A Study of Effective and Ineffective Supervisory Behavior in Special Education

Fortoul Hippolyte. Prescriptions concernant le mobilier des écoles communales. In: Bulletin administratif de l'instruction publique. Tome 5 n°51, mars 1854. pp. 66-67

Facing the Unknown: Behavioural Experiments for Intolerance of Uncertainty

Intolerance of uncertainty (IU) is a dispositional characteristic that arises from negative beliefs about uncertainty and its implications (Koerner & Dugas, 2006). IU is an important factor in both the development and maintenance of generalized anxiety disorder (GAD; APA, 2013). A cognitive-behavioural treatment (CBT) for GAD that targets IU and additional factors has shown robust efficacy across five randomized controlled trials. IU is a key cognitive mechanism in this treatment, as reductions in IU precede (Dugas & Ladouceur, 2000; Goldman, Dugas, Sexton, & Gervais, 2007) and mediate reductions in GAD symptoms (Donegan et al., 2010). Despite these encouraging results, approximately 20-30% of individuals do not achieve full GAD remission by posttreatment. Non-remitted individuals continue to endorse elevated IU. Moreover, established CBT protocols for GAD are often lengthy and complex, involving multiple therapeutic techniques. Thus, GAD treatment development and evaluation must consider parsimony and efficiency in addition to efficacy. To that end, we developed a novel, focused CBT protocol that targets IU exclusively via behavioural experiments. This cognitive-behavioural technique is an experiential method of testing idiosyncratic beliefs (here, beliefs about uncertainty). Participants with a primary diagnosis of GAD (N = 7) completed 12 sessions of this CBT protocol with a licensed clinical psychologist at a local Montreal hospital. Treatment consisted of three components: (1) psychoeducation and uncertainty awareness training; (2) behavioural experiments targeting beliefs about uncertainty, and (3) relapse prevention. Our results suggest that this CBT protocol produces substantial reductions in GAD symptomatology, IU, and general psychopathology by posttreatment. These changes were generally maintained across a 6-month follow-up period, with some deterioration in safety behaviours, general anxiety, and depression. The majority of participants (6/7) demonstrated moderate to high end-state functioning from posttreatment to 6-month follow-up. Additionally, we examined rapid, non-linear changes in IU, worry, and safety behaviours between treatment sessions. Results indicated that sudden gains in IU tended to occur first and that sudden gains occurring early in treatment were associated with improved long-term treatment outcomes. Overall, our findings suggest that the systematic application of behavioural experiments alone may provide substantial reductions in GAD symptoms and IU

Depressive Symptoms in the Cognitive-Behavioural Treatment of Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) is characterized by anxiety, excessive and uncontrollable worry, and somatic symptoms such as muscle tension and difficulty concentrating (DSM-IV-TR, American Psychiatric Association, 2000). GAD is linked to symptoms of depression both theoretically and empirically, but there is currently no consensus as to how co-occurring depressive symptoms affect GAD treatment outcome. Dugas and colleagues have developed an efficacious cognitive-behavioural treatment (CBT) based on a model of GAD that centres upon intolerance of uncertainty. This CBT program has demonstrated consistent reductions in GAD symptom severity by posttreatment (e.g., Dugas et al., 2010); however, not all individuals achieve full remission of GAD for reasons that are currently unclear. The first goal of this study was to determine the relationship between depressive symptoms and short- and long-term GAD treatment outcome. The second goal was to determine the relationship between depressive symptoms and GAD treatment engagement. The results indicated that depressive symptoms at pretreatment were largely unrelated to posttreatment severity of GAD, worry, and somatic anxiety or to treatment engagement. Posttreatment depressive symptoms were not related to the severity of overall GAD symptoms, worry, and somatic anxiety at 18-month follow-up. The theoretical and clinical implications of these findings are discussed

Validation of Electronic Systems to Collect Patient-Reported Outcome (PRO) Data - Recommendations for Clinical Trial Teams: Report of the ISPOR ePRO Systems Validation Good Research Practices Task Force

Validation of Electronic Systems to Collect Patient-Reported Outcome (PRO) Data - Recommendations for Clinical Trial Teams: Report of the ISPOR ePRO Systems Validation Good Research Practices Task Force Abstract. Outcomes research literature has many examples of high-quality, reliable patient-reported outcome (PRO) data entered directly by electronic means, ePRO, compared to data entered from original results on paper. Clinical trial managers are increasingly using ePRO data collection for PRO-based endpoints. Regulatory review dictates the rules to follow with ePRO data collection for medical label claims. A critical component for regulatory compliance is evidence of the validation of these electronic data collection systems. Validation of electronic systems is a process versus a focused activity that finishes at a single point in time. Eight steps need to be described and undertaken to qualify the validation of the data collection software in its target environment: requirements definition, design, coding, testing, tracing, user acceptance testing, installation and configuration, and decommissioning. These elements are consistent with recent regulatory guidance for systems validation. This report was written to explain how the validation process works for sponsors, trial teams, and other users of electronic data collection devices responsible for verifying the quality of the data entered into relational databases from such devices. It is a guide on the requirements and documentation needed from a data collection systems provider to demonstrate systems validation. It is a practical source of information for study teams to ensure that ePRO providers are using system validation and implementation processes that will ensure the systems and services: operate reliably when in practical use; produce accurate and complete data and data files; support management control and comply with any existing regulations. Furthermore, this short report will increase user understanding of the requirements for a technology review leading to more informed and balanced recommendations or decisions on electronic data collection methods

Molecular diet analysis of two african free-tailed bats (molossidae) using high throughput sequencing.

Given the diversity of prey consumed by insectivorous bats, it is difficult to discern the composition of their diet using morphological or conventional PCR-based analyses of their faeces. We demonstrate the use of a powerful alternate tool, the use of the Roche FLX sequencing platform to deep-sequence uniquely 5' tagged insect-generic barcode cytochrome c oxidase I (COI) fragments, that were PCR amplified from faecal pellets of two free-tailed bat species Chaerephon pumilus and Mops condylurus (family: Molossidae). Although the analyses were challenged by the paucity of southern African insect COI sequences in the GenBank and BOLD databases, similarity to existing collections allowed the preliminary identification of 25 prey families from six orders of insects within the diet of C. pumilus, and 24 families from seven orders within the diet of M. condylurus. Insects identified to families within the orders Lepidoptera and Diptera were widely present among the faecal samples analysed. The two families that were observed most frequently were Noctuidae and Nymphalidae (Lepidoptera). Species-level analysis of the data was accomplished using novel bioinformatics techniques for the identification of molecular operational taxonomic units (MOTU). Based on these analyses, our data provide little evidence of resource partitioning between sympatric M. condylurus and C. pumilus in the Simunye region of Swaziland at the time of year when the samples were collected, although as more complete databases against which to compare the sequences are generated this may have to be re-evaluated.This study was supported by Bat Conservation International, Etatsraad Georg Bestle og Hustrus Mindelegat and the Oticon Fonden (KB and CN), the Danish Council for Independent Research Natural Sciences ‘Skou’ award (MTPG), and a Natural Sciences and Engineering Research Council of Canada post-doctoral fellowship (ELC). These funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. This study was also supported by the Royal Swaziland Sugar Corporation, who provided field assistance and therefore had a role in data collection

An interdisciplinary team communication framework and its application to healthcare 'e-teams' systems design

<p>Abstract</p> <p>Background</p> <p>There are few studies that examine the processes that interdisciplinary teams engage in and how we can design health information systems (HIS) to support those team processes. This was an exploratory study with two purposes: (1) To develop a framework for interdisciplinary team communication based on structures, processes and outcomes that were identified as having occurred during weekly team meetings. (2) To use the framework to guide 'e-teams' HIS design to support interdisciplinary team meeting communication.</p> <p>Methods</p> <p>An ethnographic approach was used to collect data on two interdisciplinary teams. Qualitative content analysis was used to analyze the data according to structures, processes and outcomes.</p> <p>Results</p> <p>We present details for team meta-concepts of structures, processes and outcomes and the concepts and sub concepts within each meta-concept. We also provide an exploratory framework for interdisciplinary team communication and describe how the framework can guide HIS design to support 'e-teams'.</p> <p>Conclusion</p> <p>The structures, processes and outcomes that describe interdisciplinary teams are complex and often occur in a non-linear fashion. Electronic data support, process facilitation and team video conferencing are three HIS tools that can enhance team function.</p

How do parents manage irritability, challenging behavior, non-compliance and anxiety in children with Autism Spectrum Disorders? A meta-synthesis

Although there is increasing research interest in the parenting of children with ASD, at present, little is known about everyday strategies used to manage problem behaviour. We conducted a meta-synthesis to explore what strategies parents use to manage irritability, non-compliance, challenging behaviour and anxiety in their children with ASD. Approaches included: (1) accommodating the child; (2) modifying the environment; (3) providing structure, routine and occupation; (4) supervision and monitoring; (5) managing non-compliance with everyday tasks; (6) responding to problem behaviour; (7) managing distress; (8) maintaining safety and (9) analysing and planning. Results suggest complex parenting demands in children with ASD and problem behaviour. Findings will inform the development of a new measure to quantify parenting strategies relevant to ASD