scholarly journals Developing, Implementing, and Improving Assessment and Treatment Fidelity in Clinical Aphasia Research

2020 ◽  
Vol 29 (1) ◽  
pp. 286-298
Author(s):  
Leigh Ann Spell ◽  
Jessica D. Richardson ◽  
Alexandra Basilakos ◽  
Brielle C. Stark ◽  
Abeba Teklehaimanot ◽  
...  
Keyword(s):  
Interrater Reliability ◽  
Intervention Study ◽  
Treatment Fidelity ◽  
Recruitment Strategies ◽  
Timely Manner ◽  
Treatment Protocols ◽  
Study Staff ◽  
Assessment And Treatment ◽  
Fidelity Measures ◽  
Ongoing Monitoring

Purpose The purpose of this study was to describe the development and implementation of a fidelity program for an ongoing, multifacility, aphasia intervention study and to explain how initial fidelity measures are being used to improve study integrity. Method A Clinical Core team developed and incorporated a fidelity plan in this study. The aims of the Clinical Core team were to (a) supervise data collection and data management at each clinical site, (b) optimize and monitor assessment fidelity, and (c) optimize and monitor treatment fidelity. Preliminary data are being used to guide ongoing efforts to preserve and improve the fidelity of this intervention study. Results Preliminary results show that specific recruitment strategies help to improve appropriate referrals and that accommodations to participants and their families help to maintain excellent retention. A streamlined and centralized training program assures the reliability of assessors and raters for the study's assessment and treatment protocols. Ongoing monitoring of both assessment and treatment tasks helps to maintain study integrity. Less-than-optimal interrater reliability data for the raters of some of the discourse measures guided the Clinical Core team to address the training and coding inconsistencies in a timely manner. Conclusions The creation of a Clinical Core team is instrumental in developing and implementing a fidelity plan for improved assessment and treatment fidelity. Intentional planning and assignment of study staff to implement and monitor ongoing fidelity measures assures that clinical data are reliable and valid. Ongoing review of the plan shows areas of strengths and weaknesses for continuing adjustments and improvement of study fidelity.

Developing the Interrater Reliability of the Modified EMDR Fidelity Checklist

2019 ◽  
Vol 13 (1) ◽  
pp. 32-50 ◽  
Author(s):  
Rebecca Z. Cooper ◽  
Anita D. Smith ◽  
David Lewis ◽  
Christopher W. Lee ◽  
Andrew M. Leeds
Keyword(s):  
Interrater Reliability ◽  
Empirical Investigation ◽  
Treatment Fidelity ◽  
Past Research ◽  
The Body ◽  
Future Research ◽  
Phase Study ◽  
Three Phase ◽  
Intraclass Correlations ◽  
Fidelity Measures

Although treatment fidelity measures for eye movement desensitization and reprocessing (EMDR) have been cited in past research, none have been subject to any empirical investigation of reliability. This three-phase study aimed to quantify the interrater reliability of a measure of EMDR treatment fidelity. First, two raters refined the reprocessing section of the EMDR Fidelity Checklist (Leeds, 2016) by developing a descriptive item-by-item scoring system to improve interpretation and reliability. The resultant checklist was piloted on recordings of five EMDR session recordings from the Laugharne et al. (2016) study. The checklist was then revised. Next, the raters used the checklist to assess 15 other recorded EMDR sessions from the same study. The intraclass correlations (ICCs) were in the excellent range for all subscales and total session scores (i.e., >0.75), with an exception of the Desensitization subscale, ICC = 0.69 (0.08, 0.90). Finally, individual items in that subscale were evaluated, finding that five items did not contribute to the ICC. When these were removed/revised, the ICC for this subscale moved into the excellent range, ICC = 0.81(0.43, 0.94). The findings of this study indicate that this checklist may be a reliable measure of treatment fidelity for single reprocessing EMDR sessions with the possible exception of the Body Scan phase. Future research using the checklist with raters who were not involved in checklist development is needed to confirm the generalizability of these findings.

A Mobile Application for Wound Assessment and Treatment

2016 ◽  
Vol 15 (4) ◽  
pp. 344-353 ◽  
Author(s):  
Young Joon Jun ◽  
Donghyeok Shin ◽  
Whan Jun Choi ◽  
Ji Hyeon Hwang ◽  
Hoon Kim ◽  
...  
Keyword(s):  
Mobile Application ◽  
Wound Care ◽  
Treatment Plan ◽  
Care Providers ◽  
Treatment Protocols ◽  
Mobile Phone Application ◽  
Wound Assessment ◽  
Reasonable Solution ◽  
Assessment And Treatment ◽  
The Status

The D+Wound Solution is a mobile phone application (app) that assists users in the assessment and treatment of the wound. The app has 6 components for assessment: need for debridement, infection control, revascularization, and exudate control; whether it is chronic; and finally, the top surface of the skin. These components are named D.I.R.E.C.T. The app makes you review these components as an algorithm to provide a reasonable solution for dressing. It is designed to understand the status of the wound and provide a practical treatment idea for wound care providers. A total of 118 nurses were divided into 2 groups, designated as experienced and less-experienced groups, and surveyed. Both groups found the app to be helpful in making a treatment plan. However, the less-experienced group found it to be significantly more useful in assessing the wound ( P = .026) but difficult to understand the logic. The experienced group found the logic to be significantly easier to understand ( P = .018) and had significantly higher similarities ( P = .015) in treatment protocols compared with the less-experienced group. We may conclude that this app has a logical algorithm resembling experienced wound caregivers and is more useful in the less-experienced group.

Status Epilepticus—Work-Up and Management in Children

2020 ◽  
Vol 40 (06) ◽  
pp. 661-674
Author(s):  
Cristina Barcia Aguilar ◽  
Iván Sánchez Fernández ◽  
Tobias Loddenkemper
Keyword(s):  
Status Epilepticus ◽  
Medical Emergency ◽  
First Line ◽  
Timely Manner ◽  
Treatment Protocols ◽  
Efficacious Treatment ◽  
Life Threatening ◽  
Diagnostic Work ◽  
Work Up ◽  
Medication Choice

AbstractStatus epilepticus (SE) is one of the most common neurological emergencies in children and has a mortality of 2 to 4%. Admissions for SE are very resource-consuming, especially in refractory and super-refractory SE. An increasing understanding of the pathophysiology of SE leaves room for improving SE treatment protocols, including medication choice and timing. Selecting the most efficacious medications and giving them in a timely manner may improve outcomes. Benzodiazepines are commonly used as first line and they can be used in the prehospital setting, where most SE episodes begin. The diagnostic work-up should start simultaneously to initial treatment, or as soon as possible, to detect potentially treatable causes of SE. Although most etiologies are recognized after the first evaluation, the detection of more unusual causes may become challenging in selected cases. SE is a life-threatening medical emergency in which prompt and efficacious treatment may improve outcomes. We provide a summary of existing evidence to guide clinical decisions regarding the work-up and treatment of SE in pediatric patients.

scholarly journals Cultural Perspectives in Language and Speech Disorders

2009 ◽  
Vol 29 (4) ◽  
Author(s):  
Ruth Ndung'u ◽  
Mathew Kinyua
Keyword(s):  
Cultural Beliefs ◽  
Speech Disorders ◽  
Cultural Perspective ◽  
Gender Preferences ◽  
Treatment Protocols ◽  
Cultural Perspectives ◽  
Operation Smile ◽  
Management Procedures ◽  
Assessment And Treatment ◽  
Collaborative Therapy

<p>Culture has a heavy overlay on the perceptions and the subsequent handling of persons with language and speech disorders. This article reviews the cultural perspectives of language and speech disorders as portrayed by persons with language and speech disorders, parents, teachers, and language and speech pathologists. The information on cultural perspectives was collected between November 2006 and August 2007 during Operation Smile, Kenya Chapter Missions. 20 persons, aged between 8 and 53 years, were interviewed. The research objective was to establish the cultural perspective that determines the interpretations of language and speech disorders and their subsequent management.</p> <p>The finding of the study is that there is a notable cultural association or correlation between cultural beliefs and language and speech disorders. There is also ignorance of the causes and management procedures of language and speech disorders. We conclude that there is a need to provide assessment and treatment protocols that are culturally fair, effective, and acceptable. Such protocols include taking into account gender preferences, adhering to culturally relevant communication patterns, and using collaborative therapy.</p>

scholarly journals From Cook to Culinarian: Going Beyond the Manual When Delivering Behavior Therapy to Treat Tourette Disorder

2017 ◽  
Vol 13 (1) ◽  
pp. 51
Author(s):  
Brianna Wellen ◽  
Michael B. Himle
Keyword(s):  
Behavior Therapy ◽  
Clinical Skill ◽  
Treatment Fidelity ◽  
Treatment Protocols ◽  
Treatment Delivery ◽  
Underlying Theory ◽  
Tourette Disorder ◽  
Therapy Protocol ◽  
Vocal Tics

In the case of Hiro, Dr. Jeremy Lichtman (2017, this issue) describes how he flexibly employed a manualized behavior therapy protocol to successfully treat a child’s involuntary motor and vocal tics.  In doing so, he raises interesting observations and questions regarding manualized psychotherapy treatment protocols, including their intended role, the need for "flexibility with fidelity," and the strengths and limitations of following manuals in a step-by-step fashion. In our commentary, we draw upon Dr. Lichtman’s experience in treating Hiro to highlight what we see as the two most important factors in Hiro’s treatment: (1) the therapist’s firm grasp of the underlying theory behind behavior therapy for tics, which allowed for flexibility in treatment delivery without jeopardizing treatment fidelity, and (2) the importance of having a strong foundational clinical skill set prior to beginning treatment

scholarly journals Orbital Swelling and Ptosis as an Initial Presentation of Childhood Acute Lymphoblastic Leukaemia: A Case Report and Review of the Literature

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Ahmed Alsalem ◽  
Bayan Almasoudi ◽  
Ghaida Alzahrani ◽  
Lama Sindi ◽  
Joud Alwan
Keyword(s):  
Acute Lymphoblastic Leukaemia ◽  
Lymphoblastic Leukaemia ◽  
Bone Marrow Examination ◽  
Review Of The Literature ◽  
Lymphoid Leukaemia ◽  
Management Options ◽  
Treatment Protocols ◽  
Childhood Acute Lymphoblastic Leukaemia ◽  
Eyelid Swelling ◽  
Assessment And Treatment

We are reporting the case of a 3-year-old-girl who initially presented with unilateral eyelid swelling and ptosis. A diagnosis of acute lymphoblastic leukaemia (ALL) was eventually made based on an orbital incisional biopsy and a bone marrow examination. Historically, orbital involvement had been linked to myeloid leukaemia; however, in lymphoid leukaemia, they are increasingly being implicated and had been reported as the sole presentation of the disease. These findings stress the importance of conducting ophthalmologic assessments in cases diagnosed with ALL in order to prevent delays in proper assessment and treatment. Management options in orbital disease are fortunately not significantly different than well-established treatment protocols.

Trauma bij ASS: valkuilen in diagnostiek en behandeling

2021 ◽  
Vol 20 (2) ◽  
Author(s):  
Liesbeth Mevissen
Keyword(s):  
Mental Health Problems ◽  
Assessment Tools ◽  
Trauma Treatment ◽  
Limiting Factor ◽  
Clinical Experiences ◽  
Treatment Protocols ◽  
Trauma History ◽  
Potentially Traumatic Events ◽  
Assessment And Treatment ◽  
Research Findings

Individuals with ASD have an elevated risk of exposure to potentially traumatic events. This does not only pertain to events meeting the DSM-5 PTSD A criterion for trauma such as assault and abuse but also to seemingly less shocking adverse events such as bullying. In clinical practice, PTSD and other trauma and stressor-related patterns of complaints often remain undetected and therefore untreated. A limiting factor is that it is not common use to systematically investigate a patient’s trauma history routinely. Further, trauma-related complaints show a lot of overlap with other disorders, in particular anxiety and mood disorders, as well as overlap with characteristics of ASD. In addition, until now validated assessment tools for trauma in individuals with ASD are missing. Finally, the application of standard trauma treatment protocols is often hindered by ASD-related problems. Research into the applicability and effectiveness of trauma treatment for ASD is still in its infancy. In this paper, research findings and clinical experiences regarding assessment and treatment of trauma in individuals with ASD are shared to contribute to the prevention of long-term serious trauma-related mental health problems and to underpin the need for further research on this topic.

Treating Adolescent Misophonia With Cognitive Behavioral Therapy: Considerations for Including Exposure

2021 ◽  
pp. 153465012110457
Author(s):  
Jennifer L. Cecilione ◽  
Stephanie A. Hitti ◽  
Scott R. Vrana
Keyword(s):  
Adolescent Girl ◽  
Behavioral Therapy ◽  
Behavioral Approach ◽  
Cognitive Behavioral ◽  
Future Research ◽  
Evidence Based ◽  
Treatment Protocols ◽  
Evidence Based Treatment ◽  
Assessment And Treatment ◽  
No Gold Standard

Although misophonia is not yet included in the primary diagnostic manuals used by psychologists or psychiatrists, proposed criteria suggest that this condition is characterized by a strong negative reaction to and avoidance of certain trigger sounds. Misophonic trigger sounds are largely human-made (e.g., chewing and slurping) and evoke responses such as disgust, irritation, and/or anger that are out of proportion to the situation and cause distress and/or impairment. Currently, there is no gold standard evidence-based treatment for misophonia. As the misophonia treatment literature grows, several important questions are arising: (1) should exposure to aversive sound triggers be included in treatment for misophonia and (2) how can clinicians best assess misophonia symptoms. This case offers one example of misophonia being successfully treated with a cognitive-behavioral approach to treatment (including exposures) in an adolescent girl. This case also offers an example of how clinicians may conduct a comprehensive assessment of misophonia symptoms. Theoretically and empirically derived recommendations for including exposure in misophonia treatment are presented. Information from this case may be helpful in informing future research, as there is a paucity of evidence-based assessment and treatment protocols for misophonia.

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