57 research outputs found

    Feasibility and safety of a 6-month exercise program to increase bone and muscle strength in children with juvenile idiopathic arthritis

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    Background: Arthritis in childhood can be associated with muscle weakness around affected joints, low bone mass and low bone strength. Exercise is recognized as an important part of management of children with juvenile idiopathic arthritis (JIA) but the exercise prescription to best promote bone and muscle health is unknown. We therefore aimed to: 1. assess feasibility and safety of a 6-month home- and group-based exercise program for children with JIA; 2. estimate the effect of program participation on bone mass and strength, muscle function and clinical outcomes and 3. determine if any positive changes in bone and muscle outcomes are maintained 6 months later. Methods: We recruited 24 children with JIA who were part of the Linking Exercise, Physical Activity and Pathophysiology in Childhood Arthritis (LEAP) study to participate in a 6-month home-based exercise program involving jumping and handgrip exercises, resistance training and one group exercise session per month. We assessed lumbar spine bone mass (dual energy X-ray absorptiometry), distal tibia and radius bone microarchitecture and strength (high-resolution peripheral quantitative computed tomography), muscle function (jumping mechanography, dynamometry) and clinical outcomes (joint assessment, function, health-related quality of life) at baseline, 6- and 12-months. Adherence was assessed using weekly activity logs. Results: Thirteen children completed the 6-month intervention. Participants reported 9 adverse events and post-exercise pain was rare (0.4%). Fatigue improved, but there were no other sustained improvements in muscle, bone or clinical outcomes. Adherence to the exercise program was low (47%) and decreased over time. Conclusion: Children with JIA safely participated in a home-based exercise program designed to enhance muscle and bone strength. Fatigue improved, which may in turn facilitate physical activity participation. Prescribed exercise posed adherence challenges and efforts are needed to address facilitators and barriers to participation in and adherence to exercise programs among children with JIA. Trial registration: Data of the children with JIA are from the LEAP study (Canadian Institutes of Health Research (CIHR; GRANT# 107535). http://www.leapjia.com/

    Crowdsourcing hypothesis tests: Making transparent how design choices shape research results

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    To what extent are research results influenced by subjective decisions that scientists make as they design studies? Fifteen research teams independently designed studies to answer fiveoriginal research questions related to moral judgments, negotiations, and implicit cognition. Participants from two separate large samples (total N > 15,000) were then randomly assigned to complete one version of each study. Effect sizes varied dramatically across different sets of materials designed to test the same hypothesis: materials from different teams renderedstatistically significant effects in opposite directions for four out of five hypotheses, with the narrowest range in estimates being d = -0.37 to +0.26. Meta-analysis and a Bayesian perspective on the results revealed overall support for two hypotheses, and a lack of support for three hypotheses. Overall, practically none of the variability in effect sizes was attributable to the skill of the research team in designing materials, while considerable variability was attributable to the hypothesis being tested. In a forecasting survey, predictions of other scientists were significantly correlated with study results, both across and within hypotheses. Crowdsourced testing of research hypotheses helps reveal the true consistency of empirical support for a scientific claim.</div

    Proceedings of the 3rd Biennial Conference of the Society for Implementation Research Collaboration (SIRC) 2015: advancing efficient methodologies through community partnerships and team science

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    It is well documented that the majority of adults, children and families in need of evidence-based behavioral health interventionsi do not receive them [1, 2] and that few robust empirically supported methods for implementing evidence-based practices (EBPs) exist. The Society for Implementation Research Collaboration (SIRC) represents a burgeoning effort to advance the innovation and rigor of implementation research and is uniquely focused on bringing together researchers and stakeholders committed to evaluating the implementation of complex evidence-based behavioral health interventions. Through its diverse activities and membership, SIRC aims to foster the promise of implementation research to better serve the behavioral health needs of the population by identifying rigorous, relevant, and efficient strategies that successfully transfer scientific evidence to clinical knowledge for use in real world settings [3]. SIRC began as a National Institute of Mental Health (NIMH)-funded conference series in 2010 (previously titled the “Seattle Implementation Research Conference”; $150,000 USD for 3 conferences in 2011, 2013, and 2015) with the recognition that there were multiple researchers and stakeholdersi working in parallel on innovative implementation science projects in behavioral health, but that formal channels for communicating and collaborating with one another were relatively unavailable. There was a significant need for a forum within which implementation researchers and stakeholders could learn from one another, refine approaches to science and practice, and develop an implementation research agenda using common measures, methods, and research principles to improve both the frequency and quality with which behavioral health treatment implementation is evaluated. SIRC’s membership growth is a testament to this identified need with more than 1000 members from 2011 to the present.ii SIRC’s primary objectives are to: (1) foster communication and collaboration across diverse groups, including implementation researchers, intermediariesi, as well as community stakeholders (SIRC uses the term “EBP champions” for these groups) – and to do so across multiple career levels (e.g., students, early career faculty, established investigators); and (2) enhance and disseminate rigorous measures and methodologies for implementing EBPs and evaluating EBP implementation efforts. These objectives are well aligned with Glasgow and colleagues’ [4] five core tenets deemed critical for advancing implementation science: collaboration, efficiency and speed, rigor and relevance, improved capacity, and cumulative knowledge. SIRC advances these objectives and tenets through in-person conferences, which bring together multidisciplinary implementation researchers and those implementing evidence-based behavioral health interventions in the community to share their work and create professional connections and collaborations

    Storytelling as an Effective Leadership Tool

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    Telling stories can be done by anyone, no matter their age, income, or job title. In our research, we sought to understand how storytelling can be used by organizational leaders to pass along essential information, attitudes, and traditions. Stories are timeless, simple, educational, and powerful which make them an effective leadership tool. We began our research with a traditional literature review, incorporating information we gained in interviews with executives from a storytelling firm and from a Fortune 500 firm. We used the internet to get the most recent information that has yet to be published. Stories should be told in such a way that it portrays what the company believes in, as well as how people should behave. Stories need to be structured so that the listener understands their relevance and the conveyed message. Finally, leaders should always practice what they preach. It is extremely important that a leader is not hypocritical, even when telling stories. The best ingredients to any leader\u27s story include ideas, values, emotions, and an edge. By using these ingredients, leaders can create stories to portray the future as an unfolding drama, or they can teach stories to create a teachable point of view that will lead to success

    Factor Structure, Reliability, and Validity of the Wraparound Fidelity Index Short Form (WFI-EZ)

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    Wraparound care coordination has been demonstrated to promote positive mental health, residential, and cost outcomes for children and youth with serious emotional and behavioral disorders (SEBD) and their families. However, research also shows that positive outcomes are dependent on adequacy of Wraparound fidelity. The current study presents results from a series of studies that collectively assessed the factor structure, reliability, and validity of the Wraparound Fidelity Index, Short Form (WFI-EZ), a four section, multi-informant, self-report measure. Analyses of a sample of 10,955 caregivers of youth who received Wraparound and completed the WFI-EZ found a four-factor solution that aligned well with previous theories of change for Wraparound, with factors focused on team membership, team process, inclusion of natural supports, and intermediate outcomes, including increased family assets and more effective services and supports. Cronbach’s alpha was 0.90 for the full index and acceptable for all four empirically derived factors (α = 0.61–0.91); preliminary test-retest reliability data for the composite WFI-EZ fidelity index drawn from two small samples was found to be high for caregivers (r = 0.94) and moderate for care coordinators (r = 0.72). Results of known-groups analyses found that WFI-EZ scores discriminated groups theoretically expected to differ on Wraparound fidelity, including whether basic elements of Wraparound were provided and whether provider organizations were measured as having high versus low supports for Wraparound. Results indicate the WFI-EZ is a reliable and valid measure of Wraparound fidelity, while also pointing to opportunities for future refinement, further research, and opportunities for improving Wraparound training and implementation support
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