Increasing awareness of colorectal cancer screening through targeted exam room based video messages

Colorectal cancer (CRC) is the third largest cause of cancer death in the United States. While the disease burden is high, there are proven methods to screen for CRC and detect it at a stage that is amenable to cure. Patients with low health literacy have difficulty navigating the health care system and are at increased risk to not receive preventive care services such as colorectal cancer screening (CRCS). To address this need, an exam-room based video was developed to be played for patients in the privacy of the exam room, while they are waiting to be seen by their medical provider. In roughly 2 minutes, the video informs the patient about CRC and CRCS and how they can successfully complete CRCS. One of the key barriers to completing CRCS is the need to increase patients' knowledge and improve attitudes surrounding CRCS. This study examines the impact of the video on patients' knowledge and attitudes about CRC and CRCS in a medically underserved patient population in Houston, Texas. ^ Sixty-one patients presenting for routine medical care were enrolled in the study. Depending on their randomization, the patients either received routine information about CRC and CRCS or they watched the video. We found that the patients who did watch the video did have improvements in their knowledge and improved attitudes about CRC and CRCS. Future studies will be needed to examine whether the video improves the patients' completion of CRCS.^

HPV knowledge, HPV vaccine awareness and initiation among Hispanics: The role of language, information seeking, and information scanning

Background. Among Hispanics, the HPV vaccine has the potential to eliminate disparities in cervical cancer incidence and mortality but only if optimal rates of vaccination are achieved. Media can be an important information source for increasing HPV knowledge and awareness of the vaccine. Very little is known about how media use among Hispanics affects their HPV knowledge and vaccine awareness. Even less is known about what differences exist in media use and information processing among English- and Spanish-speaking Hispanics.^ Aims. Examine the relationships between three health communication variables (media exposure, HPV-specific information scanning and seeking) and three HPV outcomes (knowledge, vaccine awareness and initiation) among English- and Spanish-speaking Hispanics.^ Methods. Cross-sectional data from a survey administered to Hispanic mothers in Dallas, Texas was used for univariate and multivariate logistic regression analyses. Sample used for analysis included 288 mothers of females aged 8-22 recruited from clinics and community events. Dependent variables of interest were HPV knowledge, HPV vaccine awareness and initiation. Independent variables were media exposure, HPV-specific information scanning and seeking. Language was tested as an effect modifier on the relationship between health communication variables and HPV outcomes.^ Results. English-speaking mothers reported more media exposure, HPV-specific information scanning and seeking than Spanish-speakers. Scanning for HPV information was associated with more HPV knowledge (OR = 4.26, 95% CI = 2.41 - 7.51), vaccine awareness (OR = 10.01, 95% CI = 5.43 - 18.47) and vaccine initiation (OR = 2.54, 95% CI = 1.09 - 5.91). Seeking HPV-specific information was associated with more knowledge (OR = 2.27, 95% CI = 1.23 - 4.16), awareness (OR = 6.60, 95% CI = 2.74 - 15.91) and initiation (OR = 4.93, 95% CI = 2.64 - 9.20). Language moderated the effect of information scanning and seeking on vaccine awareness.^ Discussion. Differences in information scanning and seeking behaviors among Hispanic subgroups have the potential to lead to disparities in vaccine awareness.^ Conclusion. Findings from this study underscore health communication differences among Hispanics and emphasize the need to target Spanish language media as well as English language media aimed at Hispanics to improve knowledge and awareness.^

A Step in the Right Direction: Development of the Computerized Assessment for Preschool Social Emotional Learning (CAPSEL)

Invited commentary on "Computerizing Social-Emotional Assessment for School Readiness".

Computerizing Social-Emotional Assessment for School Readiness: First Steps toward an Assessment Battery for Early Childhood Settings

The transition into formal schooling is a crucial foundation that can set children on a cycle of success or failure in both academic and social domains. A child’s abilities to express healthy emotions, understand emotions of self and others, regulate emotion, attention, and behavior, make good decisions regarding social problems, and engage in a range of prosocial behaviors, all work together to promote a successful school experience. However, many children have deficits in these skills by school entry, and educators lack the requisite tools to identify, track and assess skills these children need to learn. Thus, because social-emotional learning (SEL) is so crucial, assessment tools to pinpoint children’s skills and progress are vitally necessary. Previous work by the authors and other researchers has led to the development of strong assessment tools; however, these tools are often developed solely for research use, not practitioner application. In the following, using our assessment battery as an example, we will discuss the steps necessary to adapt SEL assessment for computer-based administration and optimal utility in early childhood education programs.

Planning for Emotional Labor and Secondary Traumatic Stress in Child Welfare Organizations

This analysis provides an emergent framework that emphasizes a neglected component of both direct practice with families and organizational development. Human emotions, both beneficial (positive emotional labor) and harmful (negative emotional labor), have received short shrift in leadership development, supervision, direct practice preparation and supports, and workforce stabilization, and professionalization. Significantly, a key indicator of negative emotional labor—secondary traumatic stress (STS)—often has been ignored and neglected, despite the fact that it may be endemic in the workforce. STS typically results from traumatic events in practice, but it also stems from workplace violence. Often undetected and untreated, STS is at least a hidden correlate and perhaps a probable cause of myriad problems such as questionable practice with families, life-work conflicts, undesirable workforce turnover, and a sub-optimal organizational climate. Special interventions are needed. At the same time, new organizational designs are needed to promote and reinforce positive emotional labor. Arguably, positive emotional labor and the positive organizational climates it facilitates are requisites for harmonious relations between jobs and personal lives, desirable workforce retention, and better outcomes for children and families. What’s more, specialized interventions for positive emotional labor constitute a key component in the prevention system for STS. A dual design for positive emotional labor and STS (and other negative emotional labor) prevention/intervention is provided herewith. Early detection and rapid response systems for STS, with social work leadership, receive special attention. Guidelines for new organizational designs for emotional labor in child welfare are offered in conclusion.

Debriefing after resuscitations in a pediatric emergency department

Multiple guidelines recommend debriefing of actual resuscitations to improve clinical performance. We implemented a novel standardized debriefing program using a Debriefing In Situ Conversation after Emergent Resuscitations Now (DISCERN) tool. Following the development of the evidence-based DISCERN tool, we conducted an observational study of all resuscitations (intubation, CPR, and/or defibrillation) at a pediatric emergency department (ED) over one year. Resuscitation interventions, patient survival, and physician team leader characteristics were analyzed as predictors for debriefing. Each debriefing's participants, time duration, and content were recorded. Thematic content of debriefings was categorized by framework approach into Team Emergency Assessment Measure (TEAM) elements. There were 241 resuscitations and 63 (26%) debriefings. A higher proportion of debriefings occurred after CPR (p<0.001) or ED death (p<0.001). Debriefing participants always included an attending and nurse; the median number of staff roles present was six. Median interval (from resuscitation end to start of debriefing) & debriefing durations were 33 (IQR 15,67) and 10 minutes (IQR 5,12), respectively. Common TEAM themes included co-operation/coordination (30%), communication (22%), and situational awareness (15%). Stated reasons for not debriefing included: unnecessary (78%), time constraints (19%), or other reasons (3%). Debriefings with the DISCERN tool usually involved higher acuity resuscitations, involved most of the indicated personnel, and lasted less than 10 minutes. This qualitative tool could be adapted to other settings. Future studies are needed to evaluate for potential impacts on education, quality improvement programming, and staff emotional well-being.^

El cambio de cuerpo estresado a cuerpo relajado, a través de la respiración, la visualización y la danza en un ambiente de protección acompañada

Este trabajo muestra varias formas de conocer y relajar el cuerpo a través de técnicas de conocimiento personal y reencuentro con la naturaleza. La vida moderna y rápida, las presiones constantes desde la niñez hasta la adultez, en los diferentes medios de interrelación entre personas y grupos, acarrean la construcción de cuerpos que reflejan una anatomía emocional visible con pérdida de balance, contracturas, inflamaciones, desequilibrios múltiples por falta de conocimiento y sobre todo conciencia del ser en el mundo de manera plena, la persona se ha alejado de su relación ecológica consigo misma y el medio. Se muestran métodos para cambiar positivamente una condición de estrés constante y malestar crónico, a una condición aprendida de bienestar corporal y psicológico, con una serie de movimientos, recuperando al cuerpo a través de ejercicios, para tender hacia equilibrio personal, obteniendo una relación positiva con el medio y las personas con las que frecuenta. La propuesta se inicia promoviendo hábitos nuevos que se pueden guardar en la conciencia. Parte, fundamentalmente de la respiración, la armonización con la música y el medio ambiente y el trabajo personal y grupal

El cambio de cuerpo estresado a cuerpo relajado, a través de la respiración, la visualización y la danza en un ambiente de protección acompañada

Este trabajo muestra varias formas de conocer y relajar el cuerpo a través de técnicas de conocimiento personal y reencuentro con la naturaleza. La vida moderna y rápida, las presiones constantes desde la niñez hasta la adultez, en los diferentes medios de interrelación entre personas y grupos, acarrean la construcción de cuerpos que reflejan una anatomía emocional visible con pérdida de balance, contracturas, inflamaciones, desequilibrios múltiples por falta de conocimiento y sobre todo conciencia del ser en el mundo de manera plena, la persona se ha alejado de su relación ecológica consigo misma y el medio. Se muestran métodos para cambiar positivamente una condición de estrés constante y malestar crónico, a una condición aprendida de bienestar corporal y psicológico, con una serie de movimientos, recuperando al cuerpo a través de ejercicios, para tender hacia equilibrio personal, obteniendo una relación positiva con el medio y las personas con las que frecuenta. La propuesta se inicia promoviendo hábitos nuevos que se pueden guardar en la conciencia. Parte, fundamentalmente de la respiración, la armonización con la música y el medio ambiente y el trabajo personal y grupal

El cambio de cuerpo estresado a cuerpo relajado, a través de la respiración, la visualización y la danza en un ambiente de protección acompañada

Este trabajo muestra varias formas de conocer y relajar el cuerpo a través de técnicas de conocimiento personal y reencuentro con la naturaleza. La vida moderna y rápida, las presiones constantes desde la niñez hasta la adultez, en los diferentes medios de interrelación entre personas y grupos, acarrean la construcción de cuerpos que reflejan una anatomía emocional visible con pérdida de balance, contracturas, inflamaciones, desequilibrios múltiples por falta de conocimiento y sobre todo conciencia del ser en el mundo de manera plena, la persona se ha alejado de su relación ecológica consigo misma y el medio. Se muestran métodos para cambiar positivamente una condición de estrés constante y malestar crónico, a una condición aprendida de bienestar corporal y psicológico, con una serie de movimientos, recuperando al cuerpo a través de ejercicios, para tender hacia equilibrio personal, obteniendo una relación positiva con el medio y las personas con las que frecuenta. La propuesta se inicia promoviendo hábitos nuevos que se pueden guardar en la conciencia. Parte, fundamentalmente de la respiración, la armonización con la música y el medio ambiente y el trabajo personal y grupal

Food quality awareness : cases from shrimp producers in Thailand and vegetable producers in Vietnam

The high number of import rejections of food commodities suggests that producers in exporting countries are not complying with established standards. To understand why this is the case, we explore the behavior of producers and consumers in developing countries. First, we examine the successful transformation of production practices adopted by shrimp producers in Thailand. In support of the dramatic change in practices, we observe an important role played by the public sector in providing a means to visualize chemical residues and to control processes upstream of the supply chain via a registration system and a traceability system called Movement Document. Furthermore, very active information sharing by the private sector contributes to the dissemination of useful technical and market information among producers. We also examine the knowledge and perceptions of consumers with respect to food safety in Vietnam. We find that consumers in Hanoi and Ho Chi Minh City behave differently toward the third-party certification VietGAP, probably owing to differences in the history of market mechanisms between the two cities.

Generating Awareness from Collaborative Working Environment using Social Data

Nowadays, Internet is a place where social networks have reached an important impact in collaboration among people over the world in different ways. This article proposes a new paradigm for building CSCW business tools following the novel ideas provided by the social web to collaborate and generate awareness. An implementation of these concepts is described, including the components we provide to collaborate in workspaces, (such as videoconference, chat, desktop sharing, forums or temporal events), and the way we generate awareness from these complex social data structures. Figures and validation results are also presented to stress that this architecture has been defined to support awareness generation via joining current and future social data from business and social networks worlds, based on the idea of using social data stored in the cloud.

Abstraction carrying code and resource-awareness

Proof-Carrying Code (PCC) is a general approach to mobile code safety in which the code supplier augments the program with a certifícate (or proof). The intended benefit is that the program consumer can locally validate the certifícate w.r.t. the "untrusted" program by means of a certifícate checker—a process which should be much simpler, eíñcient, and automatic than generating the original proof. Abstraction Carrying Code (ACC) is an enabling technology for PCC in which an abstract model of the program plays the role of certifícate. The generation of the certifícate, Le., the abstraction, is automatically carried out by an abstract interpretation-based analysis engine, which is parametric w.r.t. different abstract domains. While the analyzer on the producer side typically has to compute a semantic fixpoint in a complex, iterative process, on the receiver it is only necessary to check that the certifícate is indeed a fixpoint of the abstract semantics equations representing the program. This is done in a single pass in a much more efficient process. ACC addresses the fundamental issues in PCC and opens the door to the applicability of the large body of frameworks and domains based on abstract interpretation as enabling technology for PCC. We present an overview of ACC and we describe in a tutorial fashion an application to the problem of resource-aware security in mobile code. Essentially the information computed by a cost analyzer is used to genérate cost certificates which attest a safe and efficient use of a mobile code. A receiving side can then reject code which brings cost certificates (which it cannot validate or) which have too large cost requirements in terms of computing resources (in time and/or space) and accept mobile code which meets the established requirements.

A Monitoring Infrastructure for FPGA Self-Awareness and Dynamic Adaptation

Variabilities associated with CMOS evolution affect the yield and performance of current digital designs. FPGAs, which are widely used for fast prototyping and implementation of digital circuits, also suffer from these issues. Proactive approaches start to appear to achieve self-awareness and dynamic adaptation of these devices. To support these techniques we propose the employment of a multi-purpose sensor network. This infrastructure, through adequate use of configuration and automation tools, is able to obtain relevant data along the life cycle of an FPGA. This is realised at a very reduced cost, not only in terms of area or other limited resources, but also regarding the design effort required to define and deploy the measuring infrastructure. Our proposal has been validated by measuring inter-die and intra-die variability in different FPGA families.

Model-based Self-awareness Patterns for Autonomy

Los sistemas técnicos son cada vez más complejos, incorporan funciones más avanzadas, están más integrados con otros sistemas y trabajan en entornos menos controlados. Todo esto supone unas condiciones más exigentes y con mayor incertidumbre para los sistemas de control, a los que además se demanda un comportamiento más autónomo y fiable. La adaptabilidad de manera autónoma es un reto para tecnologías de control actualmente. El proyecto de investigación ASys propone abordarlo trasladando la responsabilidad de la capacidad de adaptación del sistema de los ingenieros en tiempo de diseño al propio sistema en operación. Esta tesis pretende avanzar en la formulación y materialización técnica de los principios de ASys de cognición y auto-consciencia basadas en modelos y autogestión de los sistemas en tiempo de operación para una autonomía robusta. Para ello el trabajo se ha centrado en la capacidad de auto-conciencia, inspirada en los sistemas biológicos, y se ha explorado la posibilidad de integrarla en la arquitectura de los sistemas de control. Además de la auto-consciencia, se han explorado otros temas relevantes: modelado funcional, modelado de software, tecnología de los patrones, tecnología de componentes, tolerancia a fallos. Se ha analizado el estado de la técnica en los ámbitos pertinentes para las cuestiones de la auto-consciencia y la adaptabilidad en sistemas técnicos: arquitecturas cognitivas, control tolerante a fallos, y arquitecturas software dinámicas y computación autonómica. El marco teórico de ASys existente de sistemas autónomos cognitivos ha sido adaptado para servir de base para este análisis de autoconsciencia y adaptación y para dar sustento conceptual al posterior desarrollo de la solución. La tesis propone una solución general de diseño para la construcción de sistemas autónomos auto-conscientes. La idea central es la integración de un meta-controlador en la arquitectura de control del sistema autónomo, capaz de percibir la estado funcional del sistema de control y, si es necesario, reconfigurarlo en tiempo de operación. Esta solución de metacontrol se ha formalizado en cuatro patrones de diseño: i) el Patrón Metacontrol, que define la integración de un subsistema de metacontrol, responsable de controlar al propio sistema de control a través de la interfaz proporcionada por su plataforma de componentes, ii) el patrón Bucle de Control Epistémico, que define un bucle de control cognitivo basado en el modelos y que se puede aplicar al diseño del metacontrol, iii) el patrón de Reflexión basada en Modelo Profundo propone una solución para construir el modelo ejecutable utilizado por el meta-controlador mediante una transformación de modelo a modelo a partir del modelo de ingeniería del sistema, y, finalmente, iv) el Patrón Metacontrol Funcional, que estructura el meta-controlador en dos bucles, uno para el control de la configuración de los componentes del sistema de control, y otro sobre éste, controlando las funciones que realiza dicha configuración de componentes; de esta manera las consideraciones funcionales y estructurales se desacoplan. La Arquitectura OM y el metamodelo TOMASys son las piezas centrales del marco arquitectónico desarrollado para materializar la solución compuesta de los patrones anteriores. El metamodelo TOMASys ha sido desarrollado para la representación de la estructura y su relación con los requisitos funcionales de cualquier sistema autónomo. La Arquitectura OM es un patrón de referencia para la construcción de una metacontrolador integrando los patrones de diseño propuestos. Este meta-controlador se puede integrar en la arquitectura de cualquier sistema control basado en componentes. El elemento clave de su funcionamiento es un modelo TOMASys del sistema decontrol, que el meta-controlador usa para monitorizarlo y calcular las acciones de reconfiguración necesarias para adaptarlo a las circunstancias en cada momento. Un proceso de ingeniería, complementado con otros recursos, ha sido elaborado para guiar la aplicación del marco arquitectónico OM. Dicho Proceso de Ingeniería OM define la metodología a seguir para construir el subsistema de metacontrol para un sistema autónomo a partir del modelo funcional del mismo. La librería OMJava proporciona una implementación del meta-controlador OM que se puede integrar en el control de cualquier sistema autónomo, independientemente del dominio de la aplicación o de su tecnología de implementación. Para concluir, la solución completa ha sido validada con el desarrollo de un robot móvil autónomo que incorpora un meta-controlador con la Arquitectura OM. Las propiedades de auto-consciencia y adaptación proporcionadas por el meta-controlador han sido validadas en diferentes escenarios de operación del robot, en los que el sistema era capaz de sobreponerse a fallos en el sistema de control mediante reconfiguraciones orquestadas por el metacontrolador. ABSTRACT Technical systems are becoming more complex, they incorporate more advanced functionalities, they are more integrated with other systems and they are deployed in less controlled environments. All this supposes a more demanding and uncertain scenario for control systems, which are also required to be more autonomous and dependable. Autonomous adaptivity is a current challenge for extant control technologies. The ASys research project proposes to address it by moving the responsibility for adaptivity from the engineers at design time to the system at run-time. This thesis has intended to advance in the formulation and technical reification of ASys principles of model-based self-cognition and having systems self-handle at runtime for robust autonomy. For that it has focused on the biologically inspired capability of self-awareness, and explored the possibilities to embed it into the very architecture of control systems. Besides self-awareness, other themes related to the envisioned solution have been explored: functional modeling, software modeling, patterns technology, components technology, fault tolerance. The state of the art in fields relevant for the issues of self-awareness and adaptivity has been analysed: cognitive architectures, fault-tolerant control, and software architectural reflection and autonomic computing. The extant and evolving ASys Theoretical Framework for cognitive autonomous systems has been adapted to provide a basement for this selfhood-centred analysis and to conceptually support the subsequent development of our solution. The thesis proposes a general design solution for building self-aware autonomous systems. Its central idea is the integration of a metacontroller in the control architecture of the autonomous system, capable of perceiving the functional state of the control system and reconfiguring it if necessary at run-time. This metacontrol solution has been formalised into four design patterns: i) the Metacontrol Pattern, which defines the integration of a metacontrol subsystem, controlling the domain control system through an interface provided by its implementation component platform, ii) the Epistemic Control Loop pattern, which defines a modelbased cognitive control loop that can be applied to the design of such a metacontroller, iii) the Deep Model Reflection pattern proposes a solution to produce the online executable model used by the metacontroller by model-to-model transformation from the engineering model, and, finally, iv) the Functional Metacontrol pattern, which proposes to structure the metacontroller in two loops, one for controlling the configuration of components of the controller, and another one on top of the former, controlling the functions being realised by that configuration; this way the functional and structural concerns become decoupled. The OM Architecture and the TOMASys metamodel are the core pieces of the architectural framework developed to reify this patterned solution. The TOMASys metamodel has been developed for representing the structure and its relation to the functional requirements of any autonomous system. The OM architecture is a blueprint for building a metacontroller according to the patterns. This metacontroller can be integrated on top of any component-based control architecture. At the core of its operation lies a TOMASys model of the control system. An engineering process and accompanying assets have been constructed to complete and exploit the architectural framework. The OM Engineering Process defines the process to follow to develop the metacontrol subsystem from the functional model of the controller of the autonomous system. The OMJava library provides a domain and application-independent implementation of an OM Metacontroller than can be used in the implementation phase of OMEP. Finally, the complete solution has been validated in the development of an autonomous mobile robot that incorporates an OM metacontroller. The functional selfawareness and adaptivity properties achieved thanks to the metacontrol system have been validated in different scenarios. In these scenarios the robot was able to overcome failures in the control system thanks to reconfigurations performed by the metacontroller.

Video-based tasks for emotional processing rehabilitation in schizophrenia

Schizophrenia is a mental disorder characterized by a breakdown of cognitive processes and by a deficit of typi-cal emotional responses. Effectiveness of computerized task has been demonstrated in the field of cognitive rehabilitation. However, current rehabilitation programs based on virtual environments normally focus on higher cognitive functions, not covering social cognition training. This paper presents a set of video-based tasks specifically designed for the rehabilita-tion of emotional processing deficits in patients in early stages of schizophrenia or schizoaffective disorders. These tasks are part of the Mental Health program of Guttmann NeuroPer-sonalTrainer® cognitive tele-rehabilitation platform, and entail innovation both from a clinical and technological per-spective in relation with former traditional therapeutic con-tents.