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Most current autism research focuses on Western countries, where service availability and cultural experiences differ from those of individuals living in Asian countries, where collectivistic cultural values prevail and understanding of autism is emerging. By gathering data from Vietnamese parents of autistic children (N = 339), the current measurement study examined measure variance and invariance between the English version of the "Illness Perception Questionnaire--Revised for Autism Spectrum Disorder" (IPQ-R-ASD) and a Vietnamese translation of it, at the item, scalar, and factor levels. Results indicated measurement variance for only three of 37 items and highlighted different perceptions of autism between Vietnamese and North American parents, based on responses to the IPQ-R-ASD. Responses indicated that Vietnamese parents may have a different interpretation of the questions. Seven factors emerged on both the Vietnamese and English instruments, but items loaded differently, and a distinct factor emerged on the Vietnamese version. In sum, the current findings suggest that the IPQ-R-ASD can be useful for better understanding Vietnamese parents' perceptions of their children's autism, but the interpretation is somewhat different than on the English version, highlighting the importance of cross-cultural considerations in the study of autism in Western versus Eastern cultures.

The novel coronavirus disease 2019 (COVID-19) has considerably heightened health and financial concerns for many individuals. Similar concerns, such as those associated with poverty, impair performance on cognitive control tasks. If ongoing concerns about COVID-19 substantially increase the tendency to mind wander in tasks requiring sustained attention, these worries could degrade performance on a wide range of tasks, leading, for example, to increased traffic accidents, diminished educational achievement, and lower workplace productivity. In two pre-registered experiments, we investigated the degree to which young adults' concerns about COVID-19 correlated with their ability to sustain attention. Experiment 1 tested mainly European participants during an early phase of the pandemic. After completing a survey probing COVID-related concerns, participants engaged in a continuous performance task (CPT) over two, 4-min blocks, during which they responded to city scenes that occurred 90% of the time and withheld responses to mountain scenes that occurred 10% of the time. Despite large and stable individual differences, performance on the scene CPT did not significantly correlate with the severity of COVID-related concerns obtained from the survey. Experiment 2 tested US participants during a later phase of the pandemic. Once again, CPT performance did not significantly correlate with COVID concerns expressed in a pre-task survey. However, participants who had more task-unrelated thoughts performed more poorly on the CPT. These findings suggest that although COVID-19 increased anxiety in a broad swath of society, young adults are able to hold these concerns in a latent format, minimizing their impact on performance in a demanding sustained attention task.

This study used ClassMaps Survey to investigate third to fifth grade elementary students' perceptions of five relational (e.g., teacher-student relationships and peer friendships) and three individual (e.g., academic self-efficacy and behavioral self-control) resilience-promoting factors in classrooms in China and the United States. Examination of measurement equivalence indicates that the seven-factor model excluding peer aggression has acceptable strong factorial measurement equivalence. Comparison of group means revealed common strengths in teacher-student relationships, peer friendships, challenges in behavioral self-control, and peer conflict across the two cultural groups. Interventions should be built upon positive relationships and target behavioral self-control and peer conflict.

Based on an elaboration of the resource potential and annual production of tight sandstone gas and shale gas in the United States and China, this paper reviews the researches on the distribution of tight sandstone gas and shale gas reservoirs, and analyzes the distribution characteristics and genetic types of tight sandstone gas reservoirs. In the United States, the proportion of tight sandstone gas in the total gas production declined from 20%--35% in 2008 to about 8% in 2023, and the shale gas production was 8 310x108 m3 in 2023, about 80% of the total gas production, in contrast to the range of 5%--17% during 2000--2008. In China, the proportion of tight sandstone gas in the total gas production increased from 16% in 2010 to 28% or higher in 2023. China began to produce shale gas in 2012, with the production reaching 250x108 m3 in 2023, about 11% of the total gas production of the country. The distribution of shale gas reservoirs is continuous. According to the fault presence, fault displacement and gas layer thickness, the continuous shale gas reservoirs can be divided into two types: continuity and intermittency. Most previous studies believed that both tight sandstone gas reservoirs and shale gas reservoirs are continuous, but this paper holds that the distribution of tight sandstone gas reservoirs is not continuous. According to the trap types, tight sandstone gas reservoirs can be divided into lithologic, anticlinal, and synclinal reservoirs. The tight sandstone gas is coal-derived in typical basins in China and Egypt, but oil-type gas in typical basins in the United States and Oman. [ABSTRACT FROM AUTHOR]

Many critics view "deontology" (focusing largely on the merits of an action itself) and "utilitarianism" (evaluation of an action based on its projected consequences) as rival approaches to ethical decision making. This survey of public relations students at three universities in the United States and one each in Hong Kong and mainland China suggest that, as various theorists propose, many people adhere to both schools of thought, with utilitarianism being the dominant view overall. Furthermore, belief in both schools appears to correlate with high-minded ethical thinking as measured by assessments of several hypothetical ethical decisions. Implications for teaching are suggested.

The current study first examined the applicability of the ClassMaps Survey (CMS)--a measurement of resilience in classroom/school settings developed in the US with Chinese middle school students and then compared the group differences on student perceptions of the resilience factors in the CMS across the two cultures. The findings suggest that the CMS and all its seven subscales have good to acceptable scalar measurement equivalence. The current study supports the use of the CMS and its seven subscales with Chinese middle school students as a measurement of resilience in classroom context. Furthermore, the study found that Chinese students scored significantly higher on academic self-determination, behavior self-control, teacher-student relationship, home-school relationship, and peer conflict but significantly lower on academic self-efficacy than American students. There was no significant difference in peer friendships between the two groups. Implications for resilience promotion in school settings were discussed in cultural context.

There have been calls recently to challenge some of the orthodoxies of counterurbanisation. This paper contributes to this by highlighting the complexity of rural in-migration processes, through a focus on rural return migration. There has been a significant increase in return migration to the Republic of Ireland (ROI) since 1996. The paper is based on the life narratives of some of the 1980s generation of emigrants who have recently returned to live in Ireland. It focuses on those Irish return migrants who spent a substantial part of their lives in the large urban centres of Britain and the US, and are currently living in rural Ireland. Their narratives of return are explored in terms of discourses of rurality, in particular through notions of a rural idyll and belonging/not belonging. It is argued that return migrants draw on classic counterurbanisation discourses in their narratives of return, but that these are interwoven with notions of family/kinship. Furthermore, the idyllisation of rural life is complicated by aspects of the specificity of the position of the return migrant. It is suggested that rural return migrants are positioned somewhere between locals and incomers, reflecting the complexity of Irish rural repopulation processes, and that the phenomenon of rural return complicates accepted understandings of counterurbanisation.

Purpose: This study explored the acceptability and practicality of implementing a Direct Skills Teaching (DST) approach to increase job interview preparation for individuals who were receiving state vocational rehabilitation (VR) services in four states. Method: Counselors-in-training facilitated a four-session curriculum teaching "Presenting Qualifications" during job interviews to 137 individuals in 25 groups settings. Pre- and post-group 10-item questionnaires of skill acquisition, and a post-group satisfaction survey with open-ended questions were administered. Descriptive statistics and a nonparametric Wilcoxon signed rank test were used for data analyses. Results: All 10 items of the pre- and post-group questionnaire comparisons yielded significant improvement in the skill of "Presenting Qualifications" after group intervention. The satisfaction survey also indicated the positive experiences of participants. Conclusions: The findings demonstrate the feasibility of a structured DST curriculum in teaching job interview skills to people with disabilities (including transition age youth) served by state VR agencies. [ABSTRACT FROM AUTHOR]

With the large numbers of international students on campuses across the United States seeking help from writing centers, more research is needed on how second language writing skills develop over time. Expanding our previous studies of second language writing, we wanted to learn more about what international students think about the development of their ability to write in English and the role of the writing center in it. To that end, we designed a survey that asked participants about different features of their writing and how these had changed since starting to write at the college level. The results reveal that participants perceived their overall English-writing development positively, and they reported their rhetorical and linguistic areas as almost equal in development. We also found that participants who used our writing center perceived both rhetorical and linguistic features to be more improved than did participants who had not used the writing center. The rhetorical features participants reported as the least improved involve communicating with readers, while the linguistic features they saw as the least developed include word choice, articles, and prepositions. Confidence about writing a strong argument and confidence in writing in English were also perceived as less developed. The survey results suggest that, overall, tutors should give equal attention to the rhetorical and linguistic features of second language writing development, which for some tutors would mean focusing more on language issues than they have done in the past. They should also focus on building second language writers' confidence by coaching them in self-editing. [ABSTRACT FROM AUTHOR]

We performed a suite of numerical simulations based on the 1811-1812 New Madrid seismic zone (NMSZ) earthquakes, which demonstrate the importance of 3D geologic structure and rupture directivity on the ground-motion response throughout a broad region of the central United States (CUS) for these events. Our simulation set consists of 20 hypothetical earthquakes located along two faults associated with the current seismicity trends in the NMSZ. The hypothetical scenarios range in magnitude from M 7.0 to 7.7 and consider various epicenters, slip distributions, and rupture characterization approaches. The low-frequency component of our simulations was computed deterministically up to a frequency of 1 Hz using a regional 3D seismic velocity model and was combined with higher-frequency motions calculated for a 1D medium to generate broadband synthetics (0-40 Hz in some cases). For strike-slip earthquakes located on the southwest-northeast-striking NMSZ axial arm of seismicity, our simulations show 2-10 s period energy channeling along the trend of the Reelfoot rift and focusing strong shaking northeast toward Paducah, Kentucky, and Evansville, Indiana, and southwest toward Little Rock, Arkansas. These waveguide effects are further accentuated by rupture directivity such that an event with a western epicenter creates strong amplification toward the northeast, whereas an eastern epicenter creates strong amplification toward the southwest. These effects are not as prevalent for simulations on the reverse-mechanism Reelfoot fault, and large peak ground velocities (>40 cm/s) are typically confined to the near-source region along the up-dip projection of the fault. Nonetheless, these basin response and rupture directivity effects have a significant impact on the pattern and level of the estimated intensities, which leads to additional uncertainty not previously considered in magnitude estimates of the 1811-1812 sequence based only on historical reports. The region covered by our simulation domain encompasses a large portion of the CUS centered on the NMSZ, including several major metropolitan areas. Based on our simulations, more than eight million people living and working near the NMSZ would experience potentially damaging ground motion and modified Mercalli intensities ranging from VI to VIII if a repeat of the 1811-1812 earthquakes occurred today. Moreover, the duration of strong ground shaking in the greater Memphis metropolitan area could last from 30 to more than 60 s, depending on the magnitude and epicenter. [ABSTRACT FROM AUTHOR]

There was an increasing interest in reducing production and emission of air pollutants to improve air quality for animal feeding operations (AFOs) in the U.S. in the 21st century. Research was focused on identification, quantification, characterization, and modeling of air pollutions; effects of emissions; and methodologies and technologies for scientific research and pollution control. Mitigation effects were on pre-excretion, pre-release, pre-emission, and post-emission. More emphasis was given on reducing pollutant emissions than improving indoor air quality. Research and demonstrations were generally continuation and improvement of previous efforts. Most demonstrated technologies were still in a limited scale of application. Future efforts are needed in many fundamental and applied research areas. Advancement in instrumentation, computer technology, and biological sciences and genetic engineering is critical to bring major changes in this area. Development in research and demonstration will depend on the actual political, economic, and environmental situations. [ABSTRACT FROM AUTHOR]

As public administration programs extend their online education offerings to reach more time- and place-bound students, and as accredited institutions become interested in documenting teaching and learning effectiveness, the degree to which online students are successful as compared to their classroom counterparts is of interest to teaching faculty and others charged with assessment. By comparing student performance measures and assessments of learning experience from both online and traditional sections of a required graduate public administration research methods course taught by the same instructor, this paper provides evidence that student performance as measured by grade is independent of the mode of instruction. Persistence in an online environment may be more challenging in research methods classes than in other public administration classes. Furthermore, participation may be less intimidating, and the quality and quantity of interaction may be increased in online classes. [ABSTRACT FROM AUTHOR]

Purpose: Radical prostatectomy is a common treatment for organ confined prostate cancer and its use is increasing. We examined how the increased volume is being distributed and what hospital characteristics are associated with increasing volume. Materials and Methods: We identified all men age 40 to less than 80 years who underwent radical prostatectomy for prostate cancer from 2000 to 2008 in the NIS (Nationwide Inpatient Sample) (586,429). Ownership of a surgical robot was determined using the 2007 AHA (American Hospital Association) Annual Survey. The association between hospital radical prostatectomy volume and hospital characteristics, including ownership of a robot, was explored using multivariate linear regression. Results: From 2000 to 2008 there was a 74% increase in the number of radical prostatectomies performed (p = 0.05) along with a 19% decrease in the number of hospitals performing radical prostatectomy (p <0.001), resulting in an increase in annual hospital radical prostatectomy volume (p = 0.009). Several hospital variables were associated with greater radical prostatectomy volume including teaching status, urban location, large bed size and ownership of a robot in 2007. On multivariate analysis the year, teaching status, large bed size, urban location and presence of a robot were associated with higher hospital radical prostatectomy volume. Conclusions: Use of radical prostatectomy increased significantly between 2000 and 2008, most notably after 2005. The increase in radical prostatectomy resulted in centralization to select hospitals, particularly those in the top radical prostatectomy volume quartile and those investing in robotic technology. Our findings support the hypothesis that hospitals with the greatest volume increases are specialty centers already performing a high volume of radical prostatectomy procedures. [Copyright &y& Elsevier]

Study design:Multi-center, prospective calibration study.Objectives:To examine the psychometric properties of item banks designed for a computer adaptive test of participation.Setting:Three pediatric specialty care hospitals in North America.Methods:Newly developed item banks containing questions about participation were administered to 381 children, 8-21 years. Unidimensionality was evaluated using categorical confirmatory factor analysis and residual correlations. Pearson's correlations were calculated between simulated CATs and the full-item banks.Results:CFI=0.905, TLI=0.951 and RMSEA=0.089 for the self-participation item bank; CFI=0.924, TLI=0.963 and RMSEA=0.083 friend-participation item bank. The 15- and 5- item simulated CATs and full-item banks were highly correlated.Conclusion:The newly developed self and friend-participation item banks met the required assumptions for CAT. Simulated CATs yielded scores comparable to full-item banks. The results of the study support the use of the item banks for a CAT of participation in children following spinal cord injury.Sponsorship:The study was funded by the Shriners Hospitals for Children Research Advisory Board (RAB #9146). [ABSTRACT FROM AUTHOR]

Abstract: Ammonia (NH3) emitted from animal agriculture is the most important gaseous pollutant in agro-systems. Experimental research, as compared with indirect estimation and hypothetical calculation, on NH3 from agriculture is critical for emission assessment, regulation, and abatement. Research involving field-scale monitoring of NH3 emissions from U.S. swine facilities has greatly expanded in the past 15 years. However, published NH3 calculation tools, including emission factors, and U.S. EPA (United States Environmental Protection Agency) inventories in this field were largely based on non-U.S. research. While seasonal and diurnal variations of NH3 concentrations and emissions are acknowledged, most field studies, which these tools depended on, produced data that only represented a fraction of the overall picture of NH3 emissions because of technological and financial limitations. Different methodologies and technologies have been used in NH3 emission investigations but not compared systematically. Methodology, equipment, and software used in sampling and measurement, and methodology and software used in data processing and emission rate calculation can introduce variations into the results. Because of the lack of standardized methods and procedures, it is difficult to identify and quantify measurement and calculation errors. Although a few comprehensive field studies have been conducted that were long enough to cover seasonal and even annual variations, and continuous enough to cover diurnal and dynamic emission variations, there is a considerable delay of in-depth interpretation and publication of data following comprehensive monitoring projects in the U.S. There is also a lag of adopting/updating the latest NH3 emission factors from comprehensive field studies in country-wide NH3 emission inventories. In addition, there have been discrepancies between data obtained from research and data published by governmental and other agencies. Future development in this field will require that methodologies and criteria be made to weigh data from different projects to develop emission factors, more emphasis be put on application of comprehensive research results, more intensive and extensive field monitoring be conducted, standards and protocols for monitoring and data calculation be developed, and more investment be made on post-measurement data processing/analyzing/interpretation and development of advanced computer software. [Copyright &y& Elsevier]

The article discusses a study on the external validity of the extant heart failure (HF) risk scores namely the Framingham Heart Study and Health ABC scores in the a large biracial cohort of middle-aged participants taken from 4 U.S. communities by the Athero-sclerosis Risk in Communities (ARIC) Study. Fifteen thousand seven hundred ninety two women and men aged 45 to 64 years were enrolled. It concludes that ARIC HF risk score can predict 10 year risk of hospitalized HF in community settings.

Abstract: In this study, Mingshan county—a typical hilly region located on the western edge of the Sichuan basin was selected as the research area. Based on the health risk assessment of Cr(VI), nitrate, fluoride and iron in 41 rural drinking water resources, applying the model recommended by the U.S. Environmental Protection Agency (U.S.EPA), the evaluation grades of health risk associated with drinking water quality (HRWQ) was developed, and the Connection Degree (CD) and the weight of each index of the samples were calculated. And by evaluating them with the criterion of confidence level, Set Pair Analysis (SPA) was established. In this study, it could be seen that the HRWQ of most the resources in the area were of low-medium risk within grade I–III while the HRWQ of some other resources were in a less safe state of medium-high risk. [Copyright &y& Elsevier]

The article discusses exploratory analyses of differences in efficacy data from randomized, double-blind placebo-controlled major depressive disorder (MDD) clinical trials submitted in support of new drug applications (NDAs). It says that 81 clinical trials submitted to the U.S. Food and Drug Administration (FDA) were analyzed. The analyses found that treatment effect has declined over time in the trials. High failure rates were also observed in the trials during the entire period.

Ever since the colonial era, the US government has been influenced by a market-orientated intellectual tradition. Under such a tradition, an ideal social structure is a lean government in contrast to a robust private sector. The recent surge of neoliberalism has advanced the development of a market model of governance, which distinguishes itself from the traditional state-centered bureaucracy in fundamental dimensions. This paper provides an in-depth analysis of the contract city, which has pursued many of the market principles to an extreme. The article traces the evolution of contract cities in California, examines closely the structure, operation, and management of contract city using the City of Highland as an example, and discusses the implications of this new form of governance for public management, organizational theory, and American political economy. [ABSTRACT FROM AUTHOR]

The article offers information on the use of the precipitation data from National Aeronautics and Space Administration (NASA) for the monitoring of water quality standards within the Chesapeake Bay Watershed. It states that the data involves seven watershed found in the Chesapeake Bay, geographic information system (GIS), and the Better Assessment Science Integrating Nonpoint Sources (BASINS) Decision Support Tool (DST). It mentions that the seven watersheds present the 85% increase in water runs based on annual correlation coefficients, and the 78% increase in water runs according to low-flow correlation coefficients. It adds that the NASA precipitation data demonstrates precipitation as the major element for the rain-runoff process.

In times of crisis there is an unmistakable tendency to augment and extend the powers of the executive branch. This centralizing tendency has been exhibited in numerous legal systems and through varied kinds of crisis. More recently, similar trends have been much in evidence in the United States, and a corresponding academic discourse defending and extolling the virtues of such augmentation has emerged. This Article is skeptical of the virtues of such advice and its ultimate policy benefits. We assert that there are substantial dangers to the centralization of crisis powers in times of emergency. These tendencies hold particular perils for the democratic state. Moreover, the rush to create or cement decision and review making hierarchies can be antithetical to the project of utilizing the strengths of rule of law based societies to respond to the challenges posed by violent actors. The purported benefits of excluding, or at best sidelining, the courts from review of executive actions of crisis regulation are particularly ill-conceived. Such proposals consistently fail to engage with the importance of across-the-board institutional legal engagement with state action in times of crisis. The success and value of such engagement cannot be measured from the crisis vantage point. Rather it requires an assessment beyond the moment of exception, factoring in a return to normalcy and the impact on law and legal institutions in the post-crisis phase. We assert that scholars advocating for exclusive executive supremacy in times of crisis fail to measure the harms that may be caused by inept or illegal state action, not only as experienced by individual victims but to the broader project of discouraging and dissuading the resort to group based violence. [ABSTRACT FROM AUTHOR]

This study reviews recent progress on soil moisture data assimilation. Data assimilation is a process of merging observations with a system dynamic model to provide an improved estimate of the states of the environment. The application of data assimilation in hydrology is relatively new, however, rapid progress has been made in the last decade or so with the available remotely sensed soil moisture data. After briefing the history of soil moisture data assimilation, the review focuses on the most common data assimilation methods and recent progress made in soil moisture data assimilation through a case study of the soil moisture initialization activities for NASA's seasonal and interannual climate prediction. The example demonstrates that soil moisture data assimilation has made great progress in the last decade, however is still in its infancy. Good quality remotely sensed soil moisture data with accurate uncertainty information at continental and global scale are needed to ensure the success of the operational use of soil moisture data assimilation technique. Further advancement on the current soil moisture data assimilation methods is necessary to be able to assimilate multisource hydrological remote sensing data into land surface models for the best use of various remote sensing data sources at continental and global scales. [ABSTRACT FROM AUTHOR]

: Rationale and objectivesTo determine which factors affected the increase in average glandular dose recorded at the annual US Food and Drug Administration Mammography Quality Standards Act inspections of mammography equipment in North Carolina from 1997 to 2001.: Materials and methodsAverage glandular dose, HVL, kVp, ambient light, luminance, equipment age, processing speed, and system speed for every mammography unit at all facilities in the state were collected by state inspectors. A mixed-effect model was used to assess the average changes of glandular dose over time and to identify the factors associated with these changes.: ResultsThere was a statistically significant increase in the average glandular dose in North Carolina in 1999, 2000, and 2001 when compared with the baseline year of 1997. Factors that were statistically significantly linked to this effect were changes in kVp, processing speed, and system speed.: ConclusionAverage glandular dose for mammography has recently increased in North Carolina. This change is likely caused by changes in screen-film products and processing techniques. [Copyright &y& Elsevier]

Investigates the rates of release of odor and gas from anaerobic lagoons for treating swine waste in the U.S. Use of a buoyant convective flux chamber; Determination of the effect of lagoon loading rate on measured odor and gas releases; Evaluation of odor concentration, intensity and hedonic tone.

This research describes the development of the Work Disability Functional Assessment Battery (WD-FAB). The WD-FAB characterizes a person's functioning along six key dimensions. The WD-FAB may be useful among occupational therapists focusing on work rehabilitation and disability evaluation. [ABSTRACT FROM AUTHOR]

OBJECTIVE: We examined the prognostic significance of uterine risk factors (RF) compared to nodal metastases in endometrial cancer. STUDY DESIGN: Women with stage I-IIIC endometrioid cancer were stratified based on the presence of positive or negative lymph nodes. Each patient was characterized by the number of RF present: myoinvasion >=50%, cervical stromal involvement, and grade 3 histology. RESULTS: A total of 26,967 women were identified. In a multivariable model, uterine RF strongly influenced survival but nodal disease was a more important negative prognostic factor. Five-year overall survival was 68% (95% confidence interval [CI], 63-72%) for group 1 (node positive/no RF) vs 69% (95% CI, 66-72%) for group 5 (node negative/multiple RF). Five-year survival was lower for node-positive patients with RF (58%; 95% CI, 54-61%) than node-positive patients without RF (68%; 95% CI, 63-72%). CONCLUSION: Uterine RF strongly influenced survival both in the presence and absence of nodal metastasis. [ABSTRACT FROM AUTHOR]

Objective: To link 3 Spinal Cord Injury-Functional Index (SCI-FI) item banks (Basic Mobility, Fine Motor Function, Self-Care) to the Patient-Reported Outcome Measurement Information System (PROMIS) Physical Function (PF) metric., Design: Observational study SETTING: Six SCI Model Systems rehabilitation hospitals in the United States., Participants: Adults with SCI (n=855) and healthy individuals (n=730) (N=1585)., Interventions: Not applicable., Main Outcome Measures: Three SCI-FI item banks (Basic Mobility, Fine Motor Function, Self-Care), PROMIS PF v1.0 item bank., Results: SCI-FI item banks (including 30 items from the PROMIS PF item bank) were administered to 855 adults with SCI as part of the original SCI-FI development study. The data were used to attempt to link 3 SCI-FI banks to the PROMIS PF metric via 2 item-response theory methods: fixed-parameter calibration and separate calibration. Sixteen items common to SCI-FI and PROMIS and verified as free of differential item functioning were used as anchor items to implement the methods. Of the 3 banks, only SCI-FI Basic Mobility could be linked with sufficient precision to PROMIS PF. Comparisons of actual vs linked PROMIS PF scores and test characteristic curves suggested the fixed-parameter method provided slightly more precision than the separate calibration method., Conclusions: The linkage between PROMIS PF and SCI-FI Basic Mobility was considered satisfactory for group-level usage. Score equivalents computed from SCI-FI Basic Mobility will be useful for researchers comparing functional levels in SCI to those observed in other clinical and nonclinical groups (eg, in comparative effectiveness research)., (Copyright © 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: To establish responsiveness of 3 Spinal Cord Injury-Functional Index/Capacity (SCI-FI/C) item banks in the first year after spinal cord injury (SCI)., Design: Longitudinal patient-reported outcomes assessment replicated through secondary analysis of an independent data set., Setting: A total of 8 SCI Model Systems rehabilitation hospitals in the United States., Participants: Study 1 participants included 184 adults with recent (≤4 months) traumatic SCI and 221 community-dwelling adults (>1 year post injury) (N=405). Study 2 participants were 418 individuals with recent SCI (≤4 months) (N=418)., Interventions: In study 1, SCI-FI/C computer adaptive tests were presented in a standardized interview format either in person or by phone call at baseline and 6-month follow-up. Responsiveness was examined by comparing 6-month changes in SCI-FI scores within and across samples (recently injured vs community-dwelling) because only the recent injury sample was expected to exhibit change over time. Effect sizes were also computed. In study 2, the study 1 results were cross-validated in a second sample with recent SCI 1 year after baseline measurement. Study 2 also compared the SCI-FI/C measures' responsiveness to that of the Self-reported Functional Measure (SRFM) and stratified results by injury diagnosis and completeness., Main Outcome Measures: The SCI-FI Basic Mobility/C, Self-care/C and Fine Motor/C item banks (study 1 and study 2); Self-reported Functional Measure SRFM (study 2 only)., Results: In study 1, changes in SCI-FI/C scores between baseline and 6-month follow-up were statistically significant (P<.01) for recently injured individuals. SCI-FI Basic Mobility/C, Self-care/C, and Fine Motor/C item banks demonstrated small to medium effect sizes in the recently injured sample. In the community-dwelling sample, all SCI-FI/C effects were negligible (ie, effect size<0.08). Study 2 results were similar to study 1. As expected, SCI-FI Basic Mobility/C and Self-care/C were responsive to change for all individuals in study 2, whereas the SCI-FI Fine Motor/C was responsive only for individuals with tetraplegia and incomplete paraplegia. The SRFM demonstrated a medium effect size for responsiveness (effect size=0.65)., Conclusions: The SCI-FI Basic Mobility/C and Self-care/C banks demonstrate adequate sensitivity to change at 6 months and 1 year for all individuals with SCI, while the SCI-FI/C Fine Motor item bank is sensitive to change in individuals with tetraplegia or incomplete paraplegia. All SCI-FI/C banks demonstrate stability in a sample not expected to change. Results provide support for the use of these measures for research or clinical use., (Copyright © 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Objectives: Adverse events in nursing homes are leading causes of morbidity and mortality, prompting facilities to investigate their antecedents. This study examined the contribution of safety climate-how frontline staff typically think about safety and act on safety issues-to adverse events in Veterans Affairs (VA) nursing homes or Community Living Centers (CLCs)., Design: Cross-sectional study., Setting and Participants: A total of 56 CLCs nationwide, 1397 and 1645 CLC staff (including nurses, nursing assistants, and clinicians/specialists), respectively, responded to the CLC Employee Survey of Attitudes about Resident Safety (CESARS) in 2017 and 2018., Methods: Adverse events (pressure ulcers, falls, major injuries from falls, and catheter use) were measured using the FY2017-FY2018 Minimum Data Set (MDS). Safety climate was defined as 7 CESARS domains (safety priorities, supervisor commitment to safety, senior management commitment to safety, personal attitudes toward safety, environmental safety, coworker interactions around safety, and global rating of CLC). The associations between safety climate domains and each adverse event were determined separately for each frontline group, using beta-logistic regression with random effects., Results: Better ratings of supervisor commitment to safety were associated with lower rates of major injuries from falls [odds ratio (OR) 0.33, 95% confidence interval (CI) 0.11-0.97, clinicians] and catheter use (OR 0.42, 95% CI 0.21-0.85, nurses), and better ratings of environmental safety were associated with lower rates of pressure ulcers (OR 0.23, 95% CI 0.09-0.61, clinicians), major injuries from falls (OR 0.48, 95% CI 0.24-0.93, nurses), and catheter use (OR 0.55, 95% CI 0.32-0.93, nursing assistants). Better global CLC ratings were associated with higher rates of catheter use. No other safety climate domains had significant associations., Conclusions and Implications: Nursing homes may reduce adverse events by fostering supportive supervision of frontline staff and a safer physical environment., (Copyright © 2020 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: Although Medicare assessment files will include Standardized Patient Assessment Data Elements from 2016 forward, lack of uniformity of functional data prior to 2016 impedes longitudinal research. The purpose of this study was to create crosswalks for postacute care assessment measures and the basic mobility and daily activities scales of the Activity Measure for Post-Acute Care (AM-PAC) and to test their accuracy and validity in development and validation datasets., Methods: This cross-sectional study is a secondary analysis of AM-PAC, the Inpatient Rehabilitation Facility Patient Assessment Instrument, the Minimum Data Set, and the Outcome and Assessment Information Set data from 300 adults receiving rehabilitation recruited from 6 health care networks in 1 metropolitan area. Rasch analysis was used to co-calibrate items from the 3 measures onto the AM-PAC metric and to create look-up tables to create estimated AM-PAC (eAM-PAC) scores. Mean scores and correlation and agreement between actual and estimated scores were examined in the development dataset. Scores were estimated in a cohort of Medicare beneficiaries with hip, humerus and radius fractures. Correlations between eAM-PAC and Functional Independence Measure motor scores were examined. Differences in mean eAM-PAC scores were evaluated across groups of known differences (age, fracture type, dementia)., Results: Strong correlations were found between actual and eAM-PAC scores in the development dataset. Moderate to strong correlations were found between the eAM-PAC basic mobility and Functional Independence Measure motor scores in the validation dataset. Differences in basic mobility scores across known groups were statistically significant and appeared to be clinically important. Differences between mean daily activities scores were statistically significant but appeared not to be clinically important., Conclusion: Although further testing is warranted, the basic mobility crosswalk appears to provide valid scores for aggregate analysis of Medicare postacute care data., Impact: This study reports on a method to take data from different Medicare administrative data sources and estimate scores on 1 scale. This approach was applied separately for data related to basic mobility and to daily activities. This may allow researchers to overcome challenges with using Medicare administrative data from different sources., (© The Author(s) 2020. Published by Oxford University Press on behalf of the American Physical Therapy Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Objective: To expand an existing validated measure of basic mobility (Activity Measure for Post-Acute Care [AM-PAC]) for patients at the lowest levels of function., Design: Item replenishment for existing item response theory (IRT) derived measure via (1) idea generation and creation of potential new items, (2) item calibration and field testing, and (3) longitudinal pilot test., Setting: Two tertiary acute care hospitals., Participants: Consecutive inpatients (N=502) ≥18 years old, with an AM-PAC Inpatient Mobility Short Form (IMSF) raw score ≤15. For the longitudinal pilot test, 8 inpatients were evaluated., Results: Fifteen new AM-PAC items were developed, 2 of which improved mobility measurement at the lower levels of functioning. Specifically, with the 2 new items, the floor effect of the AM-PAC IMSF was reduced by 19%, statistical power and measurement breadth were greater, and there was greater measurement sensitivity in longitudinal pilot testing., Conclusion: Adding 2 new items to the AM-PAC IMSF lowered the floor and increased statistical power, measurement breadth, and sensitivity., (Copyright © 2020 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: Few existing instruments measure recovery-oriented organizational climate and culture. This study developed, psychometrically assessed, and validated an instrument to measure recovery climate and culture., Methods: Organizational theory and an evidence-based conceptualization of mental health recovery guided instrument development. Items from existing instruments were reviewed and adapted, and new items were developed as needed. All items were rated by recovery experts. A 35-item instrument was pilot-tested and administered to a national sample of mental health staff in U.S. Department of Veterans Affairs Psychosocial Rehabilitation and Recovery Centers (PRRCs). Analysis entailed an exploratory factor analysis (EFA) and inter-item reliability and scale correlation assessment. Blinded site visits to four PRRCs were performed to validate the instrument., Results: The EFA determined a seven-factor solution for the data. The factors identified were staff expectations, values, leadership, rewards, policies, education and training, and quality improvement. Seven items did not meet retention criteria and were dropped from the final instrument. The instrument exhibited good internal consistency (Cronbach's α=0.81; subscales, α=0.84-0.88). Scale correlations were between 0.16 and 0.61, well below the threshold (α=0.9) for indicating overlapping constructs. Site visitors validated the instrument by correctly identifying high-scoring and low-scoring centers., Conclusions: These findings provide a psychometrically tested and validated instrument for measuring recovery climate and culture in mental health programs. This instrument can be used in evaluation of mental health services to determine the extent to which programs possess the organizational precursors that drive recovery-oriented service delivery.

Background and Objectives: To better understand the disablement process among older adults, improved measures of activity limitations are needed. Traditional population-level measures lack the ability to distinguish precise gradations of activity limitation and are unable to detect degrees of differences over a wide range of ability levels. Therefore, we used contemporary measurement methods to improve upon current methodologies for characterizing activity limitations within the National Health and Aging Trends Study (NHATS) ., Research Design and Methods: We used the NHATS Round 1 cohort to assess the feasibility of constructing an Activity Limitations scale using Rasch item response theory methods. Factor analysis was used to develop the scale from a set of existing items in the NHATS Mobility, Self-Care, and Household Activity domains. Psychometric properties of the scale were evaluated and the scale was used to examine change in activity limitations among the sample from 2011 to 2015., Results: Results supported an 18-item scale (N = 7,609). Rasch infit and outfit statistics were within acceptable range for all items (Cronbach's alpha = 0.95; sample score reliability = 0.83). From 2011 to 2015, 5.88% older adults demonstrated increase in function, 15% showed decrease in function, and 78% of the sample showed no change (did not exceed ± MDC90)., Discussion and Implications: Findings demonstrate that a unidimensional, interval scale of activity limitations can be constructed using traditional survey measures nested within the NHATS. Results revealed concerns regarding ceiling effects within the current self-report items of activity limitations suggesting future work is needed to expand the range of ability currently represented in the NHATS Activity Limitation items., (© The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background and Objectives: Pediatric surveillance of young children depends on providers' assessment of developmental milestones, yet normative data are sparse. Our objectives were to develop new norms for common milestones to aid in clinical interpretation of milestone attainment., Methods: We analyzed responses to the developmental screening form of the Survey of Well-being of Young Children from 41 465 screens across 3 states. Associations between developmental status and a range of child characteristics were analyzed, and norms for individual questions were compared to guidelines regarding attainment of critical milestones from the Centers for Disease Control and Prevention (CDC)., Results: A contemporary resource of normative data for developmental milestone attainment was established. Lower developmental status was associated with child age in the presence of positive behavioral screening scores ( P < .01), social determinants of health ( P < .01), Medicaid ( P < .01), male sex ( P < .01), and child race ( P < .01). Comparisons between Survey of Well-being of Young Children developmental questions and CDC guidelines reveal that a high percentage of children are reported to pass milestones by the age at which the CDC states that "most children pass" and that an even higher percentage of children are reported to pass milestones by the age at which the CDC states that parents should "act early." An interactive data visualization tool that can assist clinicians in real-time developmental screening and surveillance interpretation is also provided., Conclusions: Detailed normative data on individual developmental milestones can help clinicians guide caregivers' expectations for milestone attainment, thereby offering greater specificity to CDC guidelines., Competing Interests: POTENTIAL CONFLICT OF INTEREST: Drs Sheldrick and Perrin are cocreators of the Survey of Well-being of Young Children, an instrument that was used to collect data for this study; the other authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2019 by the American Academy of Pediatrics.)

Accuracy in measuring function related to one's ability to work is central to public confidence in a work disability benefits system. In the United States, national disability programs are challenged to adjudicate millions of work disability claims each year in a timely and accurate manner. The Work Disability Functional Assessment Battery (WD-FAB) was developed to provide work disability agencies and other interested parties a comprehensive and efficient approach to profiling a person's function related to their ability to work. The WD-FAB is grounded by the International Classification of Functioning, Disability, and Health conceptual framework., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objective: To further improve measurement of work-related physical and mental health by updating the Work Disability Assessment Battery (WD-FAB)., Methods: Cross-sectional study with 1024 disability claimants and 1000 working age (21 to 66 years) adults in the United States. Developed new items to replenish the WD-FAB and analyzed using factor analysis and item response theory (IRT). Computer adaptive testing (CAT) simulations evaluated the psychometric properties of the original versus updated WD-FAB., Results: Analyses confirmed the structure of the WD-FAB. Twenty-three new items were added (basic mobility: 7, upper body function: 4, fine motor: 6, self-regulation: 1, resilience & sociability: 5 items)., Conclusions: Findings support the WD-FAB as a robust, psychometrically sound assessment of work-related function. Extensive content coverage (331 items) represents eight physical and mental health domains. IRT/CAT methods allow administration in under 15 minutes. The WD-FAB may prove valuable for efficiently characterizing work-related function across work rehabilitation settings.

Purpose To improve the mental health component of the Work Disability Functional Assessment Battery (WD-FAB), developed for the US Social Security Administration's (SSA) disability determination process. Specifically our goal was to expand the WD-FAB scales of mood & emotions, resilience, social interactions, and behavioral control to improve the depth and breadth of the current scales and expand the content coverage to include aspects of cognition & communication function. Methods Data were collected from a random, stratified sample of 1695 claimants applying for the SSA work disability benefits, and a general population sample of 2025 working age adults. 169 new items were developed to replenish the WD-FAB scales and analyzed using factor analysis and item response theory (IRT) analysis to construct unidimensional scales. We conducted computer adaptive test (CAT) simulations to examine the psychometric properties of the WD-FAB. Results Analyses supported the inclusion of four mental health subdomains: Cognition & Communication (68 items), Self-Regulation (34 items), Resilience & Sociability (29 items) and Mood & Emotions (34 items). All scales yielded acceptable psychometric properties. Conclusions IRT methods were effective in expanding the WD-FAB to assess mental health function. The WD-FAB has the potential to enhance work disability assessment both within the context of the SSA disability programs as well as other clinical and vocational rehabilitation settings.

Purpose: To expand content of the physical function domain of the Work Disability Functional Assessment Battery (WD-FAB), developed for the US Social Security Administration's (SSA) disability determination process., Methods: Newly developed questions were administered to 3532 recent SSA applicants for work disability benefits and 2025 US adults. Factor analyses and item response theory (IRT) methods were used to calibrate and link the new items to the existing WD-FAB, and computer-adaptive test simulations were conducted., Results: Factor and IRT analyses supported integration of 44 new items into three existing WD-FAB scales and the addition of a new 11-item scale (Community Mobility). The final physical function domain consisting of: Basic Mobility (56 items), Upper Body Function (34 items), Fine Motor Function (45 items), and Community Mobility (11 items) demonstrated acceptable psychometric properties., Conclusions: The WD-FAB offers an important tool for enhancement of work disability determination. The FAB could provide relevant information about work-related functioning for initial assessment of claimants; identifying denied applicants who may benefit from interventions to improve work and health outcomes; enhancing periodic review of work disability beneficiaries; and assessing outcomes for policies, programs and services targeting people with work disability.

Study Design: Multi-center cross-sectional cohort study., Objectives: The objectives of this study were to develop and validate short forms (SFs) of participation for child- and parent-reported outcomes following spinal cord injury (SCI)., Setting: Three pediatric orthopedic hospitals in the United States., Methods: The expert panel used calibration data from the pediatric computerized adaptive test (CAT) development study (convenience sample of 381 children and adolescents with SCI and 322 parents or caregivers) to select SF items. The panel selected items for two domains (participation self-relevant to what I want to do; participation friends-relevant to what my friends do), with parent and child versions for each domain. Psychometric analyses included group reliability, Cronbach's alpha, agreement (SFs and item banks), percent of sample with highest (ceiling) and lowest (floor) scores by level of lesion (paraplegia/tetraplegia), and test information function., Results: Group reliability and Cronbach's alpha values are acceptable (0.74-0.92) and agreement (intraclass correlation coefficients for SFs and total item banks) is strong (0.89-0.95). Floor effects were minimal for people with tetraplegia and paraplegia (0-1.19%). Ceiling effects were minimal for people with tetraplegia (0-3.13%) and slightly higher, but acceptable, for people with paraplegia (8.06-14.02%). Test information function for the SFs was sufficiently high over the range of scores for the majority of the sample., Conclusion: Pediatric Measure of Participation (PMoP) SFs are acceptable for use when CATs are not feasible., Sponsorship: The study was funded by the Shriners Hospitals for Children Research Grant 79142 (Mulcahey, PI) and the Boston ROC Grant 5R24HD065688-05 (Jette, PI).

Background: The Work Disability Functional Assessment Battery (WD-FAB), developed for potential use by the US Social Security Administration to assess work-related function, currently consists of five multi-item scales assessing physical function and four multi-item scales assessing behavioral health function; the WD-FAB scales are administered as Computerized Adaptive Tests (CATs)., Objective: The goal of this study was to evaluate the test-retest reliability of the WD-FAB Physical Function and Behavioral Health CATs., Methods: We administered the WD-FAB scales twice, 7-10 days apart, to a sample of 376 working age adults and 316 adults with work-disability. Intraclass correlation coefficients were calculated to measure the consistency of the scores between the two administrations. Standard error of measurement (SEM) and minimal detectable change (MDC90) were also calculated to measure the scales precision and sensitivity., Results: For the Physical Function CAT scales, the ICCs ranged from 0.76 to 0.89 in the working age adult sample, and 0.77-0.86 in the sample of adults with work-disability. ICCs for the Behavioral Health CAT scales ranged from 0.66 to 0.70 in the working age adult sample, and 0.77-0.80 in the adults with work-disability. The SEM ranged from 3.25 to 4.55 for the Physical Function scales and 5.27-6.97 for the Behavioral Health function scales. For all scales in both samples, the MDC90 ranged from 7.58 to 16.27., Conclusion: Both the Physical Function and Behavioral Health CATs of the WD-FAB demonstrated good test-retest reliability in adults with work-disability and general adult samples, a critical requirement for assessing work related functioning in disability applicants and in other contexts., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Physical and mental impairments represent the 2 largest health condition categories for which workers receive Social Security disability benefits. Comprehensive assessment of physical and mental impairments should include aspects beyond medical conditions such as a person's underlying capabilities as well as activity demands relevant to the context of work. The objective of this article is to describe the initial conceptual stages of developing new measurement instruments of behavioral health and physical functioning relevant for Social Security work disability evaluation purposes. To outline a clear conceptualization of the constructs to be measured, 2 content models were developed using structured and informal qualitative approaches. We performed a structured literature review focusing on work disability and incorporating aspects of the International Classification of Functioning, Disability and Health as a unifying taxonomy for framework development. Expert interviews provided advice and consultation to enhance face validity of the resulting content models. The content model for work-related behavioral health function identifies 5 major domains: (1) behavior control, (2) basic interactions, (3) temperament and personality, (4) adaptability, and (5) workplace behaviors. The content model describing physical functioning includes 3 domains: (1) changing and maintaining body position, (2) whole-body mobility, and (3) carrying, moving, and handling objects. These content models informed subsequent measurement properties including item development and measurement scale construction, and provided conceptual coherence guiding future empirical inquiry. The proposed measurement approaches show promise to comprehensively and systematically assess physical and behavioral health functioning relevant to work., (Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Objectives: To build a comprehensive item pool representing work-relevant physical functioning and to test the factor structure of the item pool. These developmental steps represent initial outcomes of a broader project to develop instruments for the assessment of function within the context of Social Security Administration (SSA) disability programs., Design: Comprehensive literature review; gap analysis; item generation with expert panel input; stakeholder interviews; cognitive interviews; cross-sectional survey administration; and exploratory and confirmatory factor analyses to assess item pool structure., Setting: In-person and semistructured interviews and Internet and telephone surveys., Participants: Sample of SSA claimants (n=1017) and a normative sample of adults from the U.S. general population (n=999)., Interventions: Not applicable., Main Outcome Measure: Model fit statistics., Results: The final item pool consisted of 139 items. Within the claimant sample, 58.7% were white; 31.8% were black; 46.6% were women; and the mean age was 49.7 years. Initial factor analyses revealed a 4-factor solution, which included more items and allowed separate characterization of: (1) changing and maintaining body position, (2) whole body mobility, (3) upper body function, and (4) upper extremity fine motor. The final 4-factor model included 91 items. Confirmatory factor analyses for the 4-factor models for the claimant and the normative samples demonstrated very good fit. Fit statistics for claimant and normative samples, respectively, were: Comparative Fit Index=.93 and .98; Tucker-Lewis Index=.92 and .98; and root mean square error approximation=.05 and .04., Conclusions: The factor structure of the physical function item pool closely resembled the hypothesized content model. The 4 scales relevant to work activities offer promise for providing reliable information about claimant physical functioning relevant to work disability., (Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Objectives: To develop a broad set of claimant-reported items to assess behavioral health functioning relevant to the Social Security disability determination processes, and to evaluate the underlying structure of behavioral health functioning for use in development of a new functional assessment instrument., Design: Cross-sectional., Setting: Community., Participants: Item pools of behavioral health functioning were developed, refined, and field tested in a sample of persons applying for Social Security disability benefits (N=1015) who reported difficulties working because of mental or both mental and physical conditions., Interventions: None., Main Outcome Measure: Social Security Administration Behavioral Health (SSA-BH) measurement instrument., Results: Confirmatory factor analysis (CFA) specified that a 4-factor model (self-efficacy, mood and emotions, behavioral control, social interactions) had the optimal fit with the data and was also consistent with our hypothesized conceptual framework for characterizing behavioral health functioning. When the items within each of the 4 scales were tested in CFA, the fit statistics indicated adequate support for characterizing behavioral health as a unidimensional construct along these 4 distinct scales of function., Conclusions: This work represents a significant advance both conceptually and psychometrically in assessment methodologies for work-related behavioral health. The measurement of behavioral health functioning relevant to the context of work requires the assessment of multiple dimensions of behavioral health functioning. Specifically, we identified a 4-factor model solution that represented key domains of work-related behavioral health functioning. These results guided the development and scale formation of a new SSA-BH instrument., (Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)