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Objective This pilot trial aimed to provide evidence for whether the integration of a wearable device with digital behavioral therapy for insomnia (dBTi) improves treatment outcomes and engagement. Participants and methods One hundred and twenty-eight participants with insomnia symptoms were randomized to a 3-week dBTi program (SleepFix®) with a wearable device enabling sleep data synchronization (dBTi+wearable group; n = 62) or dBTi alone (n = 66). Participants completed the Insomnia Severity Index (ISI) and modified Pittsburgh Sleep Quality Index (PSQI) parameters: wake-after-sleep-onset (WASO), sleep-onset-latency (SOL), and total sleep time (TST) at baseline and weeks 1, 2, 3, and primary endpoint of week 6 and follow-up at 12 weeks. Engagement was measured by the number of daily sleep diaries logged in the app. Results There was no difference in ISI change scores between the groups from pre- to post-treatment (Cohen's d= 0.7, p= .061). The dBTi+wearable group showed greater improvements in WASO (d= 0.8, p = .005) and TST (d= 0.3, p= .049) compared to the dBTi group. Significantly greater engagement (sleep diary entries) was observed in the dBTi+wearable group (mean = 22.4, SD = 10.0) compared to the dBTi group (mean = 14.1, SD = 14.2) (p = .010). Conclusions This pilot trial found that integration of wearable device with a digital insomnia therapy enhanced user engagement and led to improvements in sleep parameters compared to dBTi alone. These findings suggest that adjunctive wearable technologies may improve digital insomnia therapy effectiveness.

Background: Recent systematic reviews have questioned the ability of psychosocial intervention to add substantive benefit to buprenorphine therapy. Objectives: The purpose of the present meta-analysis was to test the random effects model (REM) null hypothesis that, for opioid use disorder (OUD) and opioid biological sample outcomes, the summary effect of cognitive-behavioral therapy (CBT) + buprenorphine randomized controlled trials (RCTs) = 0. Methods: A systematic review was conducted searching electronic databases and the reference lists of included studies. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) criteria were used to guide this review and the REM meta-analysis. Results: The initial meta-analytic model (k = 4) was insignificant (REM Hedges' g =.22, Z = 1.27, p =.206, 95% CI: -0.12-0.56) and heterogeneous (I2 = 53.47). A pre-specified categorical moderator analysis explained the heterogeneity via CBT modality. Categorical moderator analysis (k = 4) showed non-individual CBT RCTs (k = 2) to have a REM Hedges' g summary effect of.598 (p =.006) and individual-CBT RCTs (k = 2) to have a REM Hedges' g summary effect of -0.010 (p = .936). The difference between these two subgroups was significant (Q = 5.85, df = 1, p = .016). Conclusion: The evidence cautiously suggests that for OUD, there may be some benefit to adding non-individual CBT to buprenorphine therapy.

Purpose Medication nonadherence is a significant and multidimensional problem contributing to an increased risk of morbidity and mortality. Inconveniences in pharmacy and home contexts may increase nonadherence. This research examined inconveniences in pharmacy and home contexts associated with self-reported nonadherence, controlling for demographic and medication-taking covariates. Methods Data from 4682 individuals who reported self-managing medications in an online marketing survey between October and December 2017 were analyzed in this secondary analysis. Nonadherence was dichotomized using a single question about likelihood to take medications as prescribed (adherence=always; nonadherence=most of the time, some of the time, never). Multivariable logistic regression with backwards elimination was used to examine the pharmacy (use of home delivery, number prescriptions picked up and visits to pharmacy) and home context (method used to organize/manage medications, satisfaction, and bother with management) variables and the demographic (age, sex, race/ethnicity, education, income, insurance) and medication (number of oral medications, medication changes and frequency of taking) covariates associated with nonadherence. Results Overall, 25.8% of the responses indicated nonadherence. Nonadherence was more likely for individuals making fewer separate pharmacy trips (OR 0.98; 95% CI 0.97-0.99); picking up fewer prescriptions (OR 0.96; 95% CI 0.93-0.99); never, rarely or sometimes using mail order compared with always (OR 1.71; 95% CI 1.30-2.26); not satisfied with managing medications (OR 2.13; 95% CI 1.42-3.19); and using pill pouches and being bothered by them (OR 8.28; 95% CI 1.83-37.31). Using pill pouches or a pillbox and not being bothered by them significantly decreased nonadherence likelihood. Younger and female respondents and those reporting medication changes in the last year were also more likely to report nonadherence. Conclusion Though reasons for nonadherence are multidimensional, this study suggests that inconveniences in both the pharmacy and home context are important. Improving adherence requires addressing issues of inconvenience across the care continuum.

To complete a scoping review of meta-analyses summarizing evidence of the effectiveness of Tai Chi for adults with health conditions.Meta-analyses were retrieved from Medline, Embase, AMED, CINAHL, SPORTDiscus, PsychINFO, Web of Science, PubMed Health and the Cochrane Library from database inception to early September 2018. Multistage deduplication and screening processes identified full-length, unique, peer-reviewed meta-analyses. Two people independently appraised 42 meta-analyses based on the GRADE system and organized results into 3 appendices subsequently collated into heterogeneous, statistically significant, and statistically insignificant tables."High" and "moderate" quality evidence indicates that Tai Chi can significantly benefit adults with health conditions including cancers, chronic obstructive pulmonary disease, coronary heart disease, depression, heart failure, hypertension, low back pain, osteoarthritis, osteoporosis, Parkinson's Disease and stroke. Outcomes included significant improvements in activities of daily living, balance, exercise capacity, gait, mastery, mental health, mobility, motor function, participation in daily life, physical function, quality of life, range of motion, and strength; with reductions in blood pressure, body mass index, depression, disability, dyspnea, falls, fatigue, pain, stiffness, and waist circumference.Healthcare providers now have information to advise clients with health conditions on the effectiveness of Tai Chi for overall health promotion. IMPLICATIONS FOR REHABILITATIONTai Chi is a form of safe, enjoyable, light-to-moderate aerobic physical activity for adults that is inexpensive to implement in diverse community settings.Adults with health conditions require physical activity for prevention of secondary impairments and over-all health promotion.This scoping review of meta-analyses elucidates "high" and "moderate" quality evidence of the effectiveness of Tai Chi in improving important outcomes for people with numerous health conditions.This information can be useful for healthcare providers who wish to recommend effective community-based physical activity to clients they are serving.

In 1986, I was very fortunate to receive a Guggenheim Fellowship that I used to spend a semester at Harvard in the group of W. N. Lipscomb, known to all as the ‘Colonel’ because of his honorary Ken...

Difficulties falling asleep or staying asleep (symptoms of insomnia) are common following paediatric traumatic brain injury (TBI). Yet, interventions to treat insomnia in this population have not yet been reported. This single-case series examined the feasibility and acceptability of cognitive behavioral treatment for insomnia (CBT-I) for adolescents (

Objective/Background: Sleep-wake disturbance is associated with poor cognitive functioning and several other adverse outcomes that increase dementia risk in older adults. Targeting sleep-wake distu...

Travel across time zones disrupts circadian rhythms causing increased daytime sleepiness, impaired alertness and sleep disturbance. However, the effect of repeated consecutive transmeridian travel on sleep-wake cycles and circadian dynamics is unknown. The aim of this study was to investigate changes in alertness, sleep-wake schedule and sleepiness and predict circadian and sleep dynamics of an individual undergoing demanding transmeridian travel. A 47-year-old healthy male flew 16 international flights over 12 consecutive days. He maintained a sleep-wake schedule based on Sydney, Australia time (GMT + 10 h). The participant completed a sleep diary and wore an Actiwatch before, during and after the flights. Subjective alertness, fatigue and sleepiness were rated 4 hourly (08:00-00:00), if awake during the flights. A validated physiologically based mathematical model of arousal dynamics was used to further explore the dynamics and compare sleep time predictions with observational data and to estimate circadian phase changes. The participant completed 191 h and 159 736 km of flying and traversed a total of 144 time-zones. Total sleep time during the flights decreased (357.5 min actigraphy; 292.4 min diary) compared to baseline (430.8 min actigraphy; 472.1 min diary), predominately due to restricted sleep opportunities. The daily range of alertness, sleepiness and fatigue increased compared to baseline, with heightened fatigue towards the end of the flight schedule. The arousal dynamics model predicted sleep/wake states during and post travel with 88% and 95% agreement with sleep diary data. The circadian phase predicted a delay of only 34 min over the 16 transmeridian flights. Despite repeated changes in transmeridian travel direction and flight duration, the participant was able to maintain a stable sleep schedule aligned with the Sydney night. Modelling revealed only minor circadian misalignment during the flying period. This was likely due to the transitory time spent in the overseas airports that did not allow for resynchronisation to the new time zone. The robustness of the arousal model in the real-world was demonstrated for the first time using unique transmeridian travel.

Modified coupled-cluster (CC) methods such as linearized coupled-cluster doubles (LinCCD), approximate coupled pair (ACP D14), 2CC (from nCC family), parameterized CCSD (pCCSD) and distinguishable ...

To identify child, family, and service determinants of playfulness of young children with cerebral palsy.Participants were 429 children, 18-60 months. Children were divided into two groups, Gross Motor Function Classification System levels I-II and III-V. Therapists collected data on body functions and gross motor function; parents provided information about children's health conditions and adaptive behavior, family life, and services. One year after the beginning of the study, therapists assessed children's playfulness. Data were analyzed using structural equation modeling.Higher gross motor function was associated with higher playfulness for both groups. Greater impact of health conditions on daily life was associated with lower playfulness for children in levels I-II. More effective adaptive behavior was associated with higher playfulness, and higher parent perception of therapists' family-centeredness was associated with lower playfulness for children in levels III-V.Supporting gross motor function, health, and adaptive behavior may foster playfulness.

Contains fulltext : 197998.pdf (Publisher’s version ) (Closed access) Purpose: Systemic sclerosis or scleroderma is a chronic, rare connective tissue disease with negative physical and psychological implications. Coping strategies used by scleroderma patients have not been studied in-depth. The objective of the present study was to gain a greater understanding of the coping strategies employed by people living with scleroderma. Method: Three semi-structured focus group discussions were conducted with a total of 22 people with scleroderma. Interviews were recorded, transcribed, and analyzed using content analysis. Coping strategies discussed were analyzed through Lazarus and Folkman's theoretical model of coping, including: (1) problem-focused, (2) emotion-focused, and (3) meaning-focused coping. Results: Participants reported using a combination of problem-focused (e.g., professional help; seeking disease-related information), emotion-focused (e.g., social support; adaptive distraction techniques), and meaning-focused coping strategies (e.g., benefit finding; goal reappraisal) to help them to cope with and manage their disease. However, many patients reported having difficulty in accessing support services. Conclusions: Scleroderma patients use similar coping strategies as patients with more common diseases, but they may not have access to the same level of support services. Accessible interventions, including self-management programs, aimed at improving problem- and emotion-focused coping are needed. Further, increased access to support groups may provide patients with opportunities to obtain social support and enhance coping. 10 p.

Background: Individuals with cerebral palsy (CP) experience progressive changes in functional status with the development of secondary impairments such as fatigue. Detailed accounts of the fatigue experience in CP are lacking. Purpose: This study describes the severity and variability of fatigue in CP using the Fatigue Impact and Severity Self-Assessment. Methods: This was a descriptive cross-sectional study surveying 130 (61 males) individuals (mean age 18 years, 11 months; SD four years, six months) with CP. Analyses comprised comparisons between two groups (Gross Motor Function Classification System (GMFCS) I and II-V), frequency counts and proportions. Results: Significant differences exist between GMFCS groups for all fatigue severity questions. In addition, 38% of individuals classified as GMFCS level I reported their average fatigue as moderate to severe and 53% experienced fatigue on three or more days in the previous week. Sixty-eight percent of individuals classified as GMFCS II-V reported their average fatigue to be moderate to severe and 78% were fatigued on three or more days in the previous week. Conclusions: Fatigue is a highly individualized phenomenon with significant burden for individuals with CP regardless of functional ability. Individuals in GMFCS Levels II-V reported increased fatigue severity and would benefit from specific management interventions.

We examine the one-centre integrals used in semiempirical molecular orbital theory, for the elements H–Ne. The currently used parameters do not provide good estimates for the relative energies of ionised states of atoms. Directly calculating the one-electron integrals Uss and Upp with coupled-cluster theory and fitting the two-electron repulsion integrals Gss and Gpp to accurate coupled-cluster ionisation curves improves this behaviour. Since all the remaining parameters can be derived from these, the number of fitted variables is reduced from seven to two. The two-parameter model provides qualitative agreement with coupled-cluster theory for all ionisation potentials (IPs) and the principal electron affinity (EA). To obtain quantitative agreement for the principal IP and EA, Uss and Upp are included as variables in a four-parameter model. We discuss the new parameters and implications for the development of new, consistent semiempirical Hamiltonians.

Classifying children with heterogeneous health conditions is challenging. The purposes of this perspective are to explore the prevailing classifications in children with the three selected neurodisabilities using the underlying framework of ICF/ICF-CY, explore the utility of the identified classifications, and make recommendations aimed at improving classifications.A literature search on six databases and Google was conducted. Articles published between the years 2000 and 2013 were included if they provided information on classification of cerebral palsy (CP), and/or developmental coordination disorder (DCD) and/or autism spectrum disorders (ASD).Children with DCD and ASD are classified using combinations of multiple measures. The classifications in CP meet more of the proposed criteria for utility than those in DCD and ASD.None of the existing classifications addressed all the criteria. The heterogeneity associated with the selected neurodisabilities poses major challenges. Further work is required to establish improved classifications.

To test a model of child, family and service determinants of participation in family and recreational activities for young children with cerebral palsy (CP).Participants were a convenience sample of 429 children (242 males) with CP, aged 18 to 60 months, representing all levels of the Gross Motor Function Classification System (GMFCS). Children were divided into two groups by GMFCS levels, levels I to II and levels III to V. Data on impairments and gross motor function were collected by therapists; parents provided information about children's health conditions and adaptive behaviour. Seven months later, parents reported on family life and services received. One year after the beginning of the study, parents reported their children's participation. Data from the two groups of children were analysed separately using structural equation modelling.The model explained 35% and 40% of the variance of frequency of participation in family and recreation and 28% and 38% of enjoyment in participation, for the two groups of children, respectively. Children's adaptive behaviour, family ecology, and number of community recreational programs were associated with the frequency of participation for both groups. Gross motor function was only associated with the frequency of participation for children in levels III-V. Adaptive behaviour was associated with enjoyment for both groups. The extent services met children's needs was associated with enjoyment for children in levels I to II and family ecology was a determinant of enjoyment for children in levels III to V.Supporting children's adaptive behaviour, family ecology, and access to community recreational programmes may foster participation in family and recreational activities for young children with CP. Implications for Rehabilitation Participation in family and recreational activities for young children with CP is complex and influenced by child, family and environmental factors. Practitioners are encouraged to support children's adaptive behaviour and access to community programs and family relationships, involvement in community activities and expectations of their children. Optimizing gross motor function for children who have limitations in self-mobility may enhance their participation in family and recreational activities. For children with a good prognosis for walking, providing services perceived by parents to meet their children's needs may enhance children's enjoyment of participation.

Patient views about their treatment for insomnia often dictate outcome. This review explores the literature relating to the patients' global perceptions toward treatment for insomnia. A strategic literature search was conducted using five databases (PubMed, CINAHL, Medline, PsycINFO, and Embase). The 57 research articles included for this review were mapped out chronologically across three key stages of treatment-seeking (pretreatment appraisal, actual treatment experiences, and posttreatment evaluation). Patient perceptions played an important role across these three key stages and influenced subsequent health behaviors such as the initiation of help-seeking, treatment uptake, treatment adherence, and treatment adjustment. Patients' perceptions toward treatment were heavily grounded by their psychosocial contexts. Clinical implications and future directions for including patient-centered metrics in mainstream practice and research are discussed.

To test a model of child, family and service determinants of self-care participation of children with cerebral palsy (CP), grouped by Gross Motor Function Classification System levels (I-II and III-V).Participants were a convenience sample of 429 children (242 males) with CP, aged 18-60 months. Data on impairments and gross motor function were collected by reliable therapists; parents provided information about children's health conditions and adaptive behaviour. Seven months later parents reported on family life and services received. One year after study onset, parents documented children's self-care participation. Data from two groups of children were analysed using structural equation modelling.The model explained a significant proportion of the variance of self-care participation, with higher motor function, fewer health conditions and higher levels of adaptive behaviour being associated with greater self-care participation.Supporting children's gross motor function, health and adaptive behaviour may optimize self-care participation.

Insomnia is a common sleep disorder associated with substantial direct and indirect costs, yet there is a strong propensity among patients to self-medicate which often delays professional help. Understanding the process which underpins the initiation, engagement and adherence to insomnia treatment(s) is a vital step for understanding this phenomenon. The current paper explores how the patient perspective has been conceptualized in the research literature and its implications for insomnia treatment and health care delivery. A literature search was conducted using Embase, Medline and PsycINFO databases. Articles have been thematically organized into patient correlates of health behaviors, patient experiences and treatment attitudes. Deferral of professional help among insomnia patients is partially related to barriers embedded in the health care system and patient health beliefs.

The fundamentality of the exponential representation of a second-quantised correlated wave function is emphasised with an accent on the physical sense of cluster amplitudes as cumulants of the correlated ansatz. Three main wave function formalisms, namely, the configuration-interaction theory, the coupled-cluster approach, and the many-body perturbation theory (as well as their extensions, e.g. the equation-of-motion coupled-cluster method, multireference schemes, etc.), are represented in an exponential form, leading to a formulation of the working equations in terms of cluster amplitudes. By expressing the corresponding many-body tensor equations in terms of cluster amplitudes, we could unambiguously check connectivity types and the asymptotic behaviour of all tensors/scalars involved (in the formal limit of an infinite number of correlated particles). In particular, the appearance of disconnected cluster amplitudes corresponds to unphysical correlations. Besides, we demonstrate that the equation-of-mot...

PURPOSE: The aim of the study was to describe the lived bodily experience of cerebral palsy (CP). METHOD: This was a descriptive phenomenological inquiry. Ten participants were interviewed about their bodily experiences of living with CP. Interviews were semi-structured around pain and fatigue. Inductive thematic analysis was used to identify themes. RESULTS: The bodily experience of CP centered on issues of fatigue and pain as a feeling of muscle soreness. An overwhelming amount of the discussion on fatigue emphasized the fatigue that occurs with walking and prolonged activity. Self-awareness of the individuals' own bodies and adapting activity to continue to participate in various aspects of their lives emerged as the most important theme. Some participants used strategies to manage their pain or fatigue; other participants were not yet fully aware of how to recognize signs of fatigue and/or how to adapt their activities. CONCLUSIONS: Self-awareness appears to be an important process to be fostered by service providers and parents. Specifically, encouraging youth with CP to be aware of their own bodies and the effects (positive and negative) of activity on pain and fatigue should be incorporated into transition programs as the individual becomes responsible for his or her own health care needs. Implications for Rehabilitation Fatigue is a major concern for some youth and young adults with cerebral palsy. Adolescents and young adults with cerebral palsy use a variety of techniques (including adapting or restricting activity and building in rest breaks) to manage fatigue. The process of self-awareness should be fostered by health care professionals leading up to and during transition from pediatric to adult care. Clinical conversations should explore the role of exercise, adaptive equipment, rest and other strategies for dealing with fatigue with a focus on understanding each client's needs individually.

Timely access to appropriate treatment is important for optimizing insomnia management. To date, little is known about insomnia patients' treatment experiences or how they access and engage with the available health care resources. This study sought to capture the help-seeking experiences and behavioral patterns of patients with insomnia who are seeking or receiving specialist care. A purposive sample of 26 insomnia patients from specialist sleep and mental health clinics located in metropolitan New South Wales, Australia was recruited. Participants completed a brief questionnaire, followed by an in-depth, semi-structured interview. Interviews were digitally recorded, transcribed verbatim, and analyzed using framework analysis. Three key themes emerged from the data: patients' sleep beliefs, treatment beliefs, and accessing specialized care. The findings show that daytime symptoms arising from insomnia serve as important illness cues for patients to seek medical help. In addition, participants' treatment pathways highlight factors that prevent the widespread use of cognitive behavioral therapy for insomnia (CBT-I), including limited awareness about CBT-I, tentative referral mechanisms, limited service providers, and the high cost of CBT-I.

Traditionally, surface mining has been organised based on a minimum unit cost criterion. However, there is an increasing awareness for the need to reduce carbon emissions due to their negative environmental impacts. This paper explores the relationship between the optimal unit cost surface mining operation and the optimal unit emissions operation. It examines the influence of a range of operation parameters including truck size, payload, fuel use and travel and load times. It is demonstrated theoretically that the optima with respect to unit cost and unit emissions coincide, and this coincidence is invariant on changing operation parameters. To support the theoretical result, data from an extensive field study are used, including time and production measurements, and collected fuel burn data and its conversion to emissions. The paper’s findings will be of interest to those involved in designing and managing surface mining, and similar operations such as quarrying and earthmoving.

It is known that the Λ-tensor (an array of Lagrange multipliers), necessary for evaluating analytic energy gradients in the coupled-cluster theory, is diagrammatically disconnected in general. This means that the number of non-negligible elements in the Λ-tensor grows faster than linearly with the number of calculated particles. At a formal level, when evaluating the gradients of the coupled-cluster energy, this could prevent obtaining a linear scaling of the operational cost with respect to the number of correlated particles. It is shown that in ground/excited-state coupled-cluster calculations, based on localized orbitals, the disconnected part of the Λ-tensor, as well as the disconnected part of the left-hand excited-state eigenvector, can be ignored, thus justifying the use of standard screening techniques employed in linear-scaling schemes.

In this study we investigated experiences of parents of children with cerebral palsy (CP) to identify areas in which health care providers and educators could improve practice. A second objective was to create educational material for parents of young children newly diagnosed with CP. A purposive sample of nine parents, who previously participated in the Adolescent Study of Quality of Life, Mobility, and Exercise, was recruited through phone. During an interview, parents reflected on the experience of raising a child with CP from birth to young adulthood. These interviews were audiotaped, transcribed, and coded using the International Classification of Functioning, Disability and Health-informed model and analyzed to identify major themes. Parents elaborated upon what was helpful and what could be changed to improve their children's and families' experiences through supports, advocacy, and education at different levels. The results informed the development of tips for parents and children with CP to enhance their families' experiences and interactions with health care providers, educators, and others.

Today's electronic structure theory depends equally upon density functional theory (DFT) and wavefunction theory (WFT). The interconnections between the two has long been of interest, but has not been developed explicitly enough to enable the best of both worlds to be used to obtain improved results. ab initio dft has been pursued at QTP over a few years as a partial solution. ab initio dft combines elements of correlated WFT, by taking orbital dependent functionals from coupled-cluster and many-body perturbation theory with optimised potential ideas to offer a seamless connection. The emphasis has been on the correlation potentials used in Kohn–Sham theory rather than the functionals themselves, as the potential is more sensitive to various approximations. This contribution summarises that work and suggests some future developments.

Theoretical methods in chemistry lead to algorithms for the computation of electronic energies and other properties of electronic wave functions that require large numbers of floating point operations and involve large data sets. Thus, computational chemists are very interested in using massively parallel computer systems and in particular the new petascale systems. In this paper we discuss a new programming paradigm that was developed at the Quantum Theory Project to construct electronic structure software that can scale to large numbers of cores of the order of 100,000 and beyond to solve problems in materials engineering relevant to the problems facing society today.

The elements of coupled-cluster (CC) theory that distinguish it from other ways of treating the correlation problem are presented. These essential components required that new theory be developed to treat analytical gradients, excited states, higher order properties, and now multi-reference CC. Aided by these developments, CC theory provides the best answers for the largest number of problems in molecular structure and spectra. Many scientists who spent time at the Quantum Theory Project were instrumental in these developments.

OBJECTIVE: To describe distributions of contracture and spinal malalignment in adolescents with cerebral palsy (CP) and determine associations with age, gender and function. METHODS: Data were collected using the Spinal Alignment and Range of Motion Measure (SAROMM), the Gross Motor Function Classification System (GMFCS) and the Activity Scale for Kids (ASK). RESULTS: Two hundred and twenty-five adolescents (122 males; mean age 14 years 8 months; SD 1 year 8 months) participated. SAROMM scores by GMFCS levels and item scores in various body regions are presented. Correlations between indices of function and SAROMM total score were >0.70 (p

Schools today function in an environment of complicated rules and regulations. Training preservice teachers in educational law is not only necessary; it is important work. Professors and administrators were surveyed on the methods, materials, and strategies that they employed to teach education law to preservice teachers. The predominant teaching method used was lecture in combination with class discussion. Other methods used in conjunction with lecture and class discussion were case method and problem-based learning. Teaching strategies include the use of teacher-specific education law textbooks, media/technology, simulations, educational games, and cooperative learning groups. Emphasis needs to be placed on better preparing preservice teachers in the area of school law. This article offers insight into the effective methods, materials, and strategies currently being used in teaching preservice teachers school law.

Minority status has been associated with lower asthma medication adherence. We evaluated whether medication beliefs mediated this association. 86 adults with asthma on inhaled corticosteroid therapy completed surveys regarding selected beliefs about asthma medications. Medication adherence for 1 month was electronically measured. Mean daily adherence was lower in minority patients than in Caucasians (p < .001). Multiple negative asthma medication beliefs were associated with lower adherence (p's < .05). Minorities had increased adjusted odds of having a high negative medication beliefs score. Finally, a bootstrapped estimate demonstrated a mediating effect by negative asthma beliefs on the minority status-adherence association (-.073 [95% CI: -.16, -.01]).

When represented in real space, response functions show a structure that can be used to explain certain aspects of second-order properties. In the case of NMR coupling constants we demonstrate that the response function can be separated into predetermined units derived from a binary, bond-parity model whose signs are known. The Fermi-contact term then offers an immediate measure of the response function at two points: the location of the nuclei. This makes the reduced coupling constant with terms of opposite sign and parity. In particular, for A and C symmetry equivalent atoms, [ ] where , the distance dependence of K actually results from a sum of contributions to 1 K(AB) and 2 K(AC) that have equal magnitudes but may have different signs, depending on the comparative signs of the response function.

Purpose: We reviewed current practice for children with Developmental Coordination Disorder (DCD) using research evidence and the International Classification of Functioning, Disability and Health (ICF). Characteristics of children with DCD can be described at the levels of body function (impairments), whole body movements (ac- tivities) and involvement in life situations (participation). Summary of Key Points: Descriptive instruments measuring the extent of motor im- pairments or activity limitations can be used to: (1) identify children who might benefit from intervention; and (2) determine the optimal type of intervention and model of service delivery. Evaluative tools that mea- Cheryl Missiuna, PhD, OT Reg(Ont), is Assistant Professor in the School of Reha- bilitation Science and an Investigator with CanChild, Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario. Lisa Rivard, BSc(PT), is a gradu- ate student at McMaster University and a pediatric physiotherapy consultant. Doreen Bartlett, PhD, PT, is an Assistant Professor in the School of Physical Therapy, Univer- sity of Western Ontario, and an Associate Member of CanChild. Address correspondence to: Cheryl Missiuna, PhD, OT Reg (Ont), McMaster Uni- versity, School of Rehabilitation Science, 1400 Main St. West, IAHS 414, Hamilton

In the recent implementation of the second-order Optimized Effective Potential method (R.J. Bartlett, I. Grabowski, S. Hirata, S. Ivanov, J. chem. Phys. (submitted).), the effective potential is determined by requiring that the perturbative contribution to the reference density vanishes through second order. We show that in general, such a density condition for any finite order leads to an OEP equation equivalent to that obtained via the functional derivative of the corresponding order energy. We develop diagrammatic tools for functional differentiation to facilitate the transition between many-body diagrammatic expressions and those of density functional theory.

While standard ab initio methods have provided a route towards highly accurate calculations of a vast array of chemical properties, the applicability of these methods is limited essentially because the computational effort of a correlated calculation grows very rapidly with the number of atomic basis functions while the accuracy does not. Thus, extensive one-particle basis sets are required for reasonable accuracy and, therefore, only small systems can be treated routinely. A great deal of effort has gone into finding ways to circumvent this difficulty, which has been attributed to the improper description of short-range electron correlation. In a recent paper, we introduced a technique intended to partially correct this improper description by using a local density approximation for the short-range correlation hole. Here, we wish to elaborate on the basic concept in several ways. We introduce a more reliable cut-off procedure, discuss the effects of gradient corrections and show how a Hamiltonian can be ...

Molecular dynamics simulations using quantum mechanical potentials have been performed to study the interaction of water with silica. The water–water and water–silica interactions were determined at the ab initio coupled cluster and MBPT(2) levels of theory and the resulting forces and reaction mechanisms encoded into a transfer Hamiltonian. Using forces from the rapid evaluation of the transfer Hamiltonian, two prototypical systems, consisting of an (SiO2)10 ring and a 108 atom silica nanorod, were fractured in the presence of water. It was found that inclusion of water caused a reduction in tensile strength of both systems and that the water dimer, as suggested by ab initio calculations, is the most effective mediator of Si–O bond rupture.

Primary care physicians may feel ill-equipped to counsel patients about practical methods for weight loss, even though the benefits of maintaining a healthy weight are well known. The tools physicians need for tailoring therapy are a range of options that address exercise, diet, and behavior change. Overcoming the barriers to a frank discussion of weight and using available resources for weight management can make a healthy difference for overweight and obese patients.

The failure response to uniaxial tension and compression of a nanorod of SiO2, in the form of a stack of six-membered rings (Si6O18) with appropriate termination at the two ends, is investigated at the molecular level. A 144-atom rod is shown to exhibit meaningful mechanical instability that can be compared with simulations of bulk quartz; at the same time it is small enough for the interatomic forces to be treated quantum mechanically. The present work is a prelude to the study of the effects of water on the mechanical strength of silica, a fundamental issue in understanding the dislocation mechanisms of hydrolytic weakening.

The Alberta Infant Motor Scale (AIMS) was used to examine variations in motor development of infants born preterm. Sixty infants attending a Developmental Follow-up Clinic participated. Infants were assessed by physical therapists using the AIMS and independently judged by physicians to be neurodevelopmentally and neurologically "normal," "suspect," or "abnormal." The AIMS clearly differentiated infants in these three categories. Compared to the normative sample, infants judged to be "normal" demonstrated similar motor behaviors, infants judged to be "abnormal" were significantly different across a wide range of items, and infants judged to be "suspect" were significantly different on items requiring antigravity postural control, lower extremity dissociation, and trunk rotation. The AIMS can be used to identify infants developing abnormally, to affirm normalcy in infants developing typically, and to identify motor differences in infants who are neurologically "suspect." In the latter group of infants, the AIMS can be used to provide anticipatory guidance to parents regarding the components of movement they might expect their infants to be developing next.

The general formula for the number of diagrammatic terms occurring in the Tn equation within a particular coupled cluster model is derived. Both the antisymmetrized and Goldstone diagrams are considered. In addition to the full coupled cluster equation approximate approaches are discussed, and for each the general formula for the number of terms is given. Analogous expressions are presented for the number of diagrammatic terms contributing to the elements of the transformed Hamiltonian [Hbar] = e−T HeT .

The photoelectron spectrum of ethylene is studied using coupled cluster methods, including an existing ambiguity in what are reported to be its experimental vertical ionization potentals. Two complementary methods are used for generating the ionization potentials: δE CCSD(T) and IP-EOM-CCSD. The adiabatic IP of the neutral molecule in the ground state is well known and widely accepted to be 10.5122eV. The basis set extrapolated adiabatic IPS with zero-point corrections are 10.46 eV and 10.56 eV, respectively, but a vibronic coupling between the ground state cation and its first excited state can reduce these values by ∼0.03 eV. From an exponential basis set extrapolation the vertical ionization potentials are predicted to be 10.8 eV (B3u, 13.2eV (B3g 15.0eV (Ag), 16.4eV (B2u), and 19.6eV (B1u) ±0.1 eV.

Fifteen-month motor outcomes and 18-month neurological outcomes of term infants with (Group 1, n + 18) and without (Group 2, n + 18) low scores on the Alberta Infant Motor Scale (AIMS) at 10-months-of-age were compared. Their scores on the AIMS did not differ at 15-months. Infants in Group 1, however, obtained significantly lower scores on the locomotor skill area of the Peabody Developmental Motor Scales at 15 months and walked an average of 2 months later than infants in Group 2. Nevertheless, infants in both groups were functioning within the range of normal at 15 months and had neurologically normal 18-month outcomes, as assessed by a pediatrician using the Neurological Examination of the Collaborative Perinatal Project, except for one child in Group 1 who was identified as “suspicious” because he was not yet walking. The results suggest that motor delays detected at 10-months will not necessarily persist. Pediatric therapists are encouraged to consider normal variations in both rate and pattern of ea...

Tai Chi (TC) is an ancient form of meditative exercise used to improve and maintain good health. To determine whether TC is effective in improving balance, a meta-analysis of the published literatu...

The purpose of this paper is to examine the evidence-based research supporting the role of the home environment in relation to infant motor development by reviewing the literature investigating dep...

(1998). Weight loss, psychological, and nutritional patterns in competitive female bodybuilders. Eating Disorders: Vol. 6, No. 2, pp. 159-167.

Adiabatic electron affinities (E ea,ad) of the PF5 and SF6 molecules, notoriously difficult for modern density-functional-based methods, are computed at the coupled-cluster method with all singles and doubles and non-iterative inclusion of triple excitations (CCSD(T)) level with rather large basis sets. Our CCSD(T) estimates of 1.02 and 0.92eV for the E ea,ad of PF5 and SF6, respectively, are in good agreement with the corresponding experimental values of 0.75±0.15 and 1.0±0.1 eV. The computed vertical detachment energy of 3.13eV of the SF6 - anion is to be compared to the experimental value of 3.16 eV.

The psychosurgical treatment of psychiatric illnesses, using stereotactic subcaudate tractotomy (SST), has been carried out at the Geoffrey Knight Unit since 1961. Recently, the procedure has had to be modified. This paper describes the manner in which this has been achieved and the clinical implications of this change.