What is Engagement and How Do We Measure It? Toward a Domain Independent Definition and Scale

An engaging experience draws in and holds our attention. Engagement is a critical phenomenon of interest in a variety of disciplines and application domains and has been shown to lead to positive outcomes, such as enhanced learning, task performance, or job satisfaction. However, existing measures of engagement are typically specific to the domain in which the research is conducted. This paper builds on the synergies of various disciplines and proposes a discipline-independent definition of engagement and measurement scale. In this paper, we distinguished between the three temporal levels of engagement in terms of the expected length of the engagement (task/activity, initiative, and continuous). We further explored the differences in the conceptualization of engagement, viz. affective, behavioral, and cognitive engagement. We then offered a comprehensive definition of engagement. We finally developed a measurement scale that can be used across domains and contexts which we derived by iteratively refining the items in this scale through a series of five data samples to arrive at the final scale. Our results provide evidence for the scale’s validity in two domains (online learning and work engagement)

Acción : diario de Teruel y su provincia: Año IV Número 908 - (05/11/35)

Background: Activities of daily living (ADL) are often used as predictors of health and function in older persons. This systematic review is part of a series initiated by the European Network for Action on Ageing and Physical Activity (EUNAAPA). Aim: To assess psychometric properties of ADL instruments for use in older populations. Methods: Electronic databases (Medline, EMBASE, AMED, Psycinfo, CINAHL) were searched, using MeSH terms and relevant keywords. Studies, published in English, were included if they evaluated one or more psychometric properties of ADL instruments in community-dwelling older persons aged 60 years and older. Combination scales with IADL were excluded. This systematic review adhered to a pre-specified protocol regarding reliability, validity, and responsiveness. Results: In total, 140 articles describing more than 50 different ADL instruments were included. Ten instruments which were applied in minimally three different articles of good quality (clear descriptions and adequate design according to the protocol), were evaluated for reliability, validity and responsiveness; each received a summary score. The four instruments with the highest scores were the Functional Autonomy Measurement System (SMAF), 5-items Katz list (although content and wording are often inconsistent across studies), Functional Independence and Difficulty Scale (FIDS) and the Barthel Index. Discussion: Critical reflection is essential to avoid unnecessary modifications and use of instruments that have not been documented to be valid or reliable. Conclusion: Based on this systematic review, we recommend the SMAF, 5-item Katz, FIDS and Barthel index as ADL measures for research and care practice in older populations

In Critically Ill Patients, Serum Procalcitonin Is More Useful in Differentiating between Sepsis and SIRS than CRP, Il-6, or LBP

We studied the usefulness of serum procalcitonin (PCT), interleukin-6 (IL-6), lipopolysaccharide binding protein (LBP) levels and C-reactive protein (CRP) levels, in differentiating between systemic inflammatory response syndrome (SIRS) and sepsis in critically ill patients. Methods. In this single centre prospective observational study we included all consecutive patients admitted with SIRS or sepsis to the ICU. Blood samples for measuring CRP, PCT, IL-6 and LBP were taken every day until ICU discharge. Results. A total of 76 patients were included, 32 with sepsis and 44 with SIRS. Patients with sepsis were sicker on admission and had a higher mortality. CRP, PCT, IL-6 and LBP levels were significantly higher in patients with sepsis as compared to SIRS. With PCT levels in the first 24 hours after ICU admission <2 ng/mL, sepsis was virtually excluded (negative predictive value 97%). With PCT >10 ng/mL, sepsis with bacterial infection was very likely (positive predictive value 88%). PCT was best at discriminating between SIRS and sepsis with the highest area under the ROC curve (0.95, 95% CI 0.90–0.99). Discussion. This study showed that PCT is more useful than LBP, CRP and IL-6 in differentiating sepsis from SIRS

Validation of the self-management ability scale (SMAS) and development and validation of a shorter scale (SMAS-S) among older patients shortly after hospitalisation

Background: The 30-item Self-Management Ability Scale (SMAS) measures self-management abilities (SMA). Objectives of this study were to (1) validate the SMAS among older people shortly after hospitalisation and (2) shorten the SMAS while maintaining adequate validity and reliability. Methods: Our study was conducted among older individuals (>= 65) who had recently been discharged from a hospital. Three months after hospital admission, 296/456 patients (65% response) were interviewed in their homes. We tested the instrument by means of structural equation modelling, and examined its validity and reliability. In addition, we tested internal consistency of the SMAS and SMAS-S among a study sample of patients at risk for cardiovascular diseases. Results: After eliminating 12 items, the confirmatory factor analyses revealed good indices of fit with the resulting 18-item SMAS (SMAS-S). To estimate construct validity of the instrument, we looked at correlations between SMAS subscale scores and overall well-being scores as measured by Social Product Function (SPF-IL) and Cantril's ladder. All SMAS subscales of the original and short version significantly correlated with SPF-IL scores (all at p <= 0.001) and Cantril's ladder (for the cognitive well-being subscale p <= 0.01; all other subscales at p <= 0.001). The findings indicated validity. Analyses of the SMAS and SMAS-S in the sample of patients at risk for cardiovascular diseases showed that both instruments are reliable. Conclusions: The psychometric properties of both the SMAS and SMAS-S are good. The SMAS-S is a promising alternate instrument to evaluate self-management abilities

The relationship between older adults' self-management abilities, well-being and depression

This study aimed to identify the relationship between self-management abilities, well-being and depression. Our study was conducted among older adults (>65 years of age) who were vulnerable to loss of function after hospital discharge. Three months after hospital admission, 296/456 patients (65 % response rate) were interviewed in their homes. The 30-item Self-Management Ability Scale was used to measure six self-management abilities: taking initiative, investing in resources for long-term benefits, taking care of a variety of resources, taking care of resource multifunctionality, being self-efficacious and having a positive frame of mind. Well-being was measured with the Social Production Function (SPF) Instrument for the Level of Well-being (SPF-IL) and Cantril's ladder. The Geriatric Depre

The Prevention and Reactivation Care Program: intervention fidelity matters.

The Prevention and Reactivation Care Program (PReCaP) entails an innovative multidisciplinary, integrated and goal oriented approach aimed at reducing hospital related functional decline among elderly patients. Despite calls for process evaluation as an essential component of clinical trials in the geriatric care field, studies assessing fidelity lag behind the number of effect studies. The threefold purpose of this study was (1) to systematically assess intervention fidelity of the hospital phase of the PReCaP in the first year of the intervention delivery; (2) to improve our understanding of the moderating factors and modifications affecting intervention fidelity; and (3) to explore the feasibility of the PReCaP fidelity assessment in view of the modifications. Based on the PReCaP description we developed a fidelity instrument incorporating nineteen (n=19) intervention components. A combination of data collection methods was utilized, i.e. data collection from patient records and individual Goal Attainment Scaling care plans, in-depth interviews with stakeholders, and non-participant observations. Descriptive analysis was performed to obtain levels of fidelity of each of the nineteen PReCaP components. Moderating factors were identified by using the Conceptual Framework for Implementation Fidelity. Ten of the nineteen intervention components were always or often delivered to the group of twenty elderly patients. Moderating factors, suc

Molecular Dynamics Studies of the Nucleoprotein of Influenza A Virus: Role of the Protein Flexibility in RNA Binding

The influenza viruses contain a segmented, negative stranded RNA genome. Each RNA segment is covered by multiple copies of the nucleoprotein (NP). X-ray structures have shown that NP contains well-structured domains juxtaposed with regions of missing electron densities corresponding to loops. In this study, we tested if these flexible loops gated or promoted RNA binding and RNA-induced oligomerization of NP. We first performed molecular dynamics simulations of wt NP monomer and trimer in comparison with the R361A protein mutated in the RNA binding groove, using the H1N1 NP as the initial structure. Calculation of the root-mean-square fluctuations highlighted the presence of two flexible loops in NP trimer: loop 1 (73–90), loop 2 (200–214). In NP, loops 1 and 2 formed a 10–15 Å-wide pinch giving access to the RNA binding groove. Loop 1 was stabilized by interactions with K113 of the adjacent β-sheet 1 (91–112) that interacted with the RNA grove (linker 360–373) via multiple hydrophobic contacts. In R361A, a salt bridge formed between E80 of loop 1 and R208 of loop 2 driven by hydrophobic contacts between L79 and W207, due to a decreased flexibility of loop 2 and loop 1 unfolding. Thus, RNA could not access its binding groove in R361A; accordingly, R361A had a much lower affinity for RNA than NP. Disruption of the E80-R208 interaction in the triple mutant R361A-E80A-E81A increased its RNA binding affinity and restored its oligomerization back to wt levels in contrast with impaired levels of R361A. Our data suggest that the flexibility of loops 1 and 2 is required for RNA sampling and binding which likely involve conformational change(s) of the nucleoprotein

Influenza Polymerase Activity Correlates with the Strength of Interaction between Nucleoprotein and PB2 through the Host-Specific Residue K/E627

The ribonucleoprotein (RNP) complex is the essential transcription-replication machinery of the influenza virus. It is composed of the trimeric polymerase (PA, PB1 and PB2), nucleoprotein (NP) and RNA. Elucidating the molecular mechanisms of RNP assembly is central to our understanding of the control of viral transcription and replication and the dependence of these processes on the host cell. In this report, we show, by RNP reconstitution assays and co-immunoprecipitation, that the interaction between NP and polymerase is crucial for the function of the RNP. The functional association of NP and polymerase involves the C-terminal ‘627’ domain of PB2 and it requires NP arginine-150 and either lysine-627 or arginine-630 of PB2. Using surface plasmon resonance, we demonstrate that the interaction between NP and PB2 takes place without the involvement of RNA. At 33, 37 and 41°C in mammalian cells, more positive charges at aa. 627 and 630 of PB2 lead to stronger NP-polymerase interaction, which directly correlates with the higher RNP activity. In conclusion, our study provides new information on the NP-PB2 interaction and shows that the strength of NP-polymerase interaction and the resulting RNP activity are promoted by the positive charges at aa. 627 and 630 of PB2