scholarly journals Brief Report: A Contemplative Biofeedback Intervention for Adults with ASD: Feasibility of a Community-Based Treatment

2019 ◽  
Author(s):  
Rachel S. Brezis ◽  
Amitai Levin ◽  
Yuval Oded ◽  
Opher Zahavi ◽  
Nava Levit-Binnun
Keyword(s):  
Emotional Regulation ◽  
Low Cost ◽  
Real Life ◽  
Professional Staff ◽  
Self Determination ◽  
Self Awareness ◽  
Autism Symptoms ◽  
Post Intervention ◽  
Community Based ◽  
Adults With Asd

Background: As the number of adults living with ASD continues to grow, a lack of resources and lack of available interventions exacerbate their low quality of life, including low levels of education and employment, and high levels of co-morbid anxiety and depression. Here we build upon existing research showing the effectiveness of contemplative interventions on individuals with ASD, to provide a low-cost biofeedback-enhanced training which can be implemented by non-professional staff, and may help autistic individuals grasp abstract contemplative techniques. We hypothesize that the intervention will decrease participants’ anxiety and autism symptoms, and increase their self-awareness, self-determination, and empathy.Method: Fourteen adults with ASD, residing in assisted living, were provided with 16 weekly half-hour contemplative-biofeedback sessions with non-professional trainers, in which they learned to reduce their arousal levels through combined biofeedback and contemplative techniques, and apply those to everyday life. Quantitative and qualitative data was collected pre- and post-intervention, to determine changes in participants’ self-awareness, self-determination, anxiety, autism symptoms, and empathy. Results: Participants were capable of successfully improving their physiological arousal levels on the biofeedback setup, and we found initial indications for gains in all hypothesized domains on the quantitative measures. Qualitative reports by participants and counselors revealed that participants applied the techniques in many real-life situations, and these had far-ranging effects on their emotional regulation, work and social motivation, and self-determination.Conclusions: The study provides proof-of-concept for a low-cost, community-based intervention which can ameliorate the lives of adults with ASD.

Slum Kampong Tourism “Jakarta Hidden Tour”: Designing Eco-Cultural Based Pro-Poor Tourism

2015 ◽  
Vol 1 (3) ◽  
pp. 111
Author(s):  
Retnayu Prasetyanti
Keyword(s):  
International Development ◽  
Poverty Alleviation ◽  
Real Life ◽  
Tourism Development ◽  
System Thinking ◽  
Development Programs ◽  
Community Based ◽  
Economy Condition ◽  
Business Sectors ◽  
Community Movement

Forecasts of high tourism development in Jakarta, Indonesia, where massive poverty cases also exist, has directed tourism as a way of alleviating poverty; this is usually termed “pro-poor tourism” which involves multi variant stakeholders and interests. Jakarta has widespread poor areas called “slum Kampongs”, where government and business sectors are supported by international development agencies have tried to tackle down poverty by economy-community (eco-community) based development programs. However, distinguished from those programs, slum kampong development based pro-poor tourism is yet unsupported by bureaucracy agencies. “Jakarta Hidden Tour” (see “Jakarta Hidden Tour” in Trip Advisor) a “wild” tour activity which is promoted by community movement led by Ronny Poluan indicates a term of economy and cultural (eco-cultural) based slum kampong tourism that basically can pursue a better community development and economy condition through a unique culture and real life portrait experience. This paper analyses the dilemma of “Jakarta Hidden Tour” which is claimed as a poor exhibition while in another hand tries to offer a new design and approach of pro-poor tourism by utilizing thematic Kampong development with local culture excellences as such “Green Slum Kampong in Ciliwung river”, or “Sailor Slum Kampong in North Jakarta”. Key learn from Brazil with slum kampong tourism in Santa Marta is a motivation for government to live a recognition, that like any other global/industrial policies, tourism is highly driven by political interest. By conducting a system thinking perspective base, this paper analyses how “Jakarta Hidden Tour” and government’s supporting policy will ensure eco-cultural pro-poor tourism development and how stakeholders as a system’s element need to uphold poverty alleviation towards sustainability

PyDOSS: An open-source Python-based communicable disease outbreak surveillance system designed and used in a COVID-19 community care facility (Preprint)

2020 ◽  
Author(s):  
Andrew Fang ◽  
Jonathan Kia-Sheng Phua ◽  
Terrence Chiew ◽  
Daniel De-Liang Loh ◽  
Lincoln Ming Han Liow ◽  
...  
Keyword(s):  
Open Source ◽  
Surveillance System ◽  
Community Care ◽  
Communicable Disease ◽  
Low Cost ◽  
Real Life ◽  
Disease Outbreak ◽  
Disease Spread ◽  
Healthcare Team ◽  
Increased Risk

BACKGROUND During the Coronavirus Disease 2019 (COVID-19) outbreak, community care facilities (CCF) were set up as temporary out-of-hospital isolation facilities to contain the surge of cases in Singapore. Confined living spaces within CCFs posed an increased risk of communicable disease spread among residents. OBJECTIVE This inspired our healthcare team managing a CCF operation to design a low-cost communicable disease outbreak surveillance system (CDOSS). METHODS Our CDOSS was designed with the following considerations: (1) comprehensiveness, (2) efficiency through passive reconnoitering from electronic medical record (EMR) data, (3) ability to provide spatiotemporal insights, (4) low-cost and (5) ease of use. We used Python to develop a lightweight application – Python-based Communicable Disease Outbreak Surveillance System (PyDOSS) – that was able perform syndromic surveillance and fever monitoring. With minimal user actions, its data pipeline would generate daily control charts and geospatial heat maps of cases from raw EMR data and logged vital signs. PyDOSS was successfully implemented as part of our CCF workflow. We also simulated a gastroenteritis (GE) outbreak to test the effectiveness of the system. RESULTS PyDOSS was used throughout the entire duration of operation; the output was reviewed daily by senior management. No disease outbreaks were identified during our medical operation. In the simulated GE outbreak, PyDOSS was able to effectively detect an outbreak within 24 hours and provided information about cluster progression which could aid in contact tracing. The code for a stock version of PyDOSS has been made publicly available. CONCLUSIONS PyDOSS is an effective surveillance system which was successfully implemented in a real-life medical operation. With the system developed using open-source technology and the code made freely available, it significantly reduces the cost of developing and operating CDOSS and may be useful for similar temporary medical operations, or in resource-limited settings.

Development of an online transdisciplinary student wellbeing bundle: a thematic analysis (Preprint)

2020 ◽  
Author(s):  
Jena Buchan ◽  
Bonnie Clough ◽  
Jonathan Munro ◽  
Tatjana Ewais ◽  
Jaime Wallis ◽  
...  
Keyword(s):  
Focus Groups ◽  
Thematic Analysis ◽  
Personal Growth ◽  
Professional Staff ◽  
Self Awareness ◽  
Online Student ◽  
Student Wellbeing ◽  
Community Connectedness ◽  
Emerging Themes ◽  
Further Development

BACKGROUND The consequences of burnout for tertiary students across the health professions are well documented and include higher rates of mental health challenges, suicide, alcoholism, and relationship problems. As a key stakeholder in University-offered wellbeing services and support, it is desirable for students to hold a central role in development of such resources, particularly given effectiveness relies on student uptake. Hence there is a compelling need to develop a student-driven approach to promote wellbeing in the tertiary setting at individual, curricula, and systems levels. OBJECTIVE Based on this need, an online student-focused platform was developed using a bottom-up approach to support participant-driven enhancement of wellbeing and resilience to counteract burnout. This study reports on the development of the initial online “Student Bundle”, providing a foundation to inform the design of more locally based approaches to improve wellness and prevent burnout. METHODS Students and academic and professional staff from Griffith University Health groups were invited to participate in a series of focus groups. Sessions sought to collect information on desired structure, resources and overall content of the Student Bundle, with a thematic analysis undertaken to identify emerging themes. RESULTS Focus groups were conducted separately with staff (n=17) and students (n=7). Six main themes in relation to the development of the bundle emerged: Communication/Engagement; Accessibility/Flexibility; Professional practice; Community; Awareness; and Opportunity for personal growth. Stakeholders emphasized a bundle should be engaging and proactive to address wellbeing issues, incorporate aspects linked to professional identity and foster community, connectedness and self-awareness, providing an opportunity for growth. CONCLUSIONS Our research has revealed significant needs in relation to how an online student-focused wellbeing bundle could be delivered and what it could provide. Findings from this study will be used to guide further development and implementation of a multimodal, interactive student wellbeing bundle.

Care of children with type 1 diabetes mellitus in school – An interventional study

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Umamaheswari Gurunathan ◽  
Hemchand Krishna Prasad ◽  
Sherline White ◽  
Bala Prasanna ◽  
Thangavelu Sangaralingam
Keyword(s):  
Type 1 Diabetes ◽  
Education Program ◽  
School Teachers ◽  
Post Intervention ◽  
Community Based ◽  
Structured Education ◽  
Type 1 Dm ◽  
The Impact ◽  
Determining Factor

AbstractObjectivesPaucity of data from India on care of children with Type 1 diabetes in schools. Aims: To study assess the knowledge, attitude, practices and fear of Type 1 diabetes in school teachers and to assess the impact of an educational model on the fear of teachers and care of children in Type 1 DM at school hours.MethodsA community based study, involving school teachers and the intervention being educating them about diabetes conducted. Data pertaining to basic demography, attitude of teachers towards diabetic children, Hypoglycemia fear factor survey- parent version with worries domain and preparedness of school was collected. An education program was conducted on diabetes care in children. Immediately and after three months, the proforma details and HFSP-W scores reassessed.ResultsForty two teachers (mean age: 38.7±5.4; M:F ratio 2:40) participated in the study. Post intervention, a higher willingness to have the diabetic child in class (100 vs. 57.1%; p>0.05), better support in daily care (100 vs. 92%; p>0.05), participation in sports activities (100 vs. 7.1%; p<0.05) observed. HFSP-W scores were 38.8±4.5 (pre-intervention), 22.5±4.3 (immediate post intervention) and 29.5±3.2 (at 3months) (p<0.05). To study the determinants of improvement in HFSP-W a regression analysis was performed: presence of glucometer the most likely determining factor (T=1.999, p=0.05).ConclusionThere is a significant element of fear in the minds of teachers towards hypoglycemia which improves with a structured education program.

scholarly journals Modified CBT for social anxiety and social functioning in young adults with autism spectrum disorder

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Emily R. Bemmer ◽  
Kelsie A. Boulton ◽  
Emma E. Thomas ◽  
Ben Larke ◽  
Suncica Lah ◽  
...  
Keyword(s):  
Young Adults ◽  
Social Anxiety ◽  
Social Functioning ◽  
Autism Spectrum ◽  
Self Report ◽  
Post Intervention ◽  
Adults With Autism ◽  
Adolescents And Adults ◽  
Adults With Asd ◽  
Young Adults With Asd

Abstract Background There is a strong research imperative to investigate effective treatment options for adolescents and adults with autism spectrum disorder (ASD). Elevated social anxiety, difficulties with social functioning and poor mental health have all been identified as core treatment targets for this group. While theoretical models posit a strong bidirectionality between social anxiety and ASD social functioning deficits, few interventions have targeted both domains concurrently. Of the two group interventions previously conducted with adolescents and adults with ASD, significant results have only been observed in either social anxiety or social functioning, and have not generalised to changes in overall mood. The aim of this study was to evaluate the potential benefit, tolerability and acceptability of a group cognitive-behaviour therapy (CBT) intervention in young adults with ASD. Primary treatment outcomes were social anxiety symptoms and social functioning difficulties; secondary outcomes were self-reported mood and overall distress. Method Ten groups of participants completed an eight-week, modified group CBT intervention targeting both social anxiety and social functioning, that included social skills training, exposure tasks and behavioural experiment components. Seventy-eight adolescents and young adults with ASD, without intellectual impairment, aged between 16 and 38 (M = 22.77; SD = 5.31), were recruited from the community, Headspace centres and the Autism Clinic for Translational Research at the Brain and Mind Centre, University of Sydney. Outcomes (social anxiety, social functioning and mood) were measured pre- and post-intervention via self-report questionnaires (administered either online or through the return of hard-copy booklets), and participants were invited to provide anonymous feedback on the intervention (at the mid-point and end of the intervention). Results Participants demonstrated statistically significant improvements on all outcome measures in response to the intervention. Specifically, social anxiety symptoms decreased (p < .001), and specific subdomains of social functioning improved post-intervention, particularly in social motivation (p = .032) and restricted interests and repetitive behaviours (p = .025). Self-reported symptom improvements also generalised to mood (depression, anxiety and stress; p < .05). All improvements demonstrated small effect sizes. Participant feedback was positive and indicated strong satisfaction with the program. Limitations The absence of a control group and follow-up measures, reliance on self-report instruments as outcome measures and the exclusion of those with intellectual disability represent significant limitations to this study. Conclusions These findings indicate that a group CBT intervention appears to be a beneficial intervention for self-reported social anxiety, social functioning and overall mental health in adolescents and young adults with ASD. The stand-alone nature of the intervention combined with positive participant feedback indicates it was well tolerated, has potential clinical utility and warrants further study in a randomised-controlled, follow-up design.

Pedometer-Determined Step-Count Guidelines for Afterschool Programs

2012 ◽  
Vol 9 (1) ◽  
pp. 71-77 ◽  
Author(s):  
Michael W. Beets ◽  
Aaron Beighle ◽  
Matteo Bottai ◽  
Laura Rooney ◽  
Fallon Tilley
Keyword(s):  
Operating Characteristic ◽  
Low Cost ◽  
Vigorous Physical Activity ◽  
Area Under The Curve ◽  
High Specificity ◽  
Step Count ◽  
Afterschool Programs ◽  
Policy Goal ◽  
Community Based ◽  
Random Intercept

Background:Policies to require afterschool programs (ASPs, 3 PM to 6 PM) to provide children a minimum of 30 minutes of moderate-to-vigorous physical activity (MVPA) exist. With few low-cost, easy-to-use measures of MVPA available to the general public, ASP providers are limited in their ability to track progress toward achieving this policy-goal. Pedometers may fill this gap, yet there are no step-count guidelines for ASPs linked to 30 minutes of MVPA.Methods:Steps and accelerometer estimates of MVPA were collected concurrently over multiple days on 245 children (8.2 years, 48% boys, BMI-percentile 68.2) attending 3 community-based ASPs. Random intercept logit models and receiver operating characteristic (ROC) analyses were used to identify a threshold of steps that corresponded with attaining 30 minutes of MVPA.Results:Children accumulated an average of 2876 steps (standard error [SE] 79) and 16.1 minutes (SE0.5) of MVPA over 111 minutes (SE1.3) during the ASP. A threshold of 4600 steps provided high specificity (0.967) and adequate sensitivity (0.646) for discriminating children who achieved the 30 minutes of MVPA; 93% of the children were correctly classified. The total area under the curve was 0.919. Children accumulating 4600 steps were 25times more likely to accumulate 30 minutes of MVPA.Conclusions:This step threshold will provide ASP leaders with an objective, low-cost, easy-to-use tool to monitor progress toward policy-related goals.

scholarly journals Applying quality improvement principles to improve accident and emergency department overcrowding and flow in Rwanda: a case study

2015 ◽  
Vol 4 (5) ◽  
pp. 47 ◽  
Author(s):  
Jean Claude Byiringiro ◽  
Rex Wong ◽  
Caroline Davis ◽  
Jeffery Williams ◽  
Joseph Becker ◽  
...  
Keyword(s):  
Emergency Department ◽  
Quality Improvement ◽  
Success Factors ◽  
Low Cost ◽  
Post Intervention ◽  
Triage System ◽  
Accident And Emergency ◽  
Number Of Patients ◽  
Accident And Emergency Department ◽  
The Impact

Few case studies exist related to hospital accident and emergency department (A&E) quality improvement efforts in lowerresourced settings. We sought to report the impact of quality improvement principles applied to A&E overcrowding and flow in the largest referral and teaching hospital in Rwanda. A pre- and post-intervention study was conducted. A linked set of strategies included reallocating room space based on patient/visitor demand and flow, redirecting traffic, establishing a patient triage system and installing white boards to facilitate communication. Two months post-implementation, the average number of patients boarding in the A&E hallways significantly decreased from 28 (pre-intervention) to zero (post-intervention), p < .001. Foot traffic per dayshift hour significantly decreased from 221 people to 160 people (28%, p < .001), and non-A&E related foot traffic decreased from 81.4% to 36.3% (45% decrease, p < .001). One hundred percent of the A&E patients have been formally triaged since the implementation of the newly established triage system. Our project used quality improvement principles to reduce the number of patients boarding in the hallways and to decrease unnecessary foot traffic in the A&E department with little investment from the hospital. Key success factors included a collaborative multidisciplinary project team, strong internal champions, data-driven analysis, evidence-based interventions, senior leadership support, and rapid application of initial implementation learnings. Results to date show the application of quality improvement principles can help hospitals in resource-limited settings improve quality of care at relatively low cost.

Introduction of a modified analgesic ladder in the emergency department: Effect on oxycodone use for back pain

2021 ◽  
Vol 17 (1) ◽  
pp. 55-61
Author(s):  
Jenny Ly, BPharm, GradCertPharmPrac ◽  
Cristina P. Roman, BPharm (Hons), MPP ◽  
Carl Luckhoff, MB, ChB, FACEM ◽  
Peter A. Cameron, MBBS, MD, FACEM, FCEM (Hon) ◽  
Michael J. BPharm, GradDipHospPharm, PhD, AdvPracPharm, FSHP, FISOPP ◽  
...  
Keyword(s):  
Emergency Department ◽  
Back Pain ◽  
Outcome Measure ◽  
Interquartile Range ◽  
Post Intervention ◽  
Community Based ◽  
Analgesic Ladder ◽  
Multifaceted Interventions ◽  
Discharge From Hospital ◽  
Modest Reduction

Objective: The aim of this study was to assess the introduction of an analgesic ladder and targeted education on oxycodone use for patients presenting to the emergency department (ED).Design: A retrospective pre-post implementation study was conducted. Data were extracted for patients presenting from June to July 2016 (preintervention) and June to July 2017 (post-intervention).Setting: The EDs of a major metropolitan health service and an affiliated community-based hospital.Participants: Patients with back pain where nonpharmacological interventions such as mobilization and physiotherapy are recommended as the mainstay of treatment.Interventions: A modified analgesic ladder introduced in May 2017. The ladder promoted the use of simple analgesics such as paracetamol and nonsteroidal anti-inflammatory drug (NSAIDs) prior to opioids and tramadol in preference to oxycodone in selected patients.Main outcome measure(s): The proportion of patients prescribed oxycodone and total doses administered.Results: There were 107 patients pre and 107 post-intervention included in this study. After implementation of the analgesic ladder, 78 (72.9 percent) preintervention patients and 55 (51.4 percent) post-intervention patients received oxycodone in ED (p = 0.001). The median oxycodone doses administered in the ED was 14 mg (interquartile range: 5-20 mg) and 5 mg (interquartile range: 5-10 mg; p 0.001), respectively. On discharge from hospital, a prescription for oxycodone was issued for 36 (33.6 percent) patients preintervention and 26 (24.3 percent) patients post-intervention (p = 0.13). Conclusions: Among patients with back pain, implementation of a modified analgesic ladder was associated with a statistically significant but modest reduction in oxycodone prescription. Consideration of multifaceted interventions to produce major and sustained changes in opioid prescribing is required.

Comparative Study of Effect of Resistance Exercises versus Aerobic Exercises on Exercise Performance and Pulmonary Function in Adult Chronic Smokers

2021 ◽  
Vol 11 (6) ◽  
pp. 312-317
Author(s):  
Ketki Ponde –Ponkshe ◽  
Ronika Agrawal ◽  
Shimaz Khan
Keyword(s):  
Pulmonary Function ◽  
Low Cost ◽  
Exercise Program ◽  
Vascular Diseases ◽  
Premature Death ◽  
Good Health ◽  
Vo2 Max ◽  
Post Intervention ◽  
Resistance Exercises ◽  
Group B

Background: Cigarette smoking is the major cause of premature death. It accounts for 28% of all cardio vascular diseases and 40% of respiratory diseases as it is associated with impaired pulmonary function. Exercise is an effective and low cost of treatment which can promote good health of a smoker. Research indicates that individuals who maintain an exercise program are more likely to give up smoking than those who quit exercising. Methodology: 150 subjects were included in the study and divided into two groups Group A (resistance exercises) and Group B (Walking). The exercises protocol was given for six weeks. Pre post PEFR and VO2 max was calculated. Results: both the groups showed improvement post intervention (p<0.05) whereas resistance group showed better improvement than the walking group (p<0.05). Conclusion: Aerobic and Resistance exercises both showed significant improvement in PEFR and VO2 max in smokers, however the resistance exercises showed better improvement in the cardiovascular and pulmonary function. Key words: Smoking, Aerobic exercises, Resistance exercises, Theraband.

scholarly journals Extending QGroundControl for Automated Mission Planning of UAVs

Sensors ◽  
2018 ◽  
Vol 18 (7) ◽  
pp. 2339 ◽  
Author(s):  
Cristian Ramirez-Atencia ◽  
David Camacho
Keyword(s):  
Flight Control ◽  
Low Cost ◽  
Real Life ◽  
Mission Planning ◽  
Human Computer Interface ◽  
Simulation Environment ◽  
Test Bed ◽  
Multiple Vehicles ◽  
Operator Workload ◽  
Selection Of

Unmanned Aerial Vehicles (UAVs) have become very popular in the last decade due to some advantages such as strong terrain adaptation, low cost, zero casualties, and so on. One of the most interesting advances in this field is the automation of mission planning (task allocation) and real-time replanning, which are highly useful to increase the autonomy of the vehicle and reduce the operator workload. These automated mission planning and replanning systems require a Human Computer Interface (HCI) that facilitates the visualization and selection of plans that will be executed by the vehicles. In addition, most missions should be assessed before their real-life execution. This paper extends QGroundControl, an open-source simulation environment for flight control of multiple vehicles, by adding a mission designer that permits the operator to build complex missions with tasks and other scenario items; an interface for automated mission planning and replanning, which works as a test bed for different algorithms, and a Decision Support System (DSS) that helps the operator in the selection of the plan. In this work, a complete guide of these systems and some practical use cases are provided

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