Pilotstudie D-screening: screening op ontwikkelingsachterstand bij het jonge kind, uitgevoerd door de jeugdarts

In een vergelijkende proefopzet met twee groepen (een interventie- en controlegroep) werd de opbrengst en uitvoerbaarheid onderzocht van een screening op ontwikkelingsachterstand bij het jonge kind: de D(evelopmental)- screening. De screening werd uitgevoerd door de jeugdarts bij kinderen die het consultatiebureau bezochten op de leeftijd van 9, 14, of 26 maanden. Bij de kinderen in de controlegroep werd op gebruikelijke wijze door de jeugdarts een ontwikkelingsonderzoek (het Van Wiechenonderzoek) afgenomen. Bij de kinderen in de interventiegroep werden de uitslagen van het Van Wiechenonderzoek ingevoerd in een webtool en werd de D-screening uitgevoerd: Met één druk op een knop werd een thermometer getoond die het risico aangaf op een ontwikkelingsachterstand op latere leeftijd, d.w.z. het aangewezen zijn op een vorm van speciaal onderwijs. Dit risico werd geschat op basis van de uitslagen van het Van Wiechenonderzoek en achtergrondkenmerken (o.a. opleiding ouder(s), erfelijke belasting, en Apgar score van het kind bij geboorte). De D-screening kan als een aanvulling worden beschouwd op het Van Wiechenonderzoe

Філософсько-релігійний вплив екзистенціалізму на український мовно-літературний процес

Стаття підносить актуальну проблему в сьогоденні – розширення кругозору студентської молоді у створюваному творчому освітньо-виховному середовищі через знайомство з філософськими течіями, зокрема екзистенціалізмом. Такий підхід до організації навчально-виховного процесу сприятиме особистісній естетизації тих, хто навчається, зростанню їх культуротворчого рівня.Статья поднимает актуальную проблему на сегодняшнем этапе – расширение кругозора студенческой молодежи в создающейся творческой образовательно-воспитательной среде через знакомство с философскими течениями, в том числе с экзистенциализмом. Такой подход к организации учебно-воспитательного процесса будет способствовать личностной эстетизации обучаемых, повышению их культуротворческого уровня.The article raises a rather actual problem of the present – the expansion of students’ outlook at the modern creative educational environment through the acquaintance with philosophical directions and existentialism in particular. Such a method of approach to the organization of educational process will promote personal aestheticism of students and a rise in their cultural stage

Which Combinations of Techniques and Modes of Delivery in Internet-Based Interventions Effectively Change Health Behavior? A Meta-Analysis

Background: Many online interventions designed to promote health behaviors combine multiple behavior change techniques (BCTs), adopt different modes of delivery (MoD) (eg, text messages), and range in how usable they are. Research is therefore needed to examine the impact of these features on the effectiveness of online interventions. Objective: This study applies Classification and Regression Trees (CART) analysis to meta-analytic data, in order to identify synergistic effects of BCTs, MoDs, and usability factors. Methods: We analyzed data from Webb et al. This review included effect sizes from 52 online interventions targeting a variety of health behaviors and coded the use of 40 BCTs and 11 MoDs. Our research also developed a taxonomy for coding the usability of interventions. Meta-CART analyses were performed using the BCTs and MoDs as predictors and using treatment success (ie, effect size) as the outcome. Results: Factors related to usability of the interventions influenced their efficacy. Specifically, subgroup analyses indicated that more efficient interventions (interventions that take little time to understand and use) are more likely to be effective than less efficient interventions. Meta-CART identified one synergistic effect: Interventions that included barrier identification/ problem solving and provided rewards for behavior change reported an average effect size that was smaller (ḡ=0.23, 95% CI 0.08-0.44) than interventions that used other combinations of techniques (ḡ=0.43, 95% CI 0.27-0.59). No synergistic effects were found for MoDs or for MoDs combined with BCTs. Conclusions: Interventions that take little time to understand and use were more effective than those that require more time. Few specific combinations of BCTs that contribute to the effectiveness of online interventions were found. Furthermore, no synergistic effects between BCTs and MoDs were found, even though MoDs had strong effects when analyzed univariately in the original study

A flexible approach to identify interaction effects between moderators in meta-analysis.

In meta‐analytic studies, there are often multiple moderators available (eg, study characteristics). In such cases, traditional meta‐analysis methods often lack sufficient power to investigate interaction effects between moderators, especially high‐order interactions. To overcome this problem, meta‐CART was proposed: an approach that applies classification and regression trees (CART) to identify interactions, and then subgroup meta‐analysis to test the significance of moderator effects. The aim of this study is to improve meta‐CART upon two aspects: 1) to integrate the two steps of the approach into one and 2) to consistently take into account the fixed‐effect or random‐effects assumption in both the the interaction identification and testing process. For fixed effect meta‐CART, weights are applied, and subgroup analysis is adapted. For random effects meta‐CART, a new algorithm has been developed. The performance of the improved meta‐CART was investigated via an extensive simulation study on different types of moderator variables (ie, dichotomous, nominal, ordinal, and continuous variables). The simulation results revealed that the new method can achieve satisfactory performance (power greater than 0.80 and Type I error less than 0.05) if appropriate pruning rule is applied and the number of studies is large enough. The required minimum number of studies ranges from 40 to 120 depending on the complexity and strength of the interaction effects, the within‐study sample size, the type of moderators, and the residual heterogeneity.Multivariate analysis of psychological dat

Response Conversion for Improving Comparability of International Physical Activity Data

Background: Many questionnaires for measuring physical activity (PA) exist. This complicates the comparison of outcomes. Methods: In 8 European countries, PA was measured in random samples of 600 persons, using the IPAQ as a 'bridge' to historical sets of country-specific questions. We assume that a unidimensional scale of PA ability exists on which items and respondents can be placed, irrespective of country, culture, background factors, or measurement instrument. Response Conversion (RC) based on Item Response Theory (IRT) was used to estimate such a common PA scale, to compare PA levels between countries, and to create a conversion key. Comparisons were made with Eurobarometer (IPAQ) data. Results: Appropriateness of IRT was supported by the existence of a strong first dimension established by principal component analysis. The IRT analysis resulted in 1 common PA scale with a reasonable fit and face validity. However, evidence for cultural bias (Differential Item Functioning, DIF) was found in all IPAQ items. This result made actual comparison between countries difficult. Conclusions: Response Conversion can improve comparability in the field of PA. RC needs common items that are culturally unbiased. Wide-scale use of RC awaits measures that are more culturally invariant (such as international accelerometer data). © 2012 Human Kinetics, Inc

Taphonomy, environment or human plant exploitation strategies?: Deciphering changes in Pleistocene-Holocene plant representation at Umhlatuzana rockshelter, South Africa

The period between ~40 and 20 ka BP encompassing the Middle Stone Age (MSA) and Later Stone Age (LSA) transition has long been of interest because of the associated technological change. Understanding this transition in southern Africa is complicated by the paucity of archaeological sites that span this period. With its occupation sequence spanning the last ~70,000 years, Umhlatuzana Rock Shelter is one of the few sites that record this transition. Umhlatuzana thus offers a great opportunity to study past environmental dynamics from the Late Pleistocene (MIS 4) to the Late Holocene, and past human subsistence strategies, their social organisation, technological and symbolic innovations. Although organic preservation is poor (bones, seeds, and charcoal) at the site, silica phytoliths preserve generally well throughout the sequence. These microscopic silica particles can identify different plant types that are no longer visible at the site because of decomposition or burning to a reliable taxonomical level. Thus, to trace site occupation, plant resource use, and in turn reconstruct past vegetation, we applied phytolith analyses to sediment samples of the newly excavated Umhlatuzana sequence. We present results of the phytolith assemblage variability to determine change in plant use from the Pleistocene to the Holocene and discuss them in relation to taphonomical processes and human plant gathering strategies and activities. This study ultimately seeks to provide a palaeoenvironmental context for modes of occupation and will shed light on past human-environmental interactions in eastern South Africa.NWOVidi 276-60-004Human Origin

Discriminant content validity of a theoretical domains framework questionnaire for use in implementation research

Prevention, Population and Disease management (PrePoD

Implementation of a shared care guideline for back pain: effect on unnecessary referrals

Objective: To determine the effect of the implementation of a shared care guideline for the lumbosacral radicular syndrome (LRS) on unnecessary early referrals and the duration of the total diagnostic procedure. Design: Introduction of shared care guideline in November 2005. Pre-test in 2005 (April to October), a first post-test in 2006 (April to October) and a second post-test in 2007 (April to October). Setting and Intervention: The introduction of a shared care guideline derived from national guidelines for GPs and several medical/paramedical specialists in two Dutch regions. Three hundred and sixty GPs, 550 physiotherapists and two hospitals (9 neurologists and 18 radiologists) were involved. The essential component of the guideline was a trade-off: if the GP complied with the conservative management approach in the first 6 weeks, the hospital guaranteed a priority appointment with the neurologist after 6 weeks, if still required. Main Outcome Measures: The neurologists in both hospitals registered whether a patient had been unnecessarily referred during the first 6 weeks. The duration of the total diagnostic procedure was defined as the number of days between referral by the GP and the consultation when the neurologist made the final diagnosis. Results: The percentage of patients being unnecessarily referred within 6 weeks fell significantly from 15% in 2005 to 9% in 2006 and 8% in 2007. The duration of the total diagnostic procedure also fell significantly in both the long and short terms. Conclusions: The introduction of a shared care guideline for all care providers in a region reduces the number of unnecessary early referrals for patients with LRS. © The Author 2010. Published by Oxford University Press in association with the International Society for Quality in Health Care

Prevalence of anxiety disorders and subthreshold anxiety throughout later life: systematic review and meta-analysis

This systematic review and meta-analysis compared prevalence rates for subthreshold anxiety and anxiety disorders in adults aged 55 degrees and examined if these rates were associated with age. A systematic search and screening procedure resulted in 46 included articles. First, prevalence rates for subthreshold anxiety and anxiety disorders were statistically compared. Subthreshold panic, generalized anxiety and specific phobia were significantly more prevalent than the corresponding clinical disorders. In general, subthreshold anxiety appeared to be at least similarly prevalent to anxiety disorders, although firm conclusions are precluded due to the small number of samples that could be included in the analyses and the large heterogeneity between the reported prevalence rates. Second, using subgroup analyses, pooled prevalence rates for four age groups of older adults (55-64, 65-74, 75-84, 85 degrees) were compared. For specific phobia, the 75-84 and 85 degrees groups had significantly lower prevalence rates than the 55-64 and 65-74 groups. Posttraumatic stress disorder was significantly more prevalent in the 55-64 group than in the other age groups, and lowest in the 85 degrees group. No other significant differences between age groups were found. The association between later life subthreshold anxiety and age could not be examined due to a lack of reported information. The main limitation of this study is the small number of samples in the analyses, which limits their power and generalizability.Stress and Psychopatholog

The Benefits of Psychosocial Interventions for Mental Health in People Living with HIV: A Systematic Review and Meta-analysis

Public Health and primary carePrevention, Population and Disease management (PrePoD