Predicting Treatment Success in Child and Parent Therapy Among Families in Poverty

Behavior problems are prevalent in young children and those living in poverty are at increased risk for stable, high-intensity behavioral problems. Research has demonstrated that participation in child and parent therapy (CPT) programs significantly reduces problematic child behaviors while increasing positive behaviors. However, CPT programs, particularly those implemented with low-income populations, frequently report high rates of attrition (over 50%). Parental attributional style has shown some promise as a contributing factor to treatment attendance and termination in previous research. The authors examined if parental attributional style could predict treatment success in a CPT program, specifically targeting low-income urban children with behavior problems. A hierarchical logistic regression was used with a sample of 425 families to assess if parent- and child-referent attributions variables predicted treatment success over and above demographic variables and symptom severity. Parent-referent attributions, child-referent attributions, and child symptom severity were found to be significant predictors of treatment success. Results indicated that caregivers who viewed themselves as a contributing factor for their child\u27s behavior problems were significantly more likely to demonstrate treatment success. Alternatively, caregivers who viewed their child as more responsible for their own behavior problems were less likely to demonstrate treatment success. Additionally, more severe behavior problems were also predictive of treatment success. Clinical and research implications of these results are discussed

Space-Filling Designs for Multi-Layer Nested Factors

This articles considers computer experiments where levels for continuous factors are selected in sequential order with the level selected for one factor directly a ecting the range of possible levels for the nested factor, and so on for a nite number of factors. In addition, we assume the nested relationships between the factors have no closed form solution. In this paper, we propose an approach for constructing a multi-layer nested factor design, or multi-NFD for short. This space- lling design approach takes advan- tage of the maximin criterion and can be analyzed using a standard Gaussian process model. While the multi-NFD approach can be adapted for future computer experi- ments involving factor relationships of this type, we present results from a particular aerospace computer simulation study

Identification and cost of adverse events in metastatic breast cancer in taxane and capecitabine based regimens.

PurposeWe sought to compare the economic impact of treatment-related adverse events (AEs) in patients with metastatic breast cancer (mBC) using taxane- or capecitabine-based treatment regimens as either first- or second-line (FL or SL) therapy in the US.MethodsWe used healthcare claims data from the Truven Health Analytics MarketScan® Commercial Databases to conduct a retrospective cohort study comparing the economic impact of AEs amongst taxane- and capecitabine-treated mBC patients in the US. We selected women diagnosed with mBC between 2008-2010 who received a taxane or capecitabine as first- or second-line (FL or SL) chemotherapy. Costs related to hospitalization, outpatient services, emergency department visits, chemotherapy and other medications were tabulated and combined to determine total healthcare costs. The incremental monthly costs associated with the presence of AEs compared to no AEs were estimated using generalized linear models, controlling for age and Charlson Comorbidity Index.ResultsWe identified 15,443 mBC patients meeting inclusion criteria. Adjusted total monthly costs were significantly higher in those who experienced AEs than in those without AEs in both lines of treatment (FL incremental cost: taxanes $1,142, capecitabine$1,817; SL incremental cost: taxanes $1,448, capecitabine$4,437). Total costs increased with the number of AEs and were primarily driven by increased hospitalization amongst those with AEs.ConclusionsAdverse events in taxane- or capecitabine-treated mBC patients are associated with significant increases in costs. Selecting treatment options associated with fewer AEs may reduce costs and improve outcomes in these patients

Transforming Library Services for and with Teens through Continuing Education

Together with the Chief Officers of State Library Agencies (COSLA), the Young Adult Library Services Association (YALSA) embarked on a year-long exploration of the continuing education (CE) needs of staff at state library agencies (SLA) and libraries to identify challenges and opportunities and recommend ways for improving the CE landscape as a strategy to transforming serving teens through libraries.  This project was funded through a National Forum grant from the Institute of Museum and Library Services

Mathematical model predicts anti-adhesion--antibiotic--debridement combination therapies can clear an antibiotic resistant infection

As antimicrobial resistance increases, it is crucial to develop new treatment strategies to counter the emerging threat. In this paper, we consider combination therapies involving conventional antibiotics and debridement, coupled with a novel anti-adhesion therapy, and their use in the treatment of antimicrobial resistant burn wound infections. Our models predict that anti-adhesion–antibiotic–debridement combination therapies can eliminate a bacterial infection in cases where each treatment in isolation would fail. Antibiotics are assumed to have a bactericidal mode of action, killing bacteria, while debridement involves physically cleaning a wound (e.g. with a cloth); removing free bacteria. Anti-adhesion therapy can take a number of forms. Here we consider adhesion inhibitors consisting of polystyrene microbeads chemically coupled to a protein known as multivalent adhesion molecule 7, an adhesin which mediates the initial stages of attachment of many bacterial species to host cells. Adhesion inhibitors competitively inhibit bacteria from binding to host cells, thus rendering them susceptible to removal through debridement. An ordinary differential equation model is developed and the antibiotic-related parameters are fitted against new in vitro data gathered for the present study. The model is used to predict treatment outcomes and to suggest optimal treatment strategies. Our model predicts that anti-adhesion and antibiotic therapies will combine synergistically, producing a combined effect which is often greater than the sum of their individual effects, and that anti-adhesion–antibiotic–debridement combination therapy will be more effective than any of the treatment strategies used in isolation. Further, the use of inhibitors significantly reduces the minimum dose of antibiotics required to eliminate an infection, reducing the chances that bacteria will develop increased resistance. Lastly, we use our model to suggest treatment regimens capable of eliminating bacterial infections within clinically relevant timescales

SURF IA Conflict Detection and Resolution Algorithm Evaluation

The Enhanced Traffic Situational Awareness on the Airport Surface with Indications and Alerts (SURF IA) algorithm was evaluated in a fast-time batch simulation study at the National Aeronautics and Space Administration (NASA) Langley Research Center. SURF IA is designed to increase flight crew situation awareness of the runway environment and facilitate an appropriate and timely response to potential conflict situations. The purpose of the study was to evaluate the performance of the SURF IA algorithm under various runway scenarios, multiple levels of conflict detection and resolution (CD&R) system equipage, and various levels of horizontal position accuracy. This paper gives an overview of the SURF IA concept, simulation study, and results. Runway incursions are a serious aviation safety hazard. As such, the FAA is committed to reducing the severity, number, and rate of runway incursions by implementing a combination of guidance, education, outreach, training, technology, infrastructure, and risk identification and mitigation initiatives [1]. Progress has been made in reducing the number of serious incursions - from a high of 67 in Fiscal Year (FY) 2000 to 6 in FY2010. However, the rate of all incursions has risen steadily over recent years - from a rate of 12.3 incursions per million operations in FY2005 to a rate of 18.9 incursions per million operations in FY2010 [1, 2]. The National Transportation Safety Board (NTSB) also considers runway incursions to be a serious aviation safety hazard, listing runway incursion prevention as one of their most wanted transportation safety improvements [3]. The NTSB recommends that immediate warning of probable collisions/incursions be given directly to flight crews in the cockpit [4]

Gain Scheduling for the Orion Launch Abort Vehicle Controller

One of NASAs challenges for the Orion vehicle is the control system design for the Launch Abort Vehicle (LAV), which is required to abort safely at any time during the atmospheric ascent portion of ight. The focus of this paper is the gain design and scheduling process for a controller that covers the wide range of vehicle configurations and flight conditions experienced during the full envelope of potential abort trajectories from the pad to exo-atmospheric flight. Several factors are taken into account in the automation process for tuning the gains including the abort effectors, the environmental changes and the autopilot modes. Gain scheduling is accomplished using a linear quadratic regulator (LQR) approach for the decoupled, simplified linear model throughout the operational envelope in time, altitude and Mach number. The derived gains are then implemented into the full linear model for controller requirement validation. Finally, the gains are tested and evaluated in a non-linear simulation using the vehicles ight software to ensure performance requirements are met. An overview of the LAV controller design and a description of the linear plant models are presented. Examples of the most significant challenges with the automation of the gain tuning process are then discussed. In conclusion, the paper will consider the lessons learned through out the process, especially in regards to automation, and examine the usefulness of the gain scheduling tool and process developed as applicable to non-Orion vehicles

Automated Determination of [Fe/H] and [C/Fe] from Low-Resolution Spectroscopy

We develop an automated spectral synthesis technique for the estimation of metallicities ([Fe/H]) and carbon abundances ([C/Fe]) for metal-poor stars, including carbon-enhanced metal-poor stars, for which other methods may prove insufficient. This technique, autoMOOG, is designed to operate on relatively strong features visible in even low- to medium-resolution spectra, yielding results comparable to much more telescope-intensive high-resolution studies. We validate this method by comparison with 913 stars which have existing high-resolution and low- to medium-resolution to medium-resolution spectra, and that cover a wide range of stellar parameters. We find that at low metallicities ([Fe/H] < -2.0), we successfully recover both the metallicity and carbon abundance, where possible, with an accuracy of ~ 0.20 dex. At higher metallicities, due to issues of continuum placement in spectral normalization done prior to the running of autoMOOG, a general underestimate of the overall metallicity of a star is seen, although the carbon abundance is still successfully recovered. As a result, this method is only recommended for use on samples of stars of known sufficiently low metallicity. For these low-metallicity stars, however, autoMOOG performs much more consistently and quickly than similar, existing techniques, which should allow for analyses of large samples of metal-poor stars in the near future. Steps to improve and correct the continuum placement difficulties are being pursued.Comment: 8 pages, 7 figures; accepted for publication in A

Reliability of a feedback-controlled treadmill algorithm dependent on the user\u27s behavior

he reliability of the treadmill belt speed using a feedback-controlled treadmill algorithm was analyzed in this study. Using biomechanical factors of the participant\u27s walking behavior, an estimated walking speed was calculated and used to adjust the speed of the treadmill. Our proposed algorithm expands on the current hypotheses of feedback-controlled treadmill algorithms and is presented below. Nine healthy, young adults walked on a treadmill controlled by the algorithm for three trials over two days. Each participant walked on the feedback-controlled treadmill for one 16-minute and one five-minute trial during day one and one 16-minute trial during day two. Mean, standard deviation, interclass correlation coefficient (ICC), and standard error of measurement (SEM) were analyzed on the treadmill belt speed mean, standard deviation, and coefficient of variation. There were significantly high ICC for mean treadmill speed within- and between-days. Treadmill speed standard deviation and coefficient of variation were significantly reliable within-day. These results suggest the algorithm will reliably produce the same treadmill belt speed mean, but may only produce a similar treadmill belt speed standard deviation and coefficient of variation if the trials are performed in the same day. A feedback-controlled treadmill algorithm that accounts for the user\u27s behavior provides a greater level of control and minimizes any possible constraints of walking on a conventional treadmill

Muscle strength and control characteristics are altered by peripheral artery disease

Objective Peripheral artery disease (PAD), a common manifestation of atherosclerosis, is characterized by lower leg ischemia and myopathy in association with leg dysfunction. Patients with PAD have impaired gait from the first step they take with consistent defects in the movement around the ankle joint, especially in plantar flexion. Our goal was to develop muscle strength profiles to better understand the problems in motor control responsible for the walking impairment in patients with PAD. Methods Ninety-four claudicating PAD patients performed maximal isometric plantar flexion contractions lasting 10 seconds in two conditions: pain free (patient is well rested and has no claudication symptoms) and pain induced (patient has walked and has claudication symptoms). Sixteen matched healthy controls performed the pain-free condition only. Torque curves were analyzed for dependent variables of muscle strength and motor control. Independent t-tests were used to compare variables between groups, and dependent t-tests determined differences between conditions. Results Patients with PAD had significantly reduced peak torque and area under the curve compared with controls. Measures of control differed between PAD conditions only. Load rate and linear region duration were greater in the pain condition. Time to peak torque was shorter in the pain condition. Conclusions This study conclusively demonstrates that the plantar flexor muscles of the PAD patient at baseline and without pain are weaker in patients with PAD compared with controls. With the onset of claudication pain, patients with PAD exhibit altered muscle control strategies and further strength deficits are manifest compared to baseline levels. The myopathy of PAD legs appears to have a central role in the functional deterioration of the calf muscles, as it is evident both before and after onset of ischemic pain