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Worries about one’s health, while ubiquitous, can for some become quite distressing. Health anxiety occurs when one becomes focused on symptoms and fears they may become ill or die. This often overtakes their life due to continued worry. They often spend an inordinate amount of time and effort to seek answers. Other aspects of their life are placed in the periphery or abandoned. Traditional approaches are aimed at symptom relief. While effective for some, others continue to struggle. A more novel approach that aims to look at the client both holistically and individualistically can address much more than symptom amelioration.

Background Reviews on superior labral anterior to posterior (SLAP) injuries have been reported in the literature. However, current reviews have not focused on the success of athletes return to their previous level of sport or athletic performance. Hypothesis/purpose Systematically review return to sport (RTS) and return to sport at previous level (RTSP) proportions after SLAP injury while reporting any additional performance metrics and outcome measures. Study design Systematic Review & Meta-Analysis. Methods A computer assisted literature search of MEDLINE, CINAHL, Embase and SportDiscus databases utilizing keywords related to RTS post-surgery for SLAP tear was implemented. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were utilized for study methodology. Quality assessment utilized the MINORS scale. Results Twenty-two studies (617 athletes) qualified for analysis. Based on limited evidence from level 3b to 4 studies, athletes RTS post intervention for SLAP injury occurred at a rate of 93% (95% CI:87 to 98%) and overall RTSP rate was 72% (95% CI:60 to 83%). The mean time to RTS post intervention was reported in 59% of studies at 6.9 ± 2.9 months. Patient reported outcome measures (PROM's) were reported in 86% of studies. There was limited reporting of performance statistics, rehabilitation guidelines, return to sport criteria, and information regarding SLAP diagnosis in the available studies. None of the included studies reported post-surgical athletic performance or career longevity. Conclusions Limited evidence suggests that less than three in four athletes return to their previous level of sport participation after SLAP injury intervention. Treatment success for an athlete with SLAP injury remains relatively unknown as only 59% of included studies clearly delineate RTS from RTSP and neither athletic performance nor career longevity were reported in any included studies. Future studies of higher quality are required for this determination. Level of evidence Level 1a.

To evaluate the reporting of rehabilitation guidelines in studies of postoperative outcomes of patients with femoroacetabular impingement (FAI) syndrome and/or labral tear.Scoping review.A computer-assisted literature search was conducted of the MEDLINE, CINAHL, and Embase databases on June 17, 2018. Using key words related to FAI syndrome/labral tear and both open and arthroscopic surgical outcomes, we identified 169 studies that included 16 675 patients. Separate authors calculated and verified the prevalence of reported outcomes.We included intervention and observational studies that were prospective or retrospective in design. Studies must have included patients with a primary diagnosis of FAI syndrome and/or labral tear.We calculated the mean ± SD prevalence for continuous variables, where possible.Hip arthroscopy was the primary surgical procedure (76% of studies). The mean ± SD age of participants was 34.8 ± 9.2 years and the mean ± SD follow-up time was 27 ± 15.3 months. Of the 169 included studies, 74 (44%) discussed phases of rehabilitation, 49 (29%) reported details on goals between phases, 1 in 3 described details on rehabilitation progression, and fewer than 1 in 10 reported sufficient detail to replicate the rehabilitation protocol. Weight-bearing and range-of-motion restrictions were poorly reported and variable in duration.Surgical outcome studies do not provide sufficient detail or consistency for practicing clinicians to replicate a postoperative rehabilitation protocol for patients with FAI syndrome/labral tear.

Risk factors for ulnar collateral ligament injury (UCLI) are unclear despite increasing injury rates. We sought to summarize UCLI risk factors in baseball players.A computer-assisted search of 4 databases was performed using keywords related to UCLI risk factors. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used for study methodology. Odds ratios and 95% confidence intervals were calculated for dichotomous outcomes, and mean differences and 95% confidence intervals were calculated for continuous outcomes using a random-effects model.Thirteen studies qualified for inclusion. A greater nondominant (ND) shoulder internal rotation (IR) range of motion (ROM) at 90° abduction arm demonstrated strong evidence as a significant risk factor for UCLI (P .001) compared with a control group. Mean overall velocity (P .001), fastball velocity (P .001), changeup velocity (P = .03), and curveball velocity (P = .01), as well as fewer years of player experience (P .001), less humeral retrotorsion in the ND arm (P .001), and greater absolute side-to-side differences in retrotorsion (P = .006) were all moderate-evidence risk factors compared with control groups. Strong evidence suggests total ROM arc at 90° abduction in the dominant arm was not a risk factor for UCLI (P = .81).Greater ND shoulder IR ROM and less humeral retrotorsion (in professional and amateur players) as well as pitching velocity (in professional players) demonstrated strong to moderate evidence as risk factors for UCLI. Dominant arm total arc of motion, external, or IR ROM were not risk factors for UCLI. Standardized collection and reporting of risk factors is recommended to more clearly elucidate definitive risk factors for UCLI.

Effective posttraumatic stress disorder (PTSD) pharmacotherapy is needed. This 12-week randomized multicenter trial evaluated efficacy and safety of TNX-102 SL, a bedtime sublingual formulation of cyclobenzaprine, in patients with military-related PTSD randomized to TNX-102 SL 2.8 mg or 5.6 mg, or placebo. Primary analysis comparing change from baseline in Clinician-Administered PTSD Scale-5 score between 2.8 mg (n=90) and placebo (n=92) was not significant. Secondary analysis of 5.6 mg (n=49) vs placebo demonstrated a mean difference of -4.5 units, p=.05, or, accounting for missing data by multiple imputation, -5.0 units, p=.03. Clinician Global Impression - Improvement responder rate was greater in 5.6 mg than placebo (p=0.04), as was mean functional improvement in Sheehan Disability Scale social domain (p=.03) and trended in work domain (p=.05). Post-hoc analyses showed early sleep improvement predicted improvement in PTSD after 12 weeks for TNX-102 SL (p

Scott Peters represents California’s 52nd Congressional District, including the cities of Poway, Coronado and most of San Diego. He is a member of the House Energy and Commerce Committee, and is a former environmental attorney, San Diego City Council President and Port Commission Chairman.

Purpose Determine which proportion of active-duty service members return to duty (RTD), RTD without limitations, which surgical intervention returns these personnel at a better proportion and with the ability to perform their military duties after surgery compared with the pre-injury state. Methods A computer-assisted search of MEDLINE, EMBASE and SCOPUS databases was performed with keywords related to RTD for femoroacetabular impingement (FAI) syndrome. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used for study methodology. Methodologic quality of individual studies was assessed with the Methodological Index for Non-Randomized Studies scale. Results A total of 5 studies (884 service members/886 hips) qualified for inclusion. Limited evidence from level III to IV studies indicates that service members RTD at a proportion ranging from 57% (95% confidence interval [CI]: 53% to 62%) to 84% (95% CI: 73% to 91%), but only 39% (95% CI: 35% to 44%) to 59% (95% CI: 49% to 69%) do so without limitations. Mean duration of follow-up was 33.2 ± 11.3 months. No studies reported on actual duty requirements before versus after surgery, RTD criteria, or career longevity. Only 1 of 5 studies reported the RTD time-frame (mean 5 months). Only 2 of 5 studies reported complications, with a rate of 9.4% ± 6.3%. Three of 5 studies reported failures at a rate of 7.2% ± 4.7%, respectively. Femoroplasty (mean 56% of procedures in 4 studies) and acetabuloplasty (mean 55% of procedures in 4 studies) were the most commonly used procedures in studies reporting. Conclusions RTD is poorly defined in the included studies. Limited evidence substantiates that approximately 75% of service members remain on active duty for at least 1 to 2 years after surgery for FAI syndrome, whereas only approximately 47% do so without limitations at mid-term follow-up. Similarly, despite improvements in patient-reported outcome measures, service members still report continued pain and functional limitations after FAI syndrome surgery. Level of Evidence Level IV, systematic review of Level III and IV studies.

BackgroundFemoroacetabular impingement (FAI) syndrome is one source of hip pain that can limit sport participation among athletes.ObjectiveTo summarise the return to sport (RTS) rate for athletes after surgery for FAI syndrome.MethodsA computer-assisted search of MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and EMBASE databases was performed using keywords related to RTS and RTS at preinjury level (RTSPRE) of competition for FAI syndrome. The risk of bias in the included studies was assessed using the Methodological Index for Non-Randomized Studies scale.Results35 studies (1634 athletes/1828 hips) qualified for analysis. Based on evidence of limited to moderate strength (level 3b to 4 studies), athletes return to sport at preinjury level post surgery for FAI syndrome at a rate of only 74% (67%–81%). Only 37% of studies reported RTSPRE. The mean time from surgery to RTS was 7.0±2.6 months. The mean follow-up postsurgery was 28.1±15.5 months. Professional athletes returned to sport (p=0.0002) (although not the preinjury sport level; p=0.63) at a higher rate than collegiate athletes. Only 14% of studies reported on athletic presurgery and postsurgery athletic performance, which means it is impossible to comment on whether athletes return to their previous level of performance or not. No studies reported on the specific criteria used to permit players to return to sport. 20% of studies reported on career longevity, 51% reported surgical complications and 77% reported on surgical failures.ConclusionThere waslimitedtomoderateevidence that one in four athletes did not return to their previous level of sport participation after surgery for FAI syndrome. Only 37% of the included studies clearly distinguished RTS from RTSPRE. Poor outcome reporting on athletic performance postsurgery makes it difficult to determine to what level of performance these athletes actually perform. Thus, if a player asks a surgeon ‘Will I get back to my previous level of performance?’ there are presently little to no published data from which to base an answer.PROSPERO registration numberCRD42017072762.

Background Ulnar collateral ligament injury (UCLI) has significantly increased in overhead sports during the past 2 decades. Differences in return to sport (RTS) and RTS at previous level (RTSP) after UCLI have not been differentiated. Methods A computer-assisted literature search of PubMed, CINAHL, Embase, and SportDiscus databases using keywords related to RTS for UCLI was implemented. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used for study methodology. Quality assessment was conducted using a modified Downs and Black scale. Results A total of 22 retrospective, level 3b or 4, studies (n = 2289) qualified for analysis. Overall RTS proportion was 90% (95% confidence interval [CI], 86%-94%) and overall RTSP proportion was 79% (95% CI, 75%-84%), both with significant heterogeneity (P Conclusion Low-level, high-bias evidence demonstrates overall RTS proportion is higher than RTSP, regardless of treatment type for UCLI. Although RTS proportions remained consistent across various levels of play, RTSP proportions were lower in professional players, particularly Minor League Baseball compared with collegiate and high school players. Pitching performance significantly decreased postoperatively in most studies.

BackgroundThe purpose of this review was to analyse and report criteria used for open and arthroscopic surgical treatment of femoroacetabular impingement syndrome (FAIS).MethodsA librarian-assisted computer search of Medline, CINAHL and Embase for studies related to criterion for FAIS surgery was used in this study. Inclusion criteria included studies with the primary purpose of surgery or surgical outcomes for treatment of FAIS with and without labral tear, and reporting criteria for FAIS surgery.ResultsDiagnostic imaging was a criterion for surgery in 92% of the included studies, with alpha angle the most frequently reported (68% of studies) criterion. Reporting of symptoms was a criterion for surgery in 75%, and special tests a criterion in 70% of studies. Range-of-motion limitations were only a required criterion in 30%, only 12% of studies required intra-articular injection and 44% of studies described previously failed treatment (non-surgical or physiotherapist-led rehabilitation) as a criterion for surgery. Only 56% of included studies utilised the combination of symptoms, clinical signs and diagnostic imaging combined for diagnosis of FAIS as suggested by the Warwick Agreement on FAIS meeting.ConclusionDiagnostic imaging evidence of FAIS was the most commonly reported criterion for surgery. Only 56% of included studies utilised the combination of symptoms, clinical signs and diagnostic imaging for diagnosis of FAIS as suggested by the Warwick Agreement on FAIS meeting, and only 44% of studies had failed non-surgical treatment (and 18% a failed trial of physiotherapy) as a criterion for surgery.

ObjectiveTo describe the criteria used to clear athletes to return to sport (RTS) following primary ACL reconstruction.DesignScoping review.Data sourcesMEDLINE, Embase, CINAHL and SPORTDiscus electronic databases were searched using keywords related to ACL and RTS.Eligibility criteriaProspective or retrospective studies reporting at least one RTS criterion for athletes who had primary ACL reconstruction with an autograft.ResultsIn total, 209 studies fulfilled the inclusion criteria. RTS criteria were categorised into six domains: time, strength, hop testing, clinical examination, patient-report and performance-based criteria. From the 209 included studies, time was used in 178 studies (85%), and in 88 studies (42%) was the sole RTS criterion. Strength tests were reported in 86 studies (41%). Sixteen different hop tests were used in 31 studies (15%). Clinical examination was used in 54 studies (26%), patient report in 26 studies (12%) and performance-based criteria in 41 studies (20%).SummaryTime and impairment-based measures dominated RTS criteria, despite sport being a complex physical and biopsychosocial activity with demands across all aspects of function. Time was included as a criterion in 85% of studies, and over 80% of studies allowed RTS before 9 months. Whether RTS tests are valid—do they predict successful RTS?—is largely unknown.

Food intake induces synthesis of N-acylphosphatidylethanolamines (NAPEs) in the intestinal tract. While NAPEs exert leptin-like (leptogenic) effects, including reduced weight gain and food intake, the mechanisms by which NAPEs induce these leptogenic effects remain unclear. One key question is whether intestinal NAPEs act directly on cognate receptors or first require conversion to N-acylethanolamides (NAEs) by NAPE-hydrolyzing phospholipase D (NAPE-PLD). Previous studies using Nape-pld−/− mice were equivocal because intraperitoneal injection of NAPEs led to nonspecific aversive effects. To avoid the aversive effects of injection, we delivered NAPEs and NAEs intestinally using gut bacteria synthesizing these compounds. Unlike in wild-type mice, increasing intestinal levels of NAPE using NAPE-synthesizing bacteria in Nape-pld−/− mice failed to reduce food intake and weight gain or alter gene expression. In contrast, increasing intestinal NAE levels in Nape-pld−/− mice using NAE-synthesizing bacteria induced all of these effects. These NAE-synthesizing bacteria also markedly increased NAE levels and decreased inflammatory gene expression in omental adipose tissue. These results demonstrate that intestinal NAPEs require conversion to NAEs by the action of NAPE-PLD to exert their various leptogenic effects, so that the reduced intestinal NAPE-PLD activity found in obese subjects may directly contribute to excess food intake and obesity.

In 2010 the Iowa electorate denied retention to all three Supreme Court justices on the ballot. We hypothesize that when retention elections feature vigorous campaigns, they can be explained by many of the same factors that affect outcomes in partisan and nonpartisan elections. In particular, we expect partisanship, the amount of campaigning (advertising), and political context (same-sex marriage) to explain the results in Iowa. We examine county-level election results, finding that the partisanship and concentration of evangelicals within a county, as well as the amount of advertising against the justices, explain the justices' vote share. We also find evidence that ballot roll-off decreased most in counties with high concentrations of evangelical adherents and where advertising was present.

Individuals with acquired brain injuries often display problematic behaviors, such as impulsivity, disinhibition, lack of initiation, isolation, and aggression, that impact their readiness to return to home and/or the community. The occurrence and treatment of these behaviors is often complicated by impairments in cognition and self-awareness, as well as by co-occurring issues including substance abuse. Community reintegration for these individuals is a goal that can be both hazardous and difficult to attain. This article briefly reviews the literature and describes a treatment philosophy and methodology by which an interdisciplinary team can employ evidence-based behavioral principles and procedures to assess and promote behavioral stability toward the goal of community readiness within a residential rehabilitation setting. Assessment includes a comprehensive evaluation of individual strengths and barriers across all disciplines as well as an analysis of the function of problematic behaviors. Based upon these assessments and analyses, integrated interdisciplinary treatment efforts then support the development and implementation of specific strategies and tools to promote community readiness and ultimately reentry. These strategies and tools are intended to provide direction and support to the client and include prompts and cues to self-manage, as well as ways to assist clients and staff to collect and reflect upon relevant data. Additionally, other methods of data collection, techniques to develop self-management skills, and the use of contingencies as part of a community reentry plan are discussed.

Purpose The purposes of this review were (1) to collate and synthesize research studies reporting any outcome measure on both open and arthroscopic surgical treatment of femoroacetabular impingement (FAI) syndrome and (2) to report the prevalence and consistency of outcomes across the included studies. Methods A computer-assisted literature search of the MEDLINE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Embase databases was conducted using keywords related to FAI syndrome and both open and arthroscopic surgical outcomes, resulting in 2,614 studies, with 163 studies involving 14,824 subjects meeting the inclusion criteria. Two authors independently reviewed study inclusion and data extraction with independent verification. The prevalence of reported outcomes was calculated and verified by separate authors. Results Between 2004 and 2016, there has been a 2,600% increase in the publication of surgical outcome studies. Patients had a mean duration of symptoms of 27.7 ± 21.5 months before surgery. Arthroscopy was the surgical treatment used in 71% of studies. The mean final follow-up period after surgery was 32.2 ± 17.3 months. Follow-up time frames were reported in 78% of studies. Ten different patient-reported outcome measures were reported. The alpha angle was reported to be measured 42% less frequently as a surgical outcome than as a surgical indication. Surgical complications were addressed in only 53% of studies and failures in 69%. Labral pathology (91% of studies reporting) and chondral pathology (61%) were the primary coexisting pathologies reported. Clinical signs, as defined by the Warwick Agreement on FAI syndrome, were reported in fewer than 25% of studies. Conclusions Most FAI syndrome patients have longstanding pain and potential coexisting pathology. Patient-reported outcome measures and diagnostic imaging are the most frequently reported outcomes. Measures of hip strength and range of motion are under-reported. It is unclear whether the inconsistency in reporting is because of lack of measurement or lack of reporting of specific outcomes in these studies. Current surgical outcomes are limited to mid-term surgical follow-up time frames and inconsistent outcome reporting. Level of Evidence Level IV, systematic review of Level I through IV studies.

This article examines the influence of several canons within state codes of judicial ethics aimed at constraining the campaigning of candidates running for U.S. state judicial office. These canons have been much debated since 2002, when the U.S. Supreme Court ruled that one of them, the announce clause, unconstitutionally restricted the free speech rights of candidates. Based on their likely influence on the availability of information in judicial contests, I hypothesize that the primary effect of these canons is to make incumbents less accountable to the public. Looking at U.S. state supreme court contests from 1998 to 2006 where incumbents are seeking re-election, I find strong evidence that four of the five canons make it less likely for challengers to arise, and I also find evidence that restrictions on candidate solicitation of funds favor incumbents in the general election.

This article asks two questions stemming from a conflict in the literature on the U.S. Supreme Court's attention to issues: (1) Are levels of legal mobilization explained by salient Court decisions? (2) Is the Court's level of attention explained by levels of legal mobilization? To answer them, the author tests hypotheses from the public policy and public law literature on data from seven specific issue areas. The author finds that levels of legal mobilization cannot be explained by past salient decisions of the Court but finds some evidence that changes in the Court's levels of attention are explained by levels of mobilization.

Acceptance into a doctoral program is personally affirming and gives rise to optimism. It is also true that any change in the life of a person, even an apparently positive one, causes stress. The first cohort of students in a new doctoral program in counseling writes about the impact of embarking on a doctorate on themselves and their significant others. Although some of these students are young and single, most are “nontraditional” and have the family and work responsibilities that accrue as one ages.

To effectively reduce the environmental compliance costs associated with meeting specific requirements under the Aerospace Manufacturing and Rework Facility's National Emission Standard for Hazardous Air Pollutants rule, the U.S. Environmental Protection Agency's (EPA) Data Quality Objective (DQO) process has been proposed as a suitable framework for developing a scientifically defensible surface compliance monitoring program. By estimating the variability associated with the air cap pressure of high- volume, low-pressure (HVLP) surface-coating spray equipment, the number of monitoring samples necessary for an affected facility to claim compliance with a desired statistical confidence level was established. Using data taken from the pilot test facility, the DQO process indicated that the mean of at least 21 HVLP air cap pressure samples taken over the compliance period must be < or = 10 pounds per square inch (psig) gauge for the facility to claim regulatory compliance with 99.99% statistical confidence. Fewer compliance samples could be taken, but that decision would lead to a commensurate reduction in the compliance confidence level. Implementation of the DQO-based compliance sampling plan eliminates the need for an affected facility to sample all regulated HVLP surface-coating processes while still maintaining a high level of compliance assurance.

There is clinical support for the hypothesis that brain-injured patients benefit from the high degree of structure provided by an inpatient rehabilitation programme. However, they often experience mild to moderate regression in behavioural and functional skills when they are discharged to home. This paper presents an evaluation of an innovative phase within an acute brain injury programme designed to facilitate the patient's approach towards independence. 'Step-Up' programme patients, who spent the last weeks of their inpatient length of stay residing in a transitional living setting, were compared with inpatients who participated in the regular therapy programme. Eighteen months of descriptive data regarding cognitive (Rancho) and functional (Barthel) levels for 31 patients are compared. Based on survey data, the Step-Up patients reported more independence in activities of daily living than did inpatients. The Step-Up programme also proved to be more cost effective than the inpatient alternative. Challenges to innovative programming presented by payors, families, and clinicians are discussed.

Myocardial perfusion imaging using radionuclides is a well-established protocol for determining the diagnosis, prognosis, and management of coronary artery disease. Pharmacologic stress agents are used to induce cardiac hyperemia in patients unable to achieve the target workload by physical exercise alone. The vasodilators adenosine and dipyridamole are most commonly used, with dobutamine used only when these agents are contraindicated. However, because of frequent and intense side effects, as well as complex procedures both for patients and the nuclear medicine staff, there is room for improvement in these traditional stress agents. An ideal stress agent would be effective, safe, and well tolerated; have a simple protocol; be suitable for use in patients with reactive airway disease; and have few restrictions for the patient to adhere to before the procedure. Neither adenosine nor dipyridamole are receptor-specific, and act on A(1), A(2A), A(2B), and A(3) adenosine receptors. As it is the A(2A) receptor that mediates the desired coronary vasodilation, the A(1), A(2B), and A(3) adenosine receptors are deemed responsible for most side effects associated with adenosine and dipyridamole. A(2A)-selective pharmacologic stress agents should mediate the required hyperemic response while reducing the frequency of adverse events. The only selective A(2A) adenosine receptor agonist currently approved for clinical use as a pharmacologic stress agent for myocardial perfusion imaging is regadenoson. Regadenoson has demonstrated non-inferiority to adenosine for detecting reversible myocardial perfusion defects in phase 3 trials, and patients were more comfortable during the regadenoson stress procedure than during an adenosine infusion. As regadenoson dosing is not dependent on patient weight or renal impairment and can be administered by rapid injection, it has the potential to simplify the stress procedure, reduce costs, and streamline the working day for the staff of the nuclear medicine department. In this review, the need to improve on older pharmacologic stress agents will be considered, along with an assessment of how A(2A) receptor agonists fulfill that potential. Practical aspects of regadenoson are reviewed, and the impact that A(2A) receptor agonist use may have on the nuclear medicine department is evaluated.

Neural development and transplantation therapies in neurodegenerative disease share a particular feature. In both cases, undifferentiated neural precursor cells are required to differentiate into a range of neural cell types in a tissue-specific fashion. This similarity opens the possibility that the mechanisms that drive neural development play a similar role in CNS repair. In this chapter, two aspects of neural development are considered in terms of their relevance to CNS repair: the diversity of neural precursor cells and positional specification. We present evidence to suggest that neural stem cells have a degree of diversity that is beyond what might have been expected a priori. We also show that neural stem cells express genes that might encode a positional specification for these cells, and consider a number of hypotheses about the role of positional specification in CNS repair.

Preliminary results of automatically detecting unexploded ordinance (UXO) and landmines using an artificial neural network (ANN) to classify particular features in a ground penetrating radar (GPR) image are given. These features are the so-called invariant moments of a GPR image. The automatic detection algorithm is described and results of experiments conducted for both metal and dielectric targets buried in a sandbox are provided. Currently, only metallic targets can be discriminated by the ANN with many false negative indications occurring.

At the present time no single landmine detection method is able to detect landmines with a confidence required to satisfy current regulations that deem a section of land suitable for human activity. In order to adequately guarantee human safety clearance requirements imposed by international bodies are stringent.1 The scale of the problem requires a solution which is not only accurate and efficient but, given that most landmines are located in third world countries, inexpensive as well. In addition, the solution technique should require little technical expertise for its implementation. These requirements tend to diminish the prospects for ground penetrating radar (GPR) as a practicable humanitarian demining method. Given the gravity of the world-wide landmine problem, and the fact that a single modality solution is unlikely, it is worthwhile to explore the extent to which some of the problems with the GPR solution can be overcome. Making the GPR solution practicable requires that many of its associated problems be solved including the signal processing aspect of the method. In this paper, the design, construction, and testing of an inexpensive stepped-frequency continuous wave (SFCW) GPR is reported. Some of the signal processing aspects of the problem are dealt with in an accompanying paper in these proceedings.2

Individuals who have acquired brain injury (ABI) may express themselves through the use of challenging behaviors, such as aggression, withdrawal, disinhibition, and self-destructive behaviors. This article describes the effectiveness of behavior interventions derived from the assessment of behavior in a community-based setting. The premise is that behavior, no matter how difficult, has function, purpose, and meaning for the individual. A therapeutic model of behavior assessment is presented that bases its strength on behavior assessment and well-trained staff. A well-formulated behavior management plan is developed, reinforcing alternative behaviors teaching skills, and reducing unwanted behaviors. Through the use of data collection methods, the treatment team identifies variables related to unwanted behavior and outcomes of consequences as they relate to the behavior. Illustrated through a case study, the behavioral treatment model is defined through behavior identification, initial assessments, treatment approaches, and tracking outcomes.