“Dosage” Decisions for Early Intervention Services

Evan is 2 years old. He has been referred by his pediatrician to the early intervention program in his small town due to signs of global developmental delay. Evan says two words—ma (for mom, dad, or grandma) and ba (for bottle). He is still on a bottle and rejects many table foods. Evan began walking 4 months ago, and still falls down quite a bit. Although his parents report that Evan is generally a happy toddler, when he becomes upset, he is prone to intense temper tantrums that include screaming and kicking. His parents handle these episodes in a calm, consistent manner, and Evan typically regains his composure within 2 or 3 minutes. His mother and father teach in the local school district, and Evan is cared for by his grandmother during the school day. Evan’s parents are quite engaged in seeking support for Evan; they vow to do everything in their power to promote his development. Bryce is also 2 years old. He was referred to the early intervention program in the same small town by a caseworker with the Department of Health and Human Services (DHHS) as required by law under CAPTA (the Child Abuse Prevention and Treatment Act). Bryce was found one rainy day wandering alone outside the ground-level apartment where he lives with his mother and baby sister. He had succeeded in opening the screen door and walked out unnoticed. A passer-by spotted him and called the police. A DHHS caseworker was assigned to investigate the circumstances. During her visits, the caseworker observed that Bryce communicated by grunting and pointing to things, but she did not hear him using understandable words. Bryce’s mother reported that he was usually good-natured, but the caseworker noticed that when he became upset, he was prone to intense temper tantrums that included screaming and kicking. Bryce’s mother did not seem to know what to do with him at that point, and she told the caseworker she usually gave him what he wanted because he “was so upset.” Bryce was not removed from his home because his mother voluntarily agreed to services offered by the caseworker. The caseworker also explained that she was required by the CAPTA provision to refer Bryce and his family to the early intervention program for assessment of Bryce’s development; Bryce’s mother expressed interest in the program. The local community’s Early Intervention multidisciplinary team completed assessments of both children. The assessments included observations and standardized instruments completed with the boys and their parents to determine the children’s eligibility for services. Although results of the observations and standardized assessments revealed that both Evan and Bryce qualified for early intervention services as children with developmental delays in cognitive and language development, many questions remained for their early intervention teams. What were the families’ priorities for their children? What supports would be optimal to effect positive outcomes for these children? What dosage of service from the early intervention team would be needed—How often and how intensive

Fossil hyaenidae from cooper’s cave, South Africa, and the palaeoenvironmental implications

Abstract: We present material of the family Hyaenidae from Cooper’s Cave, an early Pleistocene (ca 1.5 Ma) fossil-bearing site in Gauteng, South Africa. This site is exceptionally rich in Carnivora, including five species of Hyaenidae: Chasmaporthetes nitidula, Crocuta ultra, Parahyaena brunnea, Hyaena hyaena and cf. Proteles sp. This diversity is greater than that of the entire family in the modern fauna and is matched at other sites in the vicinity of Cooper’s Cave. This raises issues about time averaging and the carrying capacity of the palaeoenvironment that require resolution if we are to properly understand the environments in which Paranthropus robustus, present at Cooper’s Cave, and other early hominins evolved. In addition, the presence of several hyaenid species with bone-eating/collecting capabilities raises questions about the identity of the accumulators of fossil bone assemblages that have yet to be fully resolved

Stabilizing Developmental Language Trajectories in Infants/Toddlers: A Preliminary Study

Parents’ interactions with their children can have influential effects on children’s language outcomes. Special supports may be needed however, when young children live in poverty and show developmental delays early in life. This study analyzed data for a subset of children enrolled in Early Head Start programs and participating in a randomized trial of the Getting Ready intervention (Sheridan, Marvin, Knoche, & Edwards, 2008). These 41 children had standard scores below 85 on the Bayley Scales of Infant Development-II when the EHS and intervention services began. Statistically significant benefits were observed for the 28 children in the treatment group compared to the 13 children in a comparison group on children’s scores on the Preschool Language Scale-4. These preliminary findings suggest that the Getting Ready intervention may provide added value to Early Head Start programs and stabilize children’s developmental trajectory for language skills for children experiencing the dual challenges of poverty and developmental delays early in life

Publishing without Publishers: a Decentralized Approach to Dissemination, Retrieval, and Archiving of Data

Making available and archiving scientific results is for the most part still considered the task of classical publishing companies, despite the fact that classical forms of publishing centered around printed narrative articles no longer seem well-suited in the digital age. In particular, there exist currently no efficient, reliable, and agreed-upon methods for publishing scientific datasets, which have become increasingly important for science. Here we propose to design scientific data publishing as a Web-based bottom-up process, without top-down control of central authorities such as publishing companies. Based on a novel combination of existing concepts and technologies, we present a server network to decentrally store and archive data in the form of nanopublications, an RDF-based format to represent scientific data. We show how this approach allows researchers to publish, retrieve, verify, and recombine datasets of nanopublications in a reliable and trustworthy manner, and we argue that this architecture could be used for the Semantic Web in general. Evaluation of the current small network shows that this system is efficient and reliable.Comment: In Proceedings of the 14th International Semantic Web Conference (ISWC) 201

Decentralized provenance-aware publishing with nanopublications

Publication and archival of scientific results is still commonly considered the responsability of classical publishing companies. Classical forms of publishing, however, which center around printed narrative articles, no longer seem well-suited in the digital age. In particular, there exist currently no efficient, reliable, and agreed-upon methods for publishing scientific datasets, which have become increasingly important for science. In this article, we propose to design scientific data publishing as a web-based bottom-up process, without top-down control of central authorities such as publishing companies. Based on a novel combination of existing concepts and technologies, we present a server network to decentrally store and archive data in the form of nanopublications, an RDF-based format to represent scientific data. We show how this approach allows researchers to publish, retrieve, verify, and recombine datasets of nanopublications in a reliable and trustworthy manner, and we argue that this architecture could be used as a low-level data publication layer to serve the Semantic Web in general. Our evaluation of the current network shows that this system is efficient and reliable

Fiber-assisted detection with photon number resolution

We report the development of a photon-number resolving detector based on a fiber-optical setup and a pair of standard avalanche photodiodes. The detector is capable of resolving individual photon numbers, and operates on the well-known principle by which a single mode input state is split into a large number (eight) of output modes. We reconstruct the photon statistics of weak coherent input light from experimental data, and show that there is a high probability of inferring the input photon number from a measurement of the number of detection events on a single run.Comment: 4 pages, 2 figures; Submitted for publicatio

Isolated Langerhans cell histiocytosis of the vulva: a case report and review of the literature

Isolated Langerhans cell histiocytosis (LCH) of the female genital tract is very rare. A review of the literature revealed that only 15 cases of primary vulvar LCH have previously been published in the English literature. We describe an additional case of confined vulvar LCH. A 49-year-old woman presented with an ulcerous lesion that turned out to be LCH confined to the vulva only. After surgical excision, four recurrences followed, which were treated again by surgery. After the fourth recurrence, adjuvant radiotherapy was applied. When the fifth recurrence occurred, only surgical excision was performed, and the patient has now been disease-free for 51months. There are no standard treatment options for this rare disease. The most effective treatment options still remain elusive. In our case in the end surgery proved to be effectiv

The use of the development and well-being assessment (DAWBA) in clinical practice: a randomized trial

The development and well-being assessment (DAWBA) has been used in various epidemiological studies, whereas the clinical value of the instrument needs support from further studies. In particular, it is important to document how the use of the DAWBA influences clinical decision-making. The present study employed the DAWBA in a consecutive series of 270 new referrals to a large public child and adolescent psychiatric service in Zurich, Switzerland. ICD-10 based diagnoses were obtained from clinicians for all patients and reliability of DAWBA expert raters was calculated. The DAWBA diagnoses were randomly disclosed (n=144) or not disclosed (n=126) before clinical decision-making. The reliability of DAWBA expert diagnoses was very satisfactory and the agreement under the disclosed versus the non-disclosed condition amounted to 77 versus 68% for internalizing disorders and to 63 versus 71% for externalizing disorders. The increment in agreement due to disclosure of the DAWBA diagnosis was significant for internalizing disorders. Access to DAWBA information was more likely to prompt clinicians to add an extra diagnosis. Professional background and degree of clinical experience did not affect diagnostic agreement. Overall, diagnostic agreements between DAWBA expert diagnoses and clinical diagnoses were in the fair to moderate range and comparable to previous studies with other structured diagnostic interviews. The inclusion of the DAWBA into the clinical assessment process had an impact on diagnostic decision-making regarding internalizing disorders but not regarding externalizing disorder