Evaluation of Dimensionality in the Assessment of Internal Consistency Reliability: Coefficient Alpha and Omega Coefficients

In the lead article, Davenport, Davison, Liou, & Love demonstrate the relationship among homogeneity, internal consistency, and coefficient alpha, and also distinguish among them. These distinctions are important because too often coefficient alpha—a reliability coefficient—is interpreted as an index of homogeneity or internal consistency. We argue that factor analysis should be conducted before calculating internal consistency estimates of reliability. If factor analysis indicates the assumptions underlying coefficient alpha are met, then it can be reported as a reliability coefficient. However, to the extent that items are multidimensional, alternative internal consistency reliability coefficients should be computed based on the parameter estimates of the factor model. Assuming a bifactor model evidenced good fit, and the measure was designed to assess a single construct, omega hierarchical—the proportion of variance of the total scores due to the general factor—should be presented. Omega—the proportion of variance of the total scores due to all factors—also should be reported in that it represents a more traditional view of reliability, although it is computed within a factor analytic framework. By presenting both these coefficients and potentially other omega coefficients, the reliability results are less likely to be misinterpreted.     

Organizational climate, services, and outcomes in child welfare systems

Objective

This study examines the association of organizational climate, casework services, and youth outcomes in child welfare systems. Building on preliminary findings linking organizational climate to youth outcomes over a 3-year follow-up period, the current study extends the follow-up period to 7 years and tests main, moderating and mediating effects of organizational climate and casework services on outcomes.

Methods

The study applies hierarchical linear models (HLMs) analyses to all 5 waves of the National Survey of Child and Adolescent Well-being (NSCAW) with a US nationwide sample of 1,678 maltreated youth aged 4–16 years and 1,696 caseworkers from 88 child welfare systems. Organizational climate is assessed on 2 dimensions, Engagement and Stress, with scales from the well established measure, Organizational Social Context (OSC); youth outcomes are measured as problems in psychosocial functioning with the Child Behavior Checklist (CBCL); and casework services are assessed with original scales developed for the study and completed by the maltreated youths’ primary caregivers and caseworkers.

Results

Maltreated youth served by child welfare systems with more engaged organizational climates have significantly better outcomes. Moreover, the quantity and quality of casework services neither mediate nor interact with the effects of organizational climate on youth outcomes.

Conclusions

Organizational climate is associated with youth outcomes in child welfare systems, but a better understanding is needed of the mechanisms that link organizational climate to outcomes. In addition, there is a need for evidence-based organizational interventions that can improve the organizational climates and effectiveness of child welfare systems.     

The effects of the ARC organizational intervention on caseworker turnover, climate, and culture in children's service systems

OBJECTIVE: This study examines the effects of the Availability, Responsiveness, and Continuity (ARC) organizational intervention strategy on caseworker turnover, climate, and culture in a child welfare and juvenile justice system. METHOD: Using a pre-post, randomized blocks, true experimental design, 10 urban and 16 rural case management teams were randomly assigned to either the ARC organizational intervention condition or to a control condition. The culture and climate of each case management team were assessed at baseline and again after the one-year organizational intervention was completed. In addition, caseworker turnover was assessed by identifying caseworkers on the sampled teams who quit their jobs during the year. RESULTS: Hierarchical Linear Models (HLM) analyses indicate that the ARC organizational intervention reduced the probability of caseworker turnover by two-thirds and improved organizational climate by reducing role conflict, role overload, emotional exhaustion, and depersonalization in both urban and rural case management teams. CONCLUSIONS: Organizational intervention strategies can be used to reduce staff turnover and improve organizational climates in urban and rural child welfare and juvenile justice systems. This is important because child welfare and juvenile justice systems in the U.S.A. are plagued by high turnover rates, and there is evidence that high staff turnover and poor organizational climates negatively affect service quality and outcomes in these systems.     

The influence of hydration on anaerobic performance: a review

This review examines the influence of dehydration on muscular strength and endurance and on single and repeated anaerobic sprint bouts. Describing hydration effects on anaerobic performance is difficult because various exercise modes are dominated by anaerobic energy pathways, but still contain inherent physiological differences. The critical level of water deficit (approximately 3-4%; mode dependent) affecting anaerobic performance is larger than the deficit (approximately 2%) impairing endurance performance. A critical performance-duration component (> 30 s) may also exist. Moderate dehydration (approximately 3% body weight; precise threshold depends on work/recovery ratio) impairs repeated anaerobic bouts, which place an increased demand on aerobic metabolism. Interactions between dehydration level, dehydration mode, testing mode, performance duration, and work/recovery ratio during repeated bouts make the dehydration threshold influencing anaerobic performance mode dependent.     

What Are the Barriers to Mobilizing Intensive Care Patients?

Purpose

Recently there has been increased interest in early mobilization of critically ill patients. Proposed benefits include improvements in respiratory function, muscle wasting, intensive care unit (ICU), and hospital length of stay. We studied the frequency of early mobilization in our intensive care unit in order to identify barriers to early mobilization.

Methods

A 4-week prospective audit of 106 patients admitted to a mixed medical-surgical tertiary ICU (mean age 60 ± 20 years, mean APACHE II score 14.7 ± 7.8) was performed. Outcome measures included number of patient days mobilized, type of mobilization, adverse events, and reasons for inability to mobilize.

Results

Patients were mobilized on 176 (54%) of 327 patient days. Adverse events occurred in 2 of 176 mobilization episodes (1.1%). In 71 (47%) of the 151 patient days where mobilization did not occur, potentially avoidable factors were identified, including vascular access devices sited in the femoral region, timing of procedures and agitation or reduced level of consciousness.

Conclusions

Critically ill patients can be safely mobilized for much of their ICU stay. Interventions that may allow more patients to mobilize include: changing the site of vascular catheters, careful scheduling of procedures, and improved sedation management.Key Words: intensive care units, mobility, physical therapy