Experimental analysis of proximity as a social stimulus: Increasing on‐task behavior of an adolescent with autism

Experimental analysis of social stimuli has typically been restricted to the presence or absence of verbal attention. In the present study, an ABAB design was used to assess the influence of proximity as a social stimulus. Close and distant proximity of a familiar adult was systematically manipulated to evaluate the effect of proximity on the on‐task behavior of a 15‐year‐old male with autism. Baseline, experimental analysis, and intervention phases were conducted within a self‐contained classroom. Pronounced effects of distant educator proximity to the participant were evident during both the experimental analysis and intervention, with increased on‐task behavior occurring in the distant condition. Future recommendations for the investigation of proximity as a relevant social stimulus are forwarded. © 2005 Wiley Periodicals, Inc. Psychol Schs 42: 189–196, 2005.     

Response time variations in an online search system.

The response time characteristics of the National Library of Medicine's (NLM) ELHILL bibliographic search system are examined in this article. Transactions for a five-week period are analyzed and average response times are calculated for typical search commands, by time of day, and by file being searched. Overall, the response time of the system was found to be 2.1 seconds, a very low value. Based on statistical tests of significance applied to the data, it was concluded that response time differences can be explained in terms of the number of users on the system and not the command issued by the user nor the file the user searched.     

Triangulating Clinically Meaningful Change in the Six-minute Walk Test in Individuals with Chronic Heart Failure: A Systematic Review

Purpose

The purpose of the present review was to use existing, published data to provide an estimate of the amount of change in six-minute walk test distance (Δ6MWT) that represents a clinically meaningful change in individuals with chronic heart failure (CHF).

Methods

The present review included two separate literature searches of the CINAHL and Medline databases for articles that: (1) reported the intraclass correlation coefficient (ICC) of the 6MWT in individuals with CHF, and (2) used the 6MWT along with either aerobic capacity or health-related quality of life (HRQL) as study endpoints in randomized controlled trials (RCTs) of exercise-based intervention for individuals with CHF. The ICCs were used to calculate the minimum detectable difference (MDD) at the 95% confidence interval for each included study. The Δ6MWT associated with aerobic capacity and HRQL within-group effect sizes for the intervention and control groups in each included RCT was analyzed using receiver operating characteristic (ROC) curves.

Results

Thirteen articles reported the ICC for the 6MWT. The mean (standard deviation) MDD calculated based on these data was 43.1(16.8) m. Eighteen RCTs measured the 6MWT and either aerobic capacity and/or HRQL. A Δ6MWT of 40–45 m was associated with at least moderate aerobic capacity and HRQL effect sizes in the intervention groups. The Δ6MWT thresholds that discriminated between intervention and control groups using ROC curves revealed the following sensitivity/specificity for the respective thresholds: 19 m, 94.4/83.3%, 32 m, 83.3/94.4%, and 48 m 44.4/100% (AUC = .935, p = .009, CI_95% .855, 1.015).

Conclusions

A Δ6MWT of approximately 45 m appears to exceed measurement error and be associated with significant changes in either aerobic capacity and/or HRQL.Key Words: heart failure, six-minute walk test, clinically meaningful change, minimum detectable difference     

Doulas as community health workers: lessons learned from a volunteer program

Doulas, women who primarily provide social support during childbirth, have been associated with a number of positive health outcomes. Because the primary model of practice for doulas is a fee-for-service model in which families privately hire a doula, many expectant women who could benefit from doula support are unable to access the service. The Doulas Care program, located in Ann Arbor, Michigan, represents one model in which doulas provide services without charge. As a result of their extended role in the community, doulas who work with the Doulas Care program have unique educational needs. Through the use of focus groups with the program's volunteer doulas, educational needs related to overcoming barriers to being a doula working in the community were identified. Recommendations for education and training are made to improve the support doulas offer as community health outreach workers.