Use of an Adaptive Climbing Program to Improve Social Skills in Children with Developmental Delays: A Feasibility Study

Purpose: A repeated measures single-group feasibility study was used to investigate the potential success and feasibility of an adaptive climbing program including group social skills activities to positively impact social skills in children with developmental delays. Methods: A convenience sample of 10 children aged 4 to 12 years participated in six social skills activity groups and adaptive climbing sessions at a rock-climbing facility in North Carolina. Trained observers measured targeted social skills via an author-generated social skills tracking form. Results: A paired t-test indicates a statistically significant improvement in social skills from session 1 to session 6 (pConclusions: Outcomes suggest participation in a community-based adaptive climbing program that involves group social skills activities may be beneficial for promoting social skill development in children with developmental delays. Opportunities exist for occupational therapists to partner with climbing gyms or other organizations to develop and tailor programming specific to each child’s developmental level and needs

Parenting mediates the impact of maternal depression on child internalizing symptoms

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141761/1/da22688.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141761/2/da22688_am.pd

Synthesis, structure and spectroscopic investigations of luminescent heterobimetallic gold(I)-Rhodium(I) species

Thesis (S.B.)--Massachusetts Institute of Technology, Dept. of Chemistry, 2005.Some images on CDROM are in colour.Includes bibliographical references (leaves 33-34, first group).A novel, three-coordinate gold(I) dimer, Au2(tfepm)3Cl2 (la, lb), was synthesized and structurally characterized. Four gold(I)-rhodium(I) heterobimetallic complexes, AuIRh'(tBuNC)2(-dppm)2C12 (2), Au'Rh'(tBuNC)2(u-dmpm)2Cl2 (3), Au'Rh'(tBuNC)2(,u-tfepm)2C12 (4), and AuIRh(tBuNC)2(u-tfepma)2Cl2 (5) were synthesized and 2, 3, and 5 were crystallographically characterized. Absorption spectra at room temperature, excitation spectra, emission spectra, and phosphorescence lifetimes of glass-solution and solid state samples at 77 K are reported for 2-5 and interpreted in context of crystallographic structure, electronic structure, and time-dependent density functional theory (TD-DFT) calculations. 2-5 are intensely luminescent at 77 K, with 4 and 5 exhibiting "dual emission."by Jillian Lee Dempsey.S.B

Gender differences in psychopathology examined under an expanded transactional theory of stress framework

Prevalence rates of many types of psychopathology are lower for men than they are for women, but the causes of these discrepancies are not known. This paper focuses on two such psychopathology groups – eating disorders and depressive disorders – and examines gender differences within a transactional theory of stress that takes into account levels of cognitive processing (an expanded transactional theory of stress). Both studies found that men are more physiologically reactive to disorder-relevant, stressful stimuli and stressful events. The study on depression also found that different cognitive processes may be depressogenic for men and women: deployment of attentional resources toward negative stimuli was associated with depression in men, while deployment of attentional resources away from positive stimuli was associated with depression in women. These findings have significant implications for choosing appropriate treatment options for men and women

Health workers' perceptions of psychosocial support services for cancer patients in rural Victoria

Literature attests to the fact that psychosocial needs for cancer patients are not being adequately addressed. The tools, frameworks and guidelines developed, reflect differing professional perspectives and models of disease. Most studies have usually looked at what is happening from the patient and family's viewpoint in terms of medical and other needs. New national initiatives in psychosocial care include the organisation of nationwide practitioner workshops to encourage the implementation of the Clinical Practice Guidelines for the Psychosocial Care of Adults with Cancer. These guidelines focus mainly on the emotional and existential areas of need. The aim of this study was to: understand how a diversity of approaches and professional perspectives play out in everyday practice within a rural context; see how issues of distance and access affect this process; and highlight the deficiencies in the delivery of psychosocial services for cancer patients in rural Victoria. The study involved 59 questionnaire respondents (a 71% response rate), from which two interviews and six focus group discussions were drawn. Key findings were: regional and metropolitan hospitals and specialists not referring for support services; private patients missing out; general practitioners not referring to support services; late referrals to palliative care and district nursing; haphazard continuity of care for support needs of patients; and disputed responsibility for initial assessment.C

Increased Speed Equals Increased Wait: The Impact of a Reduction in Emergency Department Ultrasound Order Processing Time

We exploit an exogenous process change at two emergency departments (EDs) within a health system to test the theory that increasing capacity in a discretionary work setting increases wait times due to additional services being provided to customers as a consequence of reduced marginal costs for a task. We find that an increase in physician’s capacity for ordering ultrasounds (U/S) resulted in an 11.5 percentage point increase in the probability of an U/S being ordered, confirming that resource availability induces demand. Furthermore, we find that the additional U/S demand increased the time to return other radiological tests due to the higher demand placed on radiologists from the additional U/S. Consequently, the average length of stay (LOS) for patients with an abdominal complaint increased by nearly 30 minutes, and the waiting time to enter the ED increased by 26 minutes. We do not find any indications of improved performance on clinical metrics, with no statistical change in the number of admissions to the hospital or readmissions to the ED within 72 hours. Our study highlights an important lesson for process improvement in interdependent service settings: increasing process capacity at one step in the process can increase demand at that step, as well as for a subsequent shared service, and both can result in an overall negative impact on performance

Improving Discharge Medication Education on a Sepsis Unit: A Quality Improvement Project

Ineffective discharge education plays a role in increased readmission rates, adverse drug events, and worsened patient outcomes post-hospitalization. When combined, the resulting financial burden on America’s healthcare system is exorbitant, as is the physical and mental toll on unsuspecting patients. To close the current gaps in discharge teaching, this project is incorporating the teach-back method and utilizing updated medication handouts. Starting on the sepsis unit of a large, local medical center – the Clinical Nurse Leader (CNL) interns employed assessment tools to identify areas for improvement. The data revealed rushed, incomprehensive discharge medication education and reflected in low HCAHPS scores in the areas of “Communication about Medications” and “Care Transitions.” Utilizing the Plan, Do, Study, Act tool, more succinct and personalized medication class worksheets were conceived and the unit’s discharge education protocol for nurses was updated to include the utilization of teach-back regarding prescribed medication purpose and side effects. Said changes were based on evidence-based practice and relevant literature. In order to determine the success of the project, HCAHPS scores will be analyzed. Within ten months of implementation, the anticipated HCAHPS scores will be 58.2% (from 36.7%) in “Communication about Medications” and 56.9% (from 39.1%) in “Care Transitions.” Additionally, the potential unit savings is estimated to decrease by $949 to$44,190 per patient by improving medication education upon discharge. Improved discharge medication education is attainable by utilizing enhanced medication education sheets in combination with the teach-back method. The success of this quality improvement project on the given unit can and should be seen as framework to enact similar positive changes to additional units