A video self modeling intervention to modify aggressive behaviors in students with autism spectrum disorder and intellectual disabilities

Field of study: Special education.Professor Delinda van Garderen.Includes vita."May 2018."This study evaluated the efficacy of a video self-modeling and functional behavior assessment intervention on a traditionally under-represented population. Students diagnosed with Autism Spectrum Disorder (ASD) and Intellectual Disabilities (ID) are prone to higher rates of aggressive behavior that can be resistant to treatment. Under the frameworks of Behaviorism and Social Cognitive Theory an intervention was developed to decrease aggressive behaviors and increase self-regulated behavior. A multiple baseline design across stimulus conditions with inter-subject replication was conducted to explore the effects of the intervention. Data was collected on both the rate of aggressive behaviors and the use of a replacement behavior which fostered socially appropriate self-regulation. The data indicate that both participants demonstrated a decrease in aggressive behavior immediately following intervention across all stimulus conditions. Data collected on the replacement behavior indicated a change from baseline to intervention but results differed across participants.Includes bibliographical references (pages 71-86)

Improving the management of severe acute malnutrition in an area of high HIV prevalence.

AIM: To assess the clinical outcomes of a combined approach to the treatment of severe acute malnutrition in an area of high HIV prevalence using: (i) an initial inpatient phase, based on WHO guidelines and (ii) an outpatient recovery phase using ready-to-use therapeutic food. METHODS: An operational prospective cohort study implemented in a referral hospital in Southern Malawi between May 2003 and 2004. Patient outcomes were compared with international standards and with audits carried out during the year preceding the study. RESULTS: Inpatient mortality was 18% compared to 29% the previous year. Programme recovery rate was 58.1% compared to 45% the previous year. The overall programme mortality rate was 25.7%. Of the total known HIV seropositive children, 49.5% died. CONCLUSIONS: Inpatient mortality and cure rates improved compared to pre-study data but the overall mortality rate did not meet international standards. Additional interventions will be needed if these standards are to be achieved

Acceptability and effectiveness of chickpea sesame-based ready-to-use therapeutic food in malnourished HIV-positive adults

Paluku Bahwere, Kate Sadler, Steve CollinsValid International, Oxford, United KingdomObjective: A prospective descriptive study to assess acceptability and effectiveness of a locally made ready-to-use therapeutic food (RUTF) in HIV-infected chronically sick adults (CSA) with mid-upper-arm circumference (MUAC) <210 mm or pitting edema. Methods: Sixty-three wasted AIDS adults were prescribed 500 g representing ~2600 kcal/day of locally made RUTF for three months and routine cotrimoxazole. Weight, height, MUAC, Karnofsky score and morbidity were measured at admission and at monthly intervals. The amount of RUTF intake and acceptability were assessed monthly.Results: Ninety-five percent (60/63) of the CSA that were invited to join the study agreed to participate. Mean daily intake in these 60 patients was 300 g/person/day (~1590 Kcal and 40 g of protein). Overall, 73.3% (44/60) gained weight, BMI, and MUAC. The median weight, MUAC and BMI gains after three months were 3.0 kg, 25.4 mm, and 1.1 kg/m2, respectively. The intervention improved the physical activity performance of participants and 78.3% (47/60) regained sufficient strength to walk to the nearest health facility. Mortality at three months was 18.3% (11/60).Conclusion: Locally made RUTF was acceptable to patients and was associated with a rapid weight gain and physical activity performance. The intervention is likely to be more cost effective than nutritional support using usual food-aid commodities.Keywords: ready-to-use therapeutic food, community-based intervention, adult, supplementation, HIV, Malaw

Using radio galaxies to find super-structures

Radio galaxies are excellent at tracing large-scale structure due to their high bias. We present new results from the TONS08 radio galaxy redshift survey. We find unequivocal evidence for a huge (at least 80 x 80 x 100 Mpc^3) super-structure at redshift z=0.27, confirming tentative evidence for such a structure from the 7C redshift survey (7CRS). A second, newly discovered super-structure is also tentatively found at redshift 0.35 (of dimensions at least 100 x 100 x 100 Mpc^3). Out of the total sample size of 84 radio galaxies, at least 25 are associated with the two super-structures. We use quasi-linear structure formation theory to estimate the number of such structures expected in the TONS08 volume if the canonical value for radio galaxy bias is assumed. Under this assumption, the structures represent ~ 4-5 sigma peaks in the primordial density field and their expected number is low (10^{-2}-10^{-4}). Fortunately, there are several plausible explanations (many of which are testable) for these low probabilities in the form of potential mechanisms for boosting the bias on large scales. These include: the association of radio galaxies with highly biased rich clusters in super-structures, enhanced triggering by group/group mergers, and enhanced triggering and/or redshift space distortion in collapsing systems as the growth of super-structures moves into the non-linear regime. Similar structures could have been missed in previous surveys because of the effects of Poisson-sampling fluctuations.Comment: 6 pages, 3 figures. To appear in "Radio galaxies: past, present and future", eds M. Jarvis et al., Leiden, Nov 200

Use of tuberculin skin test for assessment of immune recovery among previously malnourished children in Ethiopia.

OBJECTIVE: To compare levels of immunity in children recovering from severe acute malnutrition (cases) against those of community controls (controls). RESULTS: At baseline children recovering from severe acute malnutrition had lower, mid upper arm circumference (122 mm for cases and 135 mm for controls; p < 0.001), weight-for-height Z-score (- 1.0 for cases and - 0.5 for controls; p < 0.001), weight-for-age Z-score (- 2.8 for cases and - 1.1 for controls; p < 0.001) and height/length-for-age Z-score (- 3.6 for cases and - 1.4 for controls; p < 0.001), than controls. Age and gender matched community controls. At baseline, prevalence of a positive tuberculin skin test, assessed by cutaneous delayed-type hypersensitivity reaction skin test, was very low in both cases (3/93 = 3.2%) and controls (2/94 = 2.1%) and did not significantly increase at 6 months follow up (6/86 = 7.0% in cases and 3/84 = 3.4% in controls). The incidences of common childhood morbidities, namely fever, diarrhoea and cough, were 1.7-1.8 times higher among cases than controls. In conclusion, these results show that tuberculin skin test does not enable any conclusive statements regarding the immune status of patients following treatment for severe acute malnutrition. The increased incidence of infection in cases compared to controls suggests persistence of lower resistance to infection even after anthropometric recovery is achieved

Uptake of HIV testing and outcomes within a Community-based Therapeutic Care (CTC) programme to treat Severe Acute Malnutrition in Malawi: a descriptive study

<p>Abstract</p> <p>Background</p> <p>In Malawi and other high HIV prevalence countries, studies suggest that more than 30% of all severely malnourished children admitted to inpatient nutrition rehabilitation units are HIV-infected. However, clinical algorithms designed to diagnose paediatric HIV are neither sensitive nor specific in severely malnourished children. The present study was conducted to assess : i) whether HIV testing can be integrated into Community-based Therapeutic Care (CTC); ii) to determine if CTC can improve the identification of HIV infected children; and iii) to assess the impact of CTC programmes on the rehabilitation of HIV-infected children with Severe Acute Malnutrition (SAM).</p> <p>Methods</p> <p>This community-based cohort study was conducted in Dowa District, Central Malawi, a rural area 50 km from the capital, Lilongwe. Caregivers and children admitted in the Dowa CTC programme were prospectively (Prospective Cohort = PC) and retrospectively (Retrospective Cohort = RC) admitted into the study and offered HIV testing and counseling. Basic medical care and community nutrition rehabilitation was provided for children with SAM. The outcomes of interest were uptake of HIV testing, and recovery, relapse, and growth rates of HIV-positive and uninfected children in the CTC programme. Student's t-test and analysis of variance were used to compare means and Kruskall Wallis tests were used to compare medians. Dichotomous variables were compared using Chi²analyses and Fisher's exact test. Stepwise logistic regression with backward elimination was used to identify predictors of HIV infection (α = 0.05).</p> <p>Results</p> <p>1273 and 735 children were enrolled in the RC and PC. For the RC, the average age (SD) at CTC admission was 30.0 (17.2) months. For the PC, the average age at admission was 26.5 (13.7) months. Overall uptake of HIV testing was 60.7% for parents and 94% for children. HIV prevalence in severely malnourished children was 3%, much lower than anticipated. 59% of HIV-positive and 83% of HIV-negative children achieved discharge Weight-For-Height (WFH) ≥ 80% of the NCHS reference median (p = 0.003). Clinical algorithms for diagnosing HIV in SAM children had poor sensitivity and specificity.</p> <p>Conclusion</p> <p>CTC is a potentially valuable entry point for providing HIV testing and care in the community to HIV infected children with SAM.</p

What underlies the difference between self-reported health and disability after stroke? A qualitative study in the UK.

BACKGROUND: Levels of self-reported health do not always correlate with levels of physical disability in stroke survivors. We aimed to explore what underlies the difference between subjective self-reported health and objectively measured disability among stroke survivors. METHODS: Face to face semi-structured interviews were conducted with stroke survivors recruited from a stroke clinic or rehabilitation ward in the UK. Fifteen stroke survivors purposively sampled from the clinic who had discordant self-rated health and levels of disability i.e. reported health as 'excellent' or 'good' despite significant physical disability (eight), or as 'fair' or 'poor' despite minimal disability (seven) were compared to each other, and to a control group of 13 stroke survivors with concordant self-rated health and disability levels. Interviews were conducted 4 to 6 months after stroke and data analysed using the constant comparative method informed by Albrecht and Devlieger's concept of 'disability paradox'. RESULTS: Individuals with 'excellent' or 'good' self-rated health reported a sense of self-reliance and control over their bodies, focussed on their physical rehabilitation and lifestyle changes and reported few bodily and post-stroke symptoms regardless of level of disability. They also frequently described a positive affect and optimism towards recovery. Some, especially those with 'good' self-rated health and significant disability also found meaning from their stroke, reporting a spiritual outlook including practicing daily gratitude and acceptance of limitations. Individuals with minimal disability reporting 'fair' or 'poor' self-rated health on the other hand frequently referred to their post-stroke physical symptoms and comorbidities and indicated anxiety about future recovery. These differences in psychological outlook clustered with differences in perception of relational and social context including support offered by family and healthcare professionals. CONCLUSIONS: The disability paradox may be illuminated by patterns of individual attributes and relational dynamics observed among stroke survivors. Harnessing these wider understandings can inform new models of post-stroke care for evaluation

How Can Nutrition Research Better Reflect the Relationship Between Wasting and Stunting in Children? Learnings from the Wasting and Stunting Project

Childhood wasting and stunting affect large numbers of children globally. Both are important risk factors for illness and death yet, despite the fact that these conditions can share common risk factors and are often seen in the same child, they are commonly portrayed as relatively distinct manifestations of undernutrition. In 2014, the Wasting and Stunting project was launched by the Emergency Nutrition Network. Its aim was to better understand the complex relationship and associations between wasting and stunting and examine whether current separations that were apparent in approaches to policy, financing, and programs were justified or useful. Based on the project's work, this article aims to bring a wasting and stunting lens to how research is designed and financed in order for the nutrition community to better understand, prevent, and treat child undernutrition. Discussion of lessons learnt focuses on the synergy and temporal relationships between children's weight loss and linear growth faltering, the proximal and distal factors that drive diverse forms of undernutrition, and identifying and targeting people most at risk. Supporting progress in all these areas requires research collaborations across interest groups that highlight the value of research that moves beyond a focus on single forms of undernutrition, and ensures that there is equal attention given to wasting as to other forms of malnutrition, wherever it is present

Two 100 Mpc-scale structures in the 3-D distribution of radio galaxies and their implications

We present unequivocal evidence for a huge (~80 x 100 x 100 Mpc^3) super-structure at redshift z=0.27 in the 3-D distribution of radio galaxies from the TONS08 sample, confirming tentative evidence for such a structure from the 7C redshift survey (7CRS). A second, newly discovered super-structure is also less securely found at redshift 0.35 (of dimensions ~100 x 100 x 100 Mpc^3). We present full observational details on the TONS08 sample which was constructed to probe structures in the redshift range 0 < z < 0.5 by matching NVSS sources with objects in APM catalogues to obtain a sample of optically bright (E ~ R 3 mJy) radio galaxies in the same 25 deg^2 area as part-II of the 7CRS. Out of the total sample size of 84 radio galaxies, at least 25 are associated with the two ~100 Mpc-scale super-structures. We use quasi-linear structure formation theory to estimate the number of such structures expected in the TONS08 volume if the canonical value for radio galaxy bias is assumed. Under this assumption, the structures represent ~ 4-5 sigma peaks in the primordial density field and their expected number is low (~10^-2 - 10^-4). Fortunately, there are several plausible explanations (many of which are testable) for these low probabilities in the form of potential mechanisms for boosting the bias on large scales. These include: the association of radio galaxies with highly biased rich clusters in super-structures, enhanced triggering by group/group mergers, and enhanced triggering and/or redshift space distortion in collapsing systems as the growth of super-structures moves into the non-linear regime (abridged).Comment: Accepted for publication in MNRAS. 26 pages,16 figures. spectra can be found in: http://www-astro.physics.ox.ac.uk/~brand/08_paper.ps.g

Preliminary archaeoentomological analyses of permafrost-preserved cultural layers from the pre-contact Yup’ik Eskimo site of Nunalleq, Alaska : implications, potential and methodological considerations

Acknowledgements Site excavation and samples collection were conducted by archaeologists from the University of Aberdeen, with the help of archaeologists and student excavators from the University of Aberdeen University of Alaska Fairbanks and Bryn Mawr College, Kuskokwim Campus, College of Rural Alaska and residents of Quinhagak and Mekoryuk. This study is funded through AHRC grant to the project ‘Understanding Cultural Resilience and Climate Change on the Bering Sea through Yup’ik Ecological Knowledge, Lifeways, Learning and Archaeology’ to Rick Knecht, Kate Britton and Charlotta Hillderal (University of Aberdeen; AH/K006029/1). Thanks are due to Qanirtuuq Inc. and Quinhagak, Alaska for sampling permissions and to entomologists working at the CNC in Ottawa for allowing access to reference collections of beetles, lice and fleas. Yves Bousquet, Ales Smetana and Anthony E. Davies are specially acknowledged for their help with the identification of coleopteran specimens. Finally, we would also like to thank Scott Elias for useful comments on the original manuscript.Peer reviewedPublisher PD