Converting Physical Function Testing to the Remote Setting: Adapting Our Research Protocol During COVID-19

Objective measurement of physical function can be a more sensitive predictor of future disability and changes over time than self-report measures. However, objective measures require in-person assessments which can limit their use in hard-to-reach populations. During the COVID-19 pandemic, laboratory assessment of physical functioning in our two large randomized controlled exercise trials in older adults with cancer was temporarily suspended. We adapted testing protocols for administering the short physical performance battery (PPB), including chair stand (CS; sec) and 4m usual walk (4MW; m/s) tests, and timed-up-and go (TUG; sec) tests of physical functioning for remote assessment by video conferencing technology. We report on interim assessments of inter and intra-rater reliability and validity against newly resumed in-person tests. Repeat assessments were conducted on the same participant 1-2 weeks apart, by the same assessor (intra-rater reliability) or by another assessor (inter-rater reliability) for remote visits and by the same assessor for in-person tests (validity). Pearson-product moment correlations are provided for PPB, CS, 4MW and TUG, in that order. Intra-rater reliability values are: 0.97, 0.88, 0.90, and 0.96; Inter-rater reliability values are: 0.79, 0.14, 0.40, and 0.99; Validity values (no TUG) are: 0.66, 0.81, 0.78. Reliability of conducting remote PPB by video is very high when using the same assessor, while TUG reliability is high within and between assessors. Remote PPB administration has a good correlation with in-person visits, but the two modes of delivery should not yet be used interchangeably in longitudinal studies until sources of error can be determined and minimized.

Feasibility, Acceptance, and Safety of Metacognitive Training for Problem and Pathological Gamblers (Gambling-MCT): A Pilot Study

Approximately 90% of problem and pathological gamblers remain untreated. This treatment gap may be diminished by the implementation of low-threshold treatment programs. As cognitive distortions play a crucial role in the development and maintenance of gambling problems, interventions targeting gambling-related biases may be particularly effective. The aim of the present study was to examine the feasibility, acceptance, and safety of a novel metacognitive training for individuals with gambling problems (Gambling-MCT). Twenty-five participants were included in an uncontrolled pilot trial with two assessment points (intervention). The intervention comprised eight training modules targeting gambling-specific cognitive distortions. At baseline and post assessment, symptom severity, as measured with the PG-YBOCS, and gambling-related cognitive distortions, as measured with the GABS, were assessed. In addition, interim assessments measuring session-specific changes were conducted. Subjective appraisal was examined after each module and also post treatment. On average, participants took part in 4.16 (SD = 2.84) training sessions. Both intent-to-treat and per protocol analyses showed significant improvements on the PG-YBOCS and the GABS (dz = 0.37–1.37). After Bonferroni correction for multiple testing, linear mixed models for the analysis of session-specific changes showed no deterioration in participants’ mental state after any of the modules. Subjective appraisal of Gambling-MCT was good. The present pilot study provides first evidence for the feasibility, acceptance, and safety of Gambling-MCT. Recruitment of participants remains challenging, emphasizing the importance of overcoming patient-related treatment barriers. Future studies need to investigate the efficacy of Gambling-MCT in randomized controlled trials.

Developing Ambitious Mathematics Instruction Through Web-Based Coaching: A Randomized Field Trial

This article describes and evaluates a web-based coaching program designed to support teachers in implementing Common Core–aligned math instruction. Web-based coaching programs can be operated at relatively lower costs, are scalable, and make it more feasible to pair teachers with coaches who have expertise in their content area and grade level. Results from our randomized field trial document sizable and sustained effects on both teachers’ ability to analyze instruction and on their instructional practice, as measured by the Mathematical Quality of Instruction instrument and student surveys. However, these improvements in instruction did not result in corresponding increases in math test scores as measured by state standardized tests or interim assessments. We discuss several possible explanations for this pattern of results.

Blended Learning Practice in Russia: the History of one Experiment

The paper describes various approaches to the definition and implementation of blended learning in Russia and gives a brief overview of its development in Russia, focusing especially on one experimental case of introducing blended learning in one of the Moscow schools. The experiment lasted for two years and included students of four 5th-6th classes. The results suggest that blended learning in Math lessons has a positive effect on the quality of intersubject and metasubject educational outcomes. It is argued that such an improvement is not the effect of a particular, unique model of blended learning, but of a model which integrates a number of factors influencing the educational outcome. Supposedly, this result is achieved due to interim assessments and the teacher’s individual work with children who have difficulties with mastering new material and/or have not fully understood previous topics.

Radiation therapy for nasopharyngeal carcinoma: the predictive value of interim survival assessment

Pretreatment characteristics are suggested as predictive and/or prognostic factors for nasopharyngeal carcinoma (NPC); however, individual tumor radiosensitivities have previously not been considered. As boost planning is recommended for NPC, we performed interim assessments of magnetic resonance (MR) images for boost planning and retrospectively evaluated their predictive value for the survival of NPC patients. Radiation therapy via elective nodal irradiation (median dose: 39.6 Gy) with/without chemotherapy was used to treat 63 NPC patients. Boost irradiation (median total dose: 70 Gy) was performed based on the interim assessment. The largest lymph node (LN) was measured on MR images acquired at the time of interim assessment. The site of first failure was local in 8 (12.7%), regional in 7 (11.1%), and distant in 12 patients (19.0%). All 7 patients with regional failure harbored LNs ≥15 mm at interim assessment. We divided the 63 patients into two groups based on LN size [large (≥15 mm), n = 10 and small (<15 mm), n = 53]. Univariate analysis showed that 5-year overall survival (OS) and cause-specific survival (CSS) rates for large LNs were significantly lower than for small LNs (OS: 12.5% vs 70.5%, P < 0.001 and CSS: 25.0% vs 80.0%, P < 0.001). Multivariate analysis showed that large LNs were a significantly unfavorable factor for both OS (hazard ratio = 4.543, P = 0.002) and CSS (hazard ratio = 6.020, P = 0.001). The results suggest that LN size at interim assessment could predict survival in NPC patients.