To assess the efficacy of a single preoperative physiotherapy session to reduce postoperative pulmonary complications (PPCs) after upper abdominal surgery.
This study aimed to investigate the effectiveness of a proposed occupational therapy home program (OTHP) for children with intellectual disabilities (ID). Children with ID were randomly and equally assigned to OTHP or to no OTHP groups. The primary outcome measures were Canadian Occupational Performance, Bruininks-Oseretsky Test of Motor Proficiency-Second Edition, and The Children’s Assessment of Participation and Enjoyment scores at 10 and 20 weeks. The 20-week OTHP produced significant difference in fine motor function, activity participation, and parent satisfaction with performance, compared to those of no OTHP. Pediatricians can advise families to implement 20 weeks of OTHP with an average 15min per session to facilitate functional changes of children with ID.
Physical activity (PA) improves many facets of health. Despite this, the majority of American adults are insufficiently active. Adults who visit a physician complaining of chest pain and related cardiovascular symptoms are often referred for further testing. However, when this testing does not reveal an underlying disease or pathology, patients typically receive no additional standard care services. A PA intervention delivered within the clinic setting may be an effective strategy for improving the health of this population at a time when they may be motivated to take preventive action.
The development of information technology has paved the way for faster and more convenient payment process flows and new methodology for the design and implementation of next generation payment systems. The growth of smartphone usage nowadays has fostered a new and popular mobile payment environment. Most of the current generation smartphones support Bluetooth Low Energy (BLE) technology to communicate with nearby BLE-enabled devices. It is plausible to construct an Over-the-Air BLE-based mobile payment system as one of the payment methods for people living in modern societies. In this paper, a secure indoor positioning-based mobile payment authentication protocol with BLE technology and the corresponding mobile payment system design are proposed. The proposed protocol consists of three phases: initialization phase, session key construction phase, and authentication phase. When a customer moves toward the POS counter area, the proposed mobile payment system will automatically detect the position of the customer to confirm whether the customer is ready for the checkout process. Once the system has identified the customer is standing within the payment-enabled area, the payment system will invoke authentication process between POS and the customer’s smartphone through BLE communication channel to generate a secure session key and establish an authenticated communication session to perform the payment transaction accordingly. A prototype is implemented to assess the performance of the proposed design for mobile payment system. In addition, security analysis is conducted to evaluate the security strength of the proposed protocol.
Preventing the transmission of HIV, especially among high-risk populations, is a U.S. public health priority. Interventions aimed at easing the burden of HIV disclosure to casual sexual partners among men who have sex with men (MSM) living with HIV are essential in this endeavor. This randomized controlled study evaluated differences in disclosure behavior between a disclosure intervention (DI) and attention control case management (ACCM) group for MSM living with HIV (N = 315) and determinants (self-efficacy, outcome expectancy) of disclosure. Mixed-effects models results showed no significant differences in disclosure behavior between the DI and ACCM groups. Further, disclosure behavior changed in a curvilinear manner over 12 months and benefited from a booster session. Both disclosure self-efficacy and outcome expectancy predicted disclosure behavior. Interventions targeting HIV disclosure among MSM living with HIV should focus on improving perceptions of disclosure self-efficacy and outcome expectancy and include a booster session to facilitate HIV disclosure.
Parallel memory traces are built after an experience containing aversive and appetitive components in the crab Neohelice
- Proceedings of the National Academy of Sciences of the United States of America
- Published about 1 year ago
The neurobiology of learning and memory has been mainly studied by focusing on pure aversive or appetitive experiences. Here, we challenged this approach considering that real-life stimuli come normally associated with competing aversive and appetitive consequences and that interaction between conflicting information must be intrinsic part of the memory processes. We used Neohelice crabs, taking advantage of two well-described appetitive and aversive learning paradigms and combining them in a single training session to evaluate how this affects memory. We found that crabs build separate appetitive and aversive memories that compete during retrieval but not during acquisition. Which memory prevails depends on the balance between the strength of the unconditioned stimuli and on the motivational state of the animals. The results indicate that after a mix experience with appetitive and aversive consequences, parallel memories are established in a way that appetitive and aversive information is stored to be retrieved in an opportunistic manner.
In 2001 the CRABEL score was devised in order to obtain a numerical score of the standard of medical note keeping. With the advent of electronic discharge letters, many components of the CRABEL score are now redundant as computers automatically include some documentation. The CRABEL score was modified to form the e-CRABEL score. “Patient details on discharge letter” and “Admission and discharge dates on discharge letter” were replaced with “Summary of investigations on discharge letter” and “Documentation of VTE prophylaxis on the drug chart”. The new e-CRABEL score has been used as a monthly audit tool in a busy surgical unit to monitor long-term standards of medical note keeping, with interventions of presenting in the departmental audit meeting, and giving a teaching session to a group of junior doctors at two points. Following discussion with stakeholders: junior doctors, consultants, and the audit department; it was decided that the e-CRABEL tool was sufficiently compact to be completed on a monthly basis. Critique and interventions included using photographic examples, case note selection and clarification of the e-CRABEL criteria in a teaching session. Tools used for audit need to be updated in order to accurately represent what they measure, hence the modification of the CRABEL score to make the new e-CRABEL score. Preliminary acquisition and presentation of data using the e-CRABEL score has shown promise in improving the quality of medical record keeping. The tool is sufficiently compact as to conduct on a monthly basis, maintaining standards to a high level and also provides data on VTE documentation.
Treatment of arrhythmias by catheter ablation targeting the anatomical foci of arrhythmias by radiofrequency has evolved dramatically in recent years. A road map for the relevant heart structures is an important asset for the success of the procedure and should be obtained before the intervention. This can be achieved by intra-cardiac echocardiography, conventional angiographic methods, multidetector CT, or MRI. The electrophysiological technique comprises a diagnostic procedure and an interventional - therapeutic - procedure. Electrocardiographic-gated multidetector CT is important in the diagnostic session to evaluate the anatomical details in combination with electric activity mapping. This combined protocol provides a unique view of the propagation of electrical activity, either normal or abnormal, over cardiac structures and allows a precise functional and anatomical evaluation to be obtained. In this review, we evaluate the role of electrocardiographic-gated multidetector CT in roadmapping arrhythmias in the paediatric age group, focussing on its strengths; we also evaluated some additional aspects that need further improvement in the future.
Collaboration has been recognized as an important relationship variable in psychotherapy that is linked to client treatment outcomes. Although many therapists seek to build a collaborative working relationship with their clients when making treatment decisions, collaboration is also an important technique that can be used to help clients plan for a successful termination. Collaborative termination strategies can first be used in the initial session in order to address clients' termination expectations. Strategies can also be used throughout treatment to help clients focus on their treatment goals. Last, collaborative termination strategies should be used in the final session to help clients take ownership of their gains and to equalize the therapeutic relationship. In this article, we provide specific recommendations for collaborating with clients in preparing for psychotherapy termination. Case examples demonstrating these strategies are also provided. (PsycINFO Database Record
Objective: We aimed to assess the extent to which therapists' reports of client functioning track their clients' changing experience of their own functioning from session to session (temporal congruence) as well as the extent to which they over- or underestimate their clients' functioning (level or directional bias) and to examine whether these indices predict treatment outcomes. Method: The participants included 384 clients who were treated by 77 therapists. Both clients and therapists rated the clients' functioning each session. The clients also completed pre- and posttreatment outcome measures. Results: Using multilevel modeling, we found that therapists' reports regarding their clients' functioning tended to be temporally congruent from session to session with their clients' reported functioning. In addition, on average, therapists did not show a level bias (i.e., did not over- or underestimate their clients' functioning). Finally, temporal congruence (but not level bias) predicted better treatment outcomes. Conclusion: These findings highlight the importance of tracking clients' fluctuating symptoms over time. Thus, we discuss their implication for the policy and practice of providing session-by-session feedback to therapists. (PsycINFO Database Record