Repeated Clinical Assessment Using Sensory Modality Assessment and Rehabilitation Technique for Diagnosis in Prolonged Disorders of Consciousness

Purpose: The recommended way to assess consciousness in prolonged disorders of consciousness is to observe the patient’s responses to sensory stimulation. Multiple assessment sessions have to be completed in order to reach a correct diagnosis. There is, however, a lack of data on how many sessions are sufficient for validity and reliability. The aim of this study was to identify the number of Sensory Modality Assessment and Rehabilitation Technique (SMART) assessment sessions needed to reach a reliable diagnosis. A secondary objective was to identify which sensory stimulation modalities are more useful to reach a diagnosis.Materials and Methods: A retrospective analysis of all the adult patients (who received a SMART assessment) admitted to a specialist brain injury unit over the course of 4 years was conducted (n = 35). An independent rater analyzed the SMART levels for each modality and session and provided a suggestive diagnosis based on the highest SMART level per session.Results: For the vast majority of patients between 5 and 6 sessions was sufficient to reach the final clinical diagnosis. The visual, auditory, tactile, and motor function modalities were found to be more associated with the final diagnosis than the olfactory and gustatory modalities.Conclusion: These findings provide for the first time a rationale for optimizing the time spent on assessing patients using SMART.

Exploring Social Sustainability Handprint—Part 2: Sustainable Development and Sustainability

Social sustainability is a major part of both sustainable development and sustainability including societal sustainability and overall promotion of more sustainable societies taking into account multiple social/society–environment relationships and interfaces. These contexts have a strong focus on both present and future generations, encompassing sustainable development of both people and the planet. Social sustainability handprints provide many opportunities to promote social sustainability management and assessment by organizations and people and to create changes and encourage actions that contribute to overall social and societal sustainability. This study applied qualitative approaches to explore social sustainability handprints from the perspectives of sustainable development, sustainability, social and societal sustainability and sustainability assessment and indicators. This study addressed a clear research gap and aimed at identifying key definitions, elements, approaches and development focus areas within these frameworks as well as at suggesting associated implications for social sustainability handprint development. The findings suggest that social sustainability handprints can be created through multiple actions, changes, innovations and impacts to promote social sustainability based on sustainable development, sustainability and social and societal sustainability. Various actors such as all types of organizations, individuals, groups and companies can implement these ways to create social sustainability handprints. In addition, there are multiple assessment approaches that can be applied to the assessment of social sustainability handprints such as sustainability management, assessment and indicators, encompassing multiple specific elements and approaches.

A Comparison of Functional Abilities in Individuals with Mild Cognitive Impairment and Parkinson’s Disease with Mild Cognitive Impairment Using Multiple Assessment Methods

Objective: This study used multiple assessment methods to examine instrumental activities of daily living (IADLs) performance in individuals with Parkinson’s disease with mild cognitive impairment (PD-MCI) compared to individuals with mild cognitive impairment (MCI) and cognitively healthy older adults (HOA). Associations between functional performance and cognition were also examined. Methods: Eighteen individuals with PD-MCI, 48 individuals with MCI, and 66 HOAs were assessed with multiple IADL measures, including direct observation, a performance-based measure, and self- and informant-report questionnaires. Performance on the direct-observation measure was further characterized by coding for four error types: omissions, substitutions, and inefficient and irrelevant/off-task actions. Results: Both the PD-MCI and MCI groups performed more poorly on the overall score for all IADL measures relative to HOAs. Although the PD-MCI and MCI groups did not differ in overall performance, on the direct-observation measure, the PD-MCI group took longer and made more inefficient and irrelevant/off-task errors relative to the HOA and MCI groups, whereas the MCI group made more omission and substitution errors relative to HOAs. Further, the pattern of cognitive correlates that associated most strongly with the functional measures varied across groups and functional assessment methods. Conclusion: Compared to HOAs, PD-MCI and MCI groups demonstrated increased difficulties performing everyday activities, and cognitive and motor abilities differentially contributed to the everyday task difficulties of these two groups.

IMPLEMENTING COMPETENCY-BASED ASSESSMENT IN A FIRST YEAR ENGINEERING DESIGN COURSE

Competency-based assessment (CBA) is increasingly of interest in higher education, particularly in the professions. This assessment approach requires that students demonstrate satisfactory performance in specified measurable outcomes for progression, rather than meeting a particular overall average in a range of assessments. The paper describes the implementation of CBA in a first year engineering design and practice course. Each competency was linked to multiple assessment points to allow multiple opportunities to meet the competency without requiring the teaching staff to regrade assignments that did not meet expectations. The structure was designed to use no new additional course personnel. Based on this work the team recommends using past grades and learning outcome data the likely consequences of applying CBA to course assessment schemes, running CBA in parallel witha traditional grading scheme, and planning for flexibility in the grading scheme. Applying CBA to authentic activities was much more complex than for individual tests.

Multi-modal Assessment of Reward Functioning in Adolescent Anhedonia

Background: Anhedonia is a core symptom of depression that predicts worse treatment outcomes. Dysfunction in neural reward circuits is thought to contribute to anhedonia. However, it remains unclear whether laboratory-based assessments of anhedonia and reward-related neural function translate to adolescents' subjective affective experiences in real-world contexts. Methods: We recruited a sample of adolescents (ages 12-18; mean=15.83) who varied in anhedonia (N=82) and examined the relationships among clinician-rated and self-reported anhedonia, behaviorally assessed reward learning ability, fMRI-measured neural response to monetary reward and loss, and repeated ecological momentary assessment (EMA) of positive affect (PA) and negative affect (NA).Results: Anhedonia was associated with lower mean PA and higher mean NA across the 5-day EMA period. Anhedonia was not associated with impaired behavioral reward learning but was consistently associated with attenuated nucleus accumbens response to reward across categorical, dimensional, and ecological assessments. Greater mean NA and NA variability were associated with increased medial prefrontal response to loss, and mean NA predicted reduced insula activity to reward. Conclusions: Traditional laboratory-based measures of anhedonia were associated with lower subjective PA and higher subjective NA in youths' daily lives. Across multiple assessment modalities, anhedonia was associated with reduced reward-related striatal functioning, whereas greater subjective NA was associated with both reward and loss-related neural response in the broader corticostriatal system. Collectively, these findings demonstrate that diagnostic and self-report measures of anhedonia translate to real-world contexts, and that subjective ratings of PA and NA may be associated with distinct patterns of neural response to reward and loss.

The association between media multitasking and executive function in Chinese adolescents: Evidence from self-reported, behavioral and fNIRS data

This study examined the association between media multitasking and executive function in Chinese adolescents by comparing heavy/high and light/low media multitaskers, i.e., HMMs and LMMs, with self-reports, behavioral measures and functional near-infrared spectroscopy (fNIRS). The participants were 12 HMMs (media multitasking scores above the 75th percentile) and 10 LMMs (media multitasking scores below the 25th percentile) chosen from a sample of 61 adolescents. Each participant completed a self-reported questionnaire on executive function and three executive function cognitive tasks: 2-back, Color Stroop, and Number-letter Determination) while wearing the fNIRS. The results indicated that: (1) the HMMs showed more impairment in executive function than the LMMs based on questionnaire data analysis; (2) there were no significant differences between the HMMs and LMMs in their performance on the cognitive tasks; and (3) the HMMs showed greater prefrontal activation than the LMMs during the 2-back and Color Stroop tasks. These findings implied that media multitasking might be associated with the reduced effectiveness in the brain areas responsible for executive function. These findings provide evidence of the negative relationship between media multitasking and executive function; and indicated the benefits of using multiple assessment methods in studying this topic.

Selection of Potential Sites for Sustainable Development of Solar Photovoltaic Plants in Northeastern Brazil Using GIS and Multi-Criteria Analysis

Brazil has one of the highest percentages of solar radiation in the world and which it is a favorable condition to generate electricity using solar photovoltaic systems. The construction of photovoltaic plants depends on the site selection that influences the electricity generation capacity and the socio-economic benefits that can be derived from it in the future. This article proposes to combine Spatial analysis that involves the acquisition and management of spatial data using a Geographic Information System (GIS), and the fuzzy multi-criteria AHP-TOPSIS model to identify potential locations for the installation of solar photovoltaic systems in the northeastern region of Brazil, State of Pernambuco. The combination of GIS and fuzzy AHP-TOPSIS offers the user the possibility of assigning merit categories to the mapping according to multiple assessment criteria. The GIS include factors of the restrictions and criteria. The restrictions are inserted into the GIS using layers defined from current legislation (urban areas, undeveloped land, community sites, infrastructure, etc.), which reduce the study area by eliminating zones in which PV installation is not permitted. The results show that 22 and 40% of the area of the state of Pernambuco has the very high and high potential, respectively, for the implantation of PV.

Validity of Two Awake Wear-Time Classification Algorithms for activPAL in Youth, Adults, and Older Adults

Background: The authors assessed agreement between participant diaries and two automated algorithms applied to activPAL (PAL Technologies Ltd, Glasgow, United Kingdom) data for classifying awake wear time in three age groups. Methods: Study 1 involved 20 youth and 23 adults who, by protocol, removed the activPAL occasionally to create nonwear periods. Study 2 involved 744 older adults who wore the activPAL continuously. Both studies involved multiple assessment days. In-bed, out-of-bed, and nonwear times were recorded in the participant diaries. The CREA (in PAL processing suite) and ProcessingPAL (secondary application) algorithms estimated out-of-bed wear time. Second- and day-level agreement between the algorithms and diary was investigated, as were associations of sedentary variables with self-rated health. Results: The overall accuracy for classifying out-of-bed wear time as compared with the diary was 89.7% (Study 1) to 95% (Study 2) for CREA and 89.4% (Study 1) to 93% (Study 2) for ProcessingPAL. Over 90% of the nonwear time occurring in nonwear periods >165 min was detected by both algorithms, while <11% occurring in periods ≤165 min was detected. For the daily variables, the mean absolute errors for each algorithm were generally within 0–15% of the diary mean. Most Spearman correlations were very large (≥.81). The mean absolute errors and correlations were less favorable for days on which any nonwear time had occurred. The associations between sedentary variables and self-rated health were similar across processing methods. Conclusion: The automated awake wear-time classification algorithms performed similarly to the diary information on days without short (≤2.5–2.75 hr) nonwear periods. Because both diary and algorithm data can have inaccuracies, best practices likely involve integrating diary and algorithm output.