Search

Behavior analysts have been working in and with public schools for decades. However, there is a paucity of research related to their work; specifically, their roles and responsibilities and needed support. We conducted a 37-item online survey of 98 nationally certified behavior analysts who work in public schools in a Southeastern state in the United States to gather information about what these professionals do and whether they feel supported to complete their work effectively. The roles and responsibilities of school-based behavior analysts vary but frequently include facilitating professional development opportunities, including coaching, administration and supervision tasks, and supporting programming for both special and general education students with less emphasis on direct services to students. When asked about the types of students with whom they work, behavior analysts shared they work with a variety, including those with and without disabilities. Behavior analysts shared mixed results related to their feelings of support from school districts and their supervisors. We discuss implications for practitioners and future research.

This descriptive study included a systematic examination of provider and caregiver reflective conversations during caregiver coaching sessions focused on embedded intervention. Transcribed videos from 31 provider-caregiver dyads in two groups (Embedded Practices and Interventions with Caregivers [EPIC] vs. business-as-usual [BAU]) were used for data collection, resulting in a total of 93 transcripts across three different time points. Using methods of directed content analysis, a coding scheme describing various components of shared reflection was developed and used to code transcripts. Coding data were used to explore the rate per minute and relative frequency of types, topics, and spontaneity of reflection. Although there were no statistically significant differences in the frequency and rate of reflective versus nonreflective conversational turns, there were group differences in the reflective topics and specific types of reflective comments and questions posed by participants. Results from this study and others can help the field further define reflection as a coaching strategy and consider the potential utility of different reflective comment and question types to increase caregiver capacity to embed interventions in home routines. Further research is recommended to explicate further definitions and processes for reflection specific to caregiver coaching, including methods used to code reflective conversations and evaluate how reflection impacts caregivers' intervention implementation. [This manuscript was presented at the 2019 annual conference for the American Speech-Language-Hearing Association in Orlando, FL.]

Morgan P Lorio,1 Jordan Lee Tate,2 Thomas J Myers,3 Jon E Block,4 Douglas P Beall5 1Advanced Orthopedics, Altamonte Springs, FL, USA; 2Southern Pain and Spine Associates, Jasper, GA, USA; 3Paradigm Health System, Slidell, LA, USA; 4Private Practice, San Francisco, CA, USA; 5Comprehensive Specialty Care, Edmond, OK, USACorrespondence: Jon E Block, Private Practice, 2210 Jackson Street, Ste. 401, San Francisco, CA, 94115, USA, Tel +1(415) 775-7947, Email jb@drjonblock.comAbstract: Specific clinical diagnostic criteria have established a consensus for defining patients with lumbar discogenic pain. However, if conservative medical management fails, these patients have few treatment options short of surgery involving discectomy often coupled with fusion or arthroplasty. There is a rapidly-emerging research effort to fill this treatment gap with intradiscal therapies that can be delivered minimally-invasively via fluoroscopically guided injection without altering the normal anatomy of the affected vertebral motion segment. Viable candidate products to date have included mesenchymal stromal cells, platelet-rich plasma, nucleus pulposus structural allograft, and other cell-based compositions. The objective of these products is to repair, supplement, and restore the damaged intervertebral disc as well as retard further degeneration. In doing so, the intervention is meant to eliminate the source of discogenic pain and avoid surgery. Methodologically rigorous studies are rare, however, and based on the best clinical evidence, the safety as well as the magnitude and duration of clinical efficacy remain difficult to estimate. Further, we summarize the US Food and Drug Administration’s (FDA) guidance regarding the interpretation of the minimal manipulation and homologous use criteria, which is central to designating these products as a tissue or as a drug/device/biologic. We also provide perspectives on the core evidence and knowledge gaps associated with intradiscal therapies, propose imperatives for evaluating effectiveness of these treatments and highlight several new technologies on the horizon.Keywords: degenerative, disc, intradiscal, autologous, allogeneic, injection, regenerative, discogenic, pain

Federal mandates require special education teachers to implement evidence-based practices (EBPs) to support student learning to the extent practical. There are 28 identified EBPs specifically designed for teaching students with autism spectrum disorder (ASD). Preparing special education teachers to implement EBPs with fidelity remains a challenge. Planning and executing professional development (PD) targeting EBPs is typically a role assumed by special education administrators. This qualitative phenomenological research study examines special education administrators' capacity to develop and implement effective PD around EBPs identified for students with ASD. Findings suggest special education administrators are committed to improving classroom-based application of EBPs specific to meeting the unique needs of students with ASD through collaborative efforts. Challenges exist related to the gap between knowledge and practice and the duality of systems in education.

Students with autism spectrum disorder (ASD) have complex and unique needs that can impact their success. Evidence-based practices (EBPs) have been identified that are effective with this population, yet educators may not be adequately prepared to implement such EBPs. Special education administrators are frequently responsible for developing and implementing professional development experiences to improve teacher performance for students with ASD, including implementing EBPs. This study focused on the experiences of 10 special education administrators who plan and implement professional development experiences for educators working with students with ASD. The implementation science model was used to provide a framework for the phenomenon. This article is the first of two reporting specifically on the competency drivers described in the implementation science model. Five themes were found from the interview data including a deep commitment to coaching; participant-centered training; systematic barriers to effective training; the gap of administrator knowledge and application; and the COVID-19 impact. Findings and implications are discussed.

In the United States, families of young children with developmental disabilities may encounter many challenges and obstacles when advocating for their child's developmental services and supports. Research has highlighted that the transition from early intervention services to school-based services is especially confusing and difficult for many families. To limit confusion, the context and procedures of the transition must be clearly understood by all parties involved, including the family, early intervention providers, and school personnel. This exploratory qualitative pilot study highlights different practices used in a transition classroom for young children with developmental disabilities and the experiences of those involved in the transition process. The transition classroom was created through a collaboration between a non-profit early intervention organisation and a public Early Childhood Special Education Program. A teacher, the director of the non-profit organisation, and a parent of a child in the transition classroom were interviewed. Implications emphasising effective partnerships between families, schools, and community organisations, and how to potentially build those partnerships are discussed.

In this study, we explore parent and teacher perceptions of school readiness (SR) among 4-year-olds learning English as a second language (ESL) and native English-speaking 4-year-olds and compare these perceptions to child scores. Child assessments focused on letter and numeral knowledge. These data were collected from 387 children (52% boys), including 28% ESL children. Adult perspectives were collected from 141 parents (who rated one child each) and from 30 teachers (who rated 380 children). Findings indicated (a) children's letter and numeral knowledge did not significantly vary by ESL status; (b) teachers, but not parents, rated ESL children significantly lower on literacy knowledge compared to non-ESL children; (c) teacher and, to a lesser extent, parent perceptions of children's literacy and numeracy knowledge were positively associated with children's scores; and (d) teacher perception of numeracy was significantly more aligned with children's numeral knowledge compared to parent perception. Discussion of these findings is included.

Family routines provide young children with predictable, repeatable, and functional contexts for learning about the world. Participating in family routines is a critical pathway by which all children learn. While the use of family routines in caregiver-implemented interventions (CIIs) is supported by theories, research, and recommended practices, few investigations examine the degree to which interventions take place within routines across developmental domains in early childhood intervention research. We conducted a scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist to examine an interdisciplinary body of CIIs. We coded 42 articles for the presence and types of routines, child and family demographics, developmental targets, and how routines were identified within CIIs. Autism spectrum disorder was the highest represented disability; many studies included play routines or a combination of play with another routine. In this article, we discuss the importance of family routines in CIIs, how to jointly identify a range of routines with caregivers, and we describe the need for research on family routines in CIIs across disabilities and diverse family backgrounds.

Parents are encouraged to read to their children as early as possible. Multiple studies of parent-child shared book reading with children ages 3 years and older have shown positive outcomes on parent use of language-based strategies and child language development. However, few studies have included children under the age of 3; thus, little is known about interventions for parent-child shared book reading practices with infants and toddlers. In this systematic review, we examined 12 studies of interventions that included practice opportunities to support parent-child shared book reading practices with infants and toddlers between the ages of birth and 3 years. Across the studies, parents were taught to use interactive shared book reading strategies through a variety of teaching functions; however, only six studies included direct measurement of parent strategy use and child behaviors during shared book reading interactions. Directions for future research and the implications of this review are discussed.

Se reseña el libro de Andrea Teruel que desarrolla un estudio pormenorizado y meticuloso de la heterología batailleana, haciendo foco en los escritos de Georges Bataille de los años 30, indicando que en ese peculiar neologismo del autor francés está la clave de lectura de su obra en general y de los desarrollos de una antropología cuestionadora de lo humano en particular. La heterología como ciencia de lo heterogéneo, cuyo valor epistémico es problemático- pues plantea la pregunta sobre si se trata de “ficción propedéutica o una formulación alegórica” de la “diferencia no explicable” es retomada por Andrea Teruel como la lupa para ver esas partes excluidas por el primado de la razón, por el primado de la cabeza, por el primado de la utilidad humana. Algunos de los hitos o provocaciones señaladas en este recorrido son: la posibilidad de una revolución que no tenga un sentido utilitario, sin un fin posterior por el cual se realiza; la interpretación de la economía que tuerza la vigente de la economía clásica, señalando la importancia del gasto, el don; enmarcar una antropología mitológica retomando dos mitos batailleanos de los años 30.

In recent years, Indonesia has emerged as a powerhouse in the digital economy, aiming to become the leading force in South East Asia. In this digital era, the promotion of products and services has become a fundamental factor for businesses, largely attributed to the advent of digital marketing. The primary objectives of this study are to explore the reliance of digital marketing agencies on digital marketing and assess the success rate of this strategy, particularly during the COVID-19 pandemic, which has significantly increased productivity and sales. Additionally, the study aims to evaluate the effectiveness of digital marketing strategies for business sustainability and discuss future trends. To shed light on this phenomenon, this study employs qualitative methods, including interviews and observations, to collect data. Various analysis techniques such as EFE, IFE, CPM, IE, SWOT, and QSPM are employed. Based on the findings, this research demonstrates that digital marketing strategies have proven highly effective, particularly in terms of the promotional and advertising techniques employed. Based on the findings, SKI Digital Marketing's strategic focus on Instagram as its primary marketing platform, coupled with a commitment to content marketing, reflects a purposeful approach to engaging a broad audience and enhancing brand visibility. The adoption of a market penetration strategy underscores the agency's determination to thrive amid intense competition. Keywords: business strategy, digital business, digital communication, digital economy, digital marketing

Resumen Este libro abre preguntas acerca de la materia y sus pulsiones ofreciendo acabadas muestras y fecundas derivas de la puesta en diálogo entre territorios de la literatura, discursos de las ciencias y registros de las humanidades. Partiendo del llamado giro material, en el que los Nuevos Materialismos “vuelven a definir la materia, a redefinir los límites de lo humano y su relación con los demás existentes (...), el entorno material y sus transformaciones” (p. 15), esta investigación en equipo recorre ese paisaje teórico para ofrecer un panorámico testimonio de la potencia de sus problemas y desarrollos.

The increasing number of proposed technologies for the active treatment of acid mine drainage (AMD) raises a problem for decision-makers during the selection process. Selecting the optimum treatment technology requires extensive analysis to determine the best possible treatment based on multiple and often conflicting criteria. The introduction of multi-decision criteria analysis (MCDA) provides a systematic approach to problem-solving based on both quantitative and qualitative data. In this study, analytic hierarchy process (AHP) as an MCDA tool was used to select the optimum treatment option for AMD in a local copper mining site in the Philippines. Three treatment technologies were found to be the most applicable – a combination of Conventional Lime Neutralization and Sulfidogenic Bioreactor (CLN + SB), High-Density Sludge (HDS) Process, and a combination of Two-Step Neutralization Ferrite Formation and Sulfidogenic Bioreactor (TSNFF + SB). Three criteria – technical, economic, and environmental – and eight sub-criteria were used to evaluate and analyze the three alternatives systematically. The overall ranking of the alternatives was TSNFF + SB > HDS > CLN + SB. However, sensitivity analysis showed that HDS was the most stable treatment technology when equal weights were given for each criterion. Implications from this study could provide a more reliable information for possible technology adoption to sustainably address problems on AMD which is one of the leading global environmental problems today.

An increasing number of researchers are examining the benefits and outcomes of caregiver-implemented interventions for young children with delays or disabilities. Most report the incorporation of multiple coaching strategies within their approach; however, definitions and descriptions of coaching strategies and processes continue to be limited. This scoping review examined the use of various coaching strategies across models of caregiver coaching in early intervention, with a specific focus on problem solving and reflection coaching strategies occurring in the literature between 2011 and 2018. Problem solving and reflection are 2 coaching strategies incorporated into coaching approaches to build caregiver competency, confidence, and independence within intervention implementation. The results of this review may guide the field in further defining caregiver coaching as well as specific coaching strategies, such as problem solving and reflection. [This article was presented at the 2018 annual conference for the Division for Early Childhood (DEC) in Orlando, Florida.]

The article focuses on restorative reproductive medicine (RRM) as an approach to address reproductive health issues by identifying and treating their root causes, rather than masking symptoms with conventional treatments like IVF (In vitro fertilization) or hormonal contraception. It emphasizes viewing a woman's cycle as a vital sign of overall health and using evidence-based methods to understand and address hormonal imbalances and related health concerns.

Background: The traditional open midline posterior cervical spine fusion procedure has several shortcomings. It can cause soft tissue damage, muscle atrophy, compromise of the lateral masses and painful prominent posterior cervical instrumentation or spinous process if there is dehiscence of the fascia. Additionally, patients frequently experience the rapid development of adjacent segment disease, which can result in the reemergence of debilitating pain and functional impairment. Clinical relevance: Tissue-sparing posterior cervical fusion is an alternative method for treating patients with symptomatic cervical degenerative disc disease. However, widespread clinical adoption has been challenged by ambiguity, misunderstandings and misinterpretations regarding appropriate procedural reimbursement coding. Technological advancement: The tissue-sparing posterior cervical fusion procedure was approved by the US Food and Drug Administration (FDA) in 2018 (CORUS™ Spinal System and CAVUX® Facet Fixation System (CORUS/CAVUX); Providence™ Medical Technology). This technique addresses the concerns with traditional spine fusion methods by achieving the stability and outcomes of posterior cervical fusion without the morbidity associated with significant muscle stripping in the traditional approach. This technology uses specialized implants and instrumentation to perform all of the steps required to facilitate bone fusion and provide stability while minimizing tissue disruption. The technique involves extensive bone preparation for fusion and placement of specialized stabilization implants that span the facet joint, promoting natural bone growth and fusion while reducing the need for extensive exposure. This procedure provides an effective, less invasive solution for patients with cervical degenerative disc disease. Reimbursement and coding clarity: The article provides a comprehensive rationale for appropriate reimbursement coding for tissue-sparing posterior cervical fusion. This is a critical aspect for the adoption and accessibility of medical technologies. This information is crucial for practitioners and healthcare administrators, ensuring that innovative procedures are accurately coded and reimbursed. Procedural details and clinical evidence: By detailing the procedural steps, instruments used and the physiological basis for the procedure, this article serves as a valuable educational resource for spine surgeons and payers to appropriately code for this procedure. Conclusions: The description of work for CORUS/CAVUX is equivalent to the current surgical standard of lateral mass screw fixation with decortication and onlay posterior grafting to facilitate posterior fusion. Thus, it is recommended that CPT codes 22600/22840 be used, as they best reflect the surgical approach, instrumentation, decortication, posterior cervical fusion and bone grafting procedures. [ABSTRACT FROM AUTHOR]

3D-printing technology has revolutionized spinal implant manufacturing, particularly in developing personalized and custom-fit titanium interbody fusion cages. These cages are pivotal in supporting inter-vertebral stability, promoting bone growth, and restoring spinal alignment. This article reviews the latest advancements in 3D-printed titanium interbody fusion cages, emphasizing their relevance in modern personalized surgical spine care protocols applied to common clinical scenarios. Furthermore, the authors review the various printing and post-printing processing technologies and discuss how engineering and design are deployed to tailor each type of implant to its patient-specific clinical application, highlighting how anatomical and biomechanical considerations impact their development and manufacturing processes to achieve optimum osteoinductive and osteoconductive properties. The article further examines the benefits of 3D printing, such as customizable geometry and porosity, that enhance osteointegration and mechanical compatibility, offering a leap forward in patient-specific solutions. The comparative analysis provided by the authors underscores the unique challenges and solutions in designing cervical, and lumbar spine implants, including load-bearing requirements and bioactivity with surrounding bony tissue to promote cell attachment. Additionally, the authors discuss the clinical outcomes associated with these implants, including the implications of improvements in surgical precision on patient outcomes. Lastly, they address strategies to overcome implementation challenges in healthcare facilities, which often resist new technology acquisitions due to perceived cost overruns and preconceived notions that hinder potential savings by providing customized surgical implants with the potential for lower complication and revision rates. This comprehensive review aims to provide insights into how modern 3D-printed titanium interbody fusion cages are made, explain quality standards, and how they may impact personalized surgical spine care. [ABSTRACT FROM AUTHOR]

Purpose: Shared book reading (SBR) is an evidence-based literacy activity that promotes the development of oral language and emergent literacy skills in young children; however, literature regarding best practices for parents of children with developmental disabilities under the age of 5 years, specifically those with complex communication needs, is severely limited. In this descriptive study, we aimed to better understand how families of toddlers/preschoolers incorporated augmentative and alternative communication (AAC) into SBR interactions. Method: Videos of SBR interactions were collected across five families with children between 35 and 48 months of age who used AAC systems. Three families had previous training in AAC use during SBR; two families did not have previous training and reportedly did not use their child's AAC system during typical SBR interactions at home. Thus, SBR without AAC was considered "typical" for these two families, and behaviors were compared across two conditions: SBR without AAC and SBR with AAC. Each video was coded for a variety of parent and child behaviors, including asking questions, repetitions, modeling/ commenting, expanding/extending, defining vocabulary, affirmations, initiations, and responses. The communication modality used was coded for each behavior. Results: Analysis of the video coding revealed that parents used a variety of strategies and that children relied on multimodal means of communication during SBR. For the two families who had videos collected across two conditions, namely, SBR without AAC and SBR with AAC, family AAC use increased the overall duration of SBR activities. For all families, the frequency of parent SBR strategy use increased the SBR duration. Conclusions: This study adds to the limited research on SBR practices with toddlers/preschoolers who use AAC. Directions for future research and the implications of the study are discussed. [ABSTRACT FROM AUTHOR]

Abstract Anaplastic large‐cell lymphoma (ALCL) is a CD30 + lymphoproliferative disorder that may manifest with skin involvement.1 We present a rare case of Agent Orange‐induced ALCL with cutaneous involvement of the hand, surgical excision, and follow‐up treatment.

Abstract Background Pre-pregnancy obesity and excessive gestational weight gain (GWG) are established risk factors for adverse pregnancy, delivery and birth outcomes. Pregnancy is an ideal moment for nutritional interventions in order to establish healthier lifestyle behaviors in women at high risk of obstetric and neonatal complications. Methods Electronic-Personalized Program for Obesity during Pregnancy to Improve Delivery (ePPOP-ID) is an open multicenter randomized controlled trial which will assess the efficacy of an e-health web-based platform offering a personalized lifestyle program to obese pregnant women in order to reduce the rate of labor procedures and delivery interventions in comparison to standard care. A total of 860 eligible pregnant women will be recruited in 18 centers in France between 12 and 22 weeks of gestation, randomized into the intervention or the control arm and followed until 10 weeks of postpartum. The intervention is based on nutrition, eating behavior, physical activity, motivation and well-being advices in which personalization is central, as well as the use of a mobile/tablet application. Inputs includes data from the medical record of participants (medical history, anthropometric data), from the web platform (questionnaires on dietary habits, eating behavior, physical activity and motivation in both groups), and adherence to the program (time of connection for the intervention group only). Data are collected at inclusion, 32 weeks, delivery and 10 weeks postpartum. As primary outcome, we will use a composite endpoint score of obstetrical interventions during labor and delivery, defined as caesarean section and instrumental delivery (forceps and vacuum extractor). Secondary outcomes will consist of data routinely collected as part of usual antenatal and perinatal care, such as GWG, hypertension, preeclampsia, as well as fetal and neonatal outcomes including premature birth, gestational age at birth, birth weight, macrosomia, Apgar score, arterial umbilical cord pH, neonatal traumatism, hyperbilirubinemia, respiratory distress syndrome, transfer in neonatal intensive care unit, and neonatal adiposity. Post-natal outcomes will be duration of breastfeeding, maternal weight retention and child weight at postnatal visit. Discussion The findings of the ePPOP-ID trial will help design e-health intervention program for obese women in pregnancy. Trial registration ClinicalTrials.gov Identifier: NCT02924636 / October 5th 2016.

This study aims to provide supply chain management strategy recommendations to GAPOKTAN (Association of Farmer Groups) to meet demand from the chili sauce company. The current process of meeting the demand from the chili sauce company to GAPOKTAN is still running conventionally, where the production planning process and inventory control are still based on the performance of eight farmer groups under the auspices of the Mandiri Jaya Farmer Group Association. Seeing this obstacle, the author tries to analyze it with the value chain method approach to understand the obstacles faced by the association. This study uses a qualitative approach with the in-depth interview method. After getting the results of the interview and the data obtained. The author provides an explanation of the solution using the supply chain management method approach. Some inputs from the changed process flow are even added with this method so that the needs of the association can accommodate requests from the chili sauce company. The association itself will provide more attention to managing, planning, and forecasting for all Farmer Groups under it. Finally, this paper aims to support GAPOKTAN Mandiri Jaya in fulfilling the demand from the chili sauce company.

The advent of ultra-minimally invasive endoscopic spine surgery, characterized by significantly reduced surgery times, minimal blood loss, and minimal tissue trauma, has precipitated a paradigm shift in the preoperative management of patients with cardiac disease undergoing elective spine procedures. This perspective article explores how these advancements have influenced the requirements for preoperative cardiac workups and the protocols surrounding the cessation of anticoagulation and antiplatelet therapies. Traditionally, extensive cardiac evaluations and the need to stop anticoagulation and antiplatelet agents have posed challenges, increasing the risk of cardiac events and delaying surgical interventions. However, the reduced invasiveness of endoscopic spine surgery presents a safer profile for patients with cardiac comorbidities, potentially minimizing the necessity for rigorous cardiac clearance and allowing for more flexible anticoagulation management. This perspective article synthesizes current research and clinical practices to provide a comprehensive overview of these evolving protocols. It also discusses the implications of these changes for patient safety, surgical outcomes, and overall healthcare efficiency. Finally, the article suggests directions for future research, emphasizing the need for updated guidelines that reflect the reduced perioperative risk associated with these innovative surgical techniques. This discussion is pivotal for primary care physicians, surgeons, cardiologists, and the broader medical community in optimizing care for this high-risk patient population. [ABSTRACT FROM AUTHOR]

Falls are not a normal part of aging and pose a significant health risk to older adults. Physical therapists have a role in fall risk management. Preparation to manage falls varies across Doctor of Physical Therapy (DPT) curricula. This paper describes how six DPT programs integrated community-based fall prevention through the STOP (Screen one-Thousand Older adults to Prevent) Falls initiative. STOP Falls was collaboration among DPT faculty to integrate community-based fall risk screening into curricula using the Centers for Disease Control and Prevention Stopping Elderly Accidents, Deaths, and Injury (STEADI) initiative. Activities included screenings in nine different geriatric and clinical education courses, one interprofessional activity, and five service activities. Students reported benefits from participation and valued older adult interactions. Seven faculty, 228 students, and 27 community/clinical partners screened 605 older adults. Collaborative community-based fall prevention initiatives can be incorporated into DPT curricula. [ABSTRACT FROM AUTHOR]

Purpose: Interactions with caregivers during the ordinary activities that occur as families go about their everyday lives are critical to supporting children’s acquisition of social communication and language skills. The purpose of this study was to examine child communication and parent verbal responsiveness across interaction contexts in 211 children (Mage = 20 months) on the autism spectrum (n = 121), with developmental delay (n = 46), or with typical development (n = 44). Method: Families participated in up to eight activities during an hour-long, video-recorded home observation. We tested differences in the strength of associations between diagnostic group and interaction context using linear mixed-effects models, with child rate per minute of communication and proportions of parent follow-in comments and directives as outcome variables. Child communicative functions expressed across contexts were also examined. Results: Children across groups communicated at significantly higher rates per minute during book sharing and play with people compared to other interaction contexts. Most child communication was for the function of joint attention during book sharing, for social interaction during play with people, and for behavior regulation during necessary activities such as family chores and meals. On average, parents of children responded using proportionally more follow-in comments during book sharing and play compared to necessary activities, during which parents used more follow-in directives. Conclusion: Results provide a glimpse into the dyadic communication that may occur within everyday activities at home, which supports the need for future intervention research and may aid clinicians seeking to identify activities that serve as important contexts for intervention. [ABSTRACT FROM AUTHOR]

Acerca de La Rocca, P. y Neuburger, A. (2019). Figuras de la intemperie. Panorámica de estéticas contemporáneas. Córdoba: Editorial Universidad Nacional de Córdoba. Con textos de Noelia Billi (prólogo), Leonel Cherri, Paola Cortés Rocca (epílogo), Julia Jorge, Paula La Rocca, Franca Maccioni, Javier Eduardo Martínez Ramacciotti, Gabriela Milone, Ana Neuburger, Silvana Santucci, Belisario Zalazar.

Proponemos sondear puntos fundamentales del pensamiento de Didi-Hu- berman sobre la imagen, a partir de la centralidad de conceptos, nociones y dispositivos metodológicos propiciados por Georges Bataille. Nos interesa, especialmente, mostrar que la antropología de las imágenes —en los trabajos más actuales derivada en una antropología política de las imágenes— de Didi-Huberman está atravesada por la apertura o el desgarramiento del saber, de la forma y la subjetividad que Bataille propone a lo largo de su obra. Así, la im- portancia metodológica, teórica y política de nociones críticas como no-saber, informe, heterogeneidad y soberanía serán piedra de toque para recorrer los hitos del antropomorfismo desgarrado batailleano y su impronta en la heurística didi-hubermaniana, subrayando la gravedad de la apertura y sus modalidades: como rasgadura epistémica de la historia del arte y el saber; como apuesta por la materialidad heterológica de las imágenes y como deslizamiento hacia el poten- cial sublevatorio de las imágenes.

Introduction Ventilator-associated pneumonia (VAP) is a common healthcare-associated infection in the intensive care unit (ICU). Probiotics are defined as live microorganisms that may confer health benefits when ingested. Prior randomised trials suggest that probiotics may prevent infections such as VAP and Clostridioides difficile–associated diarrhoea (CDAD). PROSPECT (Probiotics to Prevent Severe Pneumonia and Endotracheal Colonization Trial) is a multicentre, double-blinded, randomised controlled trial comparing the efficacy of the probiotic Lactobacillus rhamnosus GG with usual care versus usual care without probiotics in preventing VAP and other clinically important outcomes in critically ill patients admitted to the ICU.Methods and analysis The objective of E-PROSPECT is to determine the incremental cost-effectiveness of L. rhamnosus GG plus usual care versus usual care without probiotics in critically ill patients. E-PROSPECT will be performed from the public healthcare payer’s perspective over a time horizon from ICU admission to hospital discharge.We will determine probabilities of in-ICU and in-hospital events from all patients alongside PROSPECT. We will retrieve unit costs for each resource use item using jurisdiction-specific public databases, supplemented by individual site unit costs if such databases are unavailable. Direct costs will include medications, personnel costs, radiology/laboratory testing, operative/non-operative procedures and per-day hospital ‘hoteling’ costs not otherwise encompassed. The primary outcome is the incremental cost per VAP prevented between the two treatment groups. Other clinical events such as CDAD, antibiotic-associated diarrhoea and in-hospital mortality will be included as secondary outcomes. We will perform pre-specified subgroup analyses (medical/surgical/trauma; age; frailty status; antibiotic use; prevalent vs no prevalent pneumonia) and probabilistic sensitivity analyses for VAP, then generate confidence intervals using the non-parametric bootstrapping approach.Ethics and dissemination Study approval for E-PROSPECT was granted by the Hamilton Integrated Research Ethics Board of McMaster University on 29 July 2019. Informed consent was obtained from the patient or substitute decision-maker in PROSPECT. The findings of this study will be published in peer-reviewed journals.Trial registration number NCT01782755; Pre-results.

While achieving premarket approval from the US Food and Drug Administration represents a significant milestone in the development and commercialization of a Class III medical device, the aftermath endeavor of gaining market access can be daunting. This article provides a case study of the Barricaid annular closure device (Barricaid), a reherniation reduction device, which has been demonstrated to decrease the risk of suffering a recurrent lumbar intervertebral disc herniation. Following Food and Drug Administration approval, clinical adoption has been slow due to barriers to market access, including the perception of low-quality clinical evidence, questionable significance of the medical necessity of the procedure, and imaging evidence of increased likelihood of vertebral endplate changes. The aim of this article is to provide appropriate examination, rationale, and rebuttal of these concerns. Weighing the compendium of evidence, we offer a definition of a separate and unique current procedural terminology code to delineate this procedure. Adoption of this code will help to streamline the processing of claims and support the conduct of research, the evaluation of health care utilization, and the development of appropriate medical guidelines. [ABSTRACT FROM AUTHOR]