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Objective To evaluate the effectiveness of a peer led parenting intervention delivered to socially disadvantaged families.Design Randomised controlled trial. Setting Schools and children’s centres in a socially deprived borough of inner London. Participants Parental caregivers seeking help with managing the problem behaviours of 116 index children, aged 2-11 years; 59 families were randomised to the intervention and 57 to a waitlist control condition. Intervention Empowering parents, empowering communities is an eight week (two hours each week), manualised programme delivered to groups of parents by trained peer facilitators from the local community. Main outcome measures Child problems (number and severity), parental stress, and parenting competencies were assessed before and after the intervention using standardised parent reported measures. Results Significantly greater improvements in positive parenting practices and child problems were observed in the intervention group compared with the waitlist group, with no difference in parental stress between the groups. An intention to treat analysis for the primary outcome measure, the intensity subscale of the Eyberg child behaviour inventory, showed an intervention effect size of 0.38 (95% confidence interval 0.01 to 0.75, P=0.01). The intervention group had high rates of treatment retention (91.5%) and user satisfaction. Conclusion The peer led parenting intervention significantly reduced child behaviour problems and improved parenting competencies. This is a promising method for providing effective and acceptable parenting support to families considered hard to reach by mainstream services.Trial registration Current Controlled Trials ISRCTN01962337.

Purpose: To determine the effectiveness of cultural sensitivity training on the knowledge and attitudes of health care providers, and to assess the satisfaction and health outcomes of patients from different minority groups with health care providers who received training. Design: In this randomised controlled trial, 114 health care providers (nurses and homecare workers) and 133 patients (from two community agencies and one hospital) were randomly assigned to experimental (training) and control groups, and were followed for 18 months. Methods: Providers completed the Cultural Awareness Questionnaire and the Dogmatism Scale. Patients completed the Off‐Axis‐Ratio (OAR) Multidimensional Measure of Functional Capacity, the Client Satisfaction Questionnaire, the Physical and Mental Health Assessment Questionnaire, and the Health and Social Services Utilization Questionnaire. A qualitative analysis was conducted to identify and analyse themes from personal journals kept by participating nurses. Findings: Cultural sensitivity training resulted in increased open‐mindedness and cultural awareness, improved understanding of multiculturalism, and ability to communicate with minority people. After 1 year patients of mostly European and British origin, who received care from trained providers, showed improvement in utilizing social resources and overall functional capacity without an increase in health care expenditures. Conclusions: The results of this study indicate that a cultural sensitivity training program not only improved knowledge and attitudes among health care providers, but it also yielded positive health outcomes for their patients.

Although impaired recognition of affective facial expressions has been conclusively linked to antisocial behavior, little is known about the modifiability of this deficit. This study investigated whether and under which circumstances the proposed perceptual insensitivity can be addressed with a brief implicit training approach. Facial affect recognition was assessed with an animated morph task, in which the participants (44 male incarcerated violent offenders and 43 matched controls) identified the onset of emotional expressions in animated morph clips that gradually changed from neutral to one of the six basic emotions. Half of the offenders were then implicitly trained to direct attention to salient face regions (attention training, AT) using a modified dot-probe task. The other half underwent the same protocol but the intensity level of the presented expressions was additionally manipulated over the course of training sessions (sensitivity to emotional expressions training, SEE training). Subsequently, participants were reassessed with the animated morph task. Facial affect recognition was significantly impaired in violent offenders as compared with controls. Further, our results indicate that only the SEE training group exhibited a pronounced improvement in emotion recognition. We demonstrated for the first time that perceptual insensitivity to facial affect can be addressed by an implicit training that directs attention to salient regions of a face and gradually decreases the intensity of the emotional expression. Future studies should focus on the potential of this intervention to effectively increase empathy and inhibit violent behavior in antisocial individuals.

Panum's limiting case is a phenomenon of monocular occlusion in binocular vision. This occurs when one object is occluded by the other object for one eye, but the two objects are both visible for the other eye. Although previous studies have found that vertical gradient of horizontal disparity and cue conflict are two important factors for double fusion, the effect of training on the sensitivity and stability of Panum's limiting case remains unknown. The current study trained 26 participants for 5 days with several of Panum's configurations (Gilliam, Frisby, and Wang series). The latency and duration of double fusion were recorded to examine the effects of training on sensitivity and stability of double fusion in Panum's limiting case. For each level of vertical gradient of horizontal disparity and cue conflict, the latency of double fusion decreased and the duration of double fusion increased with each additional training session. The results showed that vertical gradient of horizontal disparity and cue conflict interacted, and the duration of high cue conflict was significantly shorter than that of medium and low cue conflict for each level of vertical gradient of horizontal disparity. The findings suggest that there is an effect of training for vertical gradient of horizontal disparity and cue conflict in Panum's limiting case, and that the three factors jointly affect the sensitivity and stability of double fusion.

Conventional diagnosis of COVID-19 with reverse transcription polymerase chain reaction (RT-PCR) testing (hereafter, PCR) is associated with prolonged time to diagnosis and significant costs to run the test. The SARS-CoV-2 virus might lead to characteristic patterns in the results of widely available, routine blood tests that could be identified with machine learning methodologies. Machine learning modalities integrating findings from these common laboratory test results might accelerate ruling out COVID-19 in emergency department patients. We sought to develop (ie, train and internally validate with cross-validation techniques) and externally validate a machine learning model to rule out COVID 19 using only routine blood tests among adults in emergency departments. Using clinical data from emergency departments (EDs) from 66 US hospitals before the pandemic (before the end of December 2019) or during the pandemic (March-July 2020), we included patients aged ≥20 years in the study time frame. We excluded those with missing laboratory results. Model training used 2183 PCR-confirmed cases from 43 hospitals during the pandemic; negative controls were 10,000 prepandemic patients from the same hospitals. External validation used 23 hospitals with 1020 PCR-confirmed cases and 171,734 prepandemic negative controls. The main outcome was COVID 19 status predicted using same-day routine laboratory results. Model performance was assessed with area under the receiver operating characteristic (AUROC) curve as well as sensitivity, specificity, and negative predictive value (NPV). Of 192,779 patients included in the training, external validation, and sensitivity data sets (median age decile 50 [IQR 30-60] years, 40.5% male [78,249/192,779]), AUROC for training and external validation was 0.91 (95% CI 0.90-0.92). Using a risk score cutoff of 1.0 (out of 100) in the external validation data set, the model achieved sensitivity of 95.9% and specificity of 41.7%; with a cutoff of 2.0, sensitivity was 92.6% and specificity was 59.9%. At the cutoff of 2.0, the NPVs at a prevalence of 1%, 10%, and 20% were 99.9%, 98.6%, and 97%, respectively. A machine learning model developed with multicenter clinical data integrating commonly collected ED laboratory data demonstrated high rule-out accuracy for COVID-19 status, and might inform selective use of PCR-based testing.

Purpose This paper aims to discuss innovations in the training and development practices of companies and delineate a new approach to training and development in the context of the hybrid workplace using the ADDIE and Kirkpatrick training models. Design/methodology/approach This paper discusses innovations in training and development in modern times and builds on the instructional training design approach or the ADDIE Model and the Kirkpatrick Model of training evaluation. Findings The paper presents new approaches to training and development in the context of the hybrid work model applying the ADDIE Model and the Kirkpatrick Model. These new approaches are both necessitated and also made possible due to the technological advancements of modern times. Originality/value With the rapid transition of companies to the hybrid model of work in recent times, several human resource management practices need to be transformed to suit the requirements of the new work model. Training and development is one function that needs to change in the hybrid work model to ensure its effectiveness. This paper analyses innovations in the training and development practices of companies and discusses new approaches while applying existing training models, the ADDIE and Kirkpatrick Models, to adapt to the changes associated with the hybrid work model.

The sound-induced flash illusion (SiFI) is a robust auditory-dominated multisensory integration phenomenon that is used as a reliable indicator to assess multisensory integration. Previous studies have indicated that the SiFI effect is correlated with perceptual sensitivity. However, to date, there is no consensus regarding how it corresponds to sensitivity with long-term training. The present study adopted the classic SiFI paradigm with feedback training to investigate the effect of a week of long-term training on the SiFI effect. Both the training group and control group completed a pretest and a posttest before and after the perceptual training; however, only the training group was required to complete 7-day behavioral training. The results showed that (1) long-term training could reduce the response of fission and fusion illusions by improving perceptual sensitivity and that (2) there was a “plateau effect” that emerged during the training stage, which tended to stabilize by the fifth day. These findings demonstrated that the SiFI effect could be modified with long-term training by ameliorating perceptual sensitivity, especially in terms of the fission illusion. Therefore, the present study supplements perceptual training in SiFI domains and provides evidence that the SiFI could be used as an assessment intervention to improve the efficiency of multisensory integration.

Early childhood educators (ECEs) face several workplace challenges, including young children’s difficult behavior and mental health needs, workplace stress, low systemic support, and high levels of burnout. Both education and perceived confidence are often cited as important buffering factors, yet neither is well studied in the existing literature. The present study aimed to better understand and describe these factors. A survey, including both open and closed questions, was sent out to a large group of ECEs. Results were analyzed using descriptive statistics, T-tests, and the constant comparison method of qualitative coding. Findings suggest that the types of training ECEs have had is related to their comfort in recognizing and responding to young children’s mental health and challenging behaviors. Both systemic changes and didactic needs were cited as necessary to further support ECEs.

Auditory system plasticity is a promising target for neuromodulation, cognitive rehabilitation and therapeutic development in schizophrenia (SZ). Auditory-based targeted cognitive training (TCT) is a 'bottom up' intervention designed to enhance the speed and accuracy of auditory information processing, which has been shown to improve neurocognition in certain SZ patients. However, the dynamics of TCT learning as a function of training exercises and their impact on neurocognitive functioning and therapeutic outcomes are unknown. Forty subjects (SZ, = 21; healthy subjects (HS), = 19) underwent comprehensive clinical, cognitive, and auditory assessments, including measurements of auditory processing speed (APS) at baseline and after 1-h of TCT. SZ patients additionally completed 30-hours of TCT and repeated assessments ~10-12 weeks later. SZ patients were deficient in APS at baseline ( = 0.96, < 0.005) relative to HS. After 1-h of TCT, analyses revealed significant main effects of diagnosis ( = 1.75, = 0.002) and time ( = 1.04, < 0.001), and a × interaction ( = 0.85, = 0.02) on APS. APS learning effects were robust after 1-h in SZ patients ( = 1.47, < 0.001) and persisted throughout the 30-h of training. Baseline APS was associated with verbal learning gains after 30-h of TCT ( = 0.51, = 0.02) in SZ. TCT learning metrics may have prognostic utility and aid in the prospective identification of individuals likely to benefit from TCT. Future experimental medicine studies may advance predictive algorithms that enhance TCT-related clinical, cognitive and functional outcomes.

Universal health coverage (UHC) for all people, regardless of citizenship, is a global priority. Health care providers are central to the achievement of UHC, and their attitudes and behaviour could either advance or impede UHC for migrants. Using a social exclusion conceptual framework, this study examined the perspectives of health care providers on delivering health services to migrants in public health facilities in Gauteng Province, South Africa. We used stratified, random sampling to select 13 public health facilities. All health care providers working in ambulatory care were invited to complete a self-administered questionnaire. In addition to socio-demographic information, the questionnaire asked health care providers if they had witnessed discrimination against migrants at work, and measured their perspectives on social exclusionary views and practices. Multiple regression analysis was used to identify predictors of more exclusionary perspectives for each item. 277 of 308 health care providers participated in the study-a response rate of 90%. The participants were predominantly female (77.6%) and nurses (51.9%), and had worked for an average of 6.8 years in their facilities. 19.2% of health care providers reported that they had witnessed discrimination against migrants, while 20.0% reported differential treatment of migrant patients. Exclusionary perspectives varied across the different items, and for different provider groups. Enrolled nurses and nursing assistants were significantly more exclusionary on a number of items, while the opposite was found for providers born outside South Africa. For some questions, female providers held more exclusionary perspectives and this was also the case for providers from higher levels of care. Health care providers are critical to inclusive UHC. Social exclusionary views or practices must be addressed through enabling health policies; training in culture-sensitivity, ethics and human rights; and advocacy to ensure that health care providers uphold their professional obligations to all patients.