Implementation in a Changing Landscape: Provider Experiences During Rapid Scaling of Use of Evidence-Based Treatments

This study examined 133 service providers’ perspectives on a rapid shift to mandated evidence-based treatment delivery, utilizing an inductive coding process to capture themes present in their qualitative feedback. The majority of provider comments were negatively valenced, but attitudes varied considerably across response categories: comments regarding practice context and support were nearly uniformly negative, while comments regarding treatment fit and therapeutic consequences were more balanced. Treatment fit was the most commonly cited category; the fit to therapist (e.g., ease of use) subcategory was predominantly positive in contrast with the fit to client (e.g., flexibility) subcategory, which was predominantly negative. Results illustrate the intended and unintended consequences of large-scale implementation efforts on community providers, and may aid implementation researchers and system decision makers optimize the conditions under which community providers are asked to implement evidence-based treatment.     

反馈对注意缺损多动障碍儿童错误监控能力的影响

研究选取了注意缺损多动障碍(ADHD)儿童39名,正常儿童40名,采用两项选择任务,考察在无反馈和有反馈的情况下,ADHD儿童的错误监控能力是否存在缺损。结果发现,(1)无论是否提供反馈,与正常儿童相比,ADHD儿童的错误察觉能力正常,但是错误更正能力落后,这可能是由于ADHD儿童动作调节控制能力落后导致的;(2)反馈提高了ADHD儿童和正常儿童的认知加工速度,但同时降低了他们的警醒水平,导致错误监控能力下降。     

基于机体反馈调控保护扭转肿瘤治疗思路

肿瘤的临床治疗经过漫长积极探索研究,中西医疗效均未取得成就性突破,本文穿越时空隧道,基于人类亿万年适应环境生存生物进化历程形成的精细反馈调控保护视角,循证机体实施反馈调控保护顽强延续生命依据,结合肿瘤病理生理机制,剖析肿瘤形成原因,追溯肿瘤临床治疗误区,扭转肿瘤治疗思路,引领肿瘤治疗新路径。     

Perceptual strength is different from sensorimotor strength: Evidence from the centre–periphery asymmetry in masked priming

Near-threshold prime stimuli can facilitate or hinder responses to target stimuli, creating either a positive compatibility effect (PCE) or a negative compatibility effect (NCE). An asymmetry has been reported between primes presented in near periphery, which produced a PCE, and foveal primes, which produced an NCE under comparable conditions. This asymmetry has been attributed to the difference in retinal sensitivity, but it remains unclear whether this means that equating discrimination performance for primes in fovea and periphery, in order to account for differences in perceptual sensitivity, would make the priming effects the same. Wider work indicates that perceptual ability can dissociate from visuomotor effects, predicting that equating perceptual ability for fovea and periphery would not equate priming. We tested these opposite possibilities by matching discrimination performance for masked Gabor patches in fovea and near periphery (6°) and using these as primes in a masked priming paradigm expected to elicit NCEs. We found the asymmetry remained: NCE for fovea and PCE for periphery. We replicated this with both blocked and randomized procedures to check for attentional effects. We conclude that equating perceptual strength (discriminability) of stimuli does not equate their sensorimotor impact due to differences in the relative importance of different visual pathways and differing temporal dynamics in perceptual and sensorimotor processes.     

Human performance on negative slope schedules of points exchangeable for money: a failure of molar maximization

Panel pressing was generated and maintained in 5 adult humans by schedules of points exchangeable for money. Following exposure to a variable-interval 30-s schedule and to a linear variable-interval 30-s schedule (which permitted points to accumulate in an unseen "store" in the absence of responding), subjects were exposed to a series of conditions with a point-subtraction contingency arranged conjointly with the linear variable-interval schedule. Specifically, points were added to the store according to the linear-variable interval 30-s schedule and were subtracted from the store according to a ratio schedule. Ratio value varied across conditions and was determined individually for each subject such that the subtraction contingency would result in an approximately 50% reduction in the rate of point delivery. Conditions that included the subtraction contingency were termed negative slope schedules because the feedback functions were negatively sloped across all response rates greater than the inverse of the variable-interval schedule, in this case, two per minute. Overall response rates varied inversely with the subtraction ratio, indicating sensitivity to the negative slope conditions, but were in excess of that required by accounts based on strict maximization of overall reinforcement rate. Performance was also not well described by a matching-based account. Detailed analyses of response patterning revealed a consistent two-state pattern in which bursts of high-rate responding alternated with periods of prolonged pausing, perhaps reflecting the joint influence of local and overall reinforcement rates.     

Interpreting the uninterpretable: The effect of self-esteem on the interpretation of meaningless feedback

People often seek out and retain positive information about themselves via self-enhancement processes. Under other circumstances, they seek out and retain self-confirmatory information via self-verification processes. Research on both of these self-evaluation processes has been based heavily on domains such as social skills, in which people have a large database of prior information that presumably influences the way in which incoming self-relevant information is interpreted. In the present research, participants were asked to evaluate themselves on a set of imaginary "pseudotraits" to investigate how self-esteem influences the self-evaluation process when prior information is unavailable. Participants who had been identified through pre-testing as either high or low in self-esteem received false feedback on five pseudotraits (e.g., "casortic"), after which they evaluated the favorability of this feedback. High self-esteem participants tended to view their feedback as favorable, whereas low self-esteem participants did not.     

Interlimb coordination following stroke

Studies investigating whether simultaneous bilateral movements can facilitate performance of the impaired limb(s) of stroke patients have returned mixed results. In the present study we compared unilateral limb performance (amplitude, cycle duration) with performance during an interlimb coordination task involving both homologous (both arms, both legs) and non-homologous (one arm, one leg) limbs in stroke participants (n=7) and healthy age-matched controls (n=7). In addition, the effect of on-line augmented visual feedback on interlimb coordination was investigated. Participants performed cyclical flexion-extension movements of the arms and legs in the sagittal plane paced by an auditory metronome (1 Hz). Movement amplitudes were larger and cycle durations shorter during homologous limb coordination than non-homologous coordination. Compared with unilateral movements both groups had reduced movement amplitudes and the stroke group increased cycle duration when interlimb coordination tasks were performed. These effects were most evident during non-homologous (arm and leg) coordination. No evidence of facilitation of the impaired limb(s) was found in any of the interlimb coordination conditions. Augmented visual feedback had minimal effect on the movements of control participants but lead to an increase of cycle duration for stroke participants.     

Preintervention analysis and improvement of customer greeting in a restaurant

We examined customer greeting by employees at one location of a sandwich restaurant chain. First, a preintervention analysis was conducted to determine the conditions under which greeting a customer within 3 s of his or her entry into the restaurant did and did not occur. Results suggested that an appropriate customer greeting was most likely to occur when a door chime was used to indicate that a customer had entered the store and when the store manager was present behind the service counter. Next, a performance improvement intervention, which consisted of the combination of the use of a door chime and manager presence, was evaluated. Results showed that during baseline, a mean of 6% of customers were greeted; during intervention a mean of 63% of customers were greeted. The addition of manager-delivered verbal and graphic group feedback resulted in 100% of customers being greeted across two consecutive sessions.     

Evaluating a more cost-efficient alternative to providing in-home feedback to parents: the use of spousal feedback.

We evaluated the contribution of spousal feedback to a parent education curriculum designed for parents of children with autism. A modified multiple baseline design across 3 husband-and-wife dyads was used to examine the effects of teaching parents to give each other feedback on their teaching performance. For 5 of 6 participants, improvement in teaching performance occurred following didactic presentations. However, additional improvement was observed for 5 participants when the spousal feedback component was implemented.     

USING NUMBER LINE PROCEDURES AND PEER TUTORING TO IMPROVE THE MATHEMATICS COMPUTATION OF LOW-PERFORMING FIRST GRADERS

Recommendations for mathematics instruction frequently include the use of manipulatives as a critical component. There are few experimental analyses of teaching strategies involving the use of manipulatives (e.g., the number line). This investigation used a multiple baseline design across three groups of students to examine the effectiveness of an experimental procedure for improving low-performing children's skills in solving missing addend arithmetic problems using the number line. To address concerns about inadequate time for instruction and insufficient practice in most mathematics instruction, trained peer tutors implemented the procedure. The results suggest that student performance improved when trained tutors taught the students number line procedures and gave them feedback on accuracy. Further, social validation data indicate that the students, their tutors, and their classroom teachers liked the procedures.