You\u27ve Got a Friend in Me: Effectiveness of Social Skills Interventions for Children with ADHD

Children diagnosed with ADHD present with the core symptoms of inattention and hyperactivity/impulsivity, which lead to challenges with school based activities, including peer interactions, academics, and extracurricular activities (McClelland, Morrison, & Holmes, 2000; Hoza, 2007). Current research identifies social skills interventions as a potential strategy for occupational therapists (OTs) to address these participation challenges of children with ADHD, however there is a multitude of interventions that fall under this umbrella. The variety of social skills interventions allows for flexibility and diversity in implementation, but poses the challenge of choosing the most effective intervention. This choice should be informed by evidence-based practice, ensuring the viability of the profession and moving it towards the Centennial Vision (Clark, 2010). To understand the effectiveness of the available social skills interventions for children with ADHD, a systematic review was conducted. The purpose of this session is to present the results of an evidence-based review on the effectiveness of social skills interventions to improve school participation for children with ADHD and discuss implications for clinical practice. The authors searched 6 data bases, resulting in analysis of 12 articles to investigate effectiveness of social skills interventions for children with ADHD. The systematic review process is presented, including the clinical question, inclusion/exclusion criteria, and search terms. The authors outline emerging themes within the research. The authors found moderate support for effectiveness of interventions implemented in physical settings where children are naturally engaging in activities. There is also promising research supporting the use of a combined cognitive behavioral and play-based approach. Evidence did not support the use of a solely cognitive behavioral approach These results suggest that social skills interventions have potential as an effective technique to improve school participation in children with ADHD. Social skills interventions are often used in conjunction with other therapies, and provide a supplement to academics-focused therapy. To advance understanding of social skills interventions, continued research is needed to determine the effectiveness of social skills interventions, discern the most appropriate form of social skills intervention for each student, and solidify OT’s role in social participation intervention. References: Centers for Disease Control and Prevention. (2013). Attention-deficit/hyperactivity disorder (ADHD). Retrieved from: http://www.cdc.gov/ncbddd/adhd/data.html. Clark, F. (2010). High definition occupational therapy: HD OT. American Journal of Occupational Therapy, 64, 848-84. doi: 10.5014/ajot2010.64602. Hoza, B. (2007). Peer functioning in children with ADHD. Ambulatory Pediatrics, 7(1), 101- 106. doi:10.1016/j.ambp.2006.04.011 McClelland, M. M., Morrison, F. J., & Holmes, D. L. (2000). Children at risk for early academic problems: The role of learning-related social skills. Early Childhood Research Quarterly,15(3), 307-329. doi:10.1016/j.bbr.2011.03.031

Development of the MyCyberSkills™ iPad App: A Scenarios-Based, Hands-On Measure of Non-IT Professionals’ Cybersecurity Skills

Although advances in Information Technology (IT) have been significant over the past several decades when it comes to protection of corporate information systems (IS), human errors and social engineering appear to prevail in circumventing such IT protections. While most employees may have the best of intentions, without cybersecurity skills they represent the weakest link in an organization’s IS security. Skills are defined as the combination of knowledge, experience, and ability to do something well. Cybersecurity skills correspond to the skills surrounding the hardware and software required to execute IS security to mitigate cyber-attacks. However, the current measures of end-user cybersecurity skills are based on self-reported surveys. This study is the second phase of a larger research project that is aimed to develop a scenario-based iPad application to measure cybersecurity skills based on actual scenarios with hands-on tasks that the participants complete in demonstrating their skills. To design a measure that has both high validity and reliability, subject matter experts’ (SMEs) opinion of the top nine cybersecurity skills and their skill importance weight were identified in the first phase of the study following the Delphi method. This phase of the research in progress involves the design and development of the MyCyberSkills™ iPad application (app) using scenario-based, hands-on tasks related to each of the nine SMEs identified cybersecurity skills

Effect of preoperative sonographic mapping on vascular access outcomes in hemodialysis patients

Effect of preoperative sonographic mapping on vascular access outcomes in hemodialysis patients.BackgroundCurrent DOQI guidelines encourage placing arteriovenous (AV) fistulas in more hemodialysis patients. However, many new fistulas fail to mature sufficiently to be useable for hemodialysis. Preoperative vascular mapping to identify suitable vessels may improve vascular access outcomes. The present study prospectively evaluated the effect of routine preoperative vascular mapping on the type of vascular accesses placed and their outcomes.MethodsDuring a 17-month period, preoperative sonographic evaluation of the upper extremity arteries and veins was obtained routinely. The surgeons used the information obtained to plan the vascular access procedure. The types of access placed, their initial adequacy for dialysis, and their long-term outcomes were compared to institutional historical controls placed on the basis of physical examination alone.ResultsThe proportion of fistulas placed increased from 34% during the historical control period to 64% with preoperative vascular mapping (P < 0.001). When all fistulas were assessed, the initial adequacy rate for dialysis increased mildly from 46 to 54% (P = 0.34). For the subset of forearm fistulas, the initial adequacy increased substantially from 34 to 54% (P = 0.06); the greatest improvement occurred among women (from 7 to 36%, P = 0.06) and diabetic patients (from 21 to 50%, P = 0.055). In contrast, the initial adequacy rate of upper arm fistulas was not improved by preoperative vascular mapping (59 vs. 56%, P = 0.75). Primary access failure was higher for fistulas than grafts (46.4 vs. 20.6%, P = 0.001), but the subsequent long-term failure rate was higher for grafts than fistulas (P < 0.05). Moreover, grafts required a threefold higher intervention rate (1.67 vs. 0.57 per year, P < 0.001) to maintain their patency. The overall effect of this strategy was to double the proportion of patients dialyzing with a fistula in our population from 16 to 34% (P < 0.001).ConclusionsRoutine preoperative vascular mapping results in a marked increase in placement of AV fistulas, as well as an improvement in the adequacy of forearm fistulas for dialysis. This approach resulted in a substantial increase in the proportion of patients dialyzing with a fistula in our patient population. Fistulas have a higher primary failure rate than grafts, but have a lower subsequent failure rate and require fewer procedures to maintain their long-term patency

Vertical flight training: An overview of training and flight simulator technology with emphasis on rotary-wing requirements

The principal purpose of this publication is to provide a broad overview of the technology that is relevant to the design of aviation training systems and of the techniques applicable to the development, use, and evaluation of those systems. The issues addressed in our 11 chapters are, for the most part, those that would be expected to surface in any informed discussion of the major characterizing elements of aviation training systems. Indeed, many of the same facets of vertical-flight training discussed were recognized and, to some extent, dealt with at the 1991 NASA/FAA Helicopter Simulator Workshop. These generic topics are essential to a sound understanding of training and training systems, and they quite properly form the basis of any attempt to systematize the development and evaluation of more effective, more efficient, more productive, and more economical approaches to aircrew training. Individual chapters address the following topics: an overview of the vertical flight industry: the source of training requirements; training and training schools: meeting current requirements; training systems design and development; transfer of training and cost-effectiveness; the military quest for flight training effectiveness; alternative training systems; training device manufacturing; simulator aero model implementation; simulation validation in the frequency domain; cockpit motion in helicopter simulation; and visual space perception in flight simulators

Structure of the γ-D-glutamyl-L-diamino acid endopeptidase YkfC from Bacillus cereus in complex with L-Ala-γ-D-Glu: insights into substrate recognition by NlpC/P60 cysteine peptidases.

Dipeptidyl-peptidase VI from Bacillus sphaericus and YkfC from Bacillus subtilis have both previously been characterized as highly specific γ-D-glutamyl-L-diamino acid endopeptidases. The crystal structure of a YkfC ortholog from Bacillus cereus (BcYkfC) at 1.8 Å resolution revealed that it contains two N-terminal bacterial SH3 (SH3b) domains in addition to the C-terminal catalytic NlpC/P60 domain that is ubiquitous in the very large family of cell-wall-related cysteine peptidases. A bound reaction product (L-Ala-γ-D-Glu) enabled the identification of conserved sequence and structural signatures for recognition of L-Ala and γ-D-Glu and, therefore, provides a clear framework for understanding the substrate specificity observed in dipeptidyl-peptidase VI, YkfC and other NlpC/P60 domains in general. The first SH3b domain plays an important role in defining substrate specificity by contributing to the formation of the active site, such that only murein peptides with a free N-terminal alanine are allowed. A conserved tyrosine in the SH3b domain of the YkfC subfamily is correlated with the presence of a conserved acidic residue in the NlpC/P60 domain and both residues interact with the free amine group of the alanine. This structural feature allows the definition of a subfamily of NlpC/P60 enzymes with the same N-terminal substrate requirements, including a previously characterized cyanobacterial L-alanine-γ-D-glutamate endopeptidase that contains the two key components (an NlpC/P60 domain attached to an SH3b domain) for assembly of a YkfC-like active site

The structure of BVU2987 from Bacteroides vulgatus reveals a superfamily of bacterial periplasmic proteins with possible inhibitory function.

Proteins that contain the DUF2874 domain constitute a new Pfam family PF11396. Members of this family have predominantly been identified in microbes found in the human gut and oral cavity. The crystal structure of one member of this family, BVU2987 from Bacteroides vulgatus, has been determined, revealing a β-lactamase inhibitor protein-like structure with a tandem repeat of domains. Sequence analysis and structural comparisons reveal that BVU2987 and other DUF2874 proteins are related to β-lactamase inhibitor protein, PepSY and SmpA_OmlA proteins and hence are likely to function as inhibitory proteins

Assessing the Readiness of Black Churches to Engage in Health Disparities Research

We assessed church readiness to engage in health disparities research using a newly developed instrument, examined the correlates of readiness, and described strategies that churches used to promote health. We pilot tested the instrument with churches in a church-academic partnership (n = 12). We determined level of readiness to engage in research and assessed correlates of readiness. We also conducted interviews with participating pastors to explore strategies they had in place to support research engagement. Churches scored fairly high in readiness (average of 4.04 out of 5). Churches with a pastor who promoted the importance of good nutrition in a sermon or had a budget for health-related activities had significantly higher readiness scores than churches without such practices. Having a tool to evaluate church readiness to engage in research will inform targeted technical assistance and research projects that will strengthen church-academic partnerships and improve capacity to address health disparities

Integrative analysis of neuroblastoma by single-cell RNA sequencing identifies the NECTIN2-TIGIT axis as a target for immunotherapy

Pediatric patients with high-risk neuroblastoma have poor survival rates and urgently need more effective treatment options with less side effects. As novel and improved immunotherapies may fill this need, we dissected the immunoregulatory interactions in neuroblastoma by single-cell RNA-sequencing of 25 tumors (10 pre- and 15 post-chemotherapy, including 5 pairs) to identify strategies for optimizing immunotherapy efficacy. Neuroblastomas were infiltrated by NK, T and B cells, and immunosuppressive myeloid populations. NK cells showed reduced cytotoxicity and T cells had a dysfunctional profile. Interaction analysis revealed a vast immunoregulatory network and identified NECTIN2-TIGIT as a crucial immune checkpoint. Combined blockade of TIGIT and PD-L1 significantly reduced neuroblastoma growth, with complete responses in vivo. Moreover, addition of TIGIT blockade to standard relapse treatment in a chemotherapy-resistant Th-ALKF1174L/MYCN 129/SvJ syngeneic model significantly improved survival. Concluding, our integrative analysis of neuroblastoma’s vast immunoregulatory network provides novel targets and a rationale for immunotherapeutic combination strategies