295 research outputs found

    Treatment effect modifiers in a randomized trial of the good behavior game during middle childhood.

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    Objective: Two key treatment effect modifiers—implementation variability and participant cumulative risk status—are examined as predictors of disruptive behavior outcomes in the context of a large cluster randomized controlled trial of a universal, school-based behavior management intervention. The core components of the Good Behavior Game (GBG) are classroom rules, team membership, monitoring behavior, and positive reinforcement. Children work in teams to win the game, which is played alongside a normal classroom activity, during which their teacher monitors infractions to classroom rules. Teams with four or fewer infractions at the end of the game win and are rewarded. Method: Seventy-seven English primary schools (N = 3,084 children, aged 6–7) were randomly assigned to deliver the GBG or continue their usual practice over 2 years. Results: Intent-to-treat analysis found no discernible impact of the intervention on children’s disruptive behavior. Additionally, subgroup analyses revealed no differential gains among children at low, moderate or high levels of cumulative risk exposure (CRE). However, complier average causal effect estimation (CACE) using dosage as a compliance marker identified a large, statistically significant intervention effect (d = −1.35) among compliers (>1,030 min of cumulative intervention exposure). Furthermore, this compliance effect varied by participant CRE, such that children at high and low levels of exposure experienced significantly greater and lesser reductions in disruptive behavior, respectively. Conclusions: These findings highlight the importance of optimizing implementation and demonstrate the utility of CRE as a theoretically informed approach to subgroup moderator analysis. Implications are discussed and study strengths and limitations are noted

    Sox1 is required for the specification of a novel p2-derived interneuron subtype in the mouse ventral spinal cord

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    During mouse development, the ventral spinal cord becomes organized into five progenitor domains that express different combinations of transcription factors and generate different subsets of neurons and glia. One of these domains, known as the p2 domain, generates two subtypes of interneurons, V2a and V2b. Here we have used genetic fate mapping and loss-of-function analysis to show that the transcription factor Sox1 is expressed in, and is required for, a third type of p2-derived interneuron, which we named V2c. These are close relatives of V2b interneurons, and, in the absence of Sox1, they switch to the V2b fate. In addition, we show that late-born V2a and V2b interneurons are heterogeneous, and subsets of these cells express the transcription factor Pax6. Our data demonstrate that interneuron diversification in the p2 domain is more complex than previously thought and directly implicate Sox1 in this proces

    Direct exfoliation and dispersion of two-dimensional materials in pure water via temperature control

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    The high-volume synthesis of two-dimensional (2D) materials in the form of platelets is desirable for various applications. While water is considered an ideal dispersion medium, due to its abundance and low cost, the hydrophobicity of platelet surfaces has prohibited its widespread use. Here we exfoliate 2D materials directly in pure water without using any chemicals or surfactants. In order to exfoliate and disperse the materials in water, we elevate the temperature of the sonication bath, and introduce energy via the dissipation of sonic waves. Storage stability greater than one month is achieved through the maintenance of high temperatures, and through atomic and molecular level simulations, we further discover that good solubility in water is maintained due to the presence of platelet surface charges as a result of edge functionalization or intrinsic polarity. Finally, we demonstrate inkjet printing on hard and flexible substrates as a potential application of water-dispersed 2D materials.close1

    What constitutes 'good' home care for people with dementia? An investigation of the views of home care service recipients and providers

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    BACKGROUND: Our objective was to explore what people receiving and providing care consider to be ‘good’ in-home care for people living with dementia. METHODS: We conducted 36 in-depth interviews and two focus groups with key stakeholders in Australia in the first quarter of 2018. Participants included those receiving care (4 people living with dementia, 15 family carers) or providing care (9 case managers, 5 service managers, 10 home care workers). Qualitative thematic analysis was guided by Braun and Clarke’s six-step approach. RESULTS: Consensus was reached across all groups on five themes considered as important for good in-home dementia care: 1) Home care workers’ understanding of dementia and its impact; 2) Home care workers’ demonstrating person-centred care and empathy in their care relationship with their client; 3) Good relationships and communication between care worker, person with dementia and family carers; 4) Home care workers’ knowing positive practical strategies for changed behaviours; 5) Effective workplace policies and workforce culture. The results contributed to the co-design of a dementia specific training program for home care workers. CONCLUSIONS: It is crucial to consider the views and opinions of each stakeholder group involved in providing/receiving dementia care from home care workers, to inform workforce training, education program design and service design. Results can be used to inform and empower home care providers, policy, and related decision makers to guide the delivery of improved home care services. TRIAL REGISTRATION: ACTRN 12619000251123

    Mental health questionnaire research with children and young people in schools: Recommendations for good practice

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    The mental health of children and young people is recognised as an international public health priority and, therefore, a research priority. Researchers are increasingly asking children and young people to complete self-report questionnaires to better understand their health and wellbeing. Often, this research is carried out in schools, partly because this is a useful way of engaging with large groups of children and young people, but also as a way of assessing local needs and evaluating interventions

    What constitutes ‘good’ home care for people with dementia? An investigation of the views of home care service recipients and providers

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    BACKGROUND: Our objective was to explore what people receiving and providing care consider to be 'good' in-home care for people living with dementia. METHODS: We conducted 36 in-depth interviews and two focus groups with key stakeholders in Australia in the first quarter of 2018. Participants included those receiving care (4 people living with dementia, 15 family carers) or providing care (9 case managers, 5 service managers, 10 home care workers). Qualitative thematic analysis was guided by Braun and Clarke's six-step approach. RESULTS: Consensus was reached across all groups on five themes considered as important for good in-home dementia care: 1) Home care workers' understanding of dementia and its impact; 2) Home care workers' demonstrating person-centred care and empathy in their care relationship with their client; 3) Good relationships and communication between care worker, person with dementia and family carers; 4) Home care workers' knowing positive practical strategies for changed behaviours; 5) Effective workplace policies and workforce culture. The results contributed to the co-design of a dementia specific training program for home care workers. CONCLUSIONS: It is crucial to consider the views and opinions of each stakeholder group involved in providing/receiving dementia care from home care workers, to inform workforce training, education program design and service design. Results can be used to inform and empower home care providers, policy, and related decision makers to guide the delivery of improved home care services. TRIAL REGISTRATION: ACTRN 12619000251123

    Cyprus building energy performance methodology: A comparison of the calculated and measured energy consumption results

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    In order to fulfil article 4 of the 2002/91/EC Directive (EPBD) a national methodology for the energy performance of buildings was drafted and approved by the Government of Cyprus in 2009. This methodology is in line with the European standards prepared to facilitate EPBD implementation and follows the asset rating approach that is, it represents the intrinsic annual energy use of a building under standardised conditions. CEN standards leave an option, quite suitable for existing and complex buildings, for operational rating, which is an energy rating based on measured amounts of delivered and exported energy. The calculated and measured rating exhibit advantages and disadvantages and as expected the results of the two approaches vary, since the measured rating approach takes into account the effect of user behaviour, the actual weather conditions and the realized (actual) thermal comfort conditions inside the building. This paper presents the Cyprus legal framework for adopting the EPBD and exhibits the Cyprus methodology for the energy performance of buildings. Moreover the advantages and disadvantages of the asset and operational rating approaches are discussed and a comparison of the results of these two approaches for a selected number of dwellings is presented. One of these cases is also examined with respect to the climatic conditions, by changing the climatic zone in which the building is erected. The latter reveals the effect of climate on the calculated energy requirements of the building for both heating and cooling

    Carotid Ultrasound Boundary Study (CUBS): An Open Multicenter Analysis of Computerized Intima–Media Thickness Measurement Systems and Their Clinical Impact

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    Common carotid intima–media thickness (CIMT) is a commonly used marker for atherosclerosis and is often computed in carotid ultrasound images. An analysis of different computerized techniques for CIMT measurement and their clinical impacts on the same patient data set is lacking. Here we compared and assessed five computerized CIMT algorithms against three expert analysts’ manual measurements on a data set of 1088 patients from two centers. Inter- and intra-observer variability was assessed, and the computerized CIMT values were compared with those manually obtained. The CIMT measurements were used to assess the correlation with clinical parameters, cardiovascular event prediction through a generalized linear model and the Kaplan–Meier hazard ratio. CIMT measurements obtained with a skilled analyst's segmentation and the computerized segmentation were comparable in statistical analyses, suggesting they can be used interchangeably for CIMT quantification and clinical outcome investigation. To facilitate future studies, the entire data set used is made publicly available for the community at http://dx.doi.org/10.17632/fpv535fss7.1
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