TEACHING A PICTURE EXCHANGE COMMUNICATION SYSTEM TO YOUNG ADULTS WITH MODERATE TO SEVERE DISABILITIES USING THE PECS PHASE III APPLICATION

The purpose of the study was to evaluate the effectiveness of teaching a picture communication system to students with moderate to severe disabilities using the PECS Phase III application. A multiple probe across participants design was used to conduct the study and evaluate the effectiveness of the training on the PECS Phase III application. The results of the study demonstrated that teaching a picture communication system on an augmentative and alternative communication device is effective in the school setting with young adults with moderate and severe disabilities

Partitioning Structural VHDL Circuits for Parallel Execution on Hypercubes

Distributing simulations among multiple processors is one approach to reducing VHDL simulation time for large VLSI circuit designs. However, parallel simulation introduces the problem of how to partition the logic gates and system behaviors among the available processors in order to obtain maximum speedup. This research investigates deliberate partitioning algorithms that account for the complex inter-dependency structure of the circuit behaviors. Once an initial partition has been obtained, a border annealing algorithm is used to iteratively improve the partition. In addition, methods of measuring the cost of a partition and relating it to the resulting simulation performance are investigated. Structural circuits ranging from one thousand to over four thousand behaviors are simulated. The deliberate partitions consistently provided superior speedup to a random distribution of the circuit behaviors

Clinical gains for youth in psychiatric residential treatment facilities: results from a state-wide performance information system

This article presents findings on clinical gains for youth in psychiatric residential treatment facilities (PRTF) through the use of state-wide performance management information. Data was collected on 1,258 youth admitted to one of seventeen PRTF facilities in a single, mid-western state. Results suggest that youth made positive clinical changes during treatment. Furthermore, results indicate that parent and youth hopefulness and satisfaction were significant predictors of positive clinical changes in problem severity and youth functioning. These findings contribute to current literature on PRTF effectiveness in achieving positive youth outcomes and the role of consumer attitudinal factors in treatment

Cervical preparation for first trimester surgical abortion.

BACKGROUND: Preparing the cervix prior to surgical abortion is intended to make the procedure both easier and safer. Options for cervical preparation include osmotic dilators and pharmacologic agents. Many formulations and regimens are available, and recommendations from professional organizations vary for the use of preparatory techniques in women of different ages, parity or gestational age of the pregnancy. OBJECTIVES: To determine whether cervical preparation is necessary in the first trimester, and if so, which preparatory agent is preferred. SEARCH STRATEGY: We searched Cochrane, Popline, Embase, Medline and Lilacs databases for randomised controlled trials investigating the use of cervical preparatory techniques prior to first trimester surgical abortion. In addition, we hand-searched key references and contacted authors to locate unpublished studies or studies not identified in the database searches. SELECTION CRITERIA: Randomised controlled trials investigating any pharmacologic or mechanical method of cervical preparation, with the exception of nitric oxide donors (the subject of another Cochrane review), administered prior to first trimester surgical abortion were included. Outcome measures must have included the amount of cervical dilation achieved, the procedure duration or difficulty, side-effects, patient satisfaction or adverse events to be included in this review. DATA COLLECTION AND ANALYSIS: Trials under consideration were evaluated by considering whether inclusion criteria were met as well as methodologic quality. Fifty-one studies were included, resulting in 24 different cervical preparation comparisons. Results are reported as odds ratios (OR) for dichotomous outcomes and weighted mean differences for continuous data. MAIN RESULTS: When compared to placebo, misoprostol (400-600 microg given vaginally or sublingually), gemeprost, mifepristone (200 or 600 mg), prostaglandin E and F(2alpha) (2.5 mg administered intracervically) demonstrated larger cervical preparation effects. When misoprostol was compared to gemeprost, misoprostol was more effective in preparing the cervix and was associated with fewer gastrointestinal side-effects. For vaginal administration, administration 2 hours prior was less effective than administration 3 hours prior to the abortion. Compared to oral misoprostol administration, the vaginal route was associated with significantly greater initial cervical dilation and lower rates of side-effects; however, sublingual administration 2-3 hours prior to the procedure demonstrated cervical effects superior to vaginal administration.When misoprostol (600 microg oral or 800 microg vaginal) was compared to mifepristone (200 mg administered 24 hours prior to procedure), misoprostol had inferior cervical preparatory effects. Compared to day-prior laminaria tents, 200 or 400 microg vaginal misoprostol showed no differences in the need for further mechanical dilation or length of the procedure; similarly, the osmotic dilators Lamicel and Dilapan showed no differences in cervical ripening when compared to gemeprost, although gemeprost had cervical effects which were superior to laminaria tents. Older prostaglandin regimens (sulprostone, prostaglandin E(2) andF(2alpha)) were associated with high rates of gastrointestinal side-effects and unplanned pregnancy expulsions. Few studies reported women's satisfaction with cervical preparatory techniques. AUTHORS' CONCLUSIONS: Modern methods of cervical ripening are generally safe, although efficacy and side-effects between methods vary. Reports of adverse events such as cervical laceration or uterine perforation are uncommon overall in this body of evidence and no published study has investigated whether cervical preparation impacts these rare outcomes. Cervical preparation decreases the length of the abortion procedure; this may become increasingly important with increasing gestational age, as mechanical dilation at later gestational ages takes longer and becomes more difficult. These data do not suggest a gestational age where the benefits of cervical dilation outweigh the side-effects, including pain, that women experience with cervical ripening procedures or the prolongation of the time interval before procedure completion. Mifepristone 200 mg, osmotic dilators and misoprostol, 400microg administered either vaginally or sublingually, are the most effective methods of cervical preparation

Regulatory T Cells Are Dispensable for Tolerance to RBC Antigens

Autoimmune hemolytic anemia (AIHA) occurs when pathogenic autoantibodies against red blood cell (RBC) antigens are generated. Whilst the basic disease pathology of AIHA is well studied, the underlying mechanism(s) behind the failure in tolerance to RBC autoantigens are poorly understood. Thus, to investigate the tolerance mechanisms required for the establishment and maintenance of tolerance to RBC antigens, we developed a novel murine model. With this model, we evaluated the role of regulatory T cells (Tregs) in tolerance to RBC-specific antigens. Herein, we show that neither sustained depletion of Tregs nor immunization with RBC-specific proteins in conjunction with Treg depletion led to RBC-specific autoantibody generation. Thus, these studies demonstrate that Tregs are not required to prevent autoantibodies to RBCs and suggest that other tolerance mechanisms are likely involved