Acceptance and commitment therapy delivered via a mobile phone messaging robot to decrease postoperative opioid use in patients with orthopedic trauma: Randomized controlled trial

BACKGROUND: Acceptance and commitment therapy (ACT) is a pragmatic approach to help individuals decrease avoidable pain. OBJECTIVE: This study aims to evaluate the effects of ACT delivered via an automated mobile messaging robot on postoperative opioid use and patient-reported outcomes (PROs) in patients with orthopedic trauma who underwent operative intervention for their injuries. METHODS: Adult patients presenting to a level 1 trauma center who underwent operative fixation of a traumatic upper or lower extremity fracture and who used mobile phone text messaging were eligible for the study. Patients were randomized in a 1:1 ratio to either the intervention group, who received twice-daily mobile phone messages communicating an ACT-based intervention for the first 2 weeks after surgery, or the control group, who received no messages. Baseline PROs were completed. Two weeks after the operative intervention, follow-up was performed in the form of an opioid medication pill count and postoperative administration of PROs. The mean number of opioid tablets used by patients was calculated and compared between groups. The mean PRO scores were also compared between the groups. RESULTS: A total of 82 subjects were enrolled in the study. Of the 82 participants, 76 (38 ACT and 38 controls) completed the study. No differences between groups in demographic factors were identified. The intervention group used an average of 26.1 (SD 21.4) opioid tablets, whereas the control group used 41.1 (SD 22.0) tablets, resulting in 36.5% ([41.1-26.1]/41.1) less tablets used by subjects receiving the mobile phone-based ACT intervention (P=.004). The intervention group subjects reported a lower postoperative Patient-Reported Outcome Measure Information System Pain Intensity score (mean 45.9, SD 7.2) than control group subjects (mean 49.7, SD 8.8; P=.04). CONCLUSIONS: In this study, the delivery of an ACT-based intervention via an automated mobile messaging robot in the acute postoperative period decreased opioid use in selected patients with orthopedic trauma. Participants receiving the ACT-based intervention also reported lower pain intensity after 2 weeks, although this may not represent a clinically important difference. TRIAL REGISTRATION: ClinicalTrials.gov NCT03991546; https://clinicaltrials.gov/ct2/show/NCT03991546

Egg Quality Assurance Programs and Egg-associated Salmonella Enteritidis Infections, United States

A 1% increase in eggs produced under egg quality assurance programs was associated with a 0.14% decrease in Salmonella Enteritidis incidence

Concert recording 2016-04-03

[Track 01]. Fanfare pour précéder \u27La Péri\u27 / Paul Dukas -- [Track 02]. French dances revisted. I ; [Track 03]. II ; [Track 04]. III ; [Track 05]. IV ; [Track 06]. V ; [Track 07]. VI / Adam Gorb -- [Track 08]. Danses sacrée et profane / Claude Debussy -- [Track 09]. Dance mix / Rob Smith

Specific antenatal interventions for Black, Asian and Minority Ethnic (BAME) pregnant women at high risk of poor birth outcomes in the United Kingdom: a scoping review

Background: Disparity exists in maternal and infant birth outcomes of Black and Minority Ethnic (BAME) women giving birth in the United Kingdom (UK) compared to the majority. There is therefore a need to reconsider existing maternity service provision to ensure culturally competent services. The purpose of this scoping review was to ascertain what specific maternity interventions have been implemented in the UK for BAME women (2004–2014) so that increased awareness of the need and scope of specific maternity interventions for BAME women can be identified. Methods: A scoping review was conducted in order to determine the evidence base. It was determined that no prior systematic reviews had been conducted and it was apparent that literature in this field was sparse. Scoping review is an ideal method when literature is likely to be heterogeneous and the research field relatively unexplored. A keyword strategy was used implementing population (P), intervention (I), comparison (C) and outcomes (O). Results: An initial 2188 papers were identified. Following screening and review, only 5 heterogeneous papers remained suitable and were included. The included interventions employed sample sizes of N = 160-1441, examined a range of different outcome measures and were delivered across different parts of the UK with high numbers of BAME residents. Conclusions: There is a lack of rigorous research interventions and practice interventions which are currently documented, of specific maternity interventions which are aimed to address culturally competent maternity services and the sharing of best practice addressing the increased risks of BAME women delivering in the UK

A Visually Guided Swimming Robot

We describe recent results obtained with AQUA, a mobile robot capable of swimming, walking and amphibious operation. Designed to rely primarily on visual sensors, the AQUA robot uses vision to navigate underwater using servobased guidance, and also to obtain high-resolution range scans of its local environment. This paper describes some of the pragmatic and logistic obstacles encountered, and provides an overview of some of the basic capabilities of the vehicle and its associated sensors. Moreover, this paper presents the first ever amphibious transition from walking to swimming

The AQUA aquatic walking robot

Based on the RHHex hexapod robot, the AQUA robot is an aquatic robot that swims via the motion of its legs, rather than using thrusters and control surfaces for propulsion. Through an appropriate set of gaits, the AQUA vehicle is capable of five-degree-of-freedom motion in the open water, it can swim along the surface and it can walk along the seabed. The vehicle itself is augmented with a variety of sensors that can be used to estimate the robot's position with respect to local visual features as well as a global frame of reference. Here we describe the basic vehicle design along with some of the sensing and localization projects that are currently underway within the project

AQUA: An aquatic walking robot

Abstract – This paper describes an underwater walking robotic system being developed under the name AQUA, the goals of the AQUA project, the overall hardware and software design, the basic hardware and sensor packages that have been developed, and some initial experiments. The robot is based on the RHex hexapod robot and uses a suite of sensing technologies, primarily based on computer vision and INS, to allow it to navigate and map clear shallow-water environments. The sensor-based navigation and mapping algorithms are based on the use of both artificial floating visual and acoustic landmarks as well as on naturally occurring underwater landmarks and trinocular stereo. Keywords-autonomous robot, aquatic robot, robotic sensing I