Enhancing the Delivery of an Empirically-Supported Trauma-Focused Treatment for Adolescents: Providers’ Views of the Role of Technology and Web-Based Resources

Abstract

This mixed-methods study assessed providers' views of the use of technology in the delivery of an empirically supported mental health treatment for adolescents (Trauma-Focused Cognitive Behavioral Therapy; TF-CBT). Thematic qualitative interviews were conducted with nine experienced providers. Emerging themes served as the basis for the creation of a quantitative web-based survey, completed by 56 TF-CBT experts, to assess the perceived helpfulness of the recommendations. Technology was perceived as a useful, appealing, and familiar tool that could greatly enhance the delivery of this treatment modality with adolescents. Main recommendations included the creation of a mobile application targeting all of the treatment components and a website with developmentally appropriate resources for providers, caregivers, and teens. Technology may be a useful tool for enhancing service delivery and promoting engagement among youth receiving trauma-focused mental health treatment.

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Thoron exposure in Dutch dwellings – An overview

Publication date: March 2018
Source:Journal of Environmental Radioactivity, Volume 183
Author(s): G. de With, R.C.G.M. Smetsers, H. Slaper, P. de Jong
In the Netherlands considerable attention has been given to the exposure from thoron progeny in dwellings. For this purpose a nationwide survey on the thoron exhalation and thoron progeny concentration has been completed in 2015. Furthermore, extensive laboratory studies have been performed to measure activity concentrations and thoron exhalation rates from regular Dutch building materials. The purpose of this study is to demonstrate if the findings from both field experiments and laboratory results are consistent. For this reason measured properties of building materials and surface barriers, in-situ measurements on air ventilation and thoron(progeny) in dwellings as well as advanced computational modelling on indoor air and aerosol behaviour have been used. The results demonstrate that median and mean thoron progeny concentrations of 0.53 and 0.64 Bq·m⁻³ found in the survey are comparable with the mean concentration of 0.57 Bq·m⁻³ obtained from laboratory testing and calculation. Furthermore, upper thoron progeny concentrations from the survey and the calculations are with respectively 13 and 14 Bq·m⁻³ also in good agreement. Such elevated concentrations lead to an effective doses of around 4 mSv per year. The study also includes worst-case scenarios on the application of surface materials high on ²³²Th, and the expected reduction in thoron progeny when using mainstream mitigation measures.



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Inventory and vertical distribution of 137Cs, 239+240Pu and 238Pu in soil from Raivavae and Hiva Oa, two French Polynesian islands in the southern hemisphere

Publication date: March 2018
Source:Journal of Environmental Radioactivity, Volume 183
Author(s): P. Bouisset, M. Nohl, A. Bouville, G. Leclerc
Atmospheric nuclear weapons tests carried out by the United States, the former Soviet Union, the United Kingdom, France and China between 1945 and 1980 resulted in radioactive fallout over the earth's surface of long-lived radionuclides, such as ¹³⁷Cs, ^239+240Pu and ²³⁸Pu that could be detected more than 50 years after their production. In addition, the burnup in the upper atmosphere of a thermoelectric generator fueled by ²³⁸Pu, SNAP-9A, contributed to the inventory of ²³⁸Pu deposited on the ground. In order to estimate the deposition densities of ¹³⁷Cs, ^239+240Pu and ²³⁸Pu in French Polynesia, we collected undisturbed soil samples up to 30 cm deep at eight sites in two islands (Hiva Oa, 139°W - 10°S and Raivavae, 148°W - 24°S) in 2015–2016. The top 0–10 cm of the soil cores were sliced into five 2-cm layers and the bottom 10–30 cm into four 5-cm layers for gamma spectrometry and alpha spectrometry measurements. We found that more than 50% of the radioactive inventories are still contained within the first 10 cm and that the average vertical migration velocities of ¹³⁷Cs and Pu are less than 0.2 cm y⁻¹. The average accumulated depositions, deduced from the profile measurements, are 236 ± 11 Bq.m⁻² and 313 ± 39 Bq.m⁻² for ¹³⁷Cs, 12.1 ± 1.5 Bq.m⁻² and 22.1 ± 1.7 Bq.m⁻² for ^239+240Pu, and 1.23 ± 0.46 Bq.m⁻² and 1.58 ± 0.60 Bq.m⁻² for ²³⁸Pu, in Hiva Oa and Raivavae, respectively. The ²³⁸Pu/^239+240Pu ratios are 0.102 ± 0.050 at Hiva Oa and 0.072 ± 0.033 at Raivavae. Both values are higher than the ratio in nuclear weapons tests fallout estimated to be 0.016 in 2016 (Hardy et al., 1973), because of the contribution of ²³⁸Pu fallout from SNAP-9A, which is latitude dependent. The ¹³⁷Cs/^239+240Pu ratios, 19.5 ± 3.2 at Hiva Oa and 14.2 ± 2.8 at Raivavae are in the lower part of the range of values observed in other regions of the world.



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Multiple Origin but Single Domestication Led to Oryza sativa

The domestication scenario that led to Asian rice (Oryza sativa) is a contentious topic. Here, we have reanalyzed a previously published large-scale wild and domesticated rice dataset, which were also analyzed by two studies but resulted in two contrasting domestication models. We suggest the analysis of false positive selective sweep regions and phylogenetic analysis of concatenated genomic regions may have been the sources that contributed to the different results. In the end, our result indicates Asian rice originated from multiple wild progenitor subpopulations; however, de novo domestication appears to have occurred only once and the domestication alleles were transferred between rice subpopulation through introgression.

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Laparoscopic appendectomy during the third trimester: Case presentation and literature review

Abstract

Acute appendicitis is the most common general surgical problem encountered during pregnancy. Laparoscopic appendectomy (LA) is widely accepted as a minimally invasive procedure for acute appendicitis. However, LA during the third trimester is associated with problems, including technical difficulty, risk of preterm delivery, and fetal loss. We successfully managed three cases of LA during the third trimester between 2011 and 2016. None of the cases required conversion to an open procedure, and none of the patients had postoperative complications and/or fetal loss. We reviewed the literature using the PubMED database from 2007 to 2016 to acquire further evidence and identified 6 reports and 17 cases. The conversion rate was 11.8% (2 cases), the complication rate was 6.67% (1 case), and the preterm delivery rate was 20% (3 cases); no fetal loss was observed. Our study and literature review highlights the role of LA as a potentially feasible treatment approach for appendicitis during the third trimester.

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Laparoscopic repair of bowel herniation into the space between the obturator nerve and the umbilical artery after pelvic lymphadenectomy for cervical cancer

Abstract

Bowel herniation through the space between the exposed structures after pelvic lymphadenectomy is a very rare cause of postoperative bowel obstruction. Here, a case of laparoscopic release of bowel migration into the space after pelvic lymphadenectomy is described. This is the seventh such reported case in the world. A 38-year-old woman who had a history of undergoing laparoscopic radical hysterectomy and bilateral pelvic lymphadenectomy for cervical cancer was diagnosed with strangulated bowel obstruction. Emergency laparoscopic surgery was performed, and bowel migration into the space between the right umbilical artery and the obturator nerve was detected. The loop of strangulated bowel was released laparoscopically, and bowel blood flow was improved. To prevent recurrence of bowel migration, the umbilical artery was resected. It is very important to consider the possibility of bowel herniation into the space between exposed structures in patients with bowel obstruction after minimally invasive pelvic lymphadenectomy.

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Predicting postoperative language outcome using presurgical fMRI, MEG, TMS, and high gamma ECoG

Publication date: Available online 4 January 2018
Source:Clinical Neurophysiology
Author(s): Abbas Babajani-Feremi, Christen M. Holder, Shalini Narayana, Stephen P. Fulton, Asim F. Choudhri, Frederick A. Boop, James W. Wheless
ObjectiveTo predict the postoperative language outcome using the support vector regression (SVR) and results of multimodal presurgical language mapping.MethodsEleven patients with epilepsy received presurgical language mapping using functional MRI (fMRI), magnetoencephalography (MEG), transcranial magnetic stimulation (TMS), and high-gamma electrocorticography (hgECoG), as well as pre- and postoperative neuropsychological evaluation of language. We constructed 15 (2⁴-1) SVR models by considering the extent of resected language areas identified by all subsets of four modalities as input feature vector and the postoperative language outcome as output. We trained and cross-validated SVR models, and compared the cross-validation (CV) errors of all models for prediction of language outcome.ResultsSeven patients had some level of postoperative language decline and two of them had significant postoperative decline in naming. Some parts of language areas identified by four modalities were resected in these patients. We found that an SVR model consisting of fMRI, MEG, and hgECoG provided minimum CV error, although an SVR model consisting of fMRI and MEG was the optimal model that facilitated the best trade-off between model complexity and prediction accuracy.ConclusionsA multimodal SVR can be used to predict the language outcome.SignificanceThe developed multimodal SVR models in this study can be utilized to calculate the language outcomes of different resection plans prior to surgery and select the optimal surgical plan.



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