Increasing Child Compliance with Essential Healthcare Routines: Acquisition, Maintenance, and Generalization

Child noncompliance with essential healthcare routines is a widely reported problem, especially for children with intellectual and developmental disabilities (IDD) (Allen, Stanley, & McPherson, 1990). Noncompliance with essential healthcare routines has the potential to be a serious problem particularly with a given routine that involves the use of sharp objects (e.g., scissors, dental scrapper) that may cause harm to a child who refuses to comply with, or exhibits avoidant behaviors during, the procedure. Study 1 assessed the number of children who exhibit noncompliance with essential healthcare routines in a local early education program serving children, both of typical development and those with (or at risk for) intellectual and developmental disabilities, ranging in age from one to seven years. Study 2 evaluated the effects of a reinforcement-based treatment procedure, without extinction, on the acquisition, maintenance, and generalization of compliance with two essential healthcare routines identified as problematic by Study 1. To date, seven young children diagnosed with autism have participated in Study 2. Each child received compliance training within a simulated context of either a haircut appointment or a dental examination, or both. Probes in the simulated setting were conducted periodically to evaluate potential maintenance of compliance in the absence of treatment, as well as generalization of performance to novel therapists. Child compliance was also assessed during haircuts and dental examinations conducted by healthcare professionals in the actual relevant environments to determine the extent to which trained performance generalized. Results showed that mere exposure to the simulated environment increased compliance for two children. Treatment was necessary to increase compliance for five children. Successful generalization of compliance in the actual healthcare environments was observed for only two children. However, dramatic decreases in the occurrence of negative vocalizations and the use of physical restraint in the actual setting were observed across all subjects. The results extend the literature by assessing the extent to which treatment for compliance with healthcare routines that does not involve escape extinction can be effective and by assessing whether the effects of compliance training in an analogue setting will generalize to the actual healthcare setting. Keywords: demand fading, differential reinforcement, essential healthcare routines, compliance, problem behavior, negative vocalizations, generalization, maintenanc

Towards 3D printed multifunctional immobilization for proton therapy: initial materials characterization

Purpose: 3D printing technology is investigated for the purpose of patient immobilization during proton therapy. It potentially enables a merge of patient immobilization, bolus range shifting, and other functions into one single patient-speci c structure. In this rst step, a set of 3D printed materials is characterized in detail, in terms of structural and radiological properties, elemental composition, directional dependence, and structural changes induced by radiation damage. These data will serve as inputs for the design of 3D printed immobilization structure prototypes. Methods: Using four di erent 3D printing techniques, in total eight materials were subjected to testing. Samples with a nominal dimension of 20×20×80 mm3 were 3D printed. The geometrical printing accuracy of each test sample was measured with a dial gage. To assess the mechanical response of the samples, standardized compression tests were performed to determine the Young’s modulus. To investigate the e ect of radiation on the mechanical response, the mechanical tests were performed both prior and after the administration of clinically relevant dose levels (70 Gy), multiplied with a safety factor of 1.4. Dual energy computed tomography (DECT) methods were used to calculate the relative electron density to water ρe, the e ective atomic number Ze , and the proton stopping power ratio (SPR) to water SPR. In order to validate the DECT based calculation of radiological properties, beam measurements were performed on the 3D printed samples as well. Photon irradiations were performed to measure the photon linear attenuation coe cients, while proton irradiations were performed to measure the proton range shift of the samples. The direc- tional dependence of these properties was investigated by performing the irradiations for di erent orientations of the samples. Results: The printed test objects showed reduced geometric printing accuracy for 2 materials (deviation > 0.25 mm). Compression tests yielded Young’s moduli ranging from 0.6 to 2940 MPa. No deterioration in the mechanical response was observed after exposure of the samples to 100 Gy in a therapeutic MV photon beam. The DECT-based characterization yielded Ze ranging from 5.91 to 10.43. The SPR and ρe both ranged from 0.6 to 1.22. The measured photon attenuation coe cients at clinical energies scaled linearly with ρe. Good agreement was seen between the DECT estimated SPR and the measured range shift, except for the higher Ze . As opposed to the photon attenuation, the proton range shifting appeared to be printing orientation dependent for certain materials. Conclusions: In this study, the rst step toward 3D printed, multifunctional immobilization was performed, by going through a candidate clinical work ow for the rst time: from the material printing to DECT characterization with a veri cation through beam measurements. Besides a proof of concept for beam modi cation, the mechanical response of printed materials was also investigated to assess their capabilities for positioning functionality. For the studied set of printing techniques and materials, a wide variety of mechanical and radiological properties can be selected from for the intended purpose. Moreover the elaborated hybrid DECT methods aid in performing in-house quality assurance of 3D printed components, as these methods enable the estimation of the radiological properties relevant for use in radiation therapy

Common Loon, Gavia immer, Nest Attendance Patterns Recorded by Remote Video Camera

We recorded the complete day/night nesting attendance of a Common Loon (Gavia immer) pair using a remote video camera. We found that the male and female share incubation duty equally, but that the female incubates primarily at night (95.8%) when the male defends the territory

Effects of Conditioning Procedures on Vocalizations of Children with Minimal or Emerging Echoic Repertoire

Researchers have utilized conditioning procedures to establish neutral stimuli as conditioned reinforcers for decades (e.g., Greer, Pistoljevic, Cahill, & Du, 2011; Lovaas et al., 1966; Dorow, 1980). More recently, researchers have used conditioning procedures as a strategy for facilitating language acquisition (e.g., Sundberg, Michael, Partington, & Sundberg, 1996). However, the effectiveness of these procedures is unclear. Therefore, Study 1 compared three different procedures suggested to condition speech sounds as automatic reinforcers: stimulus-stimulus pairing (Esch, Carr, & Grow, 2009; Sundberg, Michael, Partington, & Sundberg, 1996), response-stimulus pairing (Lepper and Petursdottir, 2017), and operant discrimination training (Lepper, Petursdottir, & Esch, 2013). Study 2 evaluated potential barriers to the efficacy of conditioning procedures (i.e., articulation, reinforcer efficacy, attending skills) with Study 1 participants for whom none of the conditioning procedures was effective. Multielement, multiple-baseline, and reversal designs were used to demonstrate experimental control. Seven children with and without developmental disabilities participated. Results of Study 1 were idiosyncratic. At least one conditioning procedure increased vocalizations for three participants. An echoic repertoire developed during the evaluation for one participant. None of the three conditioning procedures increased vocalizations for three participants. In Study 2, at least one potential barrier was identified for the three participants. Overall, results suggest that children’s vocal behavior may be differentially sensitive to the procedures evaluated. Further, articulation skills, reinforcer efficacy, and attending skills appear to be barriers that may decrease the effectiveness of these procedures for increasing vocalizations

Radiation chemistry of solid-state carbohydrates using EMR

We review our research of the past decade towards identification of radiation-induced radicals in solid state sugars and sugar phosphates. Detailed models of the radical structures are obtained by combining EPR and ENDOR experiments with DFT calculations of g and proton HF tensors, with agreement in their anisotropy serving as most important criterion. Symmetry-related and Schonland ambiguities, which may hamper such identification, are reviewed. Thermally induced transformations of initial radiation damage into more stable radicals can also be monitored in the EPR (and ENDOR) experiments and in principle provide information on stable radical formation mechanisms. Thermal annealing experi-ments reveal, however, that radical recombination and/or diamagnetic radiation damage is also quite important. Analysis strategies are illustrated with research on sucrose. Results on dipotassium glucose-1-phosphate and trehalose dihydrate, fructose and sorbose are also briefly discussed. Our study demonstrates that radiation damage is strongly regio-selective and that certain general principles govern the stable radical formation

GWAS meta-analysis reveals novel loci and genetic correlates for general cognitive function : a report from the COGENT consortium

CORRIGENDUM Molecular Psychiatry (2017) 22, 1651–1652 http://www.nature.com/articles/mp2017197.pdfThe complex nature of human cognition has resulted in cognitive genomics lagging behind many other fields in terms of gene discovery using genome-wide association study (GWAS) methods. In an attempt to overcome these barriers, the current study utilized GWAS meta-analysis to examine the association of common genetic variation (similar to 8M single-nucleotide polymorphisms (SNP) with minor allele frequency >= 1%) to general cognitive function in a sample of 35 298 healthy individuals of European ancestry across 24 cohorts in the Cognitive Genomics Consortium (COGENT). In addition, we utilized individual SNP lookups and polygenic score analyses to identify genetic overlap with other relevant neurobehavioral phenotypes. Our primary GWAS meta-analysis identified two novel SNP loci (top SNPs: rs76114856 in the CENPO gene on chromosome 2 and rs6669072 near LOC105378853 on chromosome 1) associated with cognitive performance at the genome-wide significance level (PPeer reviewe