Support For Use Research Articles

A study of the use of artificial intelligence by student-teachers

Aim. The study aims to know how student-teachers of B.Ed. courses make use of AI for education and their opinion about the use of AI in education, in general. Methods. The Survey method was used for the study. There were 72 student-teachers of B.Ed the course of Savitribai Phule Pune University, Pune, and studying at Tilak Col- lege of Education, Pune, India, participated in the survey. The questionnaire was the data collection tool for the study. The questionnaire was circulated on WhatsApp group through Google Form which had 12 questions with choices based on the status variable. Results. The data analysis of the 12 questions was done by using percentages and it was presented in Pie charts for each question. The results summarise that most of the stu- dent- teachers use ChatGPT, most of the student-teachers use AI for lessons, practicals, reports, and presentations and student-teachers use AI sometimes in a limited manner. According to the analysis of student-teachers, the use of AI should not be banned but regulations and guidelines should be there. Conclusions. The study underlines that student-teachers use AI in their course and they are in support of use of AI in education. Hence there is a need for general guidelines from the apex bodies regarding use of AI in Education rather than a blanket ban on AI.

Examining real-time physical activity in adolescents using the Multi-Process Action Control Model: An ecological momentary assessment study

The purpose of this study was to examine real-time associations between reflective (i.e., state motivation), regulatory (i.e., self-control), and reflexive (i.e., habit) constructs from the Multi-Process Action Control (M-PAC) model and real-time moderate-to-vigorous physical activity (MVPA) behaviour among adolescents using ecological momentary assessments. One hundred and ninety adolescents (Mage = 15.76 ± .47 years; n = 101 males) wore an accelerometer for seven consecutive days and responded to digital survey prompts up to four times daily during the after-school periods. MVPA in the 60-minute time window following each survey prompt was recorded. Multilevel mixed-effects linear and logistic models were computed with disaggregated between- and within-person effects to analyze the data. Results from both linear and logistic multilevel models revealed adolescents with higher state motivation in general and experiencing higher state motivation than one’s typical levels were associated with engaging in more MVPA and higher likelihood of engaging in ≥10 minutes of MVPA. Engaging in activities less consistent with habitual behaviours were associated with more MVPA and higher likelihood of engaging in ≥10 minutes of MVPA. By contrast, self-control was not associated with MVPA. Results from this study extend previous work demonstrating the importance of conscious and non-conscious processes on MVPA behaviour by examining associations in real-time using intensive longitudinal methods. Collectively, this study provides partial support for use of the M-PAC framework to explain acute MVPA among adolescents in real-time and natural contexts.

A Quality Improvement Project On The Introduction Of A Nurse-Led, Patient Self-Monitored Blood Pressure Telehealth Platform

Abstract Background Telehealth is a strategy for health and wellbeing promotion. Hypertension is a modifiable risk factor in vascular health. Timely, reliable and accessible identification of this risk is important. Working within an interdisciplinary ambulatory neurovascular hub, a nurse-led model of service provided the opportunity to effectively identify and modify this risk through the secondary prevention measure of hypertension management. Methods An interdisciplinary neurovascular service quality improvement group, the “Stroke Big Room”, evaluated service models and telehealth platforms for patient-self monitoring of hypertension. The telehealth “Florence” platform was introduced. An accompanying Patient Information Leaflet was developed with the Communications Team within the Trust. Patients with a blood pressure of 130/80mmHg and a confirmed diagnosis of minor stroke or transient ischaemic attack were offered the “Flo” platform. Results A 20-patient sample found: 50% required no treatment change, 30% were commenced on antihypertensive treatment and 20% required antihypertensive dose increase. In the 2023/24 financial year, 285 patients participated in the Flo platform. Conclusion Timely identification and modification of hypertension is a reversible risk factor for neurovascular disease. A nurse-led service for the provision of, education on and support in use of a telehealth monitoring platform is an effective approach. This service model allows for effective secondary prevention treatment in a rapid and accessible way. The telehealth platform “Flo” was accessible to patients on the basis of patient reported outcome measures. As a result of the use of the platform, pharmacotherapeutic interventions occurred in 50% of participants in this telehealth programme.

Remote Microphone Systems for Autistic and Nonautistic Youth: Effects on Audiovisual Task Engagement

Objectives: A recent study has provided empirical support for the use of remote microphone (RM) systems to improve listening-in-noise performance of autistic youth. It has been proposed that RM system effects might be achieved by boosting engagement in this population. The present study used behavioral coding to test this hypothesis in autistic and nonautistic youth listening in an ecologically valid, noisy environment. Design: We drew on extant data from a recent experimental study in which 56 youth (32 autistic, 24 nonautistic) matched at the group level on age and biological sex completed listening-in-noise tasks wherein they reported their perception of audiovisual syllables, words, sentences, and passages with and without an RM system; conditions were counter-balanced across participants. As previously reported, perceptual accuracy varied with stimulus complexity and overall improved with the RM system, with improvements not significantly different between groups. Video recordings of participants completing listening-in-noise tasks in both conditions were coded via a 5-second, partial-interval coding system by naive coders for (a) engagement in the task (indexed via proportion of intervals in which participants displayed on-task behaviors) and (b) verbal, stimulus-specific protesting in the task (indexed via proportion of intervals in which participants displayed verbal, stimulus-specific protesting behaviors). Examples of on-task behaviors included attending to the screen and completing task activities. Examples of protesting behaviors included complaining about stimuli volume or the inability to hear. Chronological age, autism features, language ability, audiovisual speech integration as measured by psychophysical tasks, tactile responsiveness, and nonverbal intelligence quotient were evaluated as putative predictors and/or moderators of effects on behaviors of interest. Results: In general, participants were highly engaged in the task, and there were few protests, reflecting more than 90% and fewer than 0.5% of coded intervals, respectively. We did not detect any statistically significant effects of group or RM system use on task engagement. Nonautistic youth were engaged in the listening-in-noise task for an average of 97.45% of intervals, whereas autistic youth were engaged in the listening-in-noise task for an average of 94.25% of intervals. In contrast, verbal, stimulus-specific protesting in the listening-in-noise task was significantly reduced, on average, in the RM (0.04% of intervals) versus the No RM (0.2% of intervals) conditions. There were no effects related to group for this behaviorally coded outcome. In addition, select participant characteristics predicted engagement within conditions across participants. Greater language ability and nonverbal intelligence quotient predicted increased engagement when not using an RM system. Increased features of autism and wider temporal binding windows for audiovisual speech predicted reduced engagement while using an RM system, and greater audiovisual integration predicted increased engagement while using an RM system. Conclusions: The results of this study suggest that RM system use reduces verbal, stimulus-specific protesting, which likely reflects difficulty engaging when listening in noise. The present study extends our previous study to provide additional empirical support for RM system use in autistic and nonautistic youth.

Nuclear magnetic resonance-based metabolomics with machine learning for predicting progression from prediabetes to diabetes.

Identification of individuals with prediabetes who are at high risk of developing diabetes allows for precise interventions. We aimed to determine the role of nuclear magnetic resonance (NMR)-based metabolomic signature in predicting the progression from prediabetes to diabetes. This prospective study included 13,489 participants with prediabetes who had metabolomic data from the UK Biobank. Circulating metabolites were quantified via NMR spectroscopy. Cox proportional hazard (CPH) models were performed to estimate the associations between metabolites and diabetes risk. Supporting vector machine, random forest, and extreme gradient boosting were used to select the optimal metabolite panel for prediction. CPH and random survival forest (RSF) models were utilized to validate the predictive ability of the metabolites. During a median follow-up of 13.6 years, 2525 participants developed diabetes. After adjusting for covariates, 94 of 168 metabolites were associated with risk of progression to diabetes. A panel of nine metabolites, selected by all three machine-learning algorithms, was found to significantly improve diabetes risk prediction beyond conventional risk factors in the CPH model (area under the receiver-operating characteristic curve, 1 year: 0.823 for risk factors + metabolites vs 0.759 for risk factors, 5 years: 0.830 vs 0.798, 10 years: 0.801 vs 0.776, all p < 0.05). Similar results were observed from the RSF model. Categorization of participants according to the predicted value thresholds revealed distinct cumulative risk of diabetes. Our study lends support for use of the metabolite markers to help determine individuals with prediabetes who are at high risk of progressing to diabetes and inform targeted and efficient interventions. Shanghai Municipal Health Commission (2022XD017). Innovative Research Team of High-level Local Universities in Shanghai (SHSMU-ZDCX20212501). Shanghai Municipal Human Resources and Social Security Bureau (2020074). Clinical Research Plan of Shanghai Hospital Development Center (SHDC2020CR4006). Science and Technology Commission of Shanghai Municipality (22015810500).

A - 29 Support for Use of Cognitive Rehabilitation Strategies to Enhance Accessibility of Medications for Opioid Use Disorder Treatment: a Qualitative Secondary Data Analysis

Abstract Objective Despite cognitive rehabilitation paradigms gaining support as adjunctive interventions to opioid use disorder treatments, limited research details strategies that medical providers who prescribe medications for opioid use disorder (MOUD) employ to attend to patient cognitive limitations. We conducted a secondary data analysis to explore this gap in the literature. Method The parent study included individual interviews with 23 MOUD treatment providers from New Mexico and Washington state, and the interview guide centered barriers and facilitators to equitable implementation. A deductive thematic analysis was utilized to identify sources, solutions, and strategies that MOUD providers identified for patients experiencing cognitive impairments. Results Regarding sources of cognitive dysfunction, history of stroke, overdose, severe mental illness, and traumatic brain injury were emphasized. Low health literacy was also identified as a justification to modify approach. Strategies providers utilized fell under five subthemes: visual aids; communication (e.g., repetition; open questions); engaging caregivers; leveraging peer support; and increasing visit frequency. Though less common, some providers emphasized only focusing on substance use and safety. Conclusions There have been calls to better attend to cognitive functioning as a potential moderator of MOUD treatment outcomes; however, existing personalized care guidelines do not address this adequately. The present study revealed variability in clinical decision-making that may exacerbate health inequities among individuals seeking MOUD treatment –a population disproportionately impacted by social determinants of health (e.g., housing; access to healthcare; quality of education). Greater focus on equitable MOUD implementation is needed to explore methods of personalizing care for individuals seeking MOUD treatment presenting with cognitive dysfunction.

Development and psychometric evaluation of the self-care of informal caregivers inventory

BackgroundIn recent years, a growing body of literature on informal caregivers’ health and well-being has emerged, highlighting the need for a tool to measure their self-care practices. ObjectiveThe aim of the study was to develop a theory-based instrument measuring the self-care behaviors of informal caregivers and test its psychometric properties. DesignThe initial phase of instrument development entailed a detailed, six-step process (conceptualization, theoretical adaptation, back-translation and cultural adaptation, cognitive interviewing, item enhancement, and content validity), followed by formal psychometric testing (participant engagement, validity, internal consistency reliability, test-retest reliability). SettingStudy conducted at a hospital located in Tehran, Iran. ParticipantsA sample of 234 informal caregivers of cancer outpatients receiving treatment in oncology wards was enrolled. Caregivers had to be 18 years or older, recognized as the primary caregiver by the patient, and willing to provide informed consent. MethodsThe Self-Care of Informal Caregivers Inventory items comprise three dimensions: self-care maintenance (11 items), self-care monitoring (7 items), and self-care management (9 items), which achieved a content validity index rating of 100 % in a panel of experts. Data were collected from caregivers during routine clinic visits. Construct validity was verified through exploratory structural equation modelling and reliability was verified using Cronbach's α and multidimensional model-based reliability. Test-retest reliability was evaluated using the Intraclass Correlation Coefficient. ResultsAll three dimensions showed good model fit indices (self-care maintenance: Comparative Fit Index = 1.00, Tucker-Lewis Index = 0.99, Root Mean Square Error of Approximation = 0.044; self-care monitoring: Comparative Fit Index = 1.00, Tucker-Lewis Index = 1.00, Root Mean Square Error of Approximation = 0.027; self-care management: Comparative Fit Index = 0.99, Tucker-Lewis Index = 0.99, Root Mean Square Error of Approximation = 0.048) and Cronbach's α of 0.88, 0.88, and 0.91, respectively. The overall multidimensional model-based reliability was 0.93. The Intraclass Correlation Coefficient values for the three dimensions were 0.94, 0.60, and 0.51, respectively. ConclusionPreliminary testing provides support for use of the Self-Care of Informal Caregivers Inventory in research. Using this theory-based instrument to assess the self-care practices of informal caregivers can assist in identifying topics to discuss and opportunities for guidance. Tweetable AbstractThe Self-Care of Informal Caregivers Inventory: A validated tool for informal caregivers is useful for research. #Informalcaregivers #SelfCare

Phenobarbital Versus Benzodiazepines for Alcohol Withdrawal in the Medical Intensive Care Unit (ICU): A Retrospective Cohort Study.

Background: Phenobarbital (PHB) is a safe and efficacious alternative to benzodiazepines (BZD) for treating severe alcohol withdrawal (AWS). However, the safety of utilizing PHB for patients initially treated with BZD is unknown. Objective: To evaluate the safety and efficacy of PBH compared to BZDs in severe AWS in the medical intensive care unit (ICU). Methods: This was a retrospective cohort study comparing critically ill patients admitted for AWS who received BZDs or PHB. The primary outcome was time to persistent resolution of altered mentation. Secondary outcomes included development and duration of delirium, need for mechanical ventilation, development of withdrawal seizures, and ICU and hospital length of stay. Results: Ninety-five patients were evaluated (53 in PHB group, 42 in BZD group). Before study medication, less BZD patients demonstrated abnormal mentation compared with PHB patients (RASS < -2: 2.39% vsvs. 28.12%, respectively, and RASS > +2: 9.9% vsvs. 48.76%; P <0.001 for both). No difference was seen between groups for the primary outcome (1.8 hours for BZD cohort vsvs. 13.81 hours for PHB cohort; P =0.22). More patients in the BZD cohort developed a seizure after study medication administration (5.67% vs 0%, respectively; P =0.02). No significant difference was seen in other secondary outcomes. Conclusions: This study provides support for use of PHB after BZD if patients remain in uncontrolled withdrawal. Despite significant doses of BZDs before PHB, patients in the PHB cohort demonstrated similar clinical and safety outcomes compared to BZD alone.

The Inventory of Callous-Unemotional Traits (ICU) self-report version: Factor structure, measurement invariance, and predictive validity in justice-involved male adolescents.

The Inventory of Callous-Unemotional Traits (ICU) is a widely used measure of callous-unemotional (CU) traits that may aid in the assessment of the diagnostic specifier "with limited prosocial emotions," which has been added to diagnostic criteria for conduct disorder. Though there is substantial support for use of the ICU total score, the scale's factor structure has been highly debated. Inconsistencies in past factor analyses may be largely attributed to failure to control for method variance due to item wording (i.e., half of the items being worded in the callous direction and half worded in the prosocial direction). Thus, the present study used a multitrait-multimethod confirmatory factor analytic approach that models both trait and method variance to test the factor structure of the ICU self-report in a clinically relevant, high-risk sample of justice-involved male adolescents (N = 1,216). When comparing the fit of empirical and theoretical models, goodness of fit indices (χ² = 1105.877, df = 190, root-mean-square error of approximation = .063, comparative fit index = .916, Tucker-Lewis index = .878, standardized root-mean-square residual = .051) provided support for a hierarchical four-factor model (i.e., one overarching callous-unemotional factor, four latent trait factors) when accounting for method variance (i.e., covarying positively worded items). This factor structure is consistent with the way the ICU was constructed and with criteria for the limited prosocial emotions specifier. In addition, measurement invariance of this factor structure across age, race, and ethnicity was supported, and the predictive validity of the ICU was supported across these demographic groups in predicting self-reported antisocial behavior and rearrests over a 5-year period following an adolescent's first arrest. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Montana Postural Care Project: A pilot study implementing posture care management in a rural, low-resource region

BackgroundMobility impairment limits control of posture and body alignment. This leads to altered body shapes, co-occurring problems with pain and sleep, cardiopulmonary concerns, digestive health issues, and emergent health outcomes, which further complicate functions of daily living. 24-hour posture care management was developed to remedy these challenges by restoring body symmetry. ObjectiveTo determine the feasibility of introducing posture care management to a rural-based, medically complex patient population, evaluate response of body symmetry, and examine its impact on pain and sleep quality. MethodsThis pilot study employed a longitudinal, quasi-experimental study design from March 2016 to September 2018. The posture care management intervention introduced positioning support for use when lying down, a personalized training workshop for caregiver teams, and in-home initial and follow-up assessments to provide materials and collaboratively develop a personalized care plan. Participants were followed pre-post for 6–9 months. ResultsA total of 73 participants enrolled in the study; 55 (75 %) completed. The majority were male (55 %) with a median age of 11. Most caregivers were immediate family members, and most participants had 1+ diagnosis characterized as a neurodevelopmental disorder. A majority of participants improved body symmetry (56–76 %), and 53 % with comparable information saw improvement in body symmetry with no worsening of pain or sleep quality. ConclusionThis study established the feasibility of administering posture care management in North America. These findings provide preliminary evidence of improvements in body symmetry and address concerns that posture care management can interfere with pain and sleep. Future research should consider levels of caregiver engagement and explore remote-monitored options of a posture care management intervention.

Changing US Support for Public Health Data Use Through Pandemic and Political Turmoil.

Recent legislative privacy efforts have not included special provisions for public health data use. Although past studies documented support for public health data use, several global events in 2020 have raised awareness and concern about privacy and data use. This study aims to understand whether the events of 2020 affected US privacy preferences on secondary uses of identifiable data, focusing on public health and research uses. We deployed two online surveys-in February and November 2020-on data privacy attitudes and preferences using a choice-based-conjoint analysis. Participants received different data-use scenario pairs-varied by the type of data, user, and purpose-and selected scenarios based on their comfort. A hierarchical Bayes regression model simulated population preferences. There were 1,373 responses. There was no statistically significant difference in the population's data preferences between February and November, each showing the highest comfort with population health and research data activities and the lowest with profit-driven activities. Most subgroups' data preferences were comparable with the population's preferences, except African Americans who showed significant decreases in comfort with population health and research. Despite world-changing events, including a pandemic, we found bipartisan public support for using identifiable data for public health and research. The decreasing support among African Americans could relate to the increased awareness of systemic racism, its harms, and persistent disparities. The US population's preferences support including legal provisions that permit public health and research data use in US laws, which are currently lacking specific public health use permissions.

COMPARISON OF CUT POINTS FOR PREDICTING PHYSICAL ACTIVITY INTENSITY IN OLDER ADULTS

Abstract The differences between cut-points, and scarcity of comparative impact studies have prevented researchers from reaching consensus regarding the application of intensity-related accelerometer cut-points for older adults. This study will focus on the measure of physical activity using the MotionWatch 8 in older adults and compare the differences using traditional Freedson cut points versus those developed by Landry for older adults and evaluate the impact of these differences on age, gender, race, cognition, comorbidities as well as function based on the Barthel Index. A total of 177 participants between the ages of 59 to 101 (M 83) from an acute care study were used for the analysis. Physical activity intensity was estimated using 24-hour count data and compared using two independently developed cut-points. Impact on outcomes were evaluated with hierarchical regression and Multivariate analysis of variance. After controlling for age, gender, race, comorbidities, and cognition, Landry sedentary cut-points were all significantly associated with function. Overall, 14% of the variance in function was explained by all the variables in the model. The findings provide support for use of the Landry cut points to quantify physical activity intensity in hospitalized older adults living with dementia to identify low levels of activity.

Child Neurology and Neurodevelopmental Disabilities Program Directors’ Opinions on Preference Signaling in the 2023-2024 NRMP Match: A Survey

Changes in residency recruitment have significantly altered how programs and applicants evaluate each other including virtual interviews, discontinuation of the United States Medical Licensing Exam Step 2 Clinical Skills exam, and transition of United States Medical Licensing Exam Step 1 to pass-fail scoring. To improve program-applicant fit, the Electronic Residency Application Service introduced supplemental application features including geographic preference, program signaling, and the opportunity to highlight impactful and meaningful experiences. We sought to evaluate child neurology (CN) and neurodevelopmental disabilities (NDD) program director's (PD) opinions regarding these changes. A 10-question anonymous survey was sent to CN (n=75) and NDD (n=8) PDs. The questions centered on PDs' opinions regarding components of the supplemental application, having a standard application review period and in-person recruitment activities. Answer choices to the questions were all close-ended. Respondents could select questions to complete. Thirty-eight CN residency PDs (49%) and 4 NDD residency PDs (50%) responded to the survey. Among CN PDs, there was strong support for use of the supplemental application questions and for the use of 3 program signals per applicant. Most PDs supported a standardized application review period prior to programs sending interview offers; however, there was no consensus on the appropriate length of time. Nearly half agreed with virtual-only interviews, and 62% agreed with the option of in-person second-look visits. CN PDs generally support many of the recent or proposed changes to residency recruitment. The impact of these changes on recruitment will be a topic of future investigation.

A meta-analysis investigating the efficacy and adverse events linked to sacubitril-valsartan in various heart failure subtypes.

Sacubitril-valsartan, an inhibitor of the angiotensin receptor neprilysin (ARNi), has been purported to exhibit superiority over angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) in individuals diagnosed with heart failure. This paper gives an updated meta-analysis comparing the efficacy and safety of sacubitril-valsartan to that of standard treatment for different types of heart failure. The meta-analysis comprised a total of nine randomized controlled trials (RCTs), incorporating data from a substantial sample size of 15 939 patients. The study observed a decrease in overall mortality and mortality related to cardiovascular causes among patients in the heart failure with reduced ejection fraction (HFrEF) category who were treated with sacubitril-valsartan. However, no statistically significant variation in this outcome was seen among patients with heart failure with preserved ejection fraction and HFmrEF. Patients who were administered sacubitril-valsartan had a notably elevated likelihood of experiencing hypotension. Nevertheless, no significant disparities were observed in terms of other adverse events among the various treatment groups. Current meta-analysis provide support for use of sacubitril-valsartan in decreasing mortality in patients with HFrEF. However, more numbers of studies are required to draw a definite conclusion on other benefits associated with sacubitril-valsartan use over standard treatment of ACE inhibitors and ARBs.

Pilot Effectiveness and Acceptability of Partial Hospitalization Treatment Incorporating Transdiagnostic, Cognitive-Behavioral Intervention

Acute mental health treatment (e.g., partial hospitalization or PHP) is a critical component of the mental health services landscape for youth whose symptoms are too acute for a typical outpatient setting, but for whom inpatient psychiatric hospitalization is not recommended or desired. Very few interventions have been developed, adapted for, or evaluated in these fundamentally different delivery contexts. Transdiagnostic treatments may be ideal for addressing the comorbidity, complexity, and heterogeneity typical of acute mental health settings. Our aim was to examine initial acceptability and effectiveness of an adaptation of the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/A; Ehrenreich-May, Kennedy, et al., 2017), delivered as part of comprehensive therapeutic programming in a general psychiatric PHP. We recruited 152 youths (M age = 13.1 years, 62.5% female) and caregivers, who participated in an average of 11 days of intensive UP-C/A intervention. Participants rated symptoms and functioning at baseline, weekly, posttreatment, and 1-month follow-up. Latent growth curve modeling was used to examine patterns of change and evaluate the impact of potential demographic and treatment-related covariates. For all outcomes, a quadratic model best fit the data, with symptoms and emotional reactivity decreasing significantly during treatment and then leveling off during follow-up. There was a medium-sized change in functional impairment from baseline to the 1-month follow-up, and ≥90% of participants reported treatment as acceptable and helpful. Results provide initial support for use of a transdiagnostic, cognitive-behavioral intervention in acute mental health settings and suggest important future directions, including controlled trials and investigation of implementation supports.

71 Examining the Psychometric Validity of NeuroScreen to Assess Neurocognition in Hospitalized Psychosis Patients in Uganda

Objective:People with psychotic disorders often experience neurocognitive deficits, such as neurocognitive impairment (NCI), which can negatively affect their daily activities (e.g., performing independent tasks) and recovery. Because of this, the American Psychology Association advocates integrating neurocognitive testing into routine care for people living with psychotic disorders, especially those in their first episode, to inform treatment and improve clinical outcomes. However, in low-and-middle income countries (LMICs), such as Uganda where the current study took place, administering neurocognitive tests in healthcare settings presents numerous challenges. In Uganda there are few resources (e.g., trained clinical staff, and culturally relevant and normed tests) to routinely offer testing in healthcare settings. NeuroScreen is a brief, highly automated, tablet-based neurocognitive testing tool that can be administered by all levels of healthcare staff and has been translated into indigenous Ugandan languages. To examine the psychometric properties of NeuroScreen, we measured convergent and criterion validity of the NeuroScreen tests by comparing performance on them to performance on a traditional battery of neurocognitive tests widely used to assess neurocognition in people with psychotic disorders, the Matric Consensus Cognitive Battery (MCCB).Participants and Methods:Sixty-five patients admitted into Butabika Mental Referral Hospital in Uganda after experiencing a psychotic episode and forty-seven demographically similar control participants completed two neurocognitive test batteries: the MCCB and NeuroScreen. Both batteries include tests measuring the neurocognitive domains of executive functioning, working memory, verbal learning, and processing speed. Prior to completing each battery, patients were medically stabilized and could not exhibit any positive symptoms on the day of testing. On the day of testing, medication dosages were scheduled so that patients would not experience sedative effects while testing. To examine convergent validity, we examined correlations between overall performance on NeuroScreen and the MCCB, as well as tests that measured the same neurocognitive domains. To examine criterion validity, an ROC curve was computed to examine the sensitivity and specificity of NeuroScreen to detect NCI as defined by the MCCB.Results:There was a large correlation between overall performance on NeuroScreen and the MCCB battery of tests, r(110) = .65, p &lt; .001. Correlations of various strengths were found among tests measuring the same neurocognitive domains in each battery: executive functioning [r(110) = .56 p &lt;.001], processing speed [r(110) = .44, p &lt;.001)], working memory [r(110) = .29, p&lt;.01], and verbal learning [r(110) = .22, p &lt; .01]. ROC analysis of the ability of NeuroScreen to detect MCCB defined NCI showed an area under curve of .798 and optimal sensitivity and specificity of 83% and 60%, respectively.Conclusions:Overall test performance between the NeuroScreen and MCCB test batteries was similar in this sample of Ugandans with and without a psychotic disorder, with the strongest correlations in tests of executive functioning and processing speed. ROC analysis provided criterion validity evidence of NeuroScreen to detect MCCB defined NCI. These results provide support for use of NeuroScreen to assess neurocognitive functioning among patients with psychotic disorders in Uganda, however more work needs to be to determine how well it can be implemented in this setting. Future directions include assessing cultural acceptability of NeuroScreen and generating normative data from a larger population of Ugandan test-takers.

Using the Child Behavior Checklist to Screen for PTSD: A Mixed Method Study of Syrian Refugee Youth

This study investigated the utility of using an omnibus measure of child functioning, the Child Behavior Checklist (CBCL), to screen for symptoms of PTSD. Although measures to assess trauma symptoms exist, they are often not linguistically and culturally valid for many school-age populations. Data from parents of Syrian refugee youth (ages 10-18 years, M = 13.54, SD = 2.27, n = 70) who recently resettled in the U.S. were analyzed, as their refugee status implies they likely have experienced traumatic events during the Syrian War. A mixed-method design was employed, comparing qualitative data from parent focus groups to quantitative responses on the CBCL. Results provide preliminary support for use of CBCL items as a culturally-responsive screening tool for screening symptoms of PTSD in school-aged children, though it should not replace formalized assessment.

The Influence of Guardian and Warrior Police Orientations on Australian Officers’ Use of Force Attitudes and Tactical Decision-Making

Concerns about excessive use of force by U.S. police have led to calls for agencies to move from ‘warrior’ to ‘guardian’ policing. ‘Warrior’ policing embodies an aggressive or coercive approach to law enforcement, while ‘guardian’ policing prioritises communication, procedural justice and citizen safety. Associations between guardian and warrior policing orientations and use of force attitudes in the U.S. have been found, however the influence of these orientations on police use of force in Australia has not been examined. This study examined the association of guardian and warrior policing orientations with use of force attitudes, threat perceptions and tactical decision-making among Australian officers, through a survey of 183 police officers in Queensland. Regression analyses indicated that warrior policing was associated with greater support for use of force and greater perceived threat in an ambiguous threat scenario, while guardian policing was associated with more restraint in tactical decision-making among Australian police officers.

Feasibility of wearable sensors in the NICU: Psychophysiological measures of parental stress

BackgroundParents report elevated stress during their infant's NICU hospitalization. Real-time measures may improve our understanding of parental stress in the NICU. AimExamine the feasibility of wearable sensors to describe parental stress in the NICU. Study designIn this prospective feasibility study of 12 parent-infant dyads, parents wore an Empatica E4 wristband to measure psychophysiological stress via electrodermal activity (EDA) during sensory interventions (holding, massage, reading, touch, etc) with their babies. Baseline and intervention periods were delineated during which concurrent monitoring and clinical observations of infant behavior and environmental factors were recorded. Feasibility was assessed by investigating recruitment/enrollment, retention/adherence, acceptability, sensor usability, and changes in EDA waveforms based on potential stressors. For the latter, independent samples t-tests and ANOVA were used to examine differences in EDA from baseline to intervention, and the impact of environmental and infant factors on parent stress were visually analyzed against EDA waveforms. ResultsWearable sensor use in the NICU appeared feasible as assessed by all methods. Preliminary data analysis indicated that overall parent EDA levels during parent-infant interactions were low, and engagement in sensory intervention(s) led to a non-significant increase in parental EDA, measured by both skin conductance levels and non-specific skin conductance responses. Three main patterns of EDA emerged: a temporary increase in EDA at the beginning of the intervention followed by a decrease and plateau, a plateau in EDA from baseline to intervention, and a gradual rise in EDA throughout intervention. Specific environmental and infant factors, such as infant stress and health care providers entering the room, appeared to impact parent stress levels. ConclusionAlthough these preliminary findings provide support for use of EDA in the NICU, future studies are needed.

An Assessment of How Clinicians and Staff Members Use a Diabetes Artificial Intelligence Prediction Tool: Mixed Methods Study

Background Nearly one-third of patients with diabetes are poorly controlled (hemoglobin A1c≥9%). Identifying at-risk individuals and providing them with effective treatment is an important strategy for preventing poor control. Objective This study aims to assess how clinicians and staff members would use a clinical decision support tool based on artificial intelligence (AI) and identify factors that affect adoption. Methods This was a mixed methods study that combined semistructured interviews and surveys to assess the perceived usefulness and ease of use, intent to use, and factors affecting tool adoption. We recruited clinicians and staff members from practices that manage diabetes. During the interviews, participants reviewed a sample electronic health record alert and were informed that the tool uses AI to identify those at high risk for poor control. Participants discussed how they would use the tool, whether it would contribute to care, and the factors affecting its implementation. In a survey, participants reported their demographics; rank-ordered factors influencing the adoption of the tool; and reported their perception of the tool’s usefulness as well as their intent to use, ease of use, and organizational support for use. Qualitative data were analyzed using a thematic content analysis approach. We used descriptive statistics to report demographics and analyze the findings of the survey. Results In total, 22 individuals participated in the study. Two-thirds (14/22, 63%) of respondents were physicians. Overall, 36% (8/22) of respondents worked in academic health centers, whereas 27% (6/22) of respondents worked in federally qualified health centers. The interviews identified several themes: this tool has the potential to be useful because it provides information that is not currently available and can make care more efficient and effective; clinicians and staff members were concerned about how the tool affects patient-oriented outcomes and clinical workflows; adoption of the tool is dependent on its validation, transparency, actionability, and design and could be increased with changes to the interface and usability; and implementation would require buy-in and need to be tailored to the demands and resources of clinics and communities. Survey findings supported these themes, as 77% (17/22) of participants somewhat, moderately, or strongly agreed that they would use the tool, whereas these figures were 82% (18/22) for usefulness, 82% (18/22) for ease of use, and 68% (15/22) for clinic support. The 2 highest ranked factors affecting adoption were whether the tool improves health and the accuracy of the tool. Conclusions Most participants found the tool to be easy to use and useful, although they had concerns about alert fatigue, bias, and transparency. These data will be used to enhance the design of an AI tool.