement difference between Agisoft Metashape software-generated models and direct measurement was 0.01 cm with no systematic bias observed. Conversely, the Metascan app-derived models showed a mean measurement difference of-0.35 cm compared with direct measurement, displaying good agreement for smaller measurements and a systematic proportional bias with increasing measurement size. Two photogrammetric models were validated as quantitative analysis techniques for laboratory neuroanatomical studies, showing acceptable measurement error, high intrarater and interrater reliability, and good to very good agreement compared with direct measurement on dry skulls, replacing expensive and time-consuming methods such as computed tomography scans and neuronavigation systems.

Effect of telehealth yoga on loneliness and social isolation among rural older adults: a randomized controlled trial

Objectives Loneliness and social isolation are associated with a range of deleterious health outcomes. Yoga is a mind-body physical activity that is used in health care settings and increasingly in a telehealth group format. This trial aimed to determine the effect of a brief course of telehealth yoga on loneliness among rural older adults. Method In this pragmatic trial among rural-residing Veterans Affairs patients over age 60 (https://clinicaltrials.gov/study/NCT05431166), participants were randomized to eight, 60-minute telehealth yoga classes delivered to their homes or waitlist control. The primary outcome was loneliness at 10 wk. Additional outcomes included measures of social isolation, fidelity, and acceptability, as well as interview findings. Results Of 70 participants, 52 completed follow-up (mean [SD] age 67.8 [5.9] years). Loneliness significantly decreased between baseline and follow-up in both groups, but there were no significant between-group differences in loneliness or social isolation. Ratings of fidelity and acceptability were high. Qualitative findings indicated benefits related to the telehealth format and aspects of social connection not captured in quantitative measures. Conclusion A brief course of weekly telehealth yoga was feasible and acceptable among older rural patients but not effective at reducing loneliness and social isolation.

Public acceptance of microbiome management strategy in dairy calves: A European survey on colostrum, probiotic provision and prolonged cow-calf contact

The microbiome plays a crucial role in the calves’ early stage of life. Several management practices can be considered to enhance the development and composition of the microbiome in calves. However, their social acceptance is largely unknown. The aim of this study was to investigate the public acceptance of innovative microbiome management practices aimed at improving the health and welfare of calves and to assess the factors influencing these levels of acceptance. Data used in the analysis were obtained from an online survey conducted in July 2023. The final sample consists of 3 220 citizens from four EU countries (Finland=813, France=803, Ireland=801 and Poland=803). Participants were asked to assess four management practices designed to improve calves’ health and welfare: (1) using colostrum, (2) providing mix probiotics powder, (3) providing probiotics as yogurt or kefir and (4) prolonged cow-calf contact. Participants were provided with different levels of information: one group received only a short description of the intervention, while the other group received both the intervention description and information on aspects such as potential costs and environmental impact of the intervention. Participants were asked to rate the acceptance on a standardised scale ranging from 1 to 5, with 1 indicating “strongly agree” and 5 indicating “strongly disagree”. Additionally, the participants were questioned about their socio-demographic background (e.g. age, education). They were also asked to provide their perspectives on various dimensions concerning familiarity with farming and microbiome, food safety, environmental awareness, cost consideration, cultural perspective of consuming dairy products. Obtained data was analysed using ordinary least squares regression model. The findings reveal that prolonged cow-calf contact was the most acceptable measure among tested interventions in all countries (79% of responders agreed or strongly agreed). Attitudinal and socio-economic variables were found to have a differential effect across the studied management strategies. For instance, individuals with greater familiarity with farming systems and microbiomes were more inclined to accept all four interventions, while women, compared to men, showed higher acceptance of prolonged cow-calf contact. Results also indicate that the provision of additional information to the participants was associated with a decrease in the acceptance of the measures. In conclusion, the public’s perceptions regarding microbiome management strategies in dairy calves are shaped by complex factors. Also, our discussion emphasizes the importance of clarity and transparency of messages, ethical dissemination of scientific knowledge, and the necessity for balanced and coherent communication.

Pulmonary Function Testing in Healthy Infants in Rural Bangladesh: Feasibility Study.

Infant pulmonary function testing (iPFT) in low- and middle-income countries is limited. We evaluated the early feasibility of iPFT in rural Bangladesh. Experts established an iPFT laboratory at Zakiganj Upazila Health Complex in Sylhet, Bangladesh and trained staff. Infants ≤ 6 months old participating in a cohort study between 2021 and 2022 were eligible for respiratory oscillometry (Osc), tidal breath flow-volume loops (TBFVL), and sulphur hexaflouride multiple breath washout (MBW) during natural sleep. Participants with a respiratory infection within 4 weeks were not tested. Among the first 25 infants with attempted Osc, TBFVL, or MBW measurements, we report the test proportions meeting international quality standards, measurement averages, and the mean measurement differences between laboratory staff and experts. Among the first 25 eligible infants with attempted measurements, acceptable Osc measurements were achieved in 88% (22/25), TBFVL in 96% (24/25), and MBW in 88% (22/25). Infants tested by Osc at 2 months were a median (IQR) of 81 days old (73, 85) and tested at 6 months were a median of 194 days old (193, 202); TBFVL/MBW tested infants were a mean 83 days (79, 87). Mean (SD) Osc resistance at 7 Hz was 66.3 (25.2) and 64.0 (22.4) hPa.s.L-1 at 2 and 6 months. At 2 months, TBFVL mean tidal volume/body weight was 7.4 (1.4) mL/kg and MBW mean (SD) lung clearance index was 7.2 (1.0) turnovers. iPFT staff and expert interpretation differences were minimal. Establishing an iPFT laboratory and performing quality measurements and expert-level interpretations in rural Bangladesh is feasible.

Italian version of the Headache Disability Inventory: Cross-cultural adaptation, validity, and reliability.

To translate and cross-culturally adapt the Headache Disability Inventory (HDI) into Italian and study its reliability and validity. A total of 132 participants with primary and secondary headaches were included. The translation was performed following international guidelines with forward and back translation procedures. Structural validity, internal consistency, test-retest reliability, measurement error, and construct validity were studied. Test-retest reliability and measurement error were tested on a subsample of 32 participants. The cross-cultural adaptation into Italian was performed without issues. Confirmatory factor analysis supports the structural validity partially (comparative fit index = 0.963; Tucker-Lewis index = 0.959; root mean square error of approximation = 0.051; standardized root mean square residual = 0.084), showing a two-factor structure (i.e., emotional and functional). Each subscale presented high internal consistency (α = 0.87 and 0.87 for the emotional and functional subscales, respectively), excellent and good test-retest reliability (intraclass correlation coefficient = 0.93 and 0.88 for the emotional and functional subscales, respectively), and acceptable measurement error (standard error of the measurement [SEM] = 3.6 points, minimal detectable change [MDC] = 10.0 points for the emotional subscale; SEM = 3.8 points, MDC = 10.7 points for the functional subscale). Construct validity was satisfactory for the emotional subscale and moderate for the functional subscale, as 85.7% (6/7) and 57.1% (4/7) of a priori hypotheses were met, respectively. The HDI was successfully translated into Italian and has acceptable psychometric properties. The Italian version of the HDI can be used in daily clinical practice and research to assess the functional and emotional impact of primary and secondary headaches. Further research should study other psychometric properties (i.e., content validity, responsiveness, and reliability in a larger sample).

Psychometric Properties of the Lactation Assessment and Comprehensive Intervention Tool (LAT).

Despite the short- and long-term acknowledged benefits of breastfeeding for mothers and their infants, worldwide rates trail behind international goals. Prior research confirms that breastfeeding is a nurse sensitive indicator and that problems with latching the baby and painful breastfeeding rank high among the reasons given for not continuing to breastfeed. The Lactation Assessment Tool (LATTM) was previously evaluated in a study conducted in Latvia by nurse midwives. Use of the LAT to assess breastfeeding and suggesting corrective interventions were shown to decrease pain and promote healing in traumatized nipples. The inter-rater reliability for that study was by test/re-test amongst participating researcher midwives. The aim of the current study is to expand the understanding of LAT inter-rater reliability to include novice and expert assessors. A convenience sample of twenty participants, including both novices (nine nursing students) and 11 self-identified experts, assessed four videos of breastfeeding dyads using the assessment tool, the LAT. Novice participants received a 2 h training session before final tool assessment. Each video was viewed three times, with a 3 min pause between viewings. All elements of the LAT that could be visually evaluated were included, with each element appearing in at least two of the videos. Acceptable internal consistency of the LAT tool was found, with Cronbach's alpha measuring 0.799, 0.740, 0.756 and 0.735 for each video, respectively. The reliability of the novice assessors improved over the course of the four videos, from 0.484 and 0.610 to 0.714 and 0.711. All of the experts had Cronbach's alpha numbers that were acceptable, ranging from 0.769 to 1.00. Results indicate that experts perform much better using the tool than trained novices. However, the subsequent use of the tool resulted in the last two video assessments having an acceptable measure for the trained novice group. The LAT is a reliable tool for trained novices and experts to assess breastfeeding positioning and latch.

Blurring the lines: an empirical examination of the interrelationships among acceptability, appropriateness, and feasibility

BackgroundAcceptability, appropriateness, and feasibility are established implementation outcomes used to understand stakeholders’ perceptions of an intervention. Further, they are thought to provide insight into behaviors, such as adoption. To date, measurement instruments for the three outcomes have focused on their individual assessment whilst nodding to the idea that they may interrelate. Despite this acknowledgment, there is little empirical evidence of the association among these constructs. Using the example of genetic health professionals providing additional genomic results to patients, this study aimed to examine the interrelationships among acceptability, appropriateness, and feasibility.MethodsA sequential explanatory mixed methods approach was employed. All genetic counsellors and clinical geneticists involved in a large research program were invited to complete pre/post surveys using existing measures of acceptability, appropriateness, and feasibility. Follow-up interviews, informed by the survey results, explored clinicians’ perspectives of the three outcomes in relation to providing additional genomic results to patients. To categorize interrelationships and generate feedback loops, survey data were analyzed using descriptive and correlation statistics and interpreted alongside interview data analyzed using content analysis.ResultsThe survey results (pre n = 53 and post n = 40) for each outcome showed a similar midpoint mean, wide ranges, and little change post implementation (Acceptability: pre M = 3.55, range 2–5 post M = 3.56, range 1.5–5; Appropriateness: pre M = 3.35, range 1–5, post M = 3.48, range 1–5; Feasibility: pre M = 3.30, post M = 3.32; range 1.25–5). The strength of correlation among outcomes ranged from 0.54 to 0.78. Five interrelationships were categorized from analysis of interview data (n = 14) and explain how clinicians’ perceptions of the intervention, positive or negative, were determined by interrelating factors of acceptability, appropriateness, and feasibility and that in different scenarios, the function and emphasis of importance among outcomes switched.ConclusionsRather than existing separately, our study promotes the need to consider interrelationships among acceptability, appropriateness, and feasibility to better characterize clinicians’ perceptions of complex health care interventions and aid in the development of implementation strategies that have real world impact. Further, in the interest of reducing research waste, more research is needed to determine if the outcomes could serve as proxies for each other.

Testing the Feasibility of a Cross-Setting Measure to Address the Rising Trend in Hospital Outpatient TJA Procedures.

Elective primary total hip and total knee arthroplasty (collectively, total joint arthroplasties [TJAs]) are commonly performed procedures that can reduce pain and improve function. TJAs are generally safe, but complications can occur. Although historically performed as inpatient procedures, TJAs are increasingly being performed in the outpatient setting. We sought to develop a scientifically acceptable cross-setting measure for evaluating care quality across inpatient and outpatient settings. Using Medicare administrative claims and enrollment data for qualifying TJA patients, we respecified the Centers for Medicare & Medicaid Services (CMS) inpatient-only risk-standardized TJA complications measure to assess complication rates following elective primary TJAs performed in an inpatient or outpatient setting. We aligned inpatient and outpatient coding practices and used hierarchical logistic regression to calculate hospital-specific, risk-standardized complication rates (RSCRs). Lower rates correspond to better quality. Using accepted approaches for CMS measures, we tested measure reliability and vetted key measure decisions with patient and provider input. A single combined model including the procedure setting as a risk variable produced the highest discrimination (C-statistic for a single combined model with a setting indicator: 0.664, C-statistic for the inpatient-only model: 0.651, C-statistic for the outpatient-only model: 0.638). Among the 2,747 hospitals with at least 25 TJAs, the mean RSCR (using the combined model with a setting indicator) was 2.91% (median RSCR: 2.85%; interquartile range: 2.59% to 3.18%). The median odds ratio for complication occurrence at a higher-risk hospital compared with a lower-risk hospital was 1.33. We respecified a measure to assess hospital inpatient or outpatient TJA performance and evaluated the reliability and validity of the measure. The findings showed variation in hospital-level complication rates across settings as indicated by this measure, supporting the feasibility of evaluating hospital performance using a more representative population than inpatient TJAs alone. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Cognitive behavioral therapy for pediatric obsessive-compulsive disorder delivered via internet videoconferencing: a manualized sensor-assisted feasibility approach

BackgroundBetween 1 and 4% of children and adolescents suffer from obsessive-compulsive disorder (OCD) worldwide, but the majority of these young people do not have access to cognitive behavioral therapy (CBT) as a first-line treatment. CBT delivered via online videoconferencing (vCBT) offers a new way to provide young people with therapy, especially in the home environment where symptoms usually occur.MethodsIn this study, we investigated the feasibility of a newly revised vCBT manual, symptom change during treatment, and effects on family life and social functioning. 20 patients with OCD, aged 12–18 years, were treated during 14 weekly sessions while using a multimodal sensor system that assessed their physiological and behavioral responses during therapy. Treatment was delivered in real time via an online videoconferencing platform. Measurements of feasibility, acceptance, and implementation were evaluated descriptively, and clinical measures were assessed with t tests.ResultsThe primary results showed that patients and parents perceived the manual-based vCBT as feasible and easy to understand. According to the therapists’ ratings, all treatment modules and the content could be carried out in accordance with the manual. As a secondary outcome, OCD symptoms improved significantly during treatment (p <.001, d = 1.87), revealed by an average decrease of more than half in the Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) score. As the psychotherapy could be implemented directly in the patients’ home environment, low barriers to participation were reported, and the majority of participants reported improvements in family life after treatment.ConclusionsIn summary, the results of this feasibility study indicated a successful application of manual-based psychotherapy delivered via videoconferencing for pediatric OCD supported by a sensor system. This method should be further investigated in future randomized controlled trials with larger patient samples.Clinical trial registration: [www.ClinicalTrials.gov], identifier [NCT05291611], first submission: 2021-12-10.

The Effect and Acceptability of an HIV Education Intervention for Adolescents With Intellectual Disability in Uganda: A Quasi-Experimental Study.

Adolescents with intellectual disability (ID) are often deficient in knowledge about HIV/AIDS. This pilot study evaluated the impact and acceptability of an HIV education intervention for adolescents with mild-to-moderate ID delivered in a peri-urban setting in Uganda. This quasi-experimental study involved 60 adolescents with mild to moderate ID evenly split between the intervention and control groups. Data were collected using a questionnaire that included sociodemographic information, HIV knowledge and attitudes, and acceptability measures, administered at baseline, immediately postintervention, and 3 months later. Approximately 53.3% of the participants were male, and 50% had mild ID. Immediately post-intervention, the intervention group reported a significantly higher increase in HIV knowledge (8.5 vs. -0.2, p < .001) and attitudes (3.9 vs. 0.1, p < .001) than the control group. A similar significant increase was maintained at 3 months post-intervention. These findings show that tailored education programs can improve HIV knowledge and attitudes in adolescents with ID.

Unveiling AI Concerns for Sub-Saharan Africa and its Vulnerable Groups

In Sub-Saharan Africa (SSA), artificial intelligence is still in its early stages of adoption. To ensure that the already existing class imbalance in SSA communities does not hinder the realization of the Sustainable Development Goals, such as data security, safety, and equitable access to AI technologies, acceptable reliability measures must be put in place (as policies). This paper identifies some of the vulnerabilities in AI and adds a voice to the risks and ethical concerns surrounding the use of AI and its impact on SSA and its vulnerable groups. Our systematic literature review of related research between January 2014 and June 2024 shows the current state of AI adoption in SSA and the socio-political challenges that impact its development, revealing key concerns in data Governance, safety privacy, educational and skill gaps, socio-economic impacts, and stakeholder influence on AI adoption in SSA. We propose a framework for designing data governance policies for the inclusive use of AI in SSA.

Adaptation of the conflict tactics scales (CTS-2), in a Peruvian male sample

Intimate couple violence, including physical, psychological, verbal, and sexual, is a public health concern. The Conflict Tactics Scales (CTS-2) measure conflict resolution tactics. This research adapted the scale to a sample of 423 Peruvian men. The age range of the sample was from 21 to 60 years. A committee of 10 experts evaluated the validity of the CTS-2, and the Aiken V validity coefficients were calculated. A confirmatory factor analysis was performed, which showed an acceptable fit. Factors F2 (Psychological aggression), F3 (Physical Aggression), and F4 (Sexual Coercion) of the CTS-2 showed significant covariance, while factor F1 (Negotiation) did not show covariance with other factors. Structural equation analysis for convergent validity showed acceptable results between the Family Communication Scale and the CTS-2 factors. The reliability was adequate according to the Alpha Ordinal (0.88). The results generally indicate adequate reliability and validity of the CTS-2, with acceptable adjustment measures. This study contributes psychometric evidence for the use of CTS-2 in the Peruvian context.