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Improving parental sensitivity is an important objective of interventions to support families. This study examined reliability and validity of parental sensitivity ratings using a novel package of an e-learning tool and an interactive decision tree provided through a mobile application, called the OK! package. Independent raters assessed parental sensitivity using the OK! package (N = 11 raters) and the NICHD Parental Sensitivity rating scales (N = 22 raters) on the basis of videotaped mother-child interactions at 10- or 12-months-old (N = 294) and at 24-months-old (N = 204) from the Dutch longitudinal cohort study Generation2 . Mothers reported on children's externalizing and internalizing problems and social competence when children were 4 and 7 years old. Results showed excellent single interrater reliability for raters using the OK! package (mean ICC = .79), and strong evidence for convergent validity at 10- or 12-month-old (r = .57) and 24-month-old (r = .65). Prospective associations of neither parental sensitivity rated using the OK! package or the NICHD Parental Sensitivity rating scales with child developmental outcomes were statistically significant (p > .05), with overlapping 95% confidence intervals for both measures. The OK! package provides a promising direction for testing alternatives to current training and instruction modalities.

Mejorar la sensibilidad de progenitores es un objetivo importante de intervenciones para ayudar a las familias. Este estudio examinó la confiabilidad y validez de los puntajes de sensibilidad de progenitores usando un novedoso paquete de una herramienta de e-aprendizaje y un árbol interactivo de decisión, ofrecido a través de una aplicación móvil llamada ¡Paquete OK! Calificadores independientes evaluaron la sensibilidad de progenitores usando el ¡Paquete OK! (N = 11 calificadores) y las escalas de puntajes de Sensibilidad del Progenitor de NICHD (N = 22 calificadores) sobre la base de las interacciones madre-niño grabadas en video a los 10 o 12 meses de edad (N = 294) y a los 24 meses de edad (N = 204) del grupo holandés de estudio longitudinal Generación 2. Las madres reportaron sobre los problemas de externalización e internalización de los niños y la competencia social cuando los niños tenían 4 y 7 años. Los resultados muestran una excelente sola confiabilidad entre calificadores para los calificadores que usaron el ¡Paquete OK! (media ICC = .79), y una fuerte evidencia para la validez convergente a los 10 o 12 meses de edad (r = .57) y a los 24 meses de edad (r = .65). Las asociaciones probables, ni de la sensibilidad del progenitor evaluada usando el ¡Paquete OK! ni de las escalas de puntajes de Sensibilidad del Progenitor NICHD, con los resultados del desarrollo del niño, fueron estadísticamente significativas (p > .05), con intervalos de confiabilidad que coincidían 95% para ambas medidas. El ¡Paquete OK! Ofrece una prometedora directriz para examinar alternativas al entrenamiento y modalidades de instrucción actuales.

L'amélioration de la sensibilité parentale est un objectif important d'interventions pour soutenir les familles. Cette étude a examiné la fiabilité et la validité de la sensibilité parentale utilisant une nouvelle approche combinant un outil de formation en ligne et un arbre de décision interactif offert au travers d'une application mobile, appelée l'approche OK!. Des évaluateurs indépendants ont évalué la sensibilité parentale en utilisant l'approche OK! (N = 11 évaluateurs) et les échelles d'évaluation de le sensibilité parentale NICHD (N = 22 évaluateurs) sur la base d'interactions mère-enfant filmées à la vidéo à 10- ou 12 mois N = 294) et à 24 mois (N-204) de l'étude de cohorte longitudinale hollandaise Generation2. Les mères ont signalé les problèmes d'externalisation et d'internalisation des enfants et leur compétence sociale lorsque les enfants avaient 4 et 7 ans. Les résultats ont démontré une excellente fiabilité entre les évaluateurs pour les évaluateurs utilisant l'approche OK! (moyenne ICC = ,79(, et de fortes preuves d'une validité convergente à 10 ou 12 mois (r = ,57) et à 24 mois (r = ,65). Les associations prospectives d'aucune sensibilité parentale évaluée en utilisant l'approche OK! ou les échelles d'évaluation de la sensibilité parentale NICHD ave des résultats développementaux de l'enfant étaient statistiquement significatives (p . ,05) avec un chevauchement des intervalles de confiance de 95% pour les deux mesures. L'approche OK! offre une direction prometteuse d'alternatives des tests aux modalités de formation et d'instruction actuelles.

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BACKGROUND: Pragmatic randomized controlled trials are able to make an essential contribution to the further development of evidence-based treatment recommendations for primary care patients. However, drug trials are regulated by specific guidelines and have not yet become a routine task in GP practices. Within the scope of a multi-center, double-blind, randomized controlled trial on treating urinary tract infections in women with and without antibiotics (REGATTA), the feasibility of pharmaceutical studies in GP practices was evaluated by means of a questionnaire sent out to participating physicians and practice nurses. METHODS: Using a self-designed, non-validated questionnaire, the perspectives, attitudes and experiences of participating physicians and practice nurses were assessed anonymously. In this way, we identified both hindering and beneficial factors affecting the conduct of drug trials in German GP practices. RESULTS: 39 physicians and 48 practice nurses participated in the survey. 95 % of the physicians and 88 % of the practice nurses indicated that the implementation of drug trials with all their regulatory requirements is, in principle, possible in GP practices. In particular, the high amount of time and documentation necessary were identified as barriers. The implementation can be facilitated by formulating a research question that is relevant to practice and patients and by support from the study center. CONCLUSION: Although participation in a drug trial is an additional burden in everyday practice, it is considered feasible and worthwhile by the GPs and practice nurses involved. Due to an assumed selection bias, the predominantly positive experiences of the respondents may be overestimated and transferable only to a limited extent.

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BACKGROUND: The National Association of Statutory Health Insurance Physicians develops quality indicators (QIs) for ambulatory care in Germany. This study explores the feasibility of a total of 48 QIs. METHODS: Cross-sectional observational study with primary data collection in writing from medical practices in 10 specialist fields of outpatient care. "Feasibility" covers 7 criteria for indicator assessment and data collection: applicability, availability, retrievability, complexity, relevance, reliability, and acceptance. A questionnaire consisting of 10 questions was used to evaluate these feasibility criteria for each indicator. Survey results were subjected to descriptive analysis. RESULTS: The analyzed sample comprises 103 participants who have been working as practice-based physicians for an average of 13 years. 40% only keep electronic medical records and 2% only paper records, and the rest uses both. The rating of QIs in the field-specific QI sets shows the following mean values: 67% of the participants consider the QIs assigned to them as corresponding to their practice care mandate. Data on these QIs deemed to be applicable are collected by 94% of respondents, documented by 91%, and by 51% electronically. 58% of the data required for the denominator, and 38% for the numerator are retrievable from the practice management system. The time required to access data on a QI is more than 30minutes for 84% of respondents, and 67% consider the effort involved as unacceptable. The rating received was 61% for the relevance of QIs to the assessment of a practitioner's own quality of health care, 69% for the estimated reliability of data collection, and 58% for the acceptance of being evaluated via QIs. CONCLUSIONS: In order to improve the feasibility of QI-based practice assessments it will be necessary to a) fine-tune the selection of QIs for the respective groups of specialist, b) to promote the use of computerized practice management systems, and c) integrate effective and user-friendly retrieval functions in the software. Another aspect to be explored is how the acceptance of QI-based practice evaluations can be improved in individual specialist fields.

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The term "innovation" refers to new products, but also to the process of developing and distributing new products and procedures. The operative disciplines are often associated with innovations because of their continuous, stepwise adaptation of daily practice to established procedures. Medical devices play a significant role in integrating surgical technology with surgical experience. The success of a surgical innovation and other invasive treatments does not only depend on the surgical procedure, but also on the context of the whole treatment process including the pre- and postoperative phase, the interaction of the surgical team and the setting. High standards have been set for the assessment of surgical innovations in terms of patient safety, efficacy and patient benefit, which will be discussed in the present paper. A stepwise approach to evaluation will be used, split into preclinical development, clinical development (feasibility and safety), evaluation phase (efficacy and patient benefit) and longtime surveillance. Our paper is based on the expert-based consented IDEAL approach as well as the consented recommendations of the European Association of Endoscopic Surgery (EAES). (As supplied by publisher).

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