Practice Items Research Articles

Interactive Assessments of CT (IACT): Digital Interactive Logic Puzzles to Assess Computational Thinking in Grades 3–8

Background and Context: The Inclusive Assessment of Computational Thinking (CT) designed for accessibility and learner variability was studied in over 50 classes in US schools (grades 3-8).
 Objective: The validation studies of IACT sampled thousands of students to establish IACT’s construct and concurrent validity as well as test-retest reliability.
 Method: IACT items for each CT practice were correlated to examine construct validity. The CT pre-measures were correlated with post-measures to examine test-retest reliability. The CT post-measures were correlated with external measures to examine concurrent validity.
 Findings: IACT studies showed moderate evidence of test-retest reliability and concurrent validity and low to moderate evidence of construct validity for an aggregated measure of CT, but weaker validity and reliability evidence for individual CT practices. These findings were similar for students with and without IEPs or 504s.
 Implications: IACT is the first CT tool for grades 3-8 that has been validated in a large-scale study among students with and without IEPs or 504s. While improvements are needed for stronger validity, it is a promising start.

Exploring Perceptions of Age Friendliness Across Different Campus Constituent Groups

College campuses are typically considered as environments for adults ages 18-24, even though campuses are comprised of faculty, staff, students, and lifelong learners of all ages. Each group may experience the campus environment differently due to their differing roles. Faculty, staff and students from 21 participating designated Age Friendly Universities across the country answered survey questions on age friendliness, AFU awareness, and on campus practice items. Crosstab analyses show that constituent groups are equally aware of their university as an AFU (6% of each group). Students perceived their university as more age friendly (M=3.47, SD=0.73) compared to faculty and staff, the latter having the lowest perceived friendliness (M=3.27, SD=0.63). Specific age friendly practices show that staff members had markedly different perceptions of the institution’s age friendly practices. AFUs need to consider higher education environments as workplaces as well as learning centers to make policies age friendly for all groups.

Knowledge, attitudes, and practices regarding venous thromboembolism prophylaxis: A survey of medical staff at a tertiary hospital in China.

To assess the knowledge, attitudes, and practices regarding venous thromboembolism (VTE) prophylaxis among medical staff at a tertiary hospital in China.A self-administered web-based survey was completed by medical staff, and data about respondent knowledge, attitudes, and practices regarding VTE prophylaxis were gathered and analyzed with chi-square tests, using a 95% significance level.Of the 2079 medical staff invited to participate in the survey, a total of 2042 (including 921 clinicians and 1121 nurses) responded. The overall rate of correct responses to knowledge items was 57.6%; the rate was 60.1% for clinicians and 55.4% for nurses (P < .001). The median affirmative (“strongly agree”/“agree”) rate for attitude items was 99.0% (range, 83.2%-99.4%). Medical staff members were most commonly concerned about the possibility of a financial penalty when a patient could not be treated with VTE prophylaxis (49.4%). Low levels of knowledge and participation of medical staff were identified most commonly as difficulties involved in VTE prophylaxis (48.5%). The median affirmative response rate for practice items was 58.2% (range, 51.1%-68.3%). All affirmative response rates for practice items were significantly higher for nurses than for clinicians (all P < .001).Although the overall attitude toward VTE prophylaxis was positive, the knowledge level was poor, especially among nurses, and the rate of affirmative responses regarding practices was low, especially among clinicians. Medical institutions should improve staff training regarding VTE prophylaxis, and medical staff should be encouraged to actively engage in VTE prophylaxis.

Consensus on Training and Assessment of Competence in Performing Chorionic Villus Sampling and Amniocentesis: An International Delphi Survey

Introduction: The aim of this study was to obtain expert consensus on the content of a curriculum for learning chorionic villus sampling (CVS) and amniocentesis (AC) and the items of an assessment tool to evaluate CVS and AC competence. Methods: We used a 3-round iterative Delphi process. A steering committee supervised all processes. Seven international collaborators were identified to expand the breadth of the study internationally. The collaborators invited fetal medicine experts to participate as panelists. In the first round, the panelists suggested content for a CVS/AC curriculum and an assessment tool. The steering committee organized and condensed the suggested items and presented them to the panelists in round 2. In the second round, the panelists rated and commented on the suggested items. The results were processed by the steering committee and presented to the panelists in the third round, where final consensus was obtained. Consensus was defined as support by more than 80% of the panelists for an item. Results: Eighty-six experts agreed to participate in the study. The panelists represented 16 countries across 4 continents. The final list of curricular content included 12 theoretical and practical items. The final assessment tool included 11 items, systematically divided into 5 categories: pre-procedure, procedure, post-procedure, nontechnical skills, and overall performance. These items were provided with behavioral scale anchors to rate performance, and an entrustment scale was used for the final overall assessment. Conclusion: We established consensus among international fetal medicine experts on content to be included in a CVS/AC curriculum and on an assessment tool to evaluate CVS/AC skills. These results are important to help transition current training and assessment methods from a time- and volume-based approach to a competency-based approach which is a key step in improving patient safety and outcomes for the 2 most common invasive procedures in fetal medicine.

Tablet PC-based competency evaluation for nursing students in three Asian countries: Cross-sectional comparative study

AimThis study evaluated a practical competency evaluation for nursing students in three Asian countries using tablet PC-based tests. The need to evaluate practical competencies in a non-face-to-face manner continues to pose challenges in nursing education. DesignThis study presents descriptive comparative research on a tablet PC-based evaluation of practical competencies in three countries. Methodstablet PC-based clinical practice competency evaluation was conducted among nursing college students in Korea, Vietnam and Mongolia. In total, 124 students answered 65 questions for practical competency evaluation and items on its usefulness. ResultsStudents from Korea had the highest score of nursing competencies (41.6 points; n = 59, SD 6.02), followed by those from Vietnam (26.3 points; n = 30, SD 4.97) and Mongolia (18.4 points; n = 35, SD 5.36). Scores for usability showed an inverse relationship with competency scores. Questions incorporating video showed the lowest proportion of low-discrimination items. ConclusionsThis research recognized that using video which provides contextual elements can increase item discrimination. These findings suggest that incorporating video into evaluation items in tablet-PC-based tests is useful for international comparison.

How well do critical care audit and feedback interventions adhere to best practice? Development and application of the REFLECT-52 evaluation tool

BackgroundHealthcare Audit and Feedback (A&F) interventions have been shown to be an effective means of changing healthcare professional behavior, but work is required to optimize them, as evidence suggests that A&F interventions are not improving over time. Recent published guidance has suggested an initial set of best practices that may help to increase intervention effectiveness, which focus on the “Nature of the desired action,” “Nature of the data available for feedback,” “Feedback display,” and “Delivering the feedback intervention.” We aimed to develop a generalizable evaluation tool that can be used to assess whether A&F interventions conform to these suggestions for best practice and conducted initial testing of the tool through application to a sample of critical care A&F interventions.MethodsWe used a consensus-based approach to develop an evaluation tool from published guidance and subsequently applied the tool to conduct a secondary analysis of A&F interventions. To start, the 15 suggestions for improved feedback interventions published by Brehaut et al. were deconstructed into rateable items. Items were developed through iterative consensus meetings among researchers. These items were then piloted on 12 A&F studies (two reviewers met for consensus each time after independently applying the tool to four A&F intervention studies). After each consensus meeting, items were modified to improve clarity and specificity, and to help increase the reliability between coders. We then assessed the conformity to best practices of 17 critical care A&F interventions, sourced from a systematic review of A&F interventions on provider ordering of laboratory tests and transfusions in the critical care setting. Data for each criteria item was extracted by one coder and confirmed by a second; results were then aggregated and presented graphically or in a table and described narratively.ResultsIn total, 52 criteria items were developed (38 ratable items and 14 descriptive items). Eight studies targeted lab test ordering behaviors, and 10 studies targeted blood transfusion ordering. Items focused on specifying the “Nature of the Desired Action” were adhered to most commonly—feedback was often presented in the context of an external priority (13/17), showed or described a discrepancy in performance (14/17), and in all cases it was reasonable for the recipients to be responsible for the change in behavior (17/17). Items focused on the “Nature of the Data Available for Feedback” were adhered to less often—only some interventions provided individual (5/17) or patient-level data (5/17), and few included aspirational comparators (2/17), or justifications for specificity of feedback (4/17), choice of comparator (0/9) or the interval between reports (3/13). Items focused on the “Nature of the Feedback Display” were reported poorly—just under half of interventions reported providing feedback in more than one way (8/17) and interventions rarely included pilot-testing of the feedback (1/17 unclear) or presentation of a visual display and summary message in close proximity of each other (1/13). Items focused on “Delivering the Feedback Intervention” were also poorly reported—feedback rarely reported use of barrier/enabler assessments (0/17), involved target members in the development of the feedback (0/17), or involved explicit design to be received and discussed in a social context (3/17); however, most interventions clearly indicated who was providing the feedback (11/17), involved a facilitator (8/12) or involved engaging in self-assessment around the target behavior prior to receipt of feedback (12/17).ConclusionsMany of the theory-informed best practice items were not consistently applied in critical care and can suggest clear ways to improve interventions. Standardized reporting of detailed intervention descriptions and feedback templates may also help to further advance research in this field. The 52-item tool can serve as a basis for reliably assessing concordance with best practice guidance in existing A&F interventions trialed in other healthcare settings, and could be used to inform future A&F intervention development.Trial registrationNot applicable.

A Differential Item Functioning (DIF) Study of the Infection Control Standard Isolation Precaution Instrument Across Gender and Major Among Healthcare Workers

Background: Measuring healthcare workers’ (HCWs) knowledge, attitudes, and practices (KAPs) regarding isolation precaution is essential for infection control which needs a valid and reliable instrument. Objectives: This study aimed to assess differential item functioning (DIF) across gender and major for the knowledge and practice items of the questionnaire, previously designed in Shiraz, Iran. Methods: This cross-sectional survey was conducted on 1070 participants (males/females: 306/764; medical students/nurses: 466/624). The study instrument had three subscales with nine questions for each KAP subscale. The Mantel-Haenszel (MH) statistic was used. The DIF and differential test functioning (DTF) analyses were also performed in this study. Results: There were very similar DIF outcomes for the knowledge and practice subscales, with one or two items indicating moderate DIF but comparable total scores across genders. Across majors, several items showed large DIF for both subscales. It was found that large DTF affects major for both subscales. Conclusions: Our findings indicated large DIF and DTF levels of the questionnaire among medical students and nursing groups. More attention should be paid when developing the items. This study shows the importance of paying attention to valid evidence for instruments developed within the field of healthcare.

Hydration And Fluid Replacement Knowledge, Attitudes, And Practices In Recreationally Active College Students

Hydration status is essential for optimal health and human performance. Past research has shown education (e.g., knowledge) is important to ensure collegiate athletes have a positive attitude towards hydrating and adhere to adequate hydration practices. Albeit this has been elucidated in collegiate athletes, few, if any, studies have researched recreationally active college students. PURPOSE: To examine the relationship between hydration knowledge, attitudes, and practices in recreationally active college students. METHODS: Recreationally active students, as defined by ACSM (aerobic exercise ≤2 days/wk for a total of 80 min/wk) [n = 45 (10 male, 35 female), age 22 ± 5 years), completed a previously developed hydration knowledge, attitudes, and practices questionnaire. The instrument consisted of 17 knowledge items (true/false statements), 17 attitude items (5-point Likert scale; strongly agree to strongly disagree), and 17 practice items (yes/no statements). All participants were given a total score for each section which was quantified by summing the total number of correctly answered questions from all three sections. The minimum score for all three sections was zero while the maximum score was 17. After screening data for normality, Spearman’s correlations were performed to compare hydration knowledge, attitudes, and practices. RESULTS: The mean knowledge, attitude, and practice scores for all participants were 13 ± 2, 11 ± 2, and 11 ± 2, respectively. Significant positive correlations were found between knowledge and attitude towards hydration (rs = .622; p < .001) and between knowledge and hydration practices (rs = .540; p < .001). There was no significant correlation between attitude towards hydration and hydration practices. CONCLUSION: The positive correlations between knowledge and attitude towards hydration and knowledge and hydration practices indicate the importance of knowledge of hydration in recreationally active college students. Further research should compare knowledge, attitudes, and practices with measured hydration status.

Nurses Knowledge and Practices Regarding Aseptic Technique Applied with Burn Patients at Teaching Hospitals in Mosul City

Background: Burns is one of the most serious injuries to mankind, considering the difficulty of treating a burn injury.Aims of the study: this study aimed to assess nurses' knowledge and practices regarding aseptic technique applied to burn patients at Teaching Hospitals in Mosul City.Methodology: Descriptive design selected for the assessment of nurses' knowledge and practices regarding aseptic technique applied to burn patients. The period of this study was in the 1\ June \ 2020 to 15 \ January \ 2021. A purposive sample for this study choice (60) nurses who agree to participate in the study. The tool was constructed, and it is composed of the three-part represents the demographic variables, assess the knowledge of nurses, and practices to an applied aseptic technique in managing patients with burns. The answer to the questions in part two is symbolized as (0) for the incorrect answer and (1) for the correct answer. While practices items were: (3) always, (2) for some time, and (1) for never. Performed descriptive statistics and inferential statistical methods were by SPSS (Version 25) by using the data significant at P. value ≤ 0.05.Results: The results represented a higher percentage of age group (26-30) years was 41.7%, the majority of gender was 51.7% males in the study. Most certificates were secondary school nursing. The years of experience between (1-5 years), the nurses have inadequate knowledge and practiced aseptic technique for managing burn patients.Conclusion: The majorities of nurses have insufficient knowledge and used aseptic technique at an inadequate level in practice. The study discovered a significant relationship between nurses' knowledge and practices with their age.Recommendations: To reduce mortality and morbidity, burn patients must be managed using aseptic technique, which necessitates training and adequate facilities

Evaluation of a Multisite Safe Infant Sleep Education and Crib Distribution Program.

Rates of sleep-related infant deaths have plateaued in the past few decades despite ongoing infant sleep practice recommendations to reduce risk of sleep-related infant deaths by the American Academy of Pediatrics. The state department of public health trained facilitators at 28 sites across the state to facilitate a group safe sleep educational program. A prospective, matched pre- and post-test cohort design with follow-up was used to evaluate changes in self-reported knowledge, intentions, and practices. The final sample included 615 matched pre- and post-test surveys, and 66 matched follow-up surveys. The proportion of correct responses on all knowledge and intended practice items increased significantly from pre- to post-test. When asked where their babies would have slept if they had not received the portable crib, 66.1% of participants planned to use a recommended sleep location (e.g., crib or bassinet). At post-test, 62.3% planned to change something about their infant’s sleep based on what they learned. At follow-up, knowledge was maintained for all but two items and practices and for half of practice items. The results suggest that participating in the education program was associated with increased knowledge and intended adherence, but that these changes were not maintained at follow-up. These results are in line with the research literature that finds a difference in intentions and actual practices after the baby is born.

A Cross-cultural Assessment of Knowledge, Attitude, and Practice on COVID-19 among People of Afghanistan, Iran, and Turkey

Objectives: The success or failure of global and national efforts to combat the COVID-19 pandemic depends on public knowledge, attitude, and practice. Iran, Afghanistan, and Turkey are among the most affected countries in which they have approximately similar socio-cultural structures. This is an online questionnaire-based cross-sectional study to assess the knowledge, attitude, and practice levels toward the COVID-19 pandemic among the adult population of these nationalities. Methods: A total of 2736 individuals including 1080 from Turkey, 1025 from Iran, and 631 from Afghanistan responded to the questionnaire. The data was collected online through a survey using the Google form and Porsall platforms. In addition to demographic characteristics, the questionnaire consists of three main sections including items of awareness, attitude, and practice of the participants about COVID-19 using four Likert scale questions. Descriptive statistics were used to estimates the proportions of items. One-way analysis of variance (ANOVA) and independent T-test was used to analyze the difference between KAP scores among sociodemographic variables and between countries. All analyses were done with the 95% confidence level and the significant level was defined as p-value < 0.05. Results: Overall KAP scores were over 3 out of 4 among Turkey, Iran, and Afghanistan respectively. Despite no differences between subpopulations in each country, the overall attitude and practice score of the Afghan population was significantly lower than Turkish and Iranian populations (P-value<0.05). Conclusion: In spite of the high level of knowledge, positive attitude, and acceptable practice in all populations understudy, a low-risk perception in a considerable part of the population was discerned. J Microbiol Infect Dis 2021; 11(2):58-65.

Pediatric Project ECHO®: A Virtual Community of Practice to Improve Palliative Care Knowledge and Self-Efficacy among Interprofessional Health Care Providers

Background: Health care providers (HCPs) require ongoing training and mentorship to fully appreciate the palliative care needs of children. Project ECHO® (Extension for Community Healthcare Outcomes) is a model for delivering technology-enabled interprofessional education and cultivating a community of practice among HCPs who care for children with life-limiting illness.Objectives: To develop, implement, and evaluate the Project ECHO model within the pediatric palliative care (PPC) context. Specific objectives were to evaluate (1) participation levels, (2) program acceptability, (3) HCP knowledge changes, (4) HCP self-efficacy changes, and (5) perceived practice changes after six months.Intervention: An interprofessional PPC curriculum was informed by a needs assessment. The curriculum was delivered through monthly virtual 90-minute TeleECHO sessions (didactic presentation and case-based learning) from January 2018 to December 2019. The program was freely available to all HCPs wishing to participate.Design: A mixed-methods design with repeat measures was used. Surveys were distributed at baseline and six months to assess outcomes using 7-point Likert scales. Descriptive and inferential statistical analyses were conducted. The study was approved by the Research Ethics Board at the Hospital for Sick Children.Results: Twenty-four TeleECHO sessions were completed with a mean of 32 ± 12.5 attendees. Acceptability scores (n = 43) ranged from 5.1 ± 1.1 to 6.5 ± 0.6. HCPs reported improvements in knowledge and self-efficacy across most topics (11 out of 12) and skills (8 out of 10) with demonstrated statistical significance (p < 0.05). Most participants reported positive practice impacts, including enhanced ability to provide PPC in their practice.Conclusion: Project ECHO is a feasible and impactful model for fostering a virtual PPC-focused community of practice among interprofessional HCPs.

Estimation of Iranian Natural Gas Demand Function Using ARDL Estimation Method

Based on its advantages and providing a big part of total energy in the country, natural gas lies in a prominent place among other energy sources. Making cognition and accurate identification of practical elements on the volume of periodic (short and long) demands on natural gas can help us outline suitable plans and policies related to energy. By this view, practical items on natural gas demands had been evaluated. The ARDL pattern with distributed interruptions and ECM model was employed to investigate the function of demands on natural gas during the years from 1976 to 2013. The result proved all coefficients of variables in short and long periods. The natural gas price ratio confirms a contrary relation between natural gas demand and its price in the short term. This ratio in the long-term shows a direct connection between them. Related results to the electricity price ratio show that the electricity price variable has the most positive effect on natural gas demands . Related results show that natural gas's long-term price and income strain are more than short-term ones. Also, results show that natural gas in short periods is a non-strained and necessary commodity. Being non-strained in the short-term results in a lack of efficiency of price policies. So, releasing the price of natural gas can prevent unnecessary consumption of this valuable fuel. Price strain of natural gas in long spans proves that natural gas is a complete strain commodity. This fact is based on why there is some replacement for natural gas, such as electricity and gasoline, for long periods. The minus behind income strain shows that natural gas in the long-term is as low stuff. Intersecting the price of electricity in short and long-term investigations is positive and shows a substitutional relation between electricity and natural gas. The negative intersecting strain of price of kerosene shows that natural gas and kerosene in both the short and long-term are complementary. Also, the gasoline price ratio confirms the complementary relationship in the short-term and substitutional relation in the long-term between natural gas and gasoline.

Knowledge, Attitude, Practices and Obstacles to Provide Urinary incontinence Care among Nurses

Purpose: Nurses are personalities who stand with patients at all times to listen and solve their problems. Excellent knowledge, good practices and positive attitude of nurses proves very effective for improving patients with urinary incontinence in a mannered way. The study objective was, (a) evaluate the knowledge, attitudes and practices among nurses of urinary incontinence, (b) reveal the relationship between knowledge, attitudes and demographic characteristics and (c) evaluate obstacles faced by nurses during urinary incontinence care.&#x0D; Methodology: A cross-sectional study was accompanied in a government tertiary care hospital in Lahore, Pakistan. To analysis the variables statistical packages for social sciences version 25 was used. Pearson correlation test was used to correlate the knowledge, attitude and practices regarding urinary incontinence. Less than P&gt;0.05 is significant.&#x0D; Findings: 164 nurses contributed in the studies and 157 completed and return the survey questioner, with return rate of 95.7%. Of those, 117(74.5%) were female nurses and 40(25.5%) were male nurses. There is a significant correlation found between knowledge with attitude items 0.046 and knowledge with practice items 0.039. The study respondents have good knowledge, positive attitude but wrong practices regarding urinary incontinence.&#x0D; Unique contribution to theory, practice and policy: It is concluded that Nurses have good knowledge, positive attitude but wrong practices that require special training or workshops to managing and treating incontinence more efficiently. This helps to bring significant improvement in urinary incontinence care and helps to lower the heath care cost. Such clinical guidelines need to be made within the organizations to manage a significant proportion of patients with urinary incontinence.&#x0D; Keywords: Knowledge, Attitude, Practices, Obstacles, Urinary incontinence, Nurses

Relationship of Self-Efficacy with Breastfeeding Practices among Primiparous Mothers

Provision of breast milk is the most effective way to ensure baby's health and safety. Breast milk has nutritional and non-nutritional benefits both for the health of the child and the mother. WHO recommends exclusive breastfeeding for up to six months, continued for up to two years. Breastfeeding Self-Efficacy is the most powerful factor that can influence the process of breastfeeding and the success of breastfeeding. The purpose of this study was to identify the relationship between self-efficacy and breastfeeding practices among primiparous mothers. The research was a cross-sectional study. The population in this study was mothers who had given birth to a first live baby at the Widuri Primary Clinic. The sample size in this study was 40 primiparous mothers recruited with the total sampling method. Data were collected using the Breastfeeding Self Efficacy (BSES) questionnaire which contains 25 questions about the breastfeeding self-efficacy of the mothers and observation of breastfeeding practices that refer to 16 breastfeeding practice items. Data analysis was used univariate and bivariate analysis. The results showed that there was no relationship between self-efficacy and breastfeeding practice (p-value = 0.215). There is no relationship between self-efficacy and breastfeeding practice.

Current Practices Among Speech-Language Pathologists for Mild Traumatic Brain Injury: A Mixed-Methods Modified Delphi Approach.

Purpose The study purpose was to capture the clinical practice patterns of speech-language pathologists (SLPs) treating mild traumatic brain injury (mTBI; concussion). Study aims were to (a) characterize expert SLP practice patterns for the management of mTBI and (b) use qualitative content analysis to explore areas of quantitative variability within participants' responses. Method Using a modified Delphi approach, SLPs completed an online survey, with Round 1 responses shaping questions for Round 2. Round 2 results were analyzed using a concurrent partially mixed-methods approach with quantitative and qualitative items. Quantitative consensus agreement levels were set prestudy at 75% agreement or higher. Topic-level items that did not reach consensus were analyzed using qualitative content analysis. Participants SLPs engaging in a specialty mTBI-SLP networking group were invited to participate. Round 1 had nine participants (United States: 4, Canada: 5). Round 2 had 18 participants (United States: 12, Canada: 6), with a mean of 15.7 years of experience in mTBI (range: 3-33) and a mean of 7.6 clients with mTBI seen weekly (range: 1-25). Results Nearly all topic-level practice items met quantitative consensus (42/45). Consensus areas included using conceptual frameworks, interprofessional teaming, assessment and intervention practices, goal setting, and outcomes. Functional, collaborative, and client-centered care anchored clinical practice. Areas lacking consensus included SLP roles in mTBI mental and somatic health symptoms, specific measurement tools, and intervention dosages. Qualitative themes that emerged included limited interprofessional awareness for the role of SLPs in mTBI and challenges in measurement selection. Conclusions Study aims were met with clear consensus on clinical patterns implemented by SLPs specializing in mTBI. Results will inform both current clinical practices and future practice guidelines. High-level guidance and advocacy are needed to clarify SLP practice concerns and advance interprofessional education. Future work should address identified gaps, including targeted assessment tools and consensus on intervention methods.

Occupational therapy for adults with intellectual disabilities and sensory processing challenges: a Delphi study exploring practice within acute assessment and treatment units

Purpose Lack of research means guidance regarding the most effective sensory interventions for adults with intellectual disabilities is limited. Preliminary consensus evidence was created by gathering experienced occupational therapists’ views on practice. The purpose of this study was to establish important elements of practice when using sensory integration-informed approaches on assessment and treatment units. Design/methodology/approach A modified Delphi process was used to gather, explore and synthesise the views of 13 occupational therapists. Data was collected via online surveys and included quantitative importance ratings and qualitative comments. Findings An experienced panel was in strong agreement regarding many elements of practice they felt were important for use in this setting, and a list of important practice items was created. Two themes were identified: “Complexity” and “Pragmatism vs. Ideal World.” The themes highlight challenges to practice in this area and the complex clinical reasoning used to overcome these. Research limitations/implications Participants disagreed about the level of importance of a substantial number of items, therefore items that did not reach consensus may still be important. Practical implications This study indicates potentially helpful clinical tools, facilities and training and identifies support needed for occupational therapists working in these settings. Originality/value This study contributes to the body of knowledge regarding how occupational therapists do and could work with people with intellectual disabilities and sensory integration difficulties. Although this study takes a UK and Ireland perspective, similar agendas regarding care and support for those with intellectual disabilities internationally mean findings are relevant more widely.

A head above the rest: use of prosected specimens increases practical exam performance for Head and Neck anatomy

INTRODUCTION/OBJECTIVE: Kansas City University has historically used student-led dissections for anatomy education in the first year medical curriculum. In academic year (AY) 2019-20, prosected cadaver specimens were incorporated in the ‘head and neck’ component of the Neuroendocrine (NE) course. Literature addressing the use of prosected cadavers yields identical student outcomes when assessing larger structures like the extremities as compared to student-led dissections, however, a single report indicates that in areas with exceedingly small and/or complex dissections, such as the foot, using prosected specimens improves student outcomes. The aim of this study was to evaluate the impact of prosected specimens on student performance on laboratory practical exams specific to head and neck content. MATERIALS/METHODS: In AY2019-20, prosected cadavers were prepared by members of the Anatomy department prior to the start of the NE course. The number of anatomy lab sessions and structure list remained identical between the AY2018-19 and AY2019-20 cohorts. A 50-point laboratory practical exam was administered to each cohort and common assessment items (n=21) were included. Retrospective data sets were obtained for student-led dissection outcomes (SDO, n=278) from AY2018-19, and prosected specimen outcomes (PSO, n=280) from AY19-20. Common assessment items among the two cohorts were tabulated and bimodal statistics were applied including the Mann-Whitney U test, using SPSS. RESULTS: Student outcomes of mean scores on all common tags was greater in the PSO cohort (0.83 +/- 0.005) as compared to SDO performance (0.760 +/- 0.005) (P<0.000). Twelve tags performed better in the PSO cohort (average, 0.763), while nine tags performed better in the SDO cohort (average, 0.828). Of the 12 PSO tags with improved performance, ten were mapped to deeper anatomical regions, such as the infratemporal fossa and deep neck (PSO, 0.863 +/- 0.008 vs. SDO, 0.675 +/- 0.007). In contrast, eight of the nine SDO tags with improved performance map to superficial dissections areas, such as superficial face (SDO, 0.860 +/- 0.008 vs. PSO, 0.794 +/- 0.008). CONCLUSION: We completed a retrospective, region-specific analysis of assessment outcomes in head and neck laboratory practical exams. Students performed better within the PSO cohort overall, as well as on ten items specific to deep anatomical structures. This study demonstrates the impact of using prosected specimens in teaching head and neck anatomy. SIGNIFICANCE/IMPLICATION: Structures of the head and neck are very delicate and pose a perceived barrier to student success. Using prosected specimens resulted in increased exam performance overall, as well as on assessment items specific to more deeply positioned structures. In contrast, outcomes of student-dissected assessment items were increased when evaluating superficial structures. The improved performance of practical assessment items specific to prosected and deep, versus dissected and superficial, suggests that structure accessibility impacts student outcomes. This indicates that students are better able to use prosection to more successfully locate, identify, and assess deeply positioned structures.

Development and validation of a knowledge, attitude and practice questionnaire of personal use of tranquilizers

BackgroundTranquilizer misuse is insufficiently acknowledged as a public health problem despite its alarming consequences. Instruments to measure psychosocial factors related to tranquilizer misuse are lacking. We aimed to develop and validate a Knowledge, Attitude and Practice questionnaire of tranquilizer misuse by adults in Spain. MethodsThe questionnaire was designed after an extensive literature review and several meetings with experts. We assessed face and content validity, and pilot tested the questionnaire. We examined its reliability by test-retest analysis in a sample of 145 adults. We distributed the questionnaire to 879 individuals, tested the construct validity through Confirmatory Factor Analysis (CFA), measured its overall reliability and determined its acceptability. ResultsThe Item Content Validity Index (I-CVI from 0.78 to 1.00), the Scale Content Validity Index, using the averaging method (S-CVI/Ave = 0.95) and the fact that the modified Kappa statistic for each of the Knowledge, Attitude and Practice items was equal to I-CVI demonstrated the content validity of the questionnaire. The Intra-Class Correlation coefficients for Knowledge and Attitude items were > 0.5, establishing their reliability. The Knowledge and Attitude construct was modeled using CFA and the model showed a good fit, thus establishing its validity. The overall reliability of the construct was revealed by Cronbach՚s alpha values > 0.6. The questionnaire was highly accepted (response rate = 95 % and item non-response ≤ 4%). ConclusionsThe validity of the developed questionnaire was established. Its availability will stimulate the initiation of research on tranquilizer misuse and will consequently help in designing related public health interventions.

The Survey for Memory, Attention, and Reaction Time (SMART): Development and Validation of a Brief Web-Based Measure of Cognition for Older Adults

Introduction: Brief, Web-based, and self-administered cognitive assessments hold promise for early detection of cognitive decline in individuals at risk for dementia. The current study describes the design, implementation, and convergent validity of a fWeb-based cognitive assessment tool, the Survey for Memory, Attention, and Reaction Time (SMART), for older adults. Methods: A community-dwelling sample of older adults (n = 69) was included, classified as cognitively intact (n = 44) or diagnosed with mild cognitive impairment (MCI, n = 25). Participants completed the SMART at home using their computer, tablet, or other Internet-connected device. The SMART consists of 4 face-valid cognitive tasks available in the public domain assessing visual memory, attention/processing speed, and executive functioning. Participants also completed a battery of standardized neuropsychological tests, a cognitive screener, and a daily function questionnaire. Primary SMART outcome measures consisted of subtest completion time (CT); secondary meta-metrics included outcomes indirectly assessed or calculated within the SMART (e.g., click count, total CT, time to complete practice items, and time of day the test was completed). Results: Regarding validity, total SMART CT, which includes time to complete test items, practice items, and directions, had the strongest relationship with global cognition (β = −0.47, p < 0.01). Test item CT was significantly greater for the MCI group (F = 5.20, p = 0.026). Of the SMART tasks, the executive functioning subtests had the strongest relationship with cognitive status as compared to the attention/processing speed and visual memory subtests. The primary outcome measures demonstrated fair to excellent test-retest reliability (intraclass correlation coefficient = 0.50–0.76). Conclusions: This study provides preliminary evidence for the use of the SMART protocol as a feasible, reliable, and valid assessment method to monitor cognitive performance in cognitively intact and MCI older adults.