Testing the Efficacy of the Creating Opportunities for Parent Empowerment (COPE) Intervention During Hospital to Home Transition: Empowering Parents of Children with Epilepsy and Other Neurological Conditions

Thesis advisor: Judith A. VesseyBackground: Parents of children with epilepsy and other neurological conditions live with a feeling of constant uncertainty. The uncertainty associated with caring for a child with epilepsy and other neurological conditions produces stress, which leads to decreased parental belief in caregiving skills, anxiety, and depression, ultimately altering parental functioning resulting in an increase in child behavioral problems. The stress associated with caring for a child with epilepsy and other neurological conditions is unlike caring for children with other chronic conditions. Epilepsy and other neurological conditions are unpredictable and there are often no warning signs prior to an acute event. This unpredictability accompanied with stigma results in social isolation and impacts family functioning. In addition, children with epilepsy have a higher rate of psychological co-morbidities and behavior problems when compared to children with other chronic conditions. This produces an additional burden on the parents and family. Study Design: This randomized controlled trial tested the efficacy of the COPE intervention for parents of children with epilepsy and other neurological conditions. This intervention was administered at three intervals: 1) during hospital admission in writing and by audiotape, MP3 download, or Podcast; 2) three days following hospital discharge by telephone; and 3) four to six weeks after hospital discharge in writing and by audiotape, MP3 download, or Podcast. Results: Forty-six parents of children admitted to the inpatient neuroscience unit at Boston Children's Hospital participated in the study. Several study limitations resulted in an inadequate sample size to obtain the power necessary to reach statistically significant results for a majority of the research questions. A one-between, one-within multivariate analysis of variance (MANOVA) revealed that the main effect of time was significant for differences in state anxiety for both the Usual Care Group and the Intervention Group, F, (1, 20) = 9.86, p = .005, indicating that state anxiety for both groups combined was more pronounced during the hospitalization. A one-between, one-within MANOVA demonstrated that the effect of the interaction between time and group was significant for internalized behavior assessment system score only (p=.037) as the Usual Care Group reported a significant decrease in internalizing behavior scores in their children over time. Conclusions: Findings from this study have significant implications for clinical practice and future research. Parents of children with neurological conditions often struggle to manage a constant feeling of uncertainty in their daily lives. Nurses possess the knowledge and expertise necessary to identify the psychosocial needs of these parents and provide education and support as needed. Future research should focus on designing interventions to meet the needs of these families and develop strategies to help improve the quality of life for both the parent and child living with a neurological condition.Thesis (PhD) — Boston College, 2013.Submitted to: Boston College. Connell School of Nursing.Discipline: Nursing

Sensory processing and eating behaviours in autism:A systematic review

OBJECTIVES: The aim of this study was to assess the relationship between sensory processing and a broad range of eating behaviours across the lifespan. METHODS: Five electronic databases of published and unpublished quantitative studies were systematically searched, evaluated for risk of bias and synthesised according to identified eating outcomes. RESULTS: Across 25 studies, there was consistent evidence of a relationship between sensory processing and a range of eating behaviours. There was early evidence for the particular role of taste/smell sensitivities, as well as hypersensitivities, although future research is needed looking at different sensory patterns and modalities. There was also tentative evidence to suggest this relationship extends across development. DISCUSSION: Study findings are discussed in relation to implications for sensory‐based eating and feeding interventions and the development of eating disorders. Methodological and conceptual limitations are discussed and suggestions for future research are made to address these limitations. A broader investigation of multi‐sensory issues and clearly defined eating behaviours, including disordered eating in clinically diagnosed samples, will allow for a more comprehensive and robust understanding of the relationship between sensory processing and eating behaviours in autism

Sexual behaviour of Kiribati seafarers: second generation surveillance in 2005 and 2008

High-risk sexual activity, including engaging in transactional sex, concurrent sexual partnerships, and inconsistent condom use, increases the risk of infection with HIV and other sexually transmitted infections (STI). The demands of seafaring, such as long periods spent away from home, and the availability of commercial sex around seaports, can contribute to a culture of high-risk activity such as multiple casual sexual encounters and poor condom use. In 2005 and 2008, the Kiribati Ministry of Health conducted HIV and STI prevalence and behaviour surveys among seafarers. The results suggest that, while knowledge of HIV prevention and transmission improved from 2005 to 2008, this did not correlate with reduced levels of risky sexual activity in the same period. These findings suggest that HIV and STI prevention programs must extend beyond providing information, and testing and treatment facilities, towards implementing strategies that encourage and support safer sexual behaviours amongst seafarers and their partners, in particular transactional sex partners. (Int Marit Health 2010; 61; 4: 195-200

DeepPrecip: A deep neural network for precipitation retrievals

Remotely-sensed precipitation retrievals are critical for advancing our understanding of global energy and hydrologic cycles in remote regions. Radar reflectivity profiles of the lower atmosphere are commonly linked to precipitation through empirical power laws, but these relationships are tightly coupled to particle microphysical assumptions that do not generalize well to different regional climates. Here, we develop a robust, highly generalized precipitation retrieval from a deep convolutional neural network (DeepPrecip) to estimate 20-minute average surface precipitation accumulation using near-surface radar data inputs. DeepPrecip displays high retrieval skill and can accurately model total precipitation accumulation, with a mean square error (MSE) 99 % lower, on average, than current methods. DeepPrecip also outperforms a less complex machine learning retrieval algorithm, demonstrating the value of deep learning when applied to precipitation retrievals. Predictor importance analyses suggest that a combination of both near-surface (below 1 km) and higher-altitude (1.5 &ndash; 2 km) radar measurements are the primary features contributing to retrieval accuracy. Further, DeepPrecip closely captures total precipitation accumulation magnitudes and variability across nine distinct locations without requiring any explicit descriptions of particle microphysics or geospatial covariates. This research reveals the important role for deep learning in extracting relevant information about precipitation from atmospheric radar retrievals.</p

BMP13 Prevents the Effects of Annular Injury in an Ovine Model

Chronic back pain is a global health problem affecting millions of people worldwide and carries significant economic and social morbidities. Intervertebral disc damage and degeneration is a major cause of back pain, characterised by histological and biochemical changes that have been well documented in animal models. Recently there has been intense interest in early intervention in disc degeneration using growth factors or stem cell transplantation, to replenish the diseased tissues. Bone Morphogenetic Proteins (BMPs) have been approved for clinical use in augmenting spinal fusions, and may represent candidate molecules for intervertebral disc regeneration

Benchmarking Australian enabling programs for a national framework of standards

Enabling education programs in Australia assist students, who would otherwise have been excluded from higher education, to transition into undergraduate study. These programs emerged independently in response to the needs of individual universities and the varying cohorts of students they serve. The exclusion of these programs from the Australian Qualifications Framework (AQF) has meant they remain unregulated, with no national framework for standards. The development of academic standards is a dynamic, consensus driven process, and benchmarking provides a method through which academics from across institutions can work in partnership to reach shared understandings and improve and align practices. This practice report outlines the results of the first comprehensive cross-institutional benchmarking project involving nine Australian universities and demonstrates there is shared understanding of the standards of enabling programs between institutions. These findings will contribute to the establishment of national standards for enabling programs in Australia