Development of a GEM Electronic Board (GEB) for triple-GEM detectors

Developed for use with triple GEM detectors, the GEM Electronic Board (GEB) forms a crucial part of the electronics readout system being developed as part of the CMS muon upgrade program. The objective of the GEB is threefold; to provide stable powering and ground for the VFAT3 front ends, to enable high-speed communication between 24 VFAT3 front ends and an optohybrid, and to shield the GEM detector from electromagnetic interference. The paper describes the concept and design of a large-size GEB in detail, highlighting the challenges in terms of design and feasibility of this deceptively difficult system component.

Teaching family carers about home based palliative care: Final results from a group education program

Without the considerable support provided by family carers, many patients receiving palliative care would be unable to remain at home. However, family carers typically lack the required information and skills to prepare them for such a role. Pilot work has demonstrated that group education programs for family carers can be readily developed; they are feasible, accessible, and useful. This project sought to build on our pilot research to further examine the effectiveness of a group education program by evaluating the outcomes with a larger number of participants. The program aimed to prepare primary family carers for the role of supporting a relative with advanced, noncurative cancer at home. The psycho-educational program consisted of three consecutive weekly sessions presented in a group format, conducted at six home-based palliative care services across metropolitan and regional Victoria, Australia. The following dependent variables were measured at three time points: carer competence, preparedness, rewards, and information needs. The three time points were: commencement of the program (Time 1), upon completion (Time 2), and two weeks later (Time 3). A total of 156 participants (including the pilot phase) completed Time 1 questionnaires and 96 completed all three time periods (62%). Between Time 1 and Time 2, the intervention had a statistically significant positive effect on preparedness, competence, rewards, and having informational needs met. Outcomes were maintained at Time 3. There was no difference in the effectiveness of the intervention for participants in regional areas compared to participants in metropolitan areas.

This study demonstrated that a group education program to prepare family carers for the role of supporting a dying relative at home was effective. Implications for further research and practice are outlined.

A parenting intervenion for childhood behavioral problems: a randomised controlled trial in disadvantaged Community-based settings:A randomized controlled trial in disadvantaged community-based settings

Objective: A community-based randomized controlled trial (RCT) was conducted in urban areas characterized by high levels of disadvantage to test the effectiveness of the Incredible Years BASIC parent training program (IYBP) for children with behavioral problems. Potential moderators of intervention effects on child behavioral outcomes were also explored. Method: Families were included if the child (aged 32-88 months) scored above a clinical cutoff on the Eyberg Child Behavior Inventory (ECBI). Participants (n = 149) were randomly allocated on a 2:1 ratio to an intervention group (n = 103) or a waiting-list control group (n = 46). Child behavior, parenting skills, and parent well-being were assessed at baseline and 6 months later using parent-report and independent observations. An intention-to-treat analysis of covariance was used to examine postintervention differences between groups. Results: Statistically significant differences in child disordered behavior favored the intervention group on the ECBI Intensity (effect size = 0.7, p

A Randomized Controlled Trial Evaluation of Time to Read, a Volunteer Tutoring Program for 8-9 Year Olds

Tutoring is commonly employed to prevent early reading failure, and evidence suggests that it can have a positive effect. This article presents findings from a large-scale (n = 734) randomized controlled trial evaluation of the effect of Time to Read—a volunteer tutoring program aimed at children aged 8 to 9 years—on reading comprehension, self-esteem, locus of control, enjoyment of learning, and future aspirations. The study found that the program had only a relatively small effect on children’s aspirations (effect size +0.17, 95% confidence interval [0.015, 0.328]) and no other outcomes. It is suggested that this lack of evidence found may be due to misspecification of the program logic model and outcomes identified and program-related factors, particularly the low dosage of the program.

An outpatient respiratory rehabilitation program:Findings from a community hospital

Objectives: To determine patient satisfaction with a community hospital's respiratory rehabilitation program and to assess changes in patient physical and emotional function and quality of life. Design: Pre- and post-program measures were made on a variety of physiological and psychosocial factors. A modified version of the Chronic Respiratory Disease Questionnaire was administered before and after the 8-week multidisciplinary and comprehensive respiratory rehabilitation program. The post-program questionnaire also included a number of service delivery and patient satisfaction and quality-of-life questions. Setting: Respiratory Rehabilitation Program at St. Joseph's Hospital, a community hospital in Brantford, Ont., in active partnership with the Brant County Lung Association. Brant County is located in Central West Ontario, and has both urban and rural areas and a population of approximately 125 000 people. Participants: Twenty-nine patients, with a diagnosis of moderate to severe chronic obstructive pulmonary disease (COPD) who were referred to the Fall 1997 and Spring 1998 programs, were enrolled in the study. Outcome measures: Changes in physical and emotional function, health knowledge, skills mastery, quality of life and satisfaction with the program. Results: Twenty-one of 29 patients completed the program. Statistically significant and clinically important improvements were found between all pre- and post-program evaluation scores (distance walked, fatigue, dyspnea, emotional function, skills mastery and health knowledge). Participants were very satisfied with the program and felt it improved their quality of life. Conclusion: The positive outcomes reported rom randomized controlled trials of respiratory rehabilitation programs can be achieved in a community hospital setting.

First steps: study protocol for a randomized controlled trial of the effectiveness of the Group Family Nurse Partnership (gFNP) program compared to routine care in improving outcomes for high-risk mothers and their children and preventing abuse

Background: Evidence from the USA suggests that the home-based Family Nurse Partnership program (FNP), extending from early pregnancy until infants are 24 months, can reduce the risk of child abuse and neglect throughout childhood. FNP is now widely available in the UK. A new variant, Group Family Nurse Partnership (gFNP) offers similar content but in a group context and for a shorter time, until infants are 12 months old. Each group comprises 8 to 12 women with similar expected delivery dates and their partners. Its implementation has been established but there is no evidence of its effectiveness.

Methods/Design: The study comprises a multi-site randomized controlled trial designed to identify the benefits of gFNP compared to standard care. Participants (not eligible for FNP) must be either aged <20 years at their last menstrual period (LMP) with one or more previous live births, or aged 20 to 24 at LMP with low educational qualifications and no previous live births. 'Low educational qualifications' is defined as not having both Maths and English Language GCSE at grade C or higher or, if they have both, no more than four in total at grade C or higher. Exclusions are: under 20 years and previously received home-based FNP and, in either age group, severe psychotic mental illness or not able to communicate in English. Consenting women are randomly allocated (minimized by site and maternal age group) when between 10 and 16 weeks pregnant to either to the 44 session gFNP program or to standard care after the collection of baseline information. Researchers are blind to group assignment. The primary outcomes at 12 months are child abuse potential based on the revised Adult-Adolescent Parenting Inventory and parent/infant interaction coded using the CARE Index based on a video-taped interaction. Secondary outcomes are maternal depression, parenting stress, health related quality of life, social support, and use of services.

Discussion: This is the first study of the effectiveness of gFNP in the UK. Results should inform decision-making about its delivery alongside universal services, potentially enabling a wider range of families to benefit from the FNP curriculum and approach to supporting parenting.

Distinct poor prognostic subgroups of acute myeloid leukaemia, FLT3-ITD and P-glycoprotein-positive, have contrasting levels of FOXO1

Regulation of ABCB1 (P-glycoprotein/Pgp) in AML was investigated. In a historical cohort with Pgp and transcriptional regulator expression profiling data available (n=141), FOXO1 correlated with Pgp protein expression. This was confirmed in an independent cohort (n=204). Down-regulation (siRNA) or hyperactivation (nicotinamide) of FOXO1 led to corresponding changes in Pgp. Low FOXO1 expression correlated with FLT3-ITDs (p

A Randomized Controlled Trial Evaluation of an After-School Pro-Social Behavior Program in an Area of Socioeconomic Disadvantage

A randomized controlled trial was used to evaluate the effects of a pro-social behavior after-school program called Mate-Tricks for nine and ten year old children and their parents living in an area of significant socioeconomic disadvantage. The children were randomly assigned to an intervention (n=220) or a control group (n=198). Children were compared on measures of pro-social behavior, anti-social behavior and related outcome measures. The trial found adverse effects on four outcomes among the intervention group compared to the control group: anti-social behavior increased on two different measures (d=+0.20) and (d=+0.18); child reported liberal parenting increased (d=+0.16); and child reported authoritarian parenting also increased (d=+0.20). In addition, parental participation was significantly associated with several program outcomes. It was concluded, that group based after-school behavior programs may have the potential to cause iatrogenic effects and must be designed, piloted, evaluated and implemented with a high degree of care.

Effect of a Web-Based Behavior Change Program on Weight Loss and Cardiovascular Risk Factors in Overweight and Obese Adults at High Risk of Developing Cardiovascular Disease:Randomized Controlled Trial

BACKGROUND: Web-based programs are a potential medium for supporting weight loss because of their accessibility and wide reach. Research is warranted to determine the shorter- and longer-term effects of these programs in relation to weight loss and other health outcomes.

OBJECTIVE: The aim was to evaluate the effects of a Web-based component of a weight loss service (Imperative Health) in an overweight/obese population at risk of cardiovascular disease (CVD) using a randomized controlled design and a true control group.

METHODS: A total of 65 overweight/obese adults at high risk of CVD were randomly allocated to 1 of 2 groups. Group 1 (n=32) was provided with the Web-based program, which supported positive dietary and physical activity changes and assisted in managing weight. Group 2 continued with their usual self-care (n=33). Assessments were conducted face-to-face. The primary outcome was between-group change in weight at 3 months. Secondary outcomes included between-group change in anthropometric measurements, blood pressure, lipid measurements, physical activity, and energy intake at 3, 6, and 12 months. Interviews were conducted to explore participants' views of the Web-based program.

RESULTS: Retention rates for the intervention and control groups at 3 months were 78% (25/32) vs 97% (32/33), at 6 months were 66% (21/32) vs 94% (31/33), and at 12 months were 53% (17/32) vs 88% (29/33). Intention-to-treat analysis, using baseline observation carried forward imputation method, revealed that the intervention group lost more weight relative to the control group at 3 months (mean -3.41, 95% CI -4.70 to -2.13 kg vs mean -0.52, 95% CI -1.55 to 0.52 kg, P<.001), at 6 months (mean -3.47, 95% CI -4.95 to -1.98 kg vs mean -0.81, 95% CI -2.23 to 0.61 kg, P=.02), but not at 12 months (mean -2.38, 95% CI -3.48 to -0.97 kg vs mean -1.80, 95% CI -3.15 to -0.44 kg, P=.77). More intervention group participants lost ≥5% of their baseline body weight at 3 months (34%, 11/32 vs 3%, 1/33, P<.001) and 6 months (41%, 13/32 vs 18%, 6/33, P=.047), but not at 12 months (22%, 7/32 vs 21%, 7/33, P=.95) versus control group. The intervention group showed improvements in total cholesterol, triglycerides, and adopted more positive dietary and physical activity behaviors for up to 3 months verus control; however, these improvements were not sustained.

CONCLUSIONS: Although the intervention group had high attrition levels, this study provides evidence that this Web-based program can be used to initiate clinically relevant weight loss and lower CVD risk up to 3-6 months based on the proportion of intervention group participants losing ≥5% of their body weight versus control group. It also highlights a need for augmenting Web-based programs with further interventions, such as in-person support to enhance engagement and maintain these changes.

Determinants of pediatric cataract program outcomes and follow-up in a large series in Mexico.

PURPOSE:

To report determinants of outcomes and follow-up in a large Mexican pediatric cataract project.

SETTING:

Hospital Luis Sanchez Bulnes, Mexico City, Mexico.

METHODS:

Data were collected prospectively from a pediatric cataract surgery program at the Hospital Luis Sanchez Bulnes, implemented by Helen Keller International. Preoperative data included age, sex, baseline visual acuity, type of cataract, laterality, and presence of conditions such as amblyopia. Surgical data included vitrectomy, capsulotomy, complications, and use of intraocular lenses (IOLs). Postoperative data included final visual acuity, refraction, number of follow-up visits, and program support for follow-up.

RESULTS:

Of 574 eyes of 415 children (mean age 7.1 years +/- 4.7 [SD]), IOLs were placed in 416 (87%). At least 1 follow-up was attended by 408 patients (98.3%) (mean total follow-up 3.5 +/- 1.8 months); 40% of eyes achieved a final visual acuity of 6/18 or better. Children living farther from the hospital had fewer postoperative visits (P = .04), while children receiving program support had more visits (P = .001). Factors predictive of better acuity included receiving an IOL during surgery (P = .04) and provision of postoperative spectacles (P = .001). Predictive of worse acuity were amblyopia (P = .003), postoperative complications (P = .0001), unilateral surgery (P = .0075), and female sex (P = .045).

CONCLUSIONS:

The results underscore the importance of surgical training in reducing complications, early intervention before amblyopia (observed in 40% of patients) can develop, and vigorous treatment if amblyopia is present. The positive impact of program support on follow-up is encouraging, although direct financial support may pose a problem for sustainability. More work is needed to understand reasons for worse outcomes in girls.

Controlo postural na sequência de movimento de sentado para de pé em crianças com alterações do desenvolvimento neuromotor

A Sequência de Movimento de Sentado para de Pé (SMSP) é um marco importante na independência funcional da criança, sendo a sua qualidade afetada em casos de alteração do controlo postural do tronco. É por isso motivo de especial foco neste estudo, como elemento avaliativo e interventivo. Este estudo tem como objetivo a análise da modificação de componentes motores relacionados com o controlo postural, durante a SMSP, em 5 crianças com alterações neuromotoras, face à aplicação de um programa de intervenção baseado no Tratamento de Neuro Desenvolvimento (TND). Foi para tal utilizada a análise cinemática da SMSP - nomeadamente as variáveis “variação do deslocamento dos segmentos cabeça e tronco” e “variação do ângulo perna-pé” entre o momento inicial e o seat-off – complementada com a aplicação do Teste de Medida da Função Motora 88 (TMFM-88) e a Classificação Internacional da Funcionalidade Incapacidade e Saúde-Versão Crianças e Jovens (CIF-CJ), bem como a avaliação de componentes de movimento com recurso a registo de imagem. A análise cinemática demonstrou uma diminuição do deslocamento dos segmentos cabeça e tronco na maioria dos casos, bem como uma maior mobilidade da tíbia sobre pé. Verificou-se um aumento do score final do TMFM-88, em todos os casos. A CIF-CJ não evidenciou alterações entre o início e o término do período de intervenção. O registo de imagem demonstrou alterações positivas visíveis no alinhamento de segmentos, nível de atividade, controlo postural, e recurso a estratégias compensatórias no conjunto postural sentado e na SMSP. Após o período de intervenção as crianças deste estudo evidenciaram modificações positivas nas variáveis em estudo, nomeadamente 1) diminuição do deslocamento dos segmentos cabeça e tronco na fase inicial da SMSP, 2) aumento da variação do ângulo perna-pé na fase inicial da SMSP, 3) aumento do score total da TMFM-88, 4) alteração positiva dos componentes de movimento alinhamento de segmentos e nível de atividade e 5) redução do recurso a estratégias compensatórias de movimento na SMSP. Estas modificações sugerem um controlo postural mais eficiente.

Comportamento da tibiotársica na sequência de movimento de sentar para de pé em crianças prematuras

Introdução: A prematuridade constitui um fator de risco para a ocorrência de lesões ao nível do sistema nervoso central, sendo que uma idade gestacional inferior a 36 semanas potencia esse mesmo risco, nomeadamente para a paralisia cerebral (PC) do tipo diplegia espástica. A sequência de movimento de sentado para de pé (SPP), sendo uma das aprendizagens motoras que exige um controlo postural (CP) ao nível da tibiotársica, parece ser uma tarefa funcional frequentemente comprometida em crianças prematuras com e sem PC. Objetivo(s): Descrever o comportamento dos músculos da tibiotársica, tibial anterior (TA) e solear (SOL), no que diz respeito ao timing de ativação, magnitude e co-ativação muscular durante a fase I e início da fase II na sequência de movimento de SPP realizada por cinco crianças prematuras com PC do tipo diplegia espástica e cinco crianças prematuras sem diagnóstico de alteração neuromotoras, sendo as primeiras sujeitas a um programa de intervenção baseado nos princípios do conceito de Bobath – Tratamento do Neurodesenvolvimento (TND). Métodos: Foram avaliadas 10 crianças prematuras, cinco com PC e cinco sem diagnóstico de alterações neuromotoras, tendo-se recorrido à eletromiografia de superfície para registar parâmetros musculares, nomeadamente timings, magnitudes e valores de co-ativação dos músculos TA e SOL, associados à fase I e inico da fase II da sequência de movimento de SPP. Procedeu-se ao registo de imagem de modo a facilitar a avaliação dos componentes de movimento associados a esta tarefa. Estes procedimentos foram realizados num único momento, no caso das crianças sem diagnóstico de alterações neuromotoras e em dois momentos, antes e após a aplicação de um programa de intervenção segundo o Conceito de Bobath – TND no caso das crianças com PC. A estas foi ainda aplicado o Teste da Medida das Funções Motoras (TMFM–88) e a Classificação Internacional da Funcionalidade Incapacidade e Saúde – crianças e jovens (CIF-CJ). Resultados: Através da eletromiografia constatou-se que ambos os grupos apresentaram timings de ativação afastados da janela temporal considerada como ajustes posturais antecipatórios (APAs), níveis elevados de co-ativação, em alguns casos com inversão na ordem de recrutamento muscular o que foi possível modificar nas crianças com PC após o período de intervenção. Nestas, verificou-se ainda que, a sequência de movimento de SPP foi realizada com menor número de compensações e com melhor relação entre estruturas proximais e distais compatível com o aumento do score final do TMFM-88 e modificação positiva nos itens de atividade e participação da CIF-CJ. Conclusão: As crianças prematuras com e sem PC apresentaram alterações no CP da tibiotársica e níveis elevados de co-ativação muscular. Após o período de intervenção as crianças com PC apresentaram modificações positivas no timing e co-ativação muscular, com impacto funcional evidenciado no aumento do score final da TMFM-88 e modificações positivas na CIF-CJ.

The practical examination and how it correlates with the triple jump, tutorial, and written examination

This study explored the relationship between the practical examination and other course evaluation methods~ specifically, the triple jump, tutorial, and written examination. Studies correlating academic and clinical grades tended to indicate that they may not be highly correlated because each evaluation process contributes different kinds of information regarding student knowledge, skills, and attitudes. Six hypotheses were generated stating a positive relationship between the four evaluation methods. A correlation matrix was produced of the Pearson Product Moment correlation co-efficients on the four evaluation methods in the second and third year Occupational Therapy Technique and Clinical Problem Solving courses of the 1988 and 1989 graduates (n~45). The results showed that the highest correlations existed between the triple jump and the tutorial grades and the lowest correlations existed between the practical examination and written examination grades. Not all of the correlations~ however~ reached levels of significance. The correlations overall. though, were only low to moderate at best which indicates that the evaluation methods may be measuring different aspects of student learning. This conclusion supports the studies researched. The implications and significance of this study is that it will assist the faculty in defining what the various evaluation methods measure which will in turn promote more critical input into curriculum development for the remaining years of the program.

The Influence of Motivational Behaviours and Goal Profiles on Positive Youth Development

Positive Youth Development (PYD) research has started to shift focus onto how different internal factors such as temperament, dispositions, and/or personality characteristics could influence levels of PYD for youth participating is organized sport. The purpose of this study is to examine how different goal profiles, specifically categorized by diverse levels of task and ego orientation, can influence levels of PYD in an organized youth sport setting. One hundred youth sport participants (mean age = 16.8) completed the short form Youth Experiences Survey for Sport (short form YES-S; Sullivan et al., 2013) to measure PYD, as well as the Task and Ego Orientation in Sport Questionnaire (TEOSQ; Duba 1989) to assess each athlete’s goal profile. A TwoStep Cluster Analysis was used to classify each individual’s personal goal profile into 3 statistically different cluster groupings. Results indicated significant interaction between the PYD outcome factor of Initiative vs. Clusters [F(2,95)= 10.86, p < 0.001, p2= 0.19] as well as Goal Setting vs. Clusters [F(2,95)= 3.95, p < 0.05, p2= 0.08]. Post-hoc analyses provided results that suggest that those athletes who are more task oriented have fostered more positive outcomes from sport, therefore having more goal setting skills and initiative.