Significant Changes In Mean Scores Research Articles

Educational intervention based on health action model to promote safe behavior of hospital service workers

BackgroundHospitals are considered to be one of the most hazardous environments to work in, and their service workers are exposed to many serious risks. So The purpose of this study was to investigate the effect of educational intervention based on the Health Action Model to promote the safe behavior of hospital service workers.MethodsIn this quasi-experimental study, 45 workers in each of the control and experimental groups participated. Demographic information and data related to Health Action Model constructs were collected through a questionnaire and a checklist, immediately and three months after the intervention. Cronbach’s alpha coefficients were used to confirm the properties of the tools. Educational intervention accompanied was applied in the form of four training classes. The data were analyzed using SPSS 20 software.ResultsBefore the intervention, there was no significant difference between the two groups in terms of demographics and the study’s main variables. results showed significant changes in mean scores of safe behavior, Attitude, norms, belief, intention, knowledge in the experimental group three months after the intervention (P < 0.001).ConclusionsThe research results show that Health Action Model educational intervention can change workers’ awareness, attitudes, norms, beliefs, and intentions toward unsafe behavior and improve their safety performance.Trial registrationIRCTID: IRCT20160619028529N7.

Non-local syntactic interactions across an NP/DP boundary: Negative concord and wh-movement

The paper reports the results of a syntactic experiment which was aimed at comparing locality conditions imposed on two well-known longdistance syntactic processes: intra-clausal negative concord (licensing of negative pronouns by sentential negation) and wh-movement in matrix constituent questions (placement of interrogative pronouns at the beginning of the clause). Since only the latter non-local interaction nearly always results in overt displacement (while negative pronouns may remain in their base position upon agreeing with the Neg0 head), we hypothesized that sentences exemplifying negative concord should receive higher scores than sentences with wh-movement. Two structural configurations were investigated: the negative pronoun or the interrogative pronoun was (i) either (the head of) the direct object of the verb, (ii) or it was embedded inside a nominal (NP/DP). In addition to sentences with negative concord and wh-movement, our materials also included those without any such long-distance interactions. Thus, we asked 60 native speakers of Russian to judge such sentences (as well as some fillers) on a 7-point Likert scale. The results, somewhat surprisingly, did not bear out our expectations. Encapsulating the Goal of an Agree relationship inside a nominal does not lead to a significant change in mean scores (except for sentences with negative concord), while there is a statistically significant difference between sentences with negative concord on the one hand and other types of sentences (those containing wh-movement and those without any non-local dependencies) on the other. Such a stark contrast between negative concord and wh-movement casts doubt on approaches trying to assimilate them (and eventually aiming to reduce negative concord to Aʹ-movement of negative pronouns to their licensor).

Assessment of Psychological Recovery Using STORI-30

Objective: This study studied the clinical usefulness of recovery instrument, i.e., the Stages of Recovery Instrument (STORI-30) in a recovery-focused residential clinical program, Prevention and Recovery Care (PARC).&#x0D; Design and methods: This retrospective cross-sectional study included patients aged 18-65 who were admitted during the study period (1 March 2018 - 28 February 2019). Study variables, including scores of STORI-30 and the Health of the Nation Outcome Scale (HoNOS) were obtained from the medical records.&#x0D; Results: Sixty-three patients were included and compared to the admission data, more patients were in favourable psychological stages of recovery, i.e., rebuilding and growth. There was a significant change in mean scores of all stages of STORI-30, except awareness stage, showing positive changes in psychological recovery. There were significant correlations between STORI-30 and HoNOS, but it was for only certain items.&#x0D; Conclusion: Our findings suggest that STORI-30 can be a useful tool in clinical practice to measure and monitor psychological recovery. Routine assessment of psychological recovery can supplement standard clinical outcome measures.

Assessment of the Validity of the Sinonasal Outcomes Test-22 in Pituitary Surgery: A Multicenter Prospective Trial.

Sinonasal Outcomes Test-22 (SNOT-22) is used widely as a patient-reported sinonasal quality-of-life (QOL) instrument for endoscopic endonasal pituitary surgery. However, it has never been validated in this population. This study explores the psychometric validity of SNOT-22 to determine if it is a valid scale in patients undergoing endoscopic pituitary surgery. Multicenter prospective trial. Adult patients (n=113) with pituitary tumors undergoing endoscopic surgery were enrolled in a multicenter study. Patient-reported QOL was assessed using SNOT-22 and the Anterior Skull Base Nasal Inventory-12. Face validity, internal consistency, responsiveness to clinical change, test-retest reliability, and concurrent validity were determined using standard statistical methods. Internal consistency using Cronbach's alpha at baseline and 2 weeks postoperatively were 0.911 and 0.922, indicating SNOT-22 performed well as a single construct. Mean QOL scores were significantly worse at 2 weeks than baseline (16.4 ± 15.1 vs. 23.1 ± 16.4, P < .001), indicating the scale is responsive to clinical change. However, only 11/22 items demonstrated significant changes in mean scores at 2 weeks. Correlation between scores at 2 and 3 weeks was high, suggesting good test-retest reliability, r(107)=0.75, P < .001. Factor analysis suggests the five-factor solution proposed for the SNOT-22 in rhinosinusitis patients is not valid in pituitary surgery patients. The SNOT-22 is a valid QOL instrument in patients undergoing endoscopic pituitary surgery. However, because it includes 22 items, can be applied only as a single construct, 50% of the items do not demonstrate changes after surgery, and is not as sensitive to change as other scales, shorter instruments developed specifically for this patient population may be preferable. 2 Laryngoscope, 131:E2757-E2763, 2021.

Effects of Peer Education on the Knowledge and Practice Regarding Selected First Aid among Engineering Student's at South Valley University

Background: First aid becomes the essential phase and urgent intervention to carry out by general people about the spot of the accident. Peer education has been recognized as a valuable tool to giving training for under graduates in first aid which is essential as a primary response in emergency cases. Aim: Evaluate the effects of peer education on the knowledge and practice regarding selected first aid among engineering students at south valley university. Methods: A quasi experimental design (pre and posttest) was conducted on 160 students from the 1st to 4th years in the Faculty of Engineering at South Valley University. Two research tools were used in the study: A self-administered questionnaire concerning the socio-demographic characteristics of the studied student, their knowledge about first aid and student’s performance checklist regarding the first aid measures. Results: After the application of peer education there were statistically significant changes in mean scores of all items as well as the overall score of knowledge and practice (P-Value < 0.001). Conclusion: The application of peer education has been effective in achieving substantial changes in the knowledge and practices of students regarding first aid procedures. Recommendation: The research proposed the use of peer education in teaching first aid for students in other colleges as well as students in the school setting

Impact of a Culturally Tailored Education Intervention for African-American and Appalachian Men in Ohio

Men, particularly those of underserved groups, bear a disproportionate cancer burden. Knowledge about cancer and screening is associated with adherence to screening guidelines. However it is possible that a correlation exists between an individual’s education attainment and ability to gain knowledge from health education. Men were recruited from Ohio counties with significant cancer disparities and asked to participate in three education sessions. Measures included a baseline survey collecting demographic information and pre- and post-intervention knowledge assessments about each of the topics. Paired t tests were used to determine whether there were statistically significant changes in mean scores after the intervention. Repeated measures of variance (ANOVA) conducted through generalized linear models (GLM) were used to determine if scores varied significantly by educational attainment. Appalachian men, regardless of level of educational attainment, had significant increases in knowledge for all topics. African American men with at least some college education demonstrated significant increases in knowledge for all three topics, while those with no college education had significant increases for only two topics. College education had a significant effect on scores for one topic among the Appalachian men and all three topics among the African American men. The interaction between change in score and higher educational attainment was significant for only one topic among Appalachian men and no topics among African American men. Higher educational attainment was associated with greater increases in knowledge scores for only one topic among Appalachian men and no topics among African American men. Culturally tailored health educational interventions are a promising approach to reducing disparities in cancer screening and outcomes among men of underserved groups. While all groups demonstrated increases in mean knowledge scores after participating in the educational intervention, there was not a significant association between educational attainment and increases in knowledge scores. Future research is needed to explore additional approaches to delivering health education and increasing the knowledge of men with lower levels of educational attainment.

Abstract PS9-49: Comparison of the quality of life (QOL) of patients with an arm vein port (TIVAD) versus a peripherally inserted central catheter (PICC)

Abstract Introduction: Venous access is a crucial element in systemic therapy delivery. PICCs are usually more easily and quickly inserted. It remains unclear whether cancer patients prefer a port to a PICC. Our study aimed to assess cancer patients’ satisfaction with their venous access device and to compare the QOL of subjects with a PICC to those with a port. Methods: In this prospective cohort study, EORTC QLQ-C30 and a locally developed QOL survey, designed to assess satisfaction with venous access devices, were administered to breast cancer (BC) or colorectal cancer patients up to four times over a 1-year period. Mixed effects models were used controlling for other covariates to assess changes on mean scores at different time points. Results: A total of 101 patients were recruited, 50 (BC, 29) in PICC and 51 (BC, 35) in port group. Survey response rates for months 1 and 3 were, 72% and 48%, respectively. Overall, no significant differences were noted between the two groups in relation to EORTC QOL constructs. Mixed effect model showed that patients with a PICC had significantly lower pain score estimate compared to patients with a port (β= -1.98, 95% CI: -0.92 - -3.05, p&amp;lt;0.001). Conversely, patients with a port had a psychosocial score estimate significantly higher than patients with a PICC (β= 2.18, 95% CI: 0.83 - 3.53, p=0.002). As survey time variable was not significant, there was no change in the mean pain or psychological scores for both devices at 3 months. Results for the QLC-30 survey did not reveal any statistically significant changes in mean scores for the different constructs between the surveys conducted at baseline and 3 months for the devices investigated. At 3 months 66.7% patients with a PICC vs. 33.3% with a port felt they had changed the way they dressed due to their device (OR=4.0, 95% CI:1.2-13.3, p=0.02). 88.2% patients with PICC vs.18.3% with port reported difficulties with showering, bathing or performing personal hygiene activities due to their device (OR=18.3, 95% CI: 3.5-97.1, p&amp;lt;0.0001). 41.7% patients with a PICC vs. 12.5% with a port experienced comments from people about their device (OR=5.0, 95% CI: 1.2-21.5, p=0.02). 45.8% patients with a PICC worried that their device may become infected vs. 8.3% with a port (OR= 9.3, 95% CI: 1.8-48.7, p=0.003). No significant differences were noted between the two group regarding sports, exercise, social activities, or the degree of discomfort in between treatments. The 3-month mean satisfaction score between two groups showed no difference (25.0 ±6.6 vs 25.2 ±5.9, p=0.87). Complications rates were 38% in PICC vs. 41% with a port (p&amp;gt;0.24). Overall, 8% patients with a PICC vs. 12% with a port developed DVT (p=NS). Conclusions: Although patients with a port experience more pain, it had a smaller negative impact on psychosocial scores than the PICC. No significant difference in device satisfaction or complications rates was observed between the two devices. Citation Format: Shahid Ahmed, Brent Burbridge, Lynn Dwernychuk, Ha Le, Tehmina Asif, Hyun Lim. Comparison of the quality of life (QOL) of patients with an arm vein port (TIVAD) versus a peripherally inserted central catheter (PICC) [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS9-49.

Assessment of semantic memory in mild cognitive impairment: The psychometric properties of a novel semantic battery

Semantic memory is stable in healthy older adults but shows decline in mild cognitive impairment (MCI). Current measures of semantic function do not assess multiple aspects of semantic function and/or are time-consuming to administer. Here we report the psychometric properties of a battery to detect semantic impairment that we recently developed and published. Study 1 determined the face validity of the battery; interviews were conducted with five professionals with expertise in MCI and language. Face validity interviews suggested the battery appropriately assesses semantic impairments. Study 2 assessed convergent validity and reliability (inter-rater reliability, test-retest reliability, and internal consistency). Participants included 102 healthy older adults and 60 people with MCI who completed a four-task semantic battery. Results demonstrate that performance on the semantic battery correlates with traditional measures of semantic function, inter-rater reliability and internal consistency was high, and there was no significant change in mean scores between participants’ first and second testing sessions. The present findings suggest that the semantic battery is a reliable and valid assessment of semantic function. It is currently recommended for research use only.

Teaching Crisis Resource Management Skills to Nurses Using Simulation

Education programs teaching crisis resource management (CRM) skills (problem solving, situational awareness, resource utilization, communication, and leadership) have been shown to positively affect learner competence in handling crisis events. As part of an education program, a high-fidelity simulation program was used as a learning intervention to teach these skills to practicing nurses. In this repeated-measures observational study, 11 RNs were evaluated at four time points, measuring the effect of an education program on observed performance of CRM skills. Performance was measured using the Ottawa Global Rating Scale and a checklist tool. Statistically significant changes in mean scores occurred between times one and two, and nonstatistically significant improvement occurred in means overall. This study adds evidence of the effectiveness of high-fidelity simulation education and highlights the need for further research. [J Contin Educ Nurs. 2020;51(6):257-266.].

A pilot study assessing the impact of a polypharmacy mock medication simulation on student adherence and empathy

IntroductionWith non-adherence rates rising among patients, educational activities to prepare future practitioners to be more empathetic and have a more personal understanding of patients' complex medication regimens need to be developed and assessed. The objective of this study was to assess student adherence as well as change in empathy after students immerse themselves in a polypharmacy mock medication simulation. MethodsFirst professional year pharmacy (P1) students were recruited to participate in a pilot polypharmacy simulation consisting of eight prescriptions taken for seven days. Baseline characteristics and empathy (Kiersma-Chen Empathy Scale [KCES]) were assessed in pre-surveys, and student medication adherence, empathy (KCES), and insight into activity were assessed in post-surveys. ResultsThere was not a statistically significant change in the total mean empathy score between pre- and post-KCES (83 vs. 82, p = 1.0). One KCES question, “I will not allow myself to be influenced by someone's feeling when determining the best treatment,” produced a significant change in mean score (4.77 vs. 4.10, p = 0.02). The average percentage of late and missed doses as self-reported by students, was 5.63% and 5.04%, respectively. Two themes emerged regarding student perception of the experience: improved patient counseling regarding adherence and improved empathy and patient perspective on medication regimen complexity. ConclusionsDespite a lack of significant change in KCES after participating in the mock medication regimen, qualitative analysis revealed students believed the experience improved their patient counseling skills regarding adherence and further developed their empathy and patient perspective regarding medication regimen complexity.

The Impact of Collaborative Testing in Graduate Nursing Education.

Collaborative testing is an educational strategy that allows students to work in teams when completing an examination. Twenty-eight family nurse practitioner students took four course examinations individually and collaboratively. Five comprehensive questions were included on the fourth examination. A survey was administered at the end of the course, with permission. All collaborative test scores were higher than the traditional test scores (traditional mean range = 80.78 [8.53] to 84.07 [7.41], collaborative mean range = 93.54 [3.77] to 94.07 [2.80], all p values < .001). Students did not demonstrate significant changes in mean scores for cumulative content on test four. Directed content analysis revealed four themes: Enhanced Understanding of Content, Collaboration With Classmates, Socialization, and Improved Grades. In graduate nursing education, collaborative testing may be an effective strategy to improve teamwork and communication skills, enrich relationships, and enhance critical thinking. [J Nurs Educ. 2019;58(6):357-359.].

P003 APPLYING THE TRANSITION READINESS ASSESSMENT QUESTIONNAIRE TO AN UNDERSERVED ADULT INFLAMMATORY BOWEL DISEASE POPULATION

The Transition Readiness Assessment Questionnaire (TRAQ) is a 20-item, 5-domain, validated measure of preparedness for youths with chronic illnesses to transition into adult clinics. Each question is graded on a 1-5 scale, with higher scores indicating greater skill mastery. Studies of the TRAQ in pediatric inflammatory bowel disease (IBD) patients have suggested a score of 4.5 as the threshold for readiness for adult clinics and have furthermore highlighted the impact of language, race, and socioeconomic status on successful transitions. We hypothesized that the TRAQ can similarly be used to identify those who require additional education in healthcare engagement among socioeconomically-disadvantaged adult patients with IBD. As a part of routine clinical care, the TRAQ was administered to adults with IBD presenting to Bellevue Hospital, an academic public hospital in New York City. The written survey was offered in English, Chinese, or Spanish, or was read with a phone interpreter to patients who preferred another language. In a subset of patients, a second TRAQ was administered 6 months after the initial evaluation to assess for differences in patients’ understanding and behavior over time. Demographic and clinical data were extracted from electronic medical records. Two-tailed, non-parametric t-tests were used to asses for differences between groups, with a threshold of p<0.05 set for statistical significance. Missing data or questions marked as “not applicable” by study subjects were omitted from analysis and denominators were lowered accordingly. Sixty-five patients (63% male) completed the TRAQ survey (68% English, 15% Chinese and 17% Spanish) and scored an average of 4.37. The highest scoring domain was ‘Managing daily activities’ (MDA; 4.59), while the lowest was ‘Tracking health issues’ (THI; 3.879). Overall and for each domain, there was a lower average TRAQ score for non-English speaking patients compared to English speakers that was not statistically significant. Thirty-three individuals completed a second TRAQ survey in 6 months, with no significant change in mean scores. However, when these patients were stratified based on language, we found that scores of English speakers did improve (4.42 vs 4.67, p=0.01) while scores of Non-English speakers did not (4.11 vs 4.09, p=0.94). As expected, most adult IBD patients were successful in managing activities of daily living. However, almost half of the surveyed population did not reach the threshold of healthcare utilization mastery set for pediatric patients. While TRAQ scores improved in a subset of individuals, targeted education in “tracking health issues” with special attention to non-English speaking patients may be required to improve successful utilization of healthcare services in an underserved adult IBD population.

603 Clinical trial with natural extracts from Lycium chinense for eugonadal men with late-onset hypogonadism-related symptoms: placebo-control, double-blind, randomized study

The purpose of this study was to evaluate the efficacy and safety of natural extracts from Lycium chinense on eugonadal men with late-onset hypogonadism(LOH)-related symptoms. Seventy-eight eugonadal men over 40 years of age with LOH-related symptoms were included in this study, and divided into two groups: treatment group and placebo-control group. Treatment was given orally to these patients three times daily for two months. Laboratory and endocrinological profiles were reviewed, and LOH symptoms were judged by means of several health assessment instruments such as the Aging Males’ Symptoms (AMS) scale. All patients represented no significant differences in vital sign, liver and kidney profile, urinalysis. In total score of AMS scale, placebo group had no significant change in mean score after treatment, but treatment group had decreased their score about 2.63 at 4 weeks and 2.69 at 8 weeks. (p=0.019, 0.038). In AMS subscale analysis, there were no significant differences in psychological and somatic subscale but significant decreased about 1.07 score at sexual subscale in treatment group. Lipid profiles were no definite changes between two groups and also in pre-treatment and post-treatment. PSA and serum testosterone level changes shows no significant difference between two groups.

Intervention effects on communication skills and sensory regulation on children with ASD

ABSTRACTThis article evaluates the effects of an individualized intervention for children with Autism Spectrum Disorder (ASD) based on the principles of the DIR/FloortimeTM model, which encourages caregivers to follow their child’s emotions and interests and to interact with them in a natural social environment to help children develop social communication skills. Twenty-five preschool children with ASD, ranging from 3 to 6 years of age, received care from an interdisciplinary team specializing in ASD intervention, which included psychologists, speech and language pathologists, and occupational therapists. The children received supportive care from these professionals based on their individual and family needs and concerns. A pre-experimental research design, pre-tests (1)- post-test (2) was given. The effects of the intervention were evaluated using the “Assessment Scale of Children with Autism Spectrum Disorder,” which was completed by the parents before and after the intervention. Children made significant changes in mean scores within the areas of “Social Communication” and “Sensory Processing.” The results revealed that this intervention, focused on the development of relationships and interaction through play, had positive effects on the development of communication and sensory regulation with children with ASD at early ages.

Outcomes in a group of 7–8-year-old children in a developmental-based intervention in autism spectrum disorder

Healthy parent-child interaction is essential for child development. Parents play a central role in the acquisition of social and communicative skills, both in typical and atypical children. Increased support for parent-mediated intervention in autism has been demonstrated. Developmental approaches for ASD are based in establishing strong interpersonal relationships through natural play to foster developmental capacities. This work reports outcomes from an intensive approach based on a developmental, individual difference, home-based intervention program with children with severe ASD. Parents were trained with DIR approach by a specialist. An individual intensive rehabilitation program was set up for each child and implemented at school, home and rehabilitation center. The intervention program also focused on semi-structured activities to promote problem solving, and meliorate sensory dysfunction. Standardized scales were administered pre– and post-intervention, with ABC). The Childhood Autism Rating Scale (CARS), the Social Communication Questionnaire (SCQ) and Vineland Adaptive Behaviours Scales.ResultsBefore initiating the intervention all children presented severe difficulties in communication, social interaction, lack of language, and gestures of communication, auto– and hetero-aggressive behaviors. After 6 months, children showed significant changes in mean scores for emotional functioning, communication, and daily living skills and diminution of aggressive behaviors. The present results provide strong support for the effectiveness of a developmental-based intervention, specifically in the domains of social skills behavior, social responsiveness, in a group of children with severe autism. These results highlight the positive effects of a rehabilitative approach that works in harmony with the family, school and professional team.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Impact of intravesical onabotulinumtoxinA on sexual function in women with OAB.

Urgency urinary incontinence (UUI), and the symptoms of overactive bladder (OAB) have a negative impact on female sexual function. The aim of this study was to investigate the effect of intravesical onabotulinumtoxinA (Botox) injection on sexual function in women with OAB, using the multi domain Female Sexual Function Index (FSFI) questionnaire. Sixty-eight sexually active women with idiopathic OAB with at least one episode of UUI and ≥8 micturitions per 24 h were recruited. Patients completed the FSFI questionnaire before and 12 weeks after treatment with intravesical onabotulinumtoxinA injections. Baseline scores were compared with a control group of age-matched healthy women. Fifty-six women completed the study. At baseline OAB patients reported decreased quality of sexual function in all domains measured with FSFI, in comparison to healthy women (median 21.8 vs. 26.3, P < 0.001). Over 90% of participants reported clinically relevant improvements in sexual function, with statistically significant changes in mean scores in all six domains. Intravesical Botox injections provide improvement in sexual function in women with OAB. Neurourol. Urodynam. 9999:XX-XX, 2016. © 2016 Wiley Periodicals, Inc.

Critical Transitions: A Mixed Methods Examination of Sleep from Inpatient Alcohol Rehabilitation Treatment to the Community.

AimsThis prospective, repeated measures study utilized a convergent parallel mixed methods approach to assess sleep experiences among individuals who were alcohol-dependent undergoing inpatient detoxification and treatment at a clinical research facility across the transition periods associated with the rehabilitation process: the initial adjustment to becoming an inpatient and the transition from inpatient to outpatient status.MethodsThis study included individual semi-structured interviews and quantitative measures relating to psychological distress, sleep quality, daytime sleepiness, and sleep-related beliefs and behavior (n = 33; 66.7% male). Interviews were conducted and questionnaires were administered within one week of participants’ scheduled discharge date and again four to six weeks post-discharge when they returned for a follow-up visit (or via phone).ResultsParticipants self-reported significant sleep disturbances at both study time points. Of those participants with valid data at both time points (n = 28), there were no significant changes in mean scores from pre- to post-discharge with the exception of self-efficacy for sleep (SE-S) being significantly higher post-discharge. Preliminary qualitative findings suggested differences between those with ongoing sleep disturbances, those whose sleep disturbances had resolved, and those with no sleep disturbances at either time point.ConclusionsThis analysis highlights individual variation in sleep throughout the process of inpatient treatment and transition to outpatient aftercare in individuals with alcohol dependence. Collecting quantitative and qualitative data concurrently and combining emerging themes from qualitative data with quantitative analyses allowed for a more thorough examination of this relatively novel area of research and provided information that can be utilized to inform future behavioral sleep interventions.

Flip-flop footwear with a moulded foot-bed for the treatment of foot pain: A randomised controlled trial

Flip-flop footwear with a moulded foot-bed for the treatment of foot pain: A randomised controlled trial

Home-based DIR/Floortime™ Intervention Program for Preschool Children with Autism Spectrum Disorders: Preliminary Findings

ABSTRACTImproving parent–child interaction and play are important outcomes for children with autism spectrum disorder (ASD). Play is the primary occupation of children. In this pilot study conducted in Taiwan, we investigated the effects of the developmental, individual difference, and relationship-based (DIR)/Floortime™ home-based intervention program on social interaction and adaptive functioning of children with ASD. The participants were 11 children with ASD, ages from 45–69 months, and their mothers. Mothers were instructed the principles of the approach by an occupational therapist. All 11 children and their mothers completed the 10-week home-based intervention program, undergoing an average of 109.7 hr of intervention. Children made significant changes in mean scores for emotional functioning, communication, and daily living skills. Moreover, the mothers perceived positive changes in their parent-child interactions. The findings of this pilot study contribute to knowledge regarding the effects of home-based DIR/Floortime™ intervention program on increasing the social interaction and adaptive behaviors of children with ASD in Taiwan.

Burnout in Pediatric Residents Over a 2-Year Period: A Longitudinal Study

ObjectiveBurnout is a work-related syndrome characterized by emotional exhaustion (EE), depersonalization (DP), and lack of personal accomplishment (PA). We hypothesized that the transition into an environment of high physical, intellectual, and emotional demands of the medical profession would lead to an increase in the prevalence of burnout in pediatric residents, which would remain high throughout residency. MethodsThe Maslach Burnout Inventory (MBI) was administered to pediatric residents at Lucile Packard Children's Hospital 6 times between February 2010 and February 2012. These times corresponded to the start of residency, mid-intern year, end-intern year, mid-junior year, end-junior year, and mid-senior year. ResultsMean values of burnout components changed significantly between the start of residency and mid-intern year. EE increased from 15.8 to 24.5 (P < .001), DP increased from 4.5 to 9.2 (P < .001), and PA decreased from 40.2 to 38.3 (P = .04). Similarly, the prevalence of burnout increased from 17% to 46% (P = .012), or 2% to 24% (P = .002) using more restrictive criteria, between the start of residency and mid-intern year. Significant changes in mean scores or prevalence of burnout were not found between any other consecutive times throughout residency. ConclusionsThis longitudinal study documented a significant increase in the components of burnout among pediatric residents between the start of residency and mid-intern year, which persisted through the PGY2 and PGY3 years. Further studies are warranted to identify correlates of resident burnout and to develop preventative strategies to reduce its occurrence.