Aims: Many patients with temporomandibular disorders (TMD) seem to go undetected within primary dental health care. Previous studies have concluded that further efforts are needed to safeguard the clinical decision process in dentistry for patients with probable TMD. Primarily we evaluated if the implemented intervention in 2015 that was based on the 3Q/TMD increased the clinical decision-making for TMD patients compared to clinics that did not receive the intervention; secondarily we evaluated if other factors could be identified that predict performed or recommended TMD treatment; thirdly we evaluated treatment frequencies between 3Q-positives and 3Q-negatives at the intervention clinics. Methods: This case-control study was carried out within the Public dental health service in Västerbotten county, Sweden. An intervention based on a decision-tree with three screening questions for TMD (3Q/TMD) was implemented at four PDH clinics,intervention clinics. A total of 400 individuals were selected – 200 of 3Q-positives and 200 of 3Q-negatives. Clinics that were not included in the intervention programme was used as reference. The 3Q/TMD answers were analysed in relation to any TMD related decision that was collected from the digital dental records. Results: The intervention did not increase the frequencies of traceable clinical decisions among 3Q-positive patients at the interventions clinics when compared to the reference clinics. Conclusions: Despite the tailored intervention aimed at optimal use of the 3Q/TMD, the indicated under-treatment of patients with TMD remains. Future studies are still needed to gain a deeper understanding of the clinical decision-making process for TMD patients in general practice dentistry. / <p>Arbetet kommer att publiceras i en vetenskaplig tidsskrift - endast abstract publiceras på DiVA.</p>

The most thoroughly researched topic in relation to Autism Spectrum Disorders (ASD) is the evaluation of interventions. Despite there being systematic literature reviews identifying evidence-based interventions (EBIs) for students with ASD, it is not clear to what extent educational psychologists (EPs) are using EBIs in their practice. The first paper in this thesis is a systematic literature review exploring which school-based interventions are reported in educational and school psychology journals and highlights the challenges of applying research data to idiographic individual casework. The second paper in this thesis is an empirical study investigating the extent to which EPs are using EBIs in their practice and the factors which influence EPs’ decision-making when planning interventions for students with ASD. The survey findings indicate that EPs are using many EBIs for ASD; however, there are many they are unfamiliar with. The most salient factors influencing EPs’ decision-making when planning interventions for students with ASD include the student’s individual needs and factors related to the school context. The third paper in this study discusses the dissemination of evidence to professional practice and looks at the implications of this research for individual EP roles, Educational Psychology Services and future research. Finally, a strategy for disseminating the findings will be outlined alongside a strategy for evaluating the impact of the dissemination.

abstract: This action research dissertation study was undertaken to establish the foundation of a comprehensive evaluation component for the Turn-It-Around (TIA) workshop intervention program at Arizona State University (ASU), and was delivered in the form of a program development consultation. The study's intent was to enhance the ASU Counseling Service's departmental capacity to evaluate one of its important clinical services. The outcomes of this study included multiple assessments of TIA's evaluability and the fidelity of its implementation to its program design. The study products include a well-articulated program theory comprised of program goals, learning objectives, a detailed description of program activities, a logic model, and theoretical construct checklist documents articulating the behavioral science theory underlying the TIA intervention. In addition, instruments tailored to the Turn-It-Around intervention that are suitable for assessing program outcomes were developed and are implementation ready. TIA's clinical stakeholders were interviewed following the generation and delivery of the products and instruments mentioned above to determine whether they found the study's processes and products to be worthwhile and useful. In general, the clinicians reported that they were very satisfied with the benefits and outcomes of the program development consultation. As an action research dissertation, this study generated useful and usable collateral materials in the form of reports, documents, and models. These products are now at the disposal of TIA's institutional stakeholders for use in day-to-day business activities such as training new facilitators and liaisons, and giving presentations that describe the usefulness of TIA as an intervention. Beyond the documents generated to form a program evaluation infrastructure for Turn-It-Around, the processes involved in crafting the documents served to engage relevant stakeholders in a cycle of action research that enriched and solidified their understandings of TIA and furnished them with insight into their counterparts' thinking about the intervention and its potential to benefit the college students they are responsible for helping. Consistent with the intent of action research, the processes involved in accomplishing the objectives of this study surfaced new topics and questions that will be useful in subsequent cycles of program improvement. &#8195; / Dissertation/Thesis / Ed.D. Educational Leadership and Policy Studies 2012

Over the course of the past three decades, largely due to advances in technology, there has been growth in the fields of early intervention (EI) and pediatrics for infants/toddlers with special health care needs (SHCN). This growth has also brought about a change in the relationship between pediatricians and EI service coordinators, creating an increased need for communication and collaboration between these groups of professionals. In order to address these changes, the American Academy of Pediatrics (AAP) presented recommendations for care coordination and stressed the placement of care coordination practices in the medical and developmental plans of infants/toddlers with SHCN. There have also been recommendations about communication and collaboration strategies from experts in the EI field. The medical home framework and Part C (EI) of the Individuals with Disabilities Education Act (IDEA) seek to establish care coordination systems with a family-centered focus of care. The purpose of this study is to examine care coordination within the context of the pediatric medical home and EI service coordination. Eighty- two pediatricians (n=1746, 4.7%) and 52 service coordinators (n=468, 11.1%) returned The Care Coordination Survey. Responses to the 40-item quantitative survey were analyzed using descriptive statistics and independent sample t-tests. Results indicated that pediatricians and service coordinators are implementing a number of key care coordination practices such as being available to clients/patients at their convenience. However, it was also found that both groups of professionals are not consistently providing a number of recommended care coordination practices such as sharing information between disciplines (e.g., contact information, assessment results). The results also offer implications across disciplines and reveal a need for future research in areas, such as training models across disciplines and developing a care coordination model to fit both disciplines.

The current study examined the effectiveness of a computer-based cognitive defusion intervention on the degree of believability and discomfort of problematic thoughts in two adolescents and one young adult with Autism Spectrum Disorder (ASD) using a multiple probe design across participants. Participants identified a problematic thought that they often had during social interactions with peers which was then targeted throughout the intervention. Primary measures included rating scales for thought believability and discomfort and criterion for therapeutic change was a 30-increment decrease in the mean average of rating scores from baseline levels for three consecutive intervention sessions. Results demonstrated a significant change in the believability of one participant's thought believability that met the therapeutic criterion. However, the remaining participants' rating scores following the intervention did not decrease below the criterion. Secondary measures for cognitive fusion, psychological inflexibility, and mindfulness included the AAQ-II, BAFT, CFQ, and CAMM pre and posttests. Results from these pre and posttest measures did not indicate a significant therapeutic change following treatment. More research is needed to examine the effectiveness of an automated defusion intervention with this population.

Self-regulation in children has been found to be prognostic of both normative and problematic social and emotional development in later childhood and adolescence. In particular, regulation of attention is deemed central to the ability to self-regulate other behaviors. Attention regulation is commonly measured by using rating scales and by obtaining children's behavioral and neurophysiological responses during laboratory tasks. Despite the widespread use of a variety of measurement strategies, the convergent validity of diverse measurements of attention regulation has not been systematically tested. This insufficiency is problematic for understanding individual differences in self-regulation and for evaluating interventions designed to improve attention regulation in children. Mindfulness-based interventions, an increasingly influential and powerful modality of psychosocial intervention, are hypothesized to improve attention regulation directly. Improvements in psychosocial adjustment following mindfulness-based intervention are hypothesized to be mediated through attention regulation. Nevertheless, research exploring the relation between mindfulness intervention and attention regulation is limited. This study explored the construct validity of attention regulation by (a) examining the measurement model for attention regulation that incorporates questionnaire ratings, behavioral data, and neurophysiological (electroencephalographic event-related potentials) measures, and (b) testing direct effects of mindfulness intervention on multiple measurements of attention regulation and indirect treatment effects on psychosocial outcomes with attention regulation as a mediator, using data collected from a randomized controlled trial of a mindfulness-based intervention with 47 children ages 9-12 years. Results confirmed that varying measurements of attention regulation were not empirically related. Results also supported previous findings that mindfulness-based interventions improved some indices of attention regulation in children. However, results did not support the hypothesis that attention regulation served as a mediator in mindfulness-based intervention treatment effects on psychosocial outcomes. Discussion suggests approaches to the measurement of attention regulation and new directions in mindfulness-based intervention research with youth.

Despite all of the attention given to it by researchers, scientists, educators, psychologists, sociologists, etc., bullying continues to permeate K-12 schools around the world. Statistics on K-12 bullying in the U.S. confirm that not only did bullying double in the ten years between 2001 and 2011 but these numbers are not getting smaller. This thesis provides a sampling of studies and programs that have been done or are being done to understand, reduce, prevent, and eliminate school bullying. The emphasis of the sampling is on the use of top-down, hierarchical value structures, designed to encourage youth to comply with the values of a dominant adult group; these underlying values are in direct contrast to the underlying values of egalitarianism and self-determination that are inherent in the goals of the current study, where sixth grade students learned about dialogue and how to communicate with each other in nurturing non-hierarchical environments.

The current study investigated the reliability and validity of using short observations with an observation tool designed to measure implementation of small group interventions. Intervention lessons for eight instructional groups from two schools were video recorded for nine weeks, and post-test assessments of reading decoding were administered to 31 at-risk kindergarten students. Videos of intervention instruction from weeks two, five, and eight, each representing a phase in the intervention period, were used within this study for measuring implementation. Each video was divided into three ten-minute segments representing the beginning, middle, and end of each intervention lesson. Video segments were coded for implementation using the Quality of Intervention Delivery and Receipt tool (QIDR; Harn, Forbes-Spear, Fritz, & Berg, 2012). Overall, the results of this study indicate that a) reliability can be achieved when using 10-minute observations, b) QIDR scores obtained from 10-minute segments are strongly correlated with scores obtained from full-length observations, c) there is no statistical difference in scores obtained from full-length observations and those obtained in 10-minute segments, and d) QIDR scores obtained from both full-length and 10-minute segments accounted for group differences in student outcomes, with lesson segments obtained from the end of lessons accounting for the most variance. Implications for research and practice are discussed, including the importance of thorough training and calibration to maintain reliability, as well as the feasibility and utility of providing frequent observation and feedback through shorter observations.

abstract: Anxiety is one of the most common psychiatric disorders among children yet characterized by lower use of mental health services. Preventive efforts have demonstrated promise in the ability to reduce anxiety symptoms. However, as evidence-based interventions move into real-world settings, there is a need to systematically examine potential implementation factors that may affect program outcomes. The current study investigates the relations between different aspects of implementation and their effect on outcomes of a school-based preventive intervention targeting anxiety symptoms. Specifically, the study examines: (1) the measurement of quality of delivery, (2) specific relations among implementation components, (3) relations between these facets and anxiety program outcomes. Implementation data were collected from nine school-based mental health staff and observer ratings. Program outcomes (pretest and immediate posttest) were measured from 59 participants and their parents (mostly mothers) in the intervention condition. Implementation components included adherence, quality of delivery, time spent, participant responsiveness, and perceived usefulness of program materials. Program outcomes included child-reported emotional expressivity, physiological hyperarousal, negative cognitions, social skills, self-efficacy, and child and parent reported levels of child anxiety. Study findings indicated that quality of delivery was best captured as two facets: skillful presentation and positive engagement. Adherence and quality of delivery were associated with greater participant responsiveness, although time spent was not. Significant relations were found between some implementation components and some program outcomes. Further efforts can be used to optimize the translation of evidence-based programs into real-world settings. / Dissertation/Thesis / Doctoral Dissertation Psychology 2017

Mobbning i arbetslivet är ett reellt problem som inte bara drabbar den mobbade utan hela arbetsplatsen. Arbetsmiljöverket beräknade att 9 % av arbetstagarna i Sverige var mobbade år 2009. Forskare har beskrivit mobbningens omfattning, orsaker, uttryck och konsekvenser men hittills har interventionsforskningen varit mer eftersatt. Syftet med denna studie var att utveckla kunskaper om tillämpade åtgärder mot mobbning på arbetsplatser, med fokus på respondenternas uppfattning om interventioner. Vi intervjuade 7 personer om deras erfarenheter av mobbning i arbetslivet och materialet analyserades med grundad teori. Interventioner för akut, reparativt respektive preventivt arbete som kan tillämpas på individ-, grupp- samt organisationsnivå presenterades. Interventionerna sammanfattades i en interventionsmatris. Respondenternas mål var en god och mobbningsfri arbetsplats och i linje med ett salutogent perspektiv förespråkades preventivt arbete. Ett bifynd var att så stor del av frustrationen i mobbningsprocessen relaterades till diskrepanser mellan förväntningar och verklighet. Likheter mellan förväntansdiskrepans och psykologiska kontraktsbrott diskuterades.