scholarly journals Opportunities for Early Intervention Based on Theory, Basic Neuroscience, and Clinical Science

2010 ◽  
Vol 90 (12) ◽  
pp. 1868-1880 ◽  
Author(s):  
Beverly D. Ulrich
Keyword(s):  
Pediatric Population ◽  
Theoretical Perspective ◽  
Third Party ◽  
Functional Skills ◽  
Science Data ◽  
Aggressive Approach ◽  
Theoretical Concepts ◽  
Neural Organization ◽  
History Of ◽  
The Impact

Therapeutic approaches in the pediatric population have generally been less aggressive than those implemented for younger and older adults. Several factors contribute to this, starting with the challenge of engaging infants in the “goal” of therapy, their resistance to initiating behaviors that are uncomfortable or fatiguing, the desire to make therapy as functionally relevant as possible when many functional skills have yet to emerge, and residual history of outdated theoretical concepts. On the practical side of who will pay for this more aggressive approach, there is limited empirical evidence based on randomized controlled trials to convince third-party payers to fund more extensive services. This article outlines a theoretical perspective prominent in developmental science that argues not only for the importance of frequent bouts of functionally relevant activity on the self-organization of behavioral patterns, but also for the impact that should be expected from the use of rigorous interventions on underlying subsystems, such as neural organization, that support these outcomes. In order to propose some future opportunities for clinical research and application, examples from recent activity-based clinical studies are presented, along with theoretical principles, neuroscience, and other tissue science data concerning mechanisms that contribute to behavioral changes. One such opportunity is to increase the structured engagement of caregivers, guided by therapists, in administering well-defined activity intervention programs focused on the development of specific functional skills. Such an approach may be one of the few financially feasible options for generating sufficient therapy that adheres to principles for optimizing development of neuromotor control.

Disaggregating Mediations: The Impact of Multiparty Mediation

2011 ◽  
Vol 41 (4) ◽  
pp. 859-881 ◽  
Author(s):  
Tobias Böhmelt
Keyword(s):  
Conflict Resolution ◽  
Empirical Analysis ◽  
Third Party ◽  
Multiparty Mediation ◽  
History Of ◽  
Shared Culture ◽  
Using Data ◽  
The Impact ◽  
The Empirical Analysis ◽  
Mediation Effectiveness

This article disaggregates coalitions of third-party mediators and examines their effectiveness in interventions. First, it is argued that there is an inverted U-shaped relationship between the size of a mediating coalition and mediation effectiveness. Secondly, mediators sharing a history of conflict and distrust will transfer their past relationships to a mediation attempt, making it less effective. Consequently, states sharing friendly and co-operative ties with each other are more successful in managing conflicts. Finally, a coalition of mediators that is largely democratic should be more effective due to a shared culture of peaceful conflict resolution, inclusivity and increased communication flows. The empirical analysis using data from the Issues Correlates of War Project for 1965–2000 largely provides support for the theory.

Abstract 16097: Impact of Device Miniaturization on Implantable Loop Recorder Utilization in the Pediatric Population: An Analysis of the Marketscan Database

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Dustin Nash ◽  
Hannah Katcoff ◽  
Jennifer Faerber ◽  
Ramesh Iyer ◽  
Michael L O’Byrne ◽  
...  
Keyword(s):  
Pediatric Population ◽  
Study Cohort ◽  
Administrative Claims ◽  
Group 14 ◽  
Loop Recorder ◽  
Device Infection ◽  
History Of ◽  
Secondary Analyses ◽  
The Impact ◽  
Device Miniaturization

Introduction: Implantable loop recorders (ILRs) are an effective technology in the detection of paroxysmal arrhythmias, but utility in the pediatric population has been limited by device size. In 2014, a miniaturized ILR was introduced with a less invasive implant technique. The impact of this technology on ILR utilization in pediatric patients has not been evaluated. Hypothesis: We hypothesize an increase in annual pediatric ILR implants since 2014 due to device miniaturization. Methods: A retrospective observational study was conducted using administrative claims from Marketscan Medicaid and Commercial insurance claims databases. Utilization of ILR between 1/2013 and 12/2018 was measured (normalized to the total enrolled population ≤18 years) and compared to two balancing measures (Holter ambulatory monitors and encounters with syncope as a diagnosis). Secondary analyses included evaluations of subsequent interventions and complications. Results: The study cohort included 33,532,185 individual subjects, of which 769 underwent ILR implantation. ILR subjects were 52% male, with a median age of 16 years (IQR 10-17 yrs). 71% had a history of syncope, 43% had a history of palpitations, and 28% had a history of congenital heart disease. Utilization of ILR increased in 2014, from 5 procedures per million enrollees in 2013 to 11 per million between 2015-2018, while balancing measures remained static (see Figure).Of 393 subjects with ≥1 year of follow-up post-implant, interventions included catheter ablation in 24 (6%), pacemaker implant in 15 (4%) and ICD implant in 7 (1.8%). Among this group, 14 (3.6%) had a device infection and 5 (1.3%) had an erosion. Conclusions: Following introduction of the miniaturized ILR, pediatric utilization has rapidly increased. The effect of this change on outcomes and value deserves further attention.

Deductible Status in the Pediatric Population: A Barrier to Appropriate Care?

2021 ◽  
pp. 019459982110069
Author(s):  
Vanessa F. Torrecillas ◽  
Kaden Neuberger ◽  
Alexander Ramirez ◽  
Andrew Knighton ◽  
Paul Krakovitz ◽  
...  
Keyword(s):  
Elective Surgery ◽  
Pediatric Population ◽  
Fold Increase ◽  
Cross Sectional Study ◽  
Fracture Repair ◽  
Health Claims ◽  
Third Party ◽  
Cross Sectional ◽  
Inappropriate Care ◽  
The Impact

Objective The objective of this study is to evaluate the impact of high-deductible health plans on elective surgery (tonsillectomy) in the pediatric population. Study Design Cross-sectional study. Setting Health claims database from a third-party payer. Methods Data were reviewed for children up to 18 years of age who underwent tonsillectomy or arm fracture repair (nonelective control) from 2016 to 2019. Incidence of surgery by health plan deductible (high, low, or government insured) and met or unmet status of deductibles were compared. Results A total of 10,047 tonsillectomy claims and 9903 arm fracture repair claims met inclusion and exclusion criteria. The incidence of tonsillectomy was significantly different across deductible plan types. Patients with met deductibles were more likely to undergo tonsillectomy. In patients with deductibles ≥$4000, a 1.75-fold increase in tonsillectomy was observed in those who had met their deductible as compared with those who had not. These findings were not observed in controls (nonelective arm fracture). For those with met deductibles, those with high deductibles were much more likely to undergo tonsillectomy than those with low, moderate, and government deductibles. Unmet high deductibles were least likely to undergo tonsillectomy. Conclusions Health insurance plan type influences the incidence of pediatric elective surgery such as tonsillectomy but not procedures such as nonelective repair of arm fracture. High deductibles may discourage elective surgery for those deductibles that are unmet, risking inappropriate care of vulnerable pediatric patients. However, meeting the deductible may increase incidence, raising the question of overutilization.

scholarly journals Impact of Physical Fitness on Cognitive Performance in Patients at a Memory Clinic

2019 ◽  
Vol 9 (1) ◽  
pp. 129-135 ◽  
Author(s):  
Katharina Gnosa ◽  
Agnies Marczak ◽  
Jana Binder ◽  
Georg Adler
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Performance ◽  
Clinical Laboratory ◽  
Early Recognition ◽  
Third Party ◽  
Step Test ◽  
Subjective Memory ◽  
Motor Fitness ◽  
History Of ◽  
The Impact

Objective: To examine the impact of cardiovascular and motor fitness on cognitive performance in subjects interested in the prevention and early recognition of Alzheimer’s dementia (AD). Methods: The data of 388 participants of a respective project aged between 50 and 85 years were evaluated. Classification of the participants into the groups of “no cognitive impairment” (NCI), “mild cognitive impairment of the amnestic type” (MCIa), and “mild AD” (mAD) was performed by neuropsychological assessment, history of third party, and further clinical, laboratory, or imaging investigations. Subjective memory impairment (SMI) and cognitive blackouts were recorded. Cardiorespiratory fitness (CRF) was assessed by means of the 2-min step test and motor fitness (MF) by means of the 30-s chair-stand test. Results: CRF and MF were reduced in participants with MCIa and mAD. They were negatively correlated with the score for cognitive blackouts. In the group of 50- to 60-year-old nondemented participants those with low CRF and MF performed poorer in various cognitive domains, had a higher score for cognitive blackouts, and more frequently SMI. Conclusion: Low CRF and MF are associated with cognitive impairment. This applies even in 50- to 60-year-old nondemented subjects without marked physical morbidity. These findings support the potential usefulness of physical exercise for dementia prevention.

Investigating the Relationship Between Self-Esteem and Stigma Among Young Adults With History of Suicide Attempts

Crisis ◽  
2016 ◽  
Vol 37 (4) ◽  
pp. 265-270 ◽  
Author(s):  
Meshan Lehmann ◽  
Matthew R. Hilimire ◽  
Lawrence H. Yang ◽  
Bruce G. Link ◽  
Jordan E. DeVylder
Keyword(s):  
Young Adults ◽  
Suicide Attempts ◽  
Self Esteem ◽  
High Risk Population ◽  
High Functioning ◽  
People With Mental Illness ◽  
History Of ◽  
The Individual ◽  
The Impact ◽  
The Relationship

Abstract. Background: Self-esteem is a major contributor to risk for repeated suicide attempts. Prior research has shown that awareness of stigma is associated with reduced self-esteem among people with mental illness. No prior studies have examined the association between self-esteem and stereotype awareness among individuals with past suicide attempts. Aims: To understand the relationship between stereotype awareness and self-esteem among young adults who have and have not attempted suicide. Method: Computerized surveys were administered to college students (N = 637). Linear regression analyses were used to test associations between self-esteem and stereotype awareness, attempt history, and their interaction. Results: There was a significant stereotype awareness by attempt interaction (β = –.74, p = .006) in the regression analysis. The interaction was explained by a stronger negative association between stereotype awareness and self-esteem among individuals with past suicide attempts (β = –.50, p = .013) compared with those without attempts (β = –.09, p = .037). Conclusion: Stigma is associated with lower self-esteem within this high-functioning sample of young adults with histories of suicide attempts. Alleviating the impact of stigma at the individual (clinical) or community (public health) levels may improve self-esteem among this high-risk population, which could potentially influence subsequent suicide risk.

The Film World’s Cooperative Store: Institutions and Films of the 1930s and 1940s

2018 ◽  
Author(s):  
C. Claire Thomson
Keyword(s):  
World War Ii ◽  
Meat Products ◽  
Public Information ◽  
Early History ◽  
World War ◽  
International Context ◽  
German Occupation ◽  
History Of ◽  
The Uk ◽  
The Impact

This chapter traces the early history of state-sponsored informational filmmaking in Denmark, emphasising its organisation as a ‘cooperative’ of organisations and government agencies. After an account of the establishment and early development of the agency Dansk Kulturfilm in the 1930s, the chapter considers two of its earliest productions, both process films documenting the manufacture of bricks and meat products. The broader context of documentary in Denmark is fleshed out with an account of the production and reception of Poul Henningsen’s seminal film Danmark (1935), and the international context is accounted for with an overview of the development of state-supported filmmaking in the UK, Italy and Germany. Developments in the funding and output of Dansk Kulturfilm up to World War II are outlined, followed by an account of the impact of the German Occupation of Denmark on domestic informational film. The establishment of the Danish Government Film Committee or Ministeriernes Filmudvalg kick-started aprofessionalisation of state-sponsored filmmaking, and two wartime public information films are briefly analysed as examples of its early output. The chapter concludes with an account of the relations between the Danish Resistance and an emerging generation of documentarists.

The impact of fluorescein-guided technique in the surgical removal of CNS tumors in a pediatric population: results from a multicentric observational study

2020 ◽  
Vol 63 (6) ◽  
Author(s):  
Camilla de Laurentis ◽  
Julius Höhne ◽  
Claudio Cavallo ◽  
Francesco Restelli ◽  
Jacopo Falco ◽  
...  
Keyword(s):  
Observational Study ◽  
Pediatric Population ◽  
Cns Tumors ◽  
Surgical Removal ◽  
The Impact

A Left History of Liquorice: What It Means to Write "Left" History

2019 ◽  
Vol 23 (1) ◽  
Author(s):  
Bryan D. Palmer
Keyword(s):  
Historical Study ◽  
Right Wing ◽  
Special Edition ◽  
Political Climate ◽  
Historical Approach ◽  
History Of ◽  
The Impact

This article is part of a special Left History series reflecting upon changing currents and boundaries in the practice of left history, and outlining the challenges historians of the left must face in the current tumultuous political climate. This series extends a conversation first convened in a 2006 special edition of Left History (11.1), which asked the question, “what is left history?” In the updated series, contributors were asked a slightly modified question, “what does it mean to write ‘left’ history?” The article charts the impact of major political developments on the field of left history in the last decade, contending that a rising neoliberal and right-wing climate has constructed an environment inhospitable to the discipline’s survival. To remain relevant, Palmer calls for historians of the left to develop a more “open-ended and inclusive” understanding of the left and to push the boundaries of inclusion for a meaningful historical study of the left. To illustrate, Palmer provides a brief materialist history of liquorice to demonstrate the mutability of left history as a historical approach, rather than a set of traditional political concerns.

THEORETICAL AND PRACTICAL BASES OF THE CONCEPT OF SOCIO LINGUISTICS

2020 ◽  
Vol 5 (3) ◽  
pp. 20-24
Author(s):  
Durdona Karimova ◽  
Keyword(s):  
Sociolinguistic Competence ◽  
History Of ◽  
The Impact

This article discusses the theoretical and practical foundations of the concept of sociolinguistics and the importance of this field in the study of the impact of society on language. It also describes the views of linguists in this regard, the history of the origin and development of the filed, its connection with other disciplines, and explains in detail the sociolinguistic issues with practical examples.In addition, the terms as macro-sociolinguistics and micro-sociolinguistics and sociolinguistic competence are explained.

Perkembangan TIK, Globalisasi dan Peranan Guru Pendidikan Kewarganegaraan dalam Pengembangan Pendidikan Karakter

2018 ◽  
Vol 1 ◽  
Author(s):  
Zulpadli Zulpadli
Keyword(s):  
Character Education ◽  
Civic Education ◽  
Moral Values ◽  
Hard Work ◽  
Theoretical Studies ◽  
Paper Briefly ◽  
History Of ◽  
Younger Generation ◽  
The Impact

This paper briefly and through theoretical studies will discuss simply the problems formulated, the impact of globalization on Character education in Indonesia, as well as the paradigm of PKN learning and Character education challenges for the younger generation. It is on the ground by the declining awareness and moral values, as well as to increase the values of the characters seen in the young generations. Civic education in Indonesia has been running throughout the history of Indonesian independence, and has gone through various stages and arms, it certainly demands greater hard work of teachers to be able to increase the values of Pancasila and love of the homeland, and practice the character values which is based on the noble values of Indonesian culture into Indonesian youth.

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