Impact of physical activity on activity of daily living in moderate to severe dementia: a critical review

The objectives of this study were to describe the different modalities of physical activity programs designed for moderate to severe dementia and to identify their impact on functional independence in activities of daily living (ADL). A critical review of randomized controlled trials related to the impact of physical activity programs in moderately to severely demented persons on ADL performance and meta-analysis of the identified studies were performed. Among the 303 identified articles, five responded to the selection criteria. Four out of the five studies demonstrated limited methodological quality. In one high-quality study, physical activity programs significantly delayed deterioration of ADL performance. The program components and ADL assessment tools vary widely across studies. Although the proposed treatments have not proven their efficiency in improving the ADL status of the patients, they were able to limit the decline in ADL functioning. Future research is warranted in order to identify clinically relevant modalities for physical activity programs for people with moderate to severe dementia.     

Queering Counselor Education: Situational Analysis of LGBTQ+ Competent Faculty

Research demonstrates counselor educators often lack skills and knowledge to train counselors to become lesbian, gay, bisexual, transgender, queer and other sexualities and gender identities (LGBTQ+) competent. This study explores the process of educators integrating LGBTQ+ competencies into their professional work. Using grounded theory and situational analysis methodologies, in-depth interviews with seven LGBTQ+ competent counselor educators were conducted and analyzed. Findings suggest educators infuse personal passion for LGBTQ+ topics into their professional work, experienced discrimination and resistance across multiple domains, infuse advocacy into their work, and have a similar definition of LGBTQ+ competent counseling. Various techniques are presented to help educators infuse LGBTQ+ competency in the classroom.     

Asset Accumulation: An Alternative Approach to Achieving the Millennium Development Goals

The United Nations Millennium Development Goals (MDGs) are unlikely to be achieved by 2015, owing to conceptual flaws in their design as well as the structural and political constraints faced during implementation at the country level. While criticism of the MDGs is widespread, innovative ideas on addressing these operational challenges are still scanty. By reviewing a number of experiences, including those of the Foundation for the Promotion of Local Development (PRODEL) in Nicaragua and the Ministry of Cities in Brazil, this article highlights the importance of incorporating an asset‐accumulation perspective into MDG‐related policies and programmes as a way of generating an enabling environment that opens up new opportunities for poverty reduction in the cities of low‐ and middle‐low‐income countries.     

Empirical evaluation of the implementation of the EMA guideline on missing data in confirmatory clinical trials: Specification of mixed models for longitudinal data in study protocols

In confirmatory clinical trials, the prespecification of the primary analysis model is a universally accepted scientific principle to allow strict control of the type I error. Consequently, both the ICH E9 guideline and the European Medicines Agency (EMA) guideline on missing data in confirmatory clinical trials require that the primary analysis model is defined unambiguously. This requirement applies to mixed models for longitudinal data handling missing data implicitly. To evaluate the compliance with the EMA guideline, we evaluated the model specifications in those clinical study protocols from development phases II and III submitted between 2015 and 2018 to the Ethics Committee at Hannover Medical School under the German Medicinal Products Act, which planned to use a mixed model for longitudinal data in the confirmatory testing strategy. Overall, 39 trials from different types of sponsors and a wide range of therapeutic areas were evaluated. While nearly all protocols specify the fixed and random effects of the analysis model (95%), only 77% give the structure of the covariance matrix used for modeling the repeated measurements. Moreover, the testing method (36%), the estimation method (28%), the computation method (3%), and the fallback strategy (18%) are given by less than half the study protocols. Subgroup analyses indicate that these findings are universal and not specific to clinical trial phases or size of company. Altogether, our results show that guideline compliance is to various degrees poor and consequently, strict type I error rate control at the intended level is not guaranteed.     

FDR control of detected regions by multiscale matched filtering

Feature extraction from observed noisy samples is a common important problem in statistics and engineering. This paper presents a novel general statistical approach to the region detection problem in long data sequences. The proposed technique is a multiscale kernel regression in conjunction with statistical multiple testing for region detection while controlling the false discovery rate (FDR) and maximizing the signal-to-noise ratio via matched filtering. This is achieved by considering a one-dimensional region detection problem as its equivalent zero-dimensional peak detection problem. The detection method does not require a priori knowledge of the shape of the nonzero regions. However, if the shape of the nonzero regions is known a priori, e.g., rectangular pulse, the signal regions can also be reconstructed from the detected peaks, seen as their topological point representatives. Simulations show that the method can effectively perform signal detection and reconstruction in the simulated data under high noise conditions, while controlling the FDR of detected regions and their reconstructed length.     

Heterogeneity in Parent‐reported Social Skill Development in Early Elementary School Children

Despite known risks associated with aberrant social skill development, there has been a relative dearth of literature on typical developmental changes in social skills over time. In this study, we examine systematic changes in social skills from kindergarten (typical age of 5–6 years) to third grade (typical age of 8–9 years), and focus on systematic heterogeneity across these developmental trajectories. Data came from the National Head Start—Public School Early Childhood Transition Demonstration Project (N = 6964). Mixture models provide evidence for multiple classes of individuals representing heterogeneity in the development of social skills. Classes were defined as a majority class (whose trajectories remained relatively stable over time), an increasing class (whose trajectories increased at a faster rate than the majority class), and a decreasing class (whose trajectories decreased at a faster rate than the majority class). Developmental trends accounted for a substantial proportion of the variance in social skill components. Implications and limitations of the study are discussed.