Screening for Adverse Childhood Experiences and Other Determinants of Health in School Based Health Centers: A Program Evaluation

Introduction: Adverse Childhood Experiences (ACEs), such as abuse, neglect, and various household stressors, are common, connected, and contribute to multiple adverse health and wellbeing outcomes throughout life. Consequently, there has been a push to screen for adversity and toxic stress in primary care to facilitate prevention and early intervention. The purpose of this project was to evaluate and optimize the use of the Broad Level Integrated Screener (BLIS) in Neighborcare Health (NCH) School Based Health Centers (SBHCs) in Seattle, WA. Methods: An online survey including nineteen Likert-scale questions and five open-ended free response questions was administered to all middle school and high school NCH SBHC providers. Results: The survey had a response and completion rate of 100% (N=10). The most common barrier identified was time and the most common benefits identified were patient honesty and identification of issues that patients would otherwise be reluctant to bring up. Knowledge about ACEs emerged to be a determining factor for survey responses, influencing perceived utility and content of the BLIS as well as perceived responsibility to screen for and address ACEs in practice. Discussion: The data highlights the need to provide more education about ACEs and toxic stress to providers working with pediatric and adolescent populations. The study suggests that screening for ACEs and other determinants of health using the BLIS is feasible, acceptable, and yields actionable results

Bayesian Modeling of Perceived Surface Slant from Actively-Generated and Passively-Observed Optic Flow

We measured perceived depth from the optic flow (a) when showing a stationary physical or virtual object to observers who moved their head at a normal or slower speed, and (b) when simulating the same optic flow on a computer and presenting it to stationary observers. Our results show that perceived surface slant is systematically distorted, for both the active and the passive viewing of physical or virtual surfaces. These distortions are modulated by head translation speed, with perceived slant increasing directly with the local velocity gradient of the optic flow. This empirical result allows us to determine the relative merits of two alternative approaches aimed at explaining perceived surface slant in active vision: an “inverse optics” model that takes head motion information into account, and a probabilistic model that ignores extra-retinal signals. We compare these two approaches within the framework of the Bayesian theory. The “inverse optics” Bayesian model produces veridical slant estimates if the optic flow and the head translation velocity are measured with no error; because of the influence of a “prior” for flatness, the slant estimates become systematically biased as the measurement errors increase. The Bayesian model, which ignores the observer's motion, always produces distorted estimates of surface slant. Interestingly, the predictions of this second model, not those of the first one, are consistent with our empirical findings. The present results suggest that (a) in active vision perceived surface slant may be the product of probabilistic processes which do not guarantee the correct solution, and (b) extra-retinal signals may be mainly used for a better measurement of retinal information

Perceived Surface Slant Is Systematically Biased in the Actively-Generated Optic Flow

Humans make systematic errors in the 3D interpretation of the optic flow in both passive and active vision. These systematic distortions can be predicted by a biologically-inspired model which disregards self-motion information resulting from head movements (Caudek, Fantoni, & Domini 2011). Here, we tested two predictions of this model: (1) A plane that is stationary in an earth-fixed reference frame will be perceived as changing its slant if the movement of the observer's head causes a variation of the optic flow; (2) a surface that rotates in an earth-fixed reference frame will be perceived to be stationary, if the surface rotation is appropriately yoked to the head movement so as to generate a variation of the surface slant but not of the optic flow. Both predictions were corroborated by two experiments in which observers judged the perceived slant of a random-dot planar surface during egomotion. We found qualitatively similar biases for monocular and binocular viewing of the simulated surfaces, although, in principle, the simultaneous presence of disparity and motion cues allows for a veridical recovery of surface slant

Laparoscopic removal of mullerian duct remnants in boys

Abstract: Purpose: Mullerian duct remnants (MDRs) are present in a male pseudohermaphroditic form characterized by failure of the mullerian duct to regress due to insufficient production or peripheral action of mullerian inhibiting substance. The MDR can be asymptomatic but it often results in infections, stones and voiding troubles. Furthermore, it may develop into a neoplasm. Therefore, surgery is mandatory for large MDRs and symptomatic patients. Laparoscopic removal is described. Materials and Methods: Six males were treated from February 1998 to February 2003. Age at surgery was between 3 and 18 years (mean 8.6). All patients showed severe hypospadias and 2 had mixed gonadal dysgenesis with ambiguous genitalia. Three patients presented with urogenital infections and all had a large MDR. Laparoscopic procedures, which were preceded by cystoscopy, were performed using a 10 mm umbilical trocar for the camera and 3, 5 mm trocars for instruments placed in the suprapubic region and iliac fossa bilaterally. The remnants were ligated with endoscopic loops or an endoscopic GIA stapler and cut. Results: Mean operative time was 2 hours. We noted no complications. In 2 cases there was deferential ectopia and in another of mixed gonadal dysgenesis bilateral gonadectomy was performed because of the risk of degeneration. Feeding started on postoperative day I and the patients were discharged home on day 5. After a followup of 8 months to 4 years all boys were healthy. Conclusions: Multiple approaches are used in traditional surgery, often leading to complications. Laparoscopy improves the view, decreases surgical risk and operative time, avoids large scars and allows more rapid hospital discharge

The challenge of sharing data in cooperation projects: cause for reflection.

The collection of data and  their management  remain a never-ending challenge within projects carried out in low-income countries.  Data collection requires high investments, and even if great efforts have been done in building tools for data sharing, these processes need to be improved at local level in developing countries. Data are valuable items  for developing strategies leading to more effective local development. The CeTAmb LAB, on the basis of its experience, proposes a reflection on the role of the academia, which is based on principles of capacity building and sharing knowledge, in promoting the importance of data collection, conservation and sharing