Development of a method for evaluating accessibility of medical equipment for patients with disabilities

Objective

The purpose of this study was to develop a method for evaluating accessibility of medical equipment for patients with disabilities.

Methods

The researchers reviewed videotapes of patient-participants with various physical and sensory disabilities using different types of medical equipment. For each of 11 videotapes, four observers independently identified and documented access and safety barriers, such as physical, sensory, cognitive, and environmental barriers. Inter-observer variability for identifying barrier presence was assessed with kappa statistics for pairs of observers.

Results

A list of 10 access and safety barriers was developed through an iterative consensus process, which identified design features of medical equipment that presented difficulties for participants with disabilities. The list is useful for identifying and categorizing accessibility problems found in equipment. While reliability of barrier identification was substantial or moderate for some barriers, reconciliation of barrier events identified by multiple video observers is recommended for optimal results.     

Anorexia nervosa and autism spectrum disorders: Guided investigation of social cognitive endophenotypes.

Death by suicide occurs in a disproportionate percentage of individuals with anorexia nervosa (AN), with a standardized mortality ratio indicating a 57-fold greater risk of death from suicide relative to an age-matched cohort. Longitudinal studies indicate impaired social functioning increases risk for fatal outcomes, while social impairment persists following recovery. Study of social cognition in AN may elucidate impaired processes that may influence therapeutic efficacy. Symptoms of autism spectrum disorders (ASD) are overrepresented in those who evidence a chronic course. Relative to that in AN, social information processing in ASD is well characterized and may inform systematic study in AN. This article (a) reviews impaired interpersonal processes in AN, (b) compares the phenotype of AN with that of ASD, (c) highlights deficits of social cognitive disturbance in ASD relative to AN, and (d) proposes a new framework to understand the interaction of individuals with AN with their social context. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Back to basics: The importance of focus selection.

Examines the importance of selecting a therapeutic focus when teaching the introductory course in brief insight-oriented psychotherapy to psychiatric residents. The initial attention required toward the selection of a focus, and adherence to this central theme during treatment, are the essential features of the brief therapeutic technique. Case material from a 68-yr-old man provided by a resident illustrates the process of finding a therapeutic focus. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Not Now! Supporting interruption management by indicating the modality and urgency of pending tasks

Operators in complex event-driven domains must coordinate competing attentional demands in the form of multiple tasks and interactions. This study examined the extent to which this requirement can be supported more effectively through informative interruption cueing (in this case, partial information about the nature of pending tasks). The 48 participants performed a visually demanding air traffic control (ATC) task. They were randomly assigned to 1 of 3 experimental groups that differed in the availability of information (not available, available upon request, available automatically) about the urgency and modality of pending interruption tasks. Within-subject variables included ATC-related workload and the modality, frequency, and priority of interruption tasks. The results show that advance knowledge about the nature of pending tasks led participants to delay visual interruption tasks the longest, which allowed them to avoid intramodal interference and scanning costs associated with performing these tasks concurrently with ATC tasks. The 3 experimental groups did not differ significantly in terms of their interruption task performance; however, the group that automatically received task-related information showed better ATC performance, thus experiencing a net performance gain. Actual or potential applications of this research include the design of interfaces in support of attention and interruption management in a wide range of event-driven environments.     

Fibrinogen Replacement Therapy for Traumatic Coagulopathy: Does the Fibrinogen Source Matter?

Fibrinogen is the first coagulation protein to reach critically low levels during traumatic haemorrhage. There have been no differential effects on clinical outcomes between the two main sources of fibrinogen replacement: cryoprecipitate and fibrinogen concentrate (Fg-C). However, the constituents of these sources are very different. The aim of this study was to determine whether these give rise to any differences in clot stability that may occur during trauma haemorrhage. Fibrinogen deficient plasma (FDP) was spiked with fibrinogen from cryoprecipitate or Fg-C. A panel of coagulation factors, rotational thromboelastography (ROTEM), thrombin generation (TG), clot lysis and confocal microscopy were performed to measure clot strength and stability. Increasing concentrations of fibrinogen from Fg-C or cryoprecipitate added to FDP strongly correlated with Clauss fibrinogen, demonstrating good recovery of fibrinogen (r² = 0.99). A marked increase in Factor VIII, XIII and α₂-antiplasmin was observed in cryoprecipitate (p < 0.05). Increasing concentrations of fibrinogen from both sources were strongly correlated with ROTEM parameters (r² = 0.78–0.98). Cryoprecipitate therapy improved TG potential, increased fibrinolytic resistance and formed more homogeneous fibrin clots, compared to Fg-C. In summary, our data indicate that cryoprecipitate may be a superior source of fibrinogen to successfully control bleeding in trauma coagulopathy. However, these different products require evaluation in a clinical setting.     

Integrative Self‐Assembly of Graphene Quantum Dots and Biopolymers into a Versatile Biosensing Toolkit

Hybrid self‐assembly has become a reliable approach to synthesize soft materials with multiple levels of structural complexity and synergistic functionality. In this work, photoluminescent graphene quantum dots (GQDs, 2–5 nm) are used for the first time as molecule‐like building blocks to construct self‐assembled hybrid materials for label‐free biosensors. Ionic self‐assembly of disc‐shaped GQDs and charged biopolymers is found to generate a series of hierarchical structures that exhibit aggregation‐induced fluorescence quenching of the GQDs and change the protein/polypeptide secondary structure. The integration of GQDs and biopolymers via self‐assembly offers a flexible toolkit for the design of label‐free biosensors in which the GQDs serve as a fluorescent probe and the biopolymers provide biological function. The versatility of this approach is demonstrated in the detection of glycosaminoglycans (GAGs), pH, and proteases using three strategies: 1) competitive binding of GAGs to biopolymers, 2) pH‐responsive structural changes of polypeptides, and 3) enzymatic hydrolysis of the protein backbone, respectively. It is anticipated that the integrative self‐assembly of biomolecules and GQDs will open up new avenues for the design of multifunctional biomaterials with combined optoelectronic properties and biological applications.     

Measurements and simulations of polarization states of underwater light in clear oceanic waters

Polarization states of the underwater light field were measured by a hyperspectral and multiangular polarimeter and a video polarimeter under various atmospheric, surface, and water conditions, as well as solar and viewing geometries, in clear oceanic waters near Port Aransas, Texas. Some of the first comprehensive comparisons were made between the measured polarized light, including the degree and angle of linear polarization and linear Stokes parameters (Q and U), and those from Monte Carlo simulations that used concurrently measured water inherent optical properties and particle volume scattering functions as input. For selected wavelengths in the visible spectrum, measured and model-simulated polarization characteristics were found to be consistent in most cases. Measured degree and angle of linear polarization are found to be largely determined by an in-water single-scattering model. Model simulations suggest that the degree of linear polarization (DoLP) at horizontal viewing directions is highly dependent on the viewing azimuth angle for a low solar elevation. This implies that animals can use the DoLP signal for orientation.     

The effect of homework compliance on treatment outcomes for participants with myalgic encephalomyelitis/chronic fatigue syndrome.

Purpose: This study examined the relationship between level of treatment engagement through completion of homework on treatment outcomes within nonpharmacological interventions for participants with ME/CFS. Method: A sample of 82 participants with ME/CFS was randomly assigned to one of four nonpharmacological interventions. Each intervention involved 13 sessions over the course of 6 months. Change scores were computed for self-report measures taken at baseline and 12-month follow-up. Homework compliance was calculated as the percentage of completed assignments across the total number of sessions and grouped into three categories: minimum (0–25%), moderate (25.1–75%), or maximum (75.1–100%). Results: Findings revealed that after controlling for treatment condition, those who completed a maximum amount of homework had greater improvement on a number of self-report outcome measures involving role, social, and mental health functioning. There were no differential improvements in physical and fatigue functioning based on level of homework compliance. Implications: Findings from this study suggest homework compliance can have a positive influence on some aspects of physical, social, and mental health functioning in participants with ME/CFS. It should be emphasized that these interventions do not cure this illness. The lack of significant changes in physical functioning and fatigue levels suggests a need for more multidisciplinary treatment approaches that can elicit improvement in these areas. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

REVIEWS

From the Reviews Editors

Above and Beyond: Visualizing Change in Small Towns and Urban Areas Julie Campoli, Elizabeth Humstone, and Alex MacLean. APA Planners Press, Chicago, 2002. 210 pages. $54.95 (paperback).

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Geographic Information Systems for Transportation: Principles and Applications Harvey J. Miller and Shih-Lung Shaw. Oxford University Press, New York, 2001. 458 pages. $60.

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