Randomized trial of an eLearning program for training family members of children with autism in the principles and procedures of applied behavior analysis

Effective training of caregivers is an integral part of top-quality treatment programs for individuals with autism spectrum disorders (ASD). However, traditional caregiver training can be time consuming and costly. The development of Web-based electronic training programs (e.g., “eLearning”) may extend training to rural areas, thereby increasing accessibility and improving efficiency. The eLearning approach has been shown to be effective and efficient in various disciplines and industries, but studies evaluating eLearning programs for training parents of children with ASD are limited. The purpose of this study was to evaluate the effectiveness of an eLearning program for training family members of children with ASD in the principles and procedures of applied behavior analysis treatment. A total of 28 family members participated in this randomized, waitlist-controlled, between-groups study. Differences in change scores between groups were significant, with the trained group substantially outperforming the waitlist control group at post-test. The control group then received training and also demonstrated significant gains post training.     

情景模拟在HIV/AIDS职业暴露应急处置培训中的应用

为了提高职业暴露高风险工作人员在HIV职业暴露时的应急处置能力,降低HIV职业暴露的危险,保障工作人员的职业安全,我们应用了情景模拟方法,编写了HIV职业暴露的防护过程和应急处置全程情景剧本,简述了情景模拟教学方法的效果及局限性。经过培训的学员认为在规范使用防护用品、提高自我防护意识、提高标准预防的依从性、规范操作规程等方面均有良好改变,情景模拟培训方法能提高学员在HIV职业暴露中的防护能力和应急处置能力。     

BRAIN ACTIVATION RELATED TO AFFECTIVE DIMENSION DURING THERMAL STIMULATION IN HUMANS: A FUNCTIONAL MAGNETIC RESONANCE IMAGING STUDY

The aim of this study was to identify the activated brain region that is involved with the affective dimension of thermal stimulation (not pain, but innocuous warming) using functional MR imaging. Twelve healthy, right-handed male subjects participated in the study. Thermal stimulation with two different temperatures of 41°C and 34°C was applied to the subjects using a fomentation pack, wrapped around the right lower leg of each subject. On the basis of the subjects’ responses after the scanning sessions, the authors were able to observe that the subjects felt “warm” and “slightly pleasant and comfortable” under the 41°C condition. The experimental results indicated that warm stimulation produced a significant increase of activation compared to thermal neutral stimulation in various regions such as contralateral insular, ipsilateral cerebellum, ipsilateral putamen, contralateral middle frontal gyrus, ipsilateral inferior frontal gyrus, contralateral postcentral gyrus, and contralateral paracentral lobule. The activated regions are known to be related to thermal sensory, affective/emotional awareness, cognitive functions, sensory-discrimination, and emotion/affective processing, and so on. These results suggest that an appropriate thermal stimulation can produce a positive emotion and activate emotion/affect related regions of the brain.     

支架模式在护理临床教学老师急救教学能力培养中的构建

目的构建支架模式以提升护理临床教师的急救教学能力。方法基于最近发展区理论构建支架式模式,并分析其优势。结果以搭建支架-导入情境-协作学习-独立探索-效果评价5个步骤为基本环节的支架模式的构建顺利完成。结论支架模式在护理临床教师急救教学能力培养中具有一定可行性及适用性。     

Improving behavior using child-directed interaction skills: A case study determining cochlear implant candidacy

Abstract

Objective and importance

Children with hearing loss (HL) are at increased risk of developing externalizing behavior problems (e.g., hyperactivity, attention problems). These problems can lead to cascading effects on children's overall development. However, few studies have identified evidence-based interventions for this population.

Clinical presentation

A 6-year-old boy with bilateral HL presented to the clinic with significant behavioral challenges. These challenges (e.g., fatigued quickly, poor attention, and hyperactivity) were affecting the reliability of audiological testing to determine cochlear implant candidacy. Thus, the child was referred for Parent-Child Interaction Therapy (PCIT) to address these behavioral challenges.

Intervention and technique

PCIT is an evidence-based intervention that has been shown to significantly improve externalizing behavior problems. This study describes how the Child-Directed Interaction phase of PCIT was tailored for a child with bilateral HL. The goal of the intervention was to reduce externalizing behaviors in order to reliably complete a cochlear implant evaluation. Post-intervention, significant improvements were noted in behavior, including a decrease in disruptive behavior to normal levels. This led to completion of previously unsuccessful audiological testing and determination of cochlear implant candidacy.

Conclusion

This study illustrates how PCIT was successfully tailored to one child with an HL. This is critical as children with HL are at risk for behavior problems, and effective interventions for disruptive behaviors in children with HL may lead to significant improvements in medical and psychosocial outcomes for children with HL and their families.     

From formalin to thiel embalming: What changes? One anatomy department's experiences

In 2009, the Centre for Anatomy and Human Identification started Thiel embalming on a small scale to assess (i) the suitability for our current teaching in which long‐lasting dissection courses are key, (ii) the potential for new collaborations and activities, and (iii) the practical implications of changing our embalming method from formalin to Thiel. Twenty six Thiel‐embalmed cadavers have been used for dissection by staff and students on a taught MSc course, as a model for clinical and surgical training, and increasingly as a model for evaluation of new medical devices and procedures. Our experiences with dissection were mostly positive especially for teaching the musculoskeletal system. Internal organs handle differently from formalin‐fixed organs and dissection manuals need to be adjusted to reflect this. Durability of the cadavers was not an issue, though changes are seen over time due to gradual fluid loss. We have started new collaborations related to postgraduate anatomy teaching and advanced training in surgical and clinical skills. In general, feedback is very positive and demand for cadavers outstrips our current limited supply. Thiel‐embalmed cadavers were found to provide a unique opportunity for evaluation of medical products especially in areas where no suitable alternative model is available, and without the complications associated with clinical testing. This has resulted in new collaborations and research projects. As a result Thiel‐embalmed cadavers are used for longer and for more activities than formalin cadavers: this requires changes in our procedures and staff roles. Clin. Anat. 26:564–571, 2013. © 2013 Wiley Periodicals, Inc.     

“精准医学”理念下康复治疗人才培养的思考与实践

随着精准医学理念不断深入人心和"健康中国"国家战略的深入实施,患者对医疗水平的要求越来越高,康复医疗已向"精准康复"方向发展。作为人才培养的高等医学教育也必须顺应这种新的医学模式。我国康复治疗人才培养起步较晚,目前仍以"综合"康复治疗师培养为主,这种"庞杂"的康复治疗人才培养模式,与国际上专业分化培养的现状不接轨,导致培养的人才不精不专,甚至无法与国际专业组织及人员进行对话。这就要求我们要逐步改革目前康复治疗专业教育模式,构建与国际接轨、符合精准医学理念的人才培养模式。文章立足于国内康复治疗人才培养现状,从专业设置分化、课程体系和教学内容设立、教学师资队伍建设、教育教学模式和教学手段改革、临床实习带教队伍建设等5个方面,阐述了如何开展分方向培养康复治疗人才,培养符合精准医学理念的、满足国际国内需求的高、精、专高水平合格人才,以迎接精准医学教育时代的到来。