A Preliminary Evaluation: Demographic and Clinical Profiles and Changes in Functioning in Children Receiving Psychosocial Rehabilitation

The present study is the first to examine the demographic and clinical profiles at intake of children with emotional disturbances who received Child Psychosocial Rehabilitation (CPSR), a relatively new treatment for children suffering with emotional disturbance(ED). Fifty-three children ranging in age from 4 to 18 years received CPSR from a for-profit outpatient child and adolescent mental health clinic located in southwestern Idaho for a minimum of six months. The children\u27s demographic and clinical profiles were examined. In addition, the relationship between the relative change in psychological, emotional, and behavioral functioning as measured by CAFAS (Hodges, 1989, 1994) and PECFAS (Hodges, 1994) scores and the children\u27s age, gender, ethnicity, current living arrangement, type of mental health diagnosis, and severity of impairment at intake were evaluated. Significant improvement in the children\u27s overall functioning was found after six months of treatment. No significant between-group differences were found for gender, age, ethnicity, living situation, diagnosis, number of diagnoses, and overall impairment at intake

McKinstry school media center project card catalog on Hypercard

The card catalog is an integral part of any library and the patrons need to know the appropriate method of using it. This HyperCard project was developed to integrate the basics of the card catalog with the visual aspects of the computer for high-risk (special learning difficulties) second graders to motivate interest in reading and card catalog. These children were guided through a series of lessons using the HyperCard materials to assist in certain conceptual aspects like distinguishing the elemental parts of the catalog card from one another. The lessons were divided into four sections averaging around thirty minutes each (determined by the cooperating librarian since she found that thirty minutes would work for this group of children). At the end of the lessons the children did hands-on demonstrations indicating their understanding of the concepts of that day. The results showed the value of simple, visual computer-assisted instruction (CAI) in helping the teacher present vital data

Effect of home telemonitoring on glycemic and blood pressure control in primary care clinic patients with diabetes

Objective: Patient self-management support may be augmented by using home-based technologies that generate data points that providers can potentially use to make more timely changes in the patients' care. The purpose of this study was to evaluate the effectiveness of short-term targeted use of remote data transmission on treatment outcomes in patients with diabetes who had either out-of-range hemoglobin A1c (A1c) and/or blood pressure (BP) measurements. Materials and Methods: A single-center randomized controlled clinical trial design compared in-home monitoring (n=55) and usual care (n=53) in patients with type 2 diabetes and hypertension being treated in primary care clinics. Primary outcomes were A1c and systolic BP after a 12-week intervention. Results: There were no significant differences between the intervention and control groups on either A1c or systolic BP following the intervention. Conclusions: The addition of technology alone is unlikely to lead to improvements in outcomes. Practices need to be selective in their use of telemonitoring with patients, limiting it to patients who have motivation or a significant change in care, such as starting insulin. Attention to the need for effective and responsive clinic processes to optimize the use of the additional data is also important when implementing these types of technology

To Achieve Big Wins for Terrestrial Conservation, Prioritize Protection of Ecoregions Closest to Meeting Targets

Most of the terrestrial world is experiencing high rates of land conversion despite growth of the global protected area (PA) network. There is a need to assess whether the current global protection targets are achievable across all major ecosystem types and to identify those that need urgent protection. Using recent rates of habitat conversion and protection and the latest terrestrial ecoregion map, we show that if the same approach to PA establishment that has been undertaken over the past three decades continues, 558 of 748 ecoregions (ca. 75%) will not meet an aspirational 30% area protection target by 2030. A simple yet strategic acquisition plan that considers realistic futures around habitat loss and PA expansion could more than double the number of ecoregions adequately protected by 2030 given current funding constraints. These results highlight the importance of including explicit ecoregional representation targets within any new post-2020 global PA target

Law and Neuroscience: Recommendations Submitted to the President\u27s Bioethics Commission

President Obama charged the Presidential Commission for the Study of Bioethical Issues to identify a set of core ethical standards in the neuroscience domain, including the appropriate use of neuroscience in the criminal-justice system. The Commission, in turn, called for comments and recommendations. The MacArthur Foundation Research Network on Law and Neuroscience submitted a consensus statement, published here, containing 16 specific recommendations. These are organized within three main themes: 1) what steps should be taken to enhance the capacity of the criminal justice system to make sound decisions regarding the admissibility and weight of neuroscientific evidence?; 2) to what extent can the capacity of neurotechnologies to aid in the administration of criminal justice be enhanced through research?; and 3) in what additional ways might important ethical issues at the intersection of neuroscience and criminal justice be addressed

Law and Neuroscience: Recommendations Submitted to the President\u27s Bioethics Commission

President Obama charged the Presidential Commission for the Study of Bioethical Issues to identify a set of core ethical standards in the neuroscience domain, including the appropriate use of neuroscience in the criminal-justice system. The Commission, in turn, called for comments and recommendations. The MacArthur Foundation Research Network on Law and Neuroscience submitted a consensus statement, published here, containing 16 specific recommendations. These are organized within three main themes: 1) what steps should be taken to enhance the capacity of the criminal justice system to make sound decisions regarding the admissibility and weight of neuroscientific evidence?; 2) to what extent can the capacity of neurotechnologies to aid in the administration of criminal justice be enhanced through research?; and 3) in what additional ways might important ethical issues at the intersection of neuroscience and criminal justice be addressed

G2i Knowledge Brief: A Knowledge Brief of the MacArthur Foundation Research Network on Law and Neuroscience

Courts are daily confronted with admissibility issues – such as in cases involving neuroscientific testimony – that sometimes involve both the existence of a general phenomenon (i.e., “G”) and the question of whether a particular case represents a specific instance of that general phenomenon (i.e., “i”). Unfortunately, courts have yet to carefully consider the implications of “G2i” for their admissibility decisions. In some areas, courts limit an expert’s testimony to the general phenomenon. They insist that whether the case at hand is an instance of that phenomenon is exclusively a jury question, and thus not an appropriate subject of expert opinion. In other cases, in contrast, courts hold that expert evidence must be provided on both the group-data issue (i.e., that the phenomenon exists) and what is called the “diagnostic” issue (i.e., that this case is an instance of that phenomenon). Consequently, the MacArthur Foundation Research Network on Law and Neuroscience has prepared this knowledge brief to help courts manage the G2i divide. Specifically, we recommend that courts first determine whether proffered expert testimony concerns only the existence of the general phenomenon or instead concerns both that and the diagnosis that a particular case represents an instance of that phenomenon. Only after making that determination should the court make its admissibility decision (guided, for instance, by the Daubert factors for admitting scientific evidence)

Guideline for the Management of Fever and Neutropenia in Pediatric Patients With Cancer and Hematopoietic Cell Transplantation Recipients: 2023 Update.

PURPOSE To update a clinical practice guideline (CPG) for the empiric management of fever and neutropenia (FN) in pediatric patients with cancer and hematopoietic cell transplantation recipients. METHODS The International Pediatric Fever and Neutropenia Guideline Panel reconvened to conduct the second update of this CPG. We updated the previous systematic review to identify new randomized controlled trials (RCTs) evaluating any strategy for the management of FN in pediatric patients. Using the Grading of Recommendations Assessment, Development and Evaluation framework, evidence quality was classified as high, moderate, low, or very low. The panel updated recommendations related to initial management, ongoing management, and empiric antifungal therapy. Changes from the 2017 CPG were articulated, and good practice statements were considered. RESULTS We identified 10 new RCTs in addition to the 69 RCTs identified in previous FN CPGs to inform the 2023 FN CPG. Changes from the 2017 CPG included two conditional recommendations regarding (1) discontinuation of empiric antibacterial therapy in clinically well and afebrile patients with low-risk FN if blood cultures remain negative at 48 hours despite no evidence of marrow recovery and (2) pre-emptive antifungal therapy for invasive fungal disease in high-risk patients not receiving antimold prophylaxis. The panel created a good practice statement to initiate FN CPG-consistent empiric antibacterial therapy as soon as possible in clinically unstable febrile patients. CONCLUSION The updated FN CPG incorporates important modifications on the basis of recently published trials. Future work should focus on addressing knowledge gaps, improving CPG implementation, and measuring the impact of CPG-consistent care

Collaborative fisheries research reveals reserve size and age determine efficacy across a network of marine protected areas

A variety of criteria may influence the efficacy of networks of marine protected areas (MPA) designed to enhance biodiversity conservation and provide fisheries benefits. Meta-analyses have evaluated the influence of MPA attributes on abundance, biomass, and size structure of harvested species, reporting that MPA size, age, depth, and connectivity influence the strength of MPA responses. However, few empirical MPA evaluation studies have used consistent sampling methodology across multiple MPAs and years. Our collaborative fisheries research program systematically sampled 12 no-take or highly protective limited-take MPAs and paired fished reference areas across a network spanning 1100 km of coastline to evaluate the factors driving MPA efficacy across a large geographic region. We found that increased size and age consistently contributed to increased fish catch, biomass, and positive species responses inside MPAs, while accounting for factors such as latitude, primary productivity, and distance to the nearest MPA. Our study provides a model framework to collaboratively engage diverse stakeholders in fisheries research and provide high-quality data to assess the success of conservation strategies

Randomized Controlled Trial of a Computer-Based, Tailored Intervention to Increase Smoking Cessation Counseling by Primary Care Physicians

OBJECTIVE: The primary care visit represents an important venue for intervening with a large population of smokers. However, physician adherence to the Smoking Cessation Clinical Guideline (5As) remains low. We evaluated the effectiveness of a computer-tailored intervention designed to increase smoking cessation counseling by primary care physicians. METHODS: Physicians and their patients were randomized to either intervention or control conditions. In addition to brief smoking cessation training, intervention physicians and patients received a one-page report that characterized the patients’ smoking habit and history and offered tailored recommendations. Physician performance of the 5As was assessed via patient exit interviews. Quit rates and smoking behaviors were assessed 6 months postintervention via patient phone interviews. Intervention effects were tested in a sample of 70 physicians and 518 of their patients. Results were analyzed via generalized and mixed linear modeling controlling for clustering. MEASUREMENTS AND MAIN RESULTS: Intervention physicians exceeded controls on “Assess” (OR 5.06; 95% CI 3.22, 7.95), “Advise” (OR 2.79; 95% CI 1.70, 4.59), “Assist–set goals” (OR 4.31; 95% CI 2.59, 7.16), “Assist–provide written materials” (OR 5.14; 95% CI 2.60, 10.14), “Assist–provide referral” (OR 6.48; 95% CI 3.11, 13.49), “Assist–discuss medication” (OR 4.72;95% CI 2.90, 7.68), and “Arrange” (OR 8.14; 95% CI 3.98, 16.68), all p values being < 0.0001. Intervention patients were 1.77 (CI 0.94, 3.34,p = 0.078) times more likely than controls to be abstinent (12 versus 8%), a difference that approached, but did not reach statistical significance, and surpassed controls on number of days quit (18.4 versus 12.2, p < .05) but not on number of quit attempts. CONCLUSIONS: The use of a brief computer-tailored report improved physicians’ implementation of the 5As and had a modest effect on patients’ smoking behaviors 6 months postintervention