Improve implementation of a novel paediatric therapy programme : taking theories of human behaviour into account

Background: ‘COPing with and CAring for Infants with special Needs’ (COPCA) is a novel family-centred early intervention programme in paediatric physiotherapy. COPCA differs from well-known approaches, e.g. the therapist takes on the role of a coach and uses hands-off approaches. This implies, that to become a COPCA-coach, the therapist needs to change behaviour. Thus, it may be assumed that for successful implementation of new approaches, theories of human behaviour have to be taken into account. Purpose: The study aims to measure behaviour changes in therapists following a COPCA course in order to identify the challenges that interfere with the implementation of the COPCA program in daily practice. Methods: Data were collected during a three-part COPCA course over 6 months (with two months intervals between parts) in which 15 therapists learned to become a COPCA-coach. To document behaviour changes four treatment sessions (one prior to part I T0), one in each interval (T1, T2), and one after part III (T3) of each participant (n=60) were video-recorded and analysed quantitatively with the Groningen Observation Protocol version 2 (GOP 2.0). The videos were randomized and masked to the chronology of recording moment. GOP 2.0 is a quantitative tool to assess therapeutic behaviour in different categories, e.g. “educational actions toward caregivers” or “neuromotor actions”. It allows for a quantification of the relative duration of therapeutic actions (percentage of total treatment time) during a session. Interrater reliability of the GOP 2.0 was evaluated. The first author analysed changes in therapeutic behaviour over time with the Wilcox-sign rank test. Median changes and corresponding non-parametric confidence intervals were computed using the Hodges-Lehmann estimator (HL). Results: Interrater reliability of the GOP 2.0 (ICC2) was 0.48-1.00 (median 0.92). Course participation was associated especially with changes in “educational actions toward caregivers” and “ neuromotor actions”. Time spent on ‘caregiver coaching’ increased: between T0 and T1 by 77.9% (99% confidence interval (CI) 48.7-99.1) and between T0 and T3 by 96.1% (99%CI 51.7-100). Also time spent on hands-off techniques increased, 37.9% (99%CI 18.8-59.5) between T0 and T1 and 40.3% (99%CI 17.8-57.7) between T0 and T3. The implementation of hands-off approaches developed at a slower rate and somewhat less sustainable than that of coaching. Conclusions: Behaviours with a slower and less sustainable rate of change represented strong habits. The neural substrate of strong habits is located subcortically, making them relatively resistant to cognitive input. To overcome this challenge, future COPCA courses need to be adapted, by including (1) more modelling of desired behaviour and (2) more repetition and practice for the behaviours in the neuromotor domain. Implication: Quantitative analysis of therapeutic behaviour is a useful method to monitor changes in behaviour of therapists and – by doing so – may assist the implementation of new approaches. To implement new approaches successfully, theories of human behaviour have to be taken into account. The Behaviour Change Wheel of Michie et al., a method to characterise and design behaviour change in interventions, is a helpful framework to understand the nature of behaviour and to overcome behaviour change barriers

On the number of outer connected dominating sets of graphs

Let $G=(V,E)$ be a simple graph. A set $S\subseteq V(G)$ is called an outer-connected dominating set (or ocd-set) of $G$, if $S$ is a dominating set of $G$ and either $S=V(G)$ or $V\backslash S$ is a connected graph. In this paper we introduce a polynomial which its coefficients are the number of ocd-sets of $G$. We obtain some properties of this polynomial and its coefficients. Also we compute this polynomial for some specific graphs.Comment: 1 pag

State-Dependent Relay Channel with Private Messages with Partial Causal and Non-Causal Channel State Information

In this paper, we introduce a discrete memoryless State-Dependent Relay Channel with Private Messages (SD-RCPM) as a generalization of the state-dependent relay channel. We investigate two main cases: SD-RCPM with non-causal Channel State Information (CSI), and SD-RCPM with causal CSI. In each case, it is assumed that partial CSI is available at the source and relay. For non-causal case, we establish an achievable rate region using Gel'fand-Pinsker type coding scheme at the nodes informed of CSI, and Compress-and-Forward (CF) scheme at the relay. Using Shannon's strategy and CF scheme, an achievable rate region for causal case is obtained. As an example, the Gaussian version of SD-RCPM is considered, and an achievable rate region for Gaussian SD-RCPM with non-causal perfect CSI only at the source, is derived. Providing numerical examples, we illustrate the comparison between achievable rate regions derived using CF and Decode-and-Forward (DF) schemes.Comment: 5 pages, 2 figures, to be presented at the IEEE International Symposium on Information Theory (ISIT 2010), Austin, Texas, June 201

PENGEMBANGAN PASIR FEROMAGNETIK UNTUK INTI INDUKTOR DAN TRANSFORMATOR GELOMBANG MIKRO

ABSTRAKSI: Kata Kunci : ABSTRACT: Keyword

Session 2: Diversity Perspectives: In-House Counsel

This expert panel addressed diversity perspectives in the legal field. Moderated by Debbie Akhbari, six panelists shared their stories. The panelists were Leticia Hernández, Bernadette Lopez, Elida Moran, Catherine Romero, Rachel Seals, and Katina Thornock. Each panelist\u27s stories have been broken into its own section in the summary of proceedings. Many diverse candidates have incorrect assumptions made about them, resulting in doors being closed by those in positions of power. This panel shared their personal stories and encouraged students and newer attorneys to keep “knocking on those doors” and for those in positions of power to open those doors. Through their personal stories, this panel demonstrated that diverse women can overcome challenges and be incredibly successful. This panel discussed how diverse candidates often suffer from a lack of exposure to the legal field and how the idea of mentorship and sponsorship can bridge that gap

COPing with and CAring for Infant with special Needs (COPCA)

Coping with and Caring for Infants with special Needs (COPCA) ist ein familienzentriertes Frühinterventionsprogramm, welches auf den Komponenten Familieneinbezug und Entwicklungsneurologie gründet. Es unterscheidet sich in vielen Bereichen von dem in der Schweiz am meisten eingesetzten Frühinterventionskonzept der ‹Neuromotorischen Entwicklungsbehandlung› (NDT). Gemeinsamkeiten und Unterschiede in der Wirkung der beiden Ansätze werden aufgezeigt. Die Autorin berichtet über Erfahrungen, die sie während der Durchführung verschiedener Studien zum Thema «Physiotherapeutische Interventionen bei Säuglingen mit neuromotorischen Funktionsstörungen» gemacht hat