A comparison of electronic to traditional pen-and-paper data collection in discrete trial training for children with autism

There is considerable empirical evidence that demonstrates that early intensive behavioral intervention (EIBI) produces substantial improvements in young children with autism. A central feature of this treatment approach is the reliance on continuous measurement of child performance during all treatment hours (20–40 h per week) to ensure an objective and quantitative analysis of behavior. Pen-and-paper data collection is standard practice in service delivery agencies. An alternative is to collect data via an electronic format, however little research has been done on electronic data collection in these settings. The purpose of this study was to compare mTrial^®, a program that allows therapists to record, store, and report discrete trial and other behavior data for students on a personal data assistant, to traditional pen-and-paper data, in terms of the accuracy of data collected and the time required to do it. Results suggest that both formats are of approximately equal accuracy but that traditional data collection is faster. Implications of the two data collection methods for data storage and analysis are also discussed.     

Ranitidine 300 mg twice daily and 150 mg four-times daily are effective in healing erosive oesophagitis.

BACKGROUND: Ranitidine 150 mg q.d.s. is the currently recommended dosage in the United States for the treatment of erosive oesophagitis. To determine whether a higher dose of ranitidine administered less frequently would also be effective in healing erosive oesophagitis, we compared ranitidine 300 mg b.d. with ranitidine 150 mg q.d.s. in the treatment of erosive oesophagitis. METHODS: This multicentre, double- blind, randomized, placebo-controlled study conducted in the United States compared two dosages of ranitidine in 772 patients with endoscopically diagnosed erosive oesophagitis. Patients were treated with ranitidine 300 mg b.d., ranitidine 150 mg q.d.s. or placebo for up to 12 weeks. Endoscopies were repeated after 4, 8 and 12 weeks of treatment. RESULTS: Ranitidine 300 mg b.d. was significantly more effective than placebo in healing erosive oesophagitis at weeks 8 and 12 (51 vs. 36% and 66 vs. 52%, respectively; P < or = 0.004). Significantly higher healing rates were also achieved with ranitidine 150 mg q.d.s. compared with placebo at 4, 8 and 12 weeks (37 vs. 21%, 62 vs. 36% and 77 vs. 52%, respectively; P < 0.001). Healing rates were significantly higher with ranitidine 150 mg q.d.s. than with ranitidine 300 mg b.d. at all scheduled endoscopies (P < or = 0.041). CONCLUSIONS: Ranitidine 300 mg b.d. is effective in healing erosive oesophagitis and may be appropriate as an alternative dosage regimen to ranitidine 150 mg q.d.s. in some patients with erosive oesophagitis.     

海南黎族跳娘舞的健身价值

目的:评价跳娘舞者运动负荷程度,分析其健身价值。方法:①2003-03/07对海南省五指山市、陵水县、保亭县3个黎族市县的乡镇跳娘舞者120人,其中男80人,女40人,年龄20～40岁。均身体健康,且对检测项目知情同意。②跳娘舞共有8个表演程序基本动作:跳步,跳踢步,三步摆胯,二步摆胯,甩手拭汗,摊掌跳摆,甩手祈福,甩手闪臂,拍手跳。③以主观心理感觉等级表等级作为运动时心理负荷的标志,该表按自我感觉分为6～20级,级数越高,则表明被试感觉越累,运动强度越大。运动处方的适宜强度应为11～14级(心率110～140次/min)。④用芬兰产的Polar遥测心率仪对跳娘舞者心率进行测定。结果:跳娘舞者97人(81%)心率为110～140次/min,是适宜的运动负荷程度。结论:大多数跳娘舞者运动负荷程度适宜,是健身效果较好的运动。     

Living with Marfan syndrome II. Medication adherence and physical activity modification

We investigated the perceptions of and adherence to medication and physical activity guidelines in 174 adults with Marfan syndrome. Over 80% of those prescribed beta- and Ca2+-channel blockade reportedly adhere well to their medication regimen. The presence of cardiovascular symptoms and fatigue were positively correlated with the medication use. Medication-takers reported that they are psychologically receptive to the use of medication for prophylactic treatment of their cardiovascular problems. However, all do not view their medication as essential for their health. Duration of the medication regimen, type of medication, and perception of controllability of the condition were each independently associated with respondents' perceptions of the necessity of taking beta- or Ca2+-channel blockers. Over 80% of the respondents reported that they choose their physical activities with their diagnosis in mind. Modifying exercise activities was significantly correlated with an increased perception of Marfan syndrome as having negative consequences on the respondents' lives. Genetic counseling should address beliefs about medication use and physical activity restrictions, as perceptions of these health behaviors may have significant impact on how adults with Marfan syndrome adhere to these recommendations and cope with their condition.     

A review of transfusion-associated AIDS litigation: 1984 through 1993

Background : Since 1984, hundreds of lawsuits have been filed against health care providers in the United States, alleging transmission of human immunodeficiency virus by transfusion. While anecdotal reports of jury verdicts have been published, no quantitative study to identify trends in transfusion-associated AIDS litigation has been undertaken. Study Design and Methods : To identify trends in lawsuits filed against health care providers alleging human immunodeficiency virus infection transmitted via transfusion, 163 legal actions were analyzed. Included were those for which the authors provided legal defense or consultation (n = 79) and cases reported nationally (n = 84). Cases were analyzed as to characteristics of defendant(s), date of transfusion and case filing, liability theories, and verdict, if applicable. Results : Defendants were blood centers (74% of cases), hospitals (58%), and physicians (53%). Of physicians, surgeons were named in 78 percent of cases; 42 percent of these surgeons were cardiothoracic surgeons. Nationally, 14 cases have resulted in plaintiff awards totalling $75,420,798. Physicians have been liable for 41 percent of that sum, blood banks 31 percent, and hospitals 26 percent. Of the 10 liability theories raised, the most frequent were claims of medical negligence (46% of cases), failure to identify high-risk donors (45%), lack of informed consent (39%), and failure to conduct surrogate testing (39%). Twenty-six trial results favorable to health care providers were noted nationally, 17 occurring in the San Francisco Bay Area, where case filings peaked before 1990 (40/56) and where new case filings decreased (1990, 5; 1991, 3; 1992, 1; 1993, 0) as verdicts favoring health care providers were reported. Conclusion : Transfusion-associated AIDS litigation began with verdicts against blood banks, but has expanded to suits against physicians and hospitals that are based on theories of medical negligence and informed consent. Despite widely publicized verdicts for plaintiffs, health care professionals have successfully defended these lawsuits, and in one center of early litigation, a sharp decrease in new case filings has been observed.     

妊娠妇女150例的健康知识需求

1临床资料2000-01/2005-03,孕妇150例门诊进行保健咨询,随机抽样调查健康知识需求情况.按照有无合并症分为正常组和异常组.正常组116例,年龄25～38岁,孕12～36周;异常组34例,年龄28～40岁,孕16～38周.两组孕期保健和疾病知识需求比较:正常组对孕期保健知识需求108例,占93.1%;饮食营养86例,占74.1%;常见病预防50例,占43.1%;孕期用药注意事项60例,占51.7%;疾病对胎儿的影响28例,占24.1%.异常组对本身疾病方面治疗知识关注28例,占82.4%;本身疾病对胎儿影响31例,占91.2%;孕期保健知识30例,占88.2%;饮食营养22例,占64.7%;孕期用药注意事项26例,占76.5%.针对两种不同类型患者心理特点,通过心理疏导,知识普及,孕期防病用药指导,运动时胎儿安全呵护,合理改善膳食方案等知识讲解,消除妊娠期妇女心理负担.     

Symptom severity and challenging behavior in children with ASD

The prevalence of challenging behaviors in the autism spectrum disorders (ASD) population is often assumed to be high but relatively little research has actually been published on it. Furthermore, challenging behaviors are likely to impede progress in evidence-based treatment programs, such as early intensive behavioral intervention (EIBI). Little or no previous research has evaluated the prevalence of various topographies of challenging behavior in a population of children with ASD receiving EIBI services, nor evaluated the relationship between such behaviors and the severity of ASD symptoms. Using data from the ASD–DC and the ASD–BPC in 84 children with autism receiving EIBI services, the current study conducted a regression analysis of relations between endorsement of challenging behaviors and ASD symptom severity. Results indicated that 94% of the sample reported the presence of challenging behavior, stereotypical behaviors were the most commonly reported, and that the presence of challenging behavior was predicted by ASD severity.     

A review of assessments for determining the content of early intensive behavioral intervention programs for autism spectrum disorders

A large proportion of national education and treatment centers for persons with autism spectrum disorders (ASD), including those providing applied behavior analysis (ABA)-based services, show a relatively high percentage of agreement among practitioners on the instruments they routinely use for a variety of purposes, including curriculum design and treatment evaluation. In this paper, several assessments are reviewed and evaluated in terms of their utility for designing comprehensive early intensive behavioral intervention (EIBI) curriculum programs for children with ASD. The assessments found to be most useful for this purpose are reported. A general critique regarding the available pool of assessment tools is provided and the need for a comprehensive assessment directly linked to curricula is discussed.