Standardized Assessment Instruments Research Articles

Parental Assessment of Postsurgical Pain in Infants at Home Using Artificial Intelligence-Enabled and Observer-Based Tools: Construct Validity and Clinical Utility Evaluation Study.

Pain assessment in the infant population is challenging owing to their inability to verbalize and hence self-report pain. Currently, there is a paucity of data on how parents identify and manage this pain at home using standardized pain assessment tools. This study aimed to explore parents' assessment and intervention of pain in their infants at home following same-day surgery, using standardized pain assessment tools. This prospective study initially recruited 109 infant boys undergoing circumcision (same-day surgery). To assess pain at home over 3 days after surgery, parents using iOS devices were assigned to use the PainChek Infant tool, which is a point-of-care artificial intelligence-enabled tool, while parents using Android devices were assigned to use the Observer-Administered Visual Analog Scale (ObsVAS) tool. Chi-square analysis compared the intervention undertaken and pain presence. Generalized estimating equations were used to evaluate outcomes related to construct validity and clinical utility. Receiver operating characteristic analysis assessed pain score cutoffs in relation to the intervention used. A total of 69 parents completed postsurgery pain assessments at home and returned their pain diaries. Of these 69 parents, 24 used ObsVAS and 45 used PainChek Infant. Feeding alone and feeding with medication were the most common pain interventions. Pain presence over time reduced. In the presence of pain, an intervention was likely to be administered (χ22=21.4; P<.001), with a medicinal intervention being 12.6 (95% CI 4.3-37.0; P<.001) times more likely and a nonmedicinal intervention being 5.2 (95% CI 1.8-14.6; P=.002) times more likely than no intervention. In the presence of intervention, score cutoff values were ≥2 for PainChek Infant and ≥20 for ObsVAS. A significant effect between the use of the pain instrument (χ21=7.2, P=.007) and intervention (χ22=43.4, P<.001) was found, supporting the construct validity of both instruments. Standardized pain scores were the highest when a medicinal intervention was undertaken (estimated marginal mean [EMM]=34.2%), followed by a nonmedicinal intervention (EMM=23.5%) and no intervention (EMM=11.2%). Similar trends were seen for both pain instruments. Pain was reduced in 94.5% (224/237) of assessments where parents undertook an intervention. In 75.1% (178/237) of assessments indicative of pain, the score changed from pain to no pain, with PainChek Infant assessments more likely to report this change (odds ratio 4.1, 95% CI 1.4-12.3) compared with ObsVAS assessments. The use of standardized pain assessment instruments by parents at home to assess pain in their infants can inform their decision-making regarding pain identification and management, including determining the effectiveness of the chosen intervention. In addition to the construct validity and clinical utility of PainChek Infant and ObsVAS in this setting, feeding alone and a combination of feeding with medication use were the key pain intervention strategies used by parents.

Depression, posttraumatic stress of migrants and refugees in Germany – a cross -sectional study

Abstract Background Research shows associations between migration status and mental health conditions (e.g., depression). Yet, few representative data on migrants’ health are available. We aim to provide representative data on depression, and posttraumatic stress (PTSD) among migrants in a representative sample in Northwestern Germany. Methods We conducted a longitudinal study with two measurement points using a standardized assessment instrument in a representative sample of 18-65 years olds in Germany. Here we report on the baseline data. To assess socio-demographic characteristics (gender, age, marital status employment status, household income and migration status) we developed a standardized instrument. To assess depression, we used the Patient Health Questionnaire (PHQ-9), to assess PTSD we used the Harvard Trauma Questionnaire (HTQ-5). To investigate associations of migrant status with depression, and PTSD we estimated linear regression models. Results The analytical sample for this study includes n = 437 (male: n = 181, female: n = 256) individuals (age: M = 44.48, range: 18-65). In the total sample 15.1% (n = 66) showed symptoms of depression, and 6.5% showed PTSD (n = 26). Depression was more frequent in migrants than in non-migrants (22.1% vs. 13.4%, p = 0.043; 66.7). Crude linear regression models showed statistically significant associations between migration status and depression (B = 1.998, 95% CI: 0.831; 3.165, p &amp;lt; 0.001), and PTSD (B = 0.204, 95% CI: 0.085; 0.333, p = 0.002). However, models adjusted for gender, age, marital status employment status, household income and migration status suggested significant associations between migration status and PTSD (B = 0.136, 95% CI: 0.009; 0.263, p = 0.036), but not for depression. Conclusions Longitudinal data are needed to better understand trajectories between mental health conditions, PTSD and migration status. Living situation after the migration is of critical importance for mental health of migrants.

Older Adult Fall Risk Prediction with Deep Learning and Timed Up and Go (TUG) Test Data.

Falls are a major health hazard for older adults; therefore, in the context of an aging population, predicting the risk of a patient suffering falls in the near future is of great impact for health care systems. Currently, the standard prospective fall risk assessment instrument relies on a set of clinical and functional mobility assessment tools, one of them being the Timed Up and Go (TUG) test. Recently, wearable inertial measurement units (IMUs) have been proposed to capture motion data that would allow for the building of estimates of fall risk. The hypothesis of this study is that the data gathered from IMU readings while the patient is performing the TUG test can be used to build a predictive model that would provide an estimate of the probability of suffering a fall in the near future, i.e., assessing prospective fall risk. This study applies deep learning convolutional neural networks (CNN) and recurrent neural networks (RNN) to build such predictive models based on features extracted from IMU data acquired during TUG test realizations. Data were obtained from a cohort of 106 older adults wearing wireless IMU sensors with sampling frequencies of 100 Hz while performing the TUG test. The dependent variable is a binary variable that is true if the patient suffered a fall in the six-month follow-up period. This variable was used as the output variable for the supervised training and validations of the deep learning architectures and competing machine learning approaches. A hold-out validation process using 75 subjects for training and 31 subjects for testing was repeated one hundred times to obtain robust estimations of model performances At each repetition, 5-fold cross-validation was carried out to select the best model over the training subset. Best results were achieved by a bidirectional long short-term memory (BLSTM), obtaining an accuracy of 0.83 and AUC of 0.73 with good sensitivity and specificity values.

The Effects of a Structured Resiliency Program on Indicators of Burnout in Medical Residents

Because of the well documented burnout and stress experienced by medical residents, the Accreditation Council for Graduate Education (ACGME) has directed training programs to address these issues in their residents. The current study describes a resiliency enhancement program administered to residents from differing residencies. Method: Residents received group-based sessions focusing on awareness of stress reactions, mindfulness, cognitive coping skills and balancing life and work. All sessions were interactive. The training occurred over a 9-month time span. Residents provided informed consent so that data could be collected. The percentage of burnout was calculated based on one indicator (high emotional exhaustion, high depersonalization, or low personal accomplishment using the Maslach Burnout Scale). Standardized assessment instruments were administered at the beginning (September) and the end of the program (May) to assess the impact of the intervention. Residents were in training at a medium-sized academic medical center. They came from urology, internal medicine, emergency medicine and neurology training programs. Eighteen female and 51 male residents participated. Results: Baseline rates of burnout were as follows: urology residents, 89%; internal medicine, 73%; neurology, 50%; emergency medicine, 22%. There was a significant decrease in perceived stress for the overall group following the intervention. Residents who significantly improved on mindfulness measures also showed significant improvement on resiliency, stress, and personal accomplishment scores. Residents who significantly lowered perceived stress also lowered emotional exhaustion, depersonalization, and increased resiliency and compassion satisfaction. Discussion: This study demonstrated that a resiliency enhancement program and data collection after IRB approval is feasible and effective during medical residency. Based on our analysis, mindfulness, and cognitive skills to reduce perceptions of stress seem to be critical components. Future research is necessary to identify elements of the program most relevant to specific residencies.

Use of an electronic wellness instrument in the integrated health and social care of older adults: a group concept mapping study

BackgroundHealth system fragmentation directly contributes to poor health and social outcomes for older adults with multiple chronic conditions and their care partners. Older adults often require support from primary care, multiple specialists, home care, community support services, and other health-care sectors and communication between these providers is unstructured and not standardized. Integrated and interprofessional team-based models of care are a recommended strategy to improve health service delivery to older adults with complex needs. Standardized assessment instruments deployed on digital platforms are considered a necessary component of integrated care. The aim of this study was to develop strategies to leverage an electronic wellness instrument, interRAI Check Up Self Report, to support integrated health and social care for older adults and their care partners in a community in Southern Ontario, Canada.MethodsGroup concept mapping, a participatory mixed-methods approach, was conducted. Participants included older adults, care partners, and representatives from: home care, community support services, specialized geriatric services, primary care, and health informatics. In a series of virtual meetings, participants generated ideas to implement the interRAI Check Up and rated the relative importance of these ideas. Hierarchical cluster analysis was used to map the ideas into clusters of similar statements. Participants reviewed the map to co-create an action plan.ResultsForty-one participants contributed to a cluster map of ten action areas (e.g., engagement of older adults and care partners, instrument’s ease of use, accessibility of the assessment process, person-centred process, training and education for providers, provider coordination, health information integration, health system decision support and quality improvement, and privacy and confidentiality). The health system decision support cluster was rated as the lowest relative importance and the health information integration was cluster rated as the highest relative importance.ConclusionsMany person-, provider-, and system-level factors need to be considered when implementing and using an electronic wellness instrument across health- and social-care providers. These factors are highly relevant to the integration of other standardized instruments into interprofessional team care to ensure a compassionate care approach as technology is introduced.

HOTS-Based Science Learning Outcomes Assessment Instrument for Measuring Elementary School Learning Outcomes

Teachers should develop effective assessment instruments to measure student learning outcomes well. Assessment instruments must also improve students' thinking abilities (HOTS). However, teachers need help compiling assessment instruments based on Revised Bloom's KKO Taxonomy, and the assessment instruments prepared are still LOTS-oriented. So far, research has yet to discuss the preparation of HOTS-based science learning outcomes assessment instruments. Therefore, this research aims to develop a HOTS-oriented assessment instrument for science content. This research is development research with a 4-D model. The subjects of this research were 69 students and involved two expert lecturers/science experts. Data collection in this study used the multiple-choice test method. The data analysis techniques in this research are validity, reliability, distinguishability, level of difficulty, and quality of distractors. The results of the research show that the assessment instrument developed is declared valid, has high reliability (reliable), and the level of difficulty is in the very good category; in terms of different power, it is stated that the instrument has good different power, and the quality of the distractor functions well. The test results show that the HOTS-oriented science learning outcomes assessment instrument is suitable for measuring student learning outcomes. This research implies that continuously using the HOTS standard assessment instrument will improve students' thinking.

Development and validation of the perceived symptom manageability scale among people living with the human immunodeficiency virus

Background“Perceived Symptom Manageability (PSM)” is essential in symptom management among people living with HIV. As a standardized assessment instrument was lacking, we developed a PSM scale for people living with human immunodeficiency virus (PSM-HIV).MethodsData analysis was performed using the sample from HIV-designated medical institutions (N = 540). Psychometric testing, namely reliability and validity, is assessed by unidimensionality, internal consistency, exploratory and confirmatory factor analysis, and structural equation modeling.ResultsThe final version of the PSM- HIV scale contained 15 items. This scale was submitted to a principal components analysis with varimax rotation, and three factors were obtained, explained by a total variance of 63.10%. The three factors were named Cognitive-Behavioral, Affective Interaction, and Self-Attitude. The results show that the scale had high reliability, Cronbach’s α of the scale ranged from 0.71 to 0.92, and the Intraclass Correlation Coefficient was 0.88. The structural equation model supports a factor model with the acceptable fit (χ2/df (CMIN/DF) = 2.50, Root Mean square Residual (RMR) = 0.03, Goodness-of-Fit Index (GFI) = 0.93, Adjusted Goodness of Fit Index (AGFI) = 0.90, Normed Fit Index (NFI) = 0.93, Incremental Fit Index (IFI) = 0.96, Comparative Fit Index (CFI) = 0.96). The average variance extracted was 0.38 ∼ 0.59, and the composite reliability was 0.70 ∼ 0.91, indicating that the convergent validity of the scale is acceptable. Subjects with different stages of the disease reached significance(χ2 = 9.02; df = 2, P<0.05), meaning moderate Known-Groups Comparison Validation.ConclusionsThe PSM-HIV scale is a valid instrument that measures overall attitude and belief about controlling or coping with HIV-relevant symptoms.

An Application of Classical Test Theory for Item Characteristic Analysis of Chemical Literacy Instruments

The science literacy skills of students in Indonesia are very concerning, the cause is that students are not accustomed to working on questions based on science literacy, so it is necessary to have a standardized assessment instrument based on chemical literacy that can measure the level of achievement of scientific identification and interpret science/chemistry learning. This study aimed to describe the characteristics of chemical literacy-based assessment instrument items of reaction rate material with a classical test theory approach. The type of research is descriptive quantitative. The research subjects were 80 class XI MIPA SMA Negeri 4 Takalar students. Data were analyzed using the ITEMAN 4.3 program. Based on the results of the analysis, a reliability coefficient of 0.834 was obtained, the level of favorability of 87% of the items was in the moderate category, and 13% was in the difficult category. In the difference test, as many as 73% of the items are in the very good category, and for the distractor test, 93% of all items have shown distractors that function properly, so it can be concluded that overall the items have high reliability and good item characteristics.

The relationship between stress and the use of humour as a coping mechanism in nurses

The present study focuses on the occupational health of nurses, investigating the relationship between dimensions of occupational burnout and the use of coping mechanisms through humor. To conduct the research, we used standardized assessment instruments to measure dimensions of occupational burnout and investigated how nurses resort to coping mechanisms through humor using the questionnaire method. Our results revealed significant correlations between certain dimensions of burnout and the use of coping mechanisms through humor. Mental detachment was positively associated with heavy use of humor as a coping strategy, indicating that nurses experiencing increased emotional exhaustion tend to turn more often to humor to cope with professional stress. This finding suggests that humour may play an important role in counteracting burnout. This research adds significantly to our understanding of nurses' occupational health and suggests that interventions focused on promoting the adaptive use of humour may be effective in reducing emotional exhaustion in this important profession.

Comprehensive Standardized Assessment for Information Continuity: What Does the Workforce Need

Introduction: Older adults living with frailty and multimorbidity interact with multiple care providers across different health settings increasing the risk for fragmented care and information discontinuity. Information discontinuity results in workforce inefficiencies and adverse health events, including duplication of assessment and diagnostics, medication errors and increased health service use. Standardized assessments potentiate integrated care by communicating consistent measures of health information between health care sectors and providers. InterRAI assessments facilitate integration through promoting a common language and aligning successive assessments across the care continuum.&#x0D; Description: We used a pragmatic case example of a theoretical medically-complex older adult to illustrate effective use of interRAI standardized assessments throughout the health care journey. The interRAI suite of instruments spans across the age continuum, from pediatrics to geriatrics, and is designed to be used across diverse care settings, including community services, primary care, home care, long-term care, acute care, inpatient and community mental health, and palliative services. The case example represents one patient’s assessment findings, derived from standardized assessment instruments, such as the contact assessment, home care assessment and long-term care facility assessment. Automated and embedded risk algorithms are generated as outputs from the assessment, acting as decision support tools to inform care planning for clinical, functional, and social support needs. Process schematics depict potential workflows, where instruments can guide care strategies and facilitate the flow of information between the care team members.&#x0D; Discussion: Integrating elements such as using a common language, standardized assessment items, and embedded decision support algorithms, can support effective communication and collaboration in the care of older adults between clinical settings. Risk algorithms and scales support real-time identification of care issues, with standardized assessment items allowing for changes in health status to be easily recognized. Operationalizing a suite of standardized assessment instruments across the health system offers advantages for the individual including improved continuity of care, as well as for organizations and the system through use of a consistent measurement of health metrics between health providers and sectors, and evaluating health system performance. Successful adoption of comprehensive assessment tools to support integration requires training, stakeholder engagement and time to embed work and care processes into practice.&#x0D; Conclusion: Standardized language and algorithms used in interRAI comprehensive assessments can increase capacity for integration and continuity of care across the full spectrum of health sectors and settings. Findings from this pragmatic case example demonstrate real-world application and utility of standardized assessments to support an integrated workforce.

EVALUATING WAYFINDING INFRASTRUCTURES FOR PEOPLE LIVING WITH DEMENTIA—THE 360 DEGREE MAPS STUDY DENHB

Abstract Recent studies point to the importance of the built environment for the cognitive and social health of community-dwelling people living with dementia. One key aspect is wayfinding infrastructure, especially in urban areas. However, currently there are no clear indicators of wayfaring infrastructure and no standardized assessment instruments. Here, we provide such an instrument with the potential for online digital assessment as the result of the German DenHB-study. Based on an umbrella review and further research, we first developed a questionnaire to evaluate local wayfinding structures which are sectioned in different thematic blocks like general streetscape, signage, public transportation, buildings etc. Second, we conducted a cross-sectional validation study in the urban area of Bremen, Germany using Apple Maps Street View (2022) with a 360-degree viewing angle at more than 3,000 randomly selected geo coordinates within urban districts with a high proportion of older residents (&amp;gt;65 years). The results document supportive as well as inhibiting wayfinding structures from the perspective of people living with dementia and can also form a basis for a later automated digital evaluation of wayfinding structures. Hence, providing easy to obtain new insights helps to support the development of actions to promote the dementia-friendliness of urban living structures.

Predicting 60-Day Mortality in a Home-Care Service: Development of a New Inter-RAI 49-Frailty Index in Patients with Chronic Disease and without a Cancer Diagnosis

ObjectiveFrailty Index (FI) is used to define the level of frailty in various clinical settings. Fifteen- and 26-item FIs have been demonstrated to predict 1-year mortality and intensity of care in home care (HC) and palliative home care (PHC). The objective of this study was to develop a new FI to predict the 60-day risk of death or transition to a PHC service after the initiation of an HC service in patients with chronic disease and without a cancer diagnosis. DesignRetrospective cohort study. Setting and ParticipantsPatients 18 years and older followed in an HC service of a “Frailty Department-Local Palliative Care Network” from January 1, 2017, to October 31, 2021. MethodsA 49-item FI (FI-49) was developed selecting variables within the standardized international Residential Assessment Instrument assessments (interRAI-HC) and compared to existing FIs with 15 and 26 variables. ResultsA total of 2099 patients were included in the study with a median age of 80.0 years (IQR: 72.0-86.0) and a predominantly female population (62.4%). Among these patients, 8% died or were transferred to PHC within the 60-day follow-up. The FI-49 demonstrated a higher ability to predict 60-day mortality (C index 0.8165, 95% CI 0.7848-0.8481) compared to the 26- and 15-item FI. An FI-49 cutoff of 0.33 was also selected to provide clinicians with a more practical approach (C-index of 0.7044, 95% CI 0.6796-0.7292). Conclusion and ImplicationThe FI-49 is a good predictor of short-term mortality or transition to palliative care among older patients referred to an HC service. The automatic calculation of this tool could facilitate more appropriate care planning and the correct allocation of healthcare resources, especially considering the rapid ageing of the population.

App-Based Interventions for Moderate to Severe Depression

Mobile mental health applications (apps) for moderate to severe depression are proliferating, likely owing to their capacity to overcome the limitations of conventional psychotherapy, but research on the potential moderators of treatment efficacy is lacking. To examine the treatment efficacy associated with mobile app interventions for moderate to severe depression and identify the potential moderators associated with better treatment outcomes. PubMed, Embase, and PsycINFO were searched from their inception to January 22, 2023. Only randomized clinical trials evaluating mobile app treatments in adults with moderate to severe depression that published their results in English were included in the analysis. Three independent researchers extracted and assessed relevant studies, their risk of bias, the characteristics of the population and study design, and the components of the intervention program following the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guidelines. A fixed-effects model was used for data analysis, and exploratory post hoc meta-regression and subgroup analyses were also conducted. Data were analyzed from February 16 to March 25, 2023. The main outcome was changes in depression symptom severity from before to after treatment, measured by standardized depression assessment instruments. Secondary outcomes included study-, intervention-, and patient-level factors associated with app efficacy. Of 2128 studies identified, 13 studies evaluating 16 intervention apps with 1470 participants with moderate to severe depression were included in the analysis. The overall pooled effect size of mobile app interventions vs both active and inactive control groups was 0.50 (95% CI, 0.40 to 0.61). Interventions with in-app notifications were associated with significantly lower treatment outcomes (standardized mean difference [SMD], 0.45; 95% CI, 0.29-0.60) than interventions without (SMD, 0.71; 95% CI, 0.54-0.87; P = .02). In addition, app interventions delivered for less than 8 weeks were associated with a significantly greater effect size (SMD, 0.77; 95% CI, 0.59-0.96) than interventions delivered for 8 weeks or longer (SMD, 0.43; 95% CI, 0.30-0.57; P = .004). In this systematic review and meta-analysis, the feasibility and efficacy of mobile app interventions were supported in treating moderate and severe depression, and practical implications were also provided for developing effective app-based interventions in clinical practice.

Test of Validity, Reliability and Relevance of the "ITN 10.3 ITF Test" on the Level of Basic Technical Ability in Forehand and Backhand Groundstrokes for Tennis Players Aged 12 Years and Under

Several skill tests have been developed to assess the level of proficiency in forehand and backhand groundstroke techniques several decades ago, including the International Tennis Number (ITN) 10.3 Test by the ITF. However, the validity, reliability, and suitability of these tests may not necessarily be guaranteed when used to measure proficiency in these two techniques. This research aims to examine the level of validity, reliability, and relevance of the ITN 10.3 Test in relation to the proficiency level of forehand and backhand groundstroke techniques among junior tennis players aged 12 and below in the Special Region of Yogyakarta Province. This study is a quantitative descriptive research using a survey method. Data collection techniques involve tests and measurements. The population in this study consists of junior tennis players in the Special Region of Yogyakarta. The research sample was selected using purposive sampling technique, consisting of 30 male and female junior tennis players aged 12 and below in Yogyakarta. The research instrument uses the "ITN 10.3 Test" to measure the basic technical proficiency of forehand and backhand groundstroke. Validity test data analysis is performed by correlating the best results from the ITN 10.3 Test with the results of half-competition matches using Pearson Product Moment Correlation, reliability test using Pearson Product Moment Correlation analysis technique, and relevance test is analyzed using T-Score scores. The research results show that the validity of the ITN 10.3 Test is -0.976. The test reliability is 0.982, and the test relevance is categorized as moderate, good, and very good at 69.99%. Thus, it can be concluded that the ITN 10.3 ITF Test can be used as a standardized assessment instrument to measure the proficiency level of forehand and backhand groundstroke techniques among junior tennis players aged 12 and below in DIY.

Prevalence and factors associated with depression and anxiety among older adults: A large-scale cross-sectional study in China

BackgroundTo determine the prevalence of depression and anxiety among older adults in China, and explore the associated factors. MethodsThis cross-sectional study recruited participants between October 2022 and December 2022. The sample collection utilized a multi-stage stratified equal probability random sampling method. This study included 8436 older adults who underwent interviews utilizing standardized assessment instruments. The assessment of depressive symptoms employed the Patient Health Questionnaire 9, while the evaluation of anxiety utilized the Generalized Anxiety Disorder 7. Multivariate logistic regression was conducted to determine the odds ratio and 95 % confidence interval (CI). ResultsThe weighted prevalence rates for depression and anxiety were 2.79 % (95 % CI: 2.38 %–3.28 %) and 1.39 % (95 % CI: 1.12 %–1.74 %), respectively. Older adults who were female, widowed, had irregular dietary habits, spent <1 h per day using electronic devices for socializing and entertainment, engaged in >8 h of sedentary behavior per day, and had chronic diseases (cardiovascular disease, cerebrovascular disease, insomnia, and Chronic gastroenteritis) displayed a higher likelihood of encountering symptoms indicative of depression and anxiety. Conversely, older adults living in rural areas and those who walked daily were less prone to experience symptoms of depression and anxiety. ConclusionsThis study suggests that the psychological well-being of older adults should be cared for when treating chronic diseases. Moreover, families, communities, and clinics should recognize that supporting regular diets, providing social engagement and recreational activities, encouraging physical activity, and minimizing sedentary behavior can reduce the risk of depression and anxiety.

The impact of COVID-19 and socioeconomic status on psychological distress in cancer patients

ObjectiveWe aimed to investigate the impact of the COVID-19 pandemic on psychological symptom burden against the socioeconomic background of cancer patients using data from routine assessments before and during the pandemic MethodIn this cross-sectional study, standardised assessment instruments were applied in N = 1,329 patients to screen for symptoms of anxiety, depression, post-traumatic stress, and fatigue from 2018 to 2022. Two MANOVAs with post-hoc tests were computed. First, only time was included as predictor to examine the isolated impact of the pandemic. Second, income level and education level were included as further predictors to additionally test the predictive power of socioeconomic factors ResultsIn the final model, only income had a significant impact on all aspects of psychological symptom burden, with patients with low income being highly burdened (partial η² = .01, p = .023). The highest mean difference was found for depressive symptoms (MD = 0.13, CI = [0.07; 0.19], p < .001). The pandemic had no further influence on psychological distress ConclusionsAlthough the pandemic is a major stressor in many respects, poverty may be the more important risk factor for psychological symptom burden in cancer outpatients, outweighing the impact of the pandemic.

Basketball Learning Model for Children with Autism

This is a Research and Development (R&amp;D) study for elementary school students aged 10 years to 12 years. It was conducted in three cities in Subang, Purwakarta and Karawang, West Java Province. Respondents were divided into small trials of 20 students, large trials of 60 students, and effectiveness tests of 74 students. The objective of this study is to form a basketball learning model through basketball mini learning specifically for autistic children. The pilot study was conducted by giving questionnaires to teachers, principals, and parents with a total 200 respondents. The study used a descriptive method while the data collection method uses data triangulation, namely questionnaires, interviews, and observations using the random sampling method. The 90-minute learning time used physical education learning time at school conducted face-to-face with a duration of 16 times. Thirty-six basketball learning models were made for children with autism. The instruments consisted of passing, dribbling, and shooting following the standard assessment instruments from the basketball learning curriculum. The data were analyzed using the statistical method of the average difference test (t-test) to determine the effectiveness of the basketball mini learning model. The study results showed that: 1) the basketball mini learning model can be applied in the learning process; 2) the average score of the experimental group was 60.26 &gt; the average control group was 18.29, while the t-count effectiveness test (8,316) &gt; t-table (1.687). It was found that the basketball learning model for autistic children was effectively for elementary school-age autistic students known sig. scores (2-tailed) is 0.00 &lt; 0.05. Based on our findings, it can be concluded that there is a significant difference in effectiveness (real) between the experimental group and the control group in improving learning basketball skills for children with autism.

Neurodevelopmental Profiles of 4-Year-Olds in the Navajo Birth Cohort Study

Native American children disproportionally face many risk factors for poor developmental outcomes; these factors include poverty, environmental toxicant exposure, and limited medical, and intervention services. To understand these risks, comprehensive documentation of developmental and behavioral phenotypes are needed. In the current descriptive study, we assessed the neurodevelopment of young Diné (Navajo) children using standardized assessment instruments in combination with expert clinician judgment. As part of an ongoing, population-based, prospective birth cohort study, we conducted comprehensive neurodevelopmental assessments of 138, 3-5-year-old, Diné children residing on or near the Navajo Nation. We report results from standardized parent reports, psychiatric examinations, and direct assessments of children's language, cognitive, adaptive, and social-emotional development, as well as best estimate clinical diagnoses. Forty-nine percent of our sample met DSM-5 criteria for a neurodevelopmental disorder (NDD) diagnosis. Language and speech sound disorders were most common, although autism spectrum disorder (ASD) was also elevated compared to the general population. Though language performance was depressed amongst all groups of children with, and without, NDDs, those meeting criteria for certain NDDs performed significantly lower on all language measures, when compared to those without. Social-emotional, behavioral, and nonverbal cognitive ability were in the average range overall. Diné children in our study were found to have a high percentage of clinically significant developmental delays. Overall, children presented with a pervasive pattern of depressed language performance across measures, irrespective of diagnosis (or no diagnosis), while other domains of functioning were similar to normative samples. Findings support the need to identify appropriate intervention and educational efforts for affected youth, while also exploring the causes of the specific developmental delays. However, longitudinal studies are necessary to establish best practices for identifying delays and delineating resilience factors to optimize development of Diné children.

To compare the clinical efficacy and side effects of implant (Jadelle) and IUCD (Copper T)

This study aims to compare the performance and side effects of the subdermal implant JADELLE and intrauterine contraceptive device Copper-T as long-acting reversible contraceptive methods. The study design involved a comparative analysis of Jadelle and Copper-T contraceptives, assessing clinical performance and side effects. Sample data from 336 participants was collected using stratified random sampling, with standardized instruments for demographic information, clinical assessment, and contraceptive side effects. Inclusion criteria were reproductive-age multipara women, while exclusion criteria included primary para, preexisting medical disorders, nullipara, and other contraceptive use. Ethical guidelines were followed, ensuring informed consent, privacy, and the right to withdraw. Statistical analysis employed descriptive statistics, chi-square test, independent samples t-test, and Kaplan-Meier survival analysis. SPSS (version 23.0) was used for analysis. The comparison between Group A (Jadelle) and Group B (Copper-T) reveals interesting findings. Group A has a higher mean age, but no significant differences in parity, blood pressure, or weight. Group B has more total and ongoing pregnancies. Group A experiences higher prevalence of side effects, including expulsion, infection, severe menstrual changes, pain or discomfort, and mood swings. Blood parameters show no significant differences. Variations exist in follow-up rates, informed consent, and privacy maintenance.

Description of Neuropsychological Profile in Patients with 22q11 Syndrome

Background: 22q11 deletion syndrome (SD22Q11) is a neurogenetic condition that is associated with a high risk of neurodevelopmental disorders and intellectual disability. People with SD22Q11, both children and adults, often experience significant difficulties in social interactions, as well as neurocognitive deficits, and have elevated rates of autism spectrum disorder (ASD). Despite this, the relationship between basic cognitive processes and cognitive ability in this population has not been well investigated. Methods: the main objective of the present research is to describe the neurocognitive profile of people with SD22Q11 using standardized neuropsychological assessment instruments. For this purpose, a sample of 10 participants aged between 7 and 15 years was administered an assessment battery with the following tests: WISC-V, CELF-5, NEPSY-II, CSAT-R, CARAS-R, TP, MABC-2, BRIEF-2, SENA, DABAS, ABAS-II, SCQ, and ADOS-2. Results: the results showed IQ scores in the borderline normal range, as well as difficulties in language functions, social skills, motor skills, and executive functions. Conclusions: an individualized assessment taking into account the globality of its expression, and a therapeutic approach adapted to the specific needs of children with this syndrome is essential.