Transcript: Beaudoin, J. A., Sebire, G., & Couture, M. (2019). Parent-mediated intervention tends to improve parent-child engagement, and behavioral outcomes of toddlers with ASD-positive screening: A randomized crossover trail. Research in Autism Spectrum Disorder, 66, 1-12. doi: https://doi.org/10.1016/j.rasd.2019.101416 Evidence Communication The feeling of being a "Good Parent" Understanding/ Interacting Play together! PICO Question: What are the effects of a parent-mediated intervention on child development and parent-child interaction for children diagnosed with autism? Why Parent Mediated Therapy? References Evidence ASD Symptoms: Shire, S.Y., Gulsrud, A., & Kasari, A. (2016). Increasing responsive parent- child interactions and joint engagement: Comparing the influence of parent-mediated intervention and parent psychoeducation. J Autism Dev Disord., 46(5), 1737–1747. doi:10.1007/s10803-016-2702-z. By: Lauren Moore Gives parents efficacy Supports Parent Extended treatment time Natural Environment Feasible Child's Interest Oono, I. P., Honey, E. J., & McConachie, H. (2013). Parent-mediated early intervention for young children with autism spectrum disorders. Cochrane Database of Systematic Reviews, 4, 1-81. doi: 10.1002/14651858.CD009774.pub2. Parent-Mediated Therapy Taking Turns Communication Following Directions Eating Fine Motor Social Skills Dressing Play Gains: Joint attention Language Reduce Symptoms Importance of Parent-Child Interaction Ingersoll, B., Wainer, A., Berger, N., Pickard, K., & Bonter, N. (2016). Comparison of a self-directed and therapist-assisted telehealth parent-mediated intervention for children with ASD: A pilot RCT. Journal of Autism and Developmental Disorders, 46(7), 2275-2284. doi: 10.1007/s10803-016-2755-z Further research on: Joint-interaction Parent Stress Levels Adaptive skills Other diagnoses
Transcript: Preoperative exercise in total knee replacement Our workgroup recommends not to use preoperative exercise to decrease pain levels and increase ADL function levels after total knee replacement in patients with osteoarthritis aged 70+ GRADE-quality: low Evidence based recommendation Evidence based recommendation Total knee replacement (TKR) is only performed when conservative interventions have been exhausted. Although TKR is very cost-effective, there are several known medical complications it can cause. The two most well known factors are preoperative health status and utilized clinical TKR care pathway. To improve the outcome of TKR, the suggestion has been made to let patients follow preoperative exercise programs which could improve the physical fitness of patients and therefore improve the preoperative health status. Clinical scenario Clinical scenario Is preoperative exercise beneficial to postoperative ADL and pain scores in patients aged 70+ with osteoarthritis undergoing total knee replacement compared to patients who will undergo total knee replacement but will not follow a preoperative exercise program? Research question Research question Population: 70+ patients who will get the knee surgery with osteoarthritis Intervention: exercise before the surgery (TKR) Comparison: 70+ patients who will get the knee surgery with osteoarthritis but did not get the preoperative exercise. Outcome: pain and ADL Time: 3 and 12 months PICOT PICOT P: age, osteoarthritis and knee replacement I: exercise and preoperative C: - O: KOOS score and later Womac on Pain and ADL RCT Search strategy Search strategy Flow chart Critical appraisal Critical appraisal Risk of bias summary Risk of bias graph SoF Table SoF table No significant difference No proven long term effects on ADL and pain No prescription of preoperative exercise Conclusion Conclusion
Transcript: Millennials and Generational Differences in Workplace Attitudes and Behaviours Introduction Millennials: early 1980s to the early 2000s Negative: “Want it all and Want it now” generation, narcissistic, over-confident, over-indulged, lazy, demanding, disloyal, uncooperative Postivie: “Greatest Generation,” societal fairness, creating a better economic, geopolitical, and environmental future, technologically adept Research Question: Based upon the existing body of literature, do Millennials differ significantly from other generational cohorts in relation to work-place attitudes and behaviours? Introduction Search Strategy Databases: Business Source Complete, PsycINFO and One Search Search terms: “millennial*,” “generational difference*," “attitude*,” “behavi*,” “workplace,” “work” 13 articles were selected for final inclusion Search Strategy Critical Appraisal Main Findings Critical Appraisal & Synthesis Differences between generational cohorts do exist for specific workplace values. Differences among generations relating to workplace attitudes and behaviours are minimal. Workplace differences can be attributed to factors other than generational membership. Considerations Critical Appraisal & Synthesis Cross-sectional vs. Longitudinal design Casuation: Age/Life Stage or generational cohort? Effect Sizes Limitations Recommendations Mold organizational initiatives/structures to specific generational inclinations? Base workplace models/practices not on generational stereotypes, but individual employee needs? Combination of both? Future research needed Recommendations Questions?
Transcript: CAT presentation Thijs Schutten, Joris-Jan van der Stoep, Anne Theunissen Content PIO Search strategy Introduction Internal validity Interpretation of results Transfer to daily practice Discussion/Conclusion Content PIO QUESTION: Does manual therapy have a pain reduction effect by a 45 years old man with cervical radiculopathy? P: 45 years old man with radiculopathy in the cervical spine I: manual therapy O: reduction in pain PIO Search strategy Search strategy Search via PubMed: First article in the list: Manual Therapy in Cervical and Lumbar Radiculopathy: A Systematic Review of the Literature Introduction Title Manual Therapy in Cervical and Lumbar Radiculopathy: A Systematic Review of the Literature Introduction Wich were the methods that were used? - PubMed and web of science - Inclusion criteria Wich were the results? - PEDro scale What was the conclusion? - Cervical radiculopathie - Lumbar radiculopathie Introduction Internal validity Selection bias Only English studies were included Only used 2 databases to search for literature Grey literature not included Information bias Most participants (93%) and therapists (96%) weren't blinded in the included studies Methodigical quality Assessment (AMSTAR-2 & McMaster) The AMSTAR -2 score is considered as low. 1 critical weakness Internal validity Interpretation of results Difficult to interpret the results. P-value not mentioned in the SR Only conlusion of the included RCT's are mentioned in the SR Interpretation of results Transfer to daily practice Neurodynamic tests should be mandatory in individuals with radiculopathy. Multimodal intervention CR: traction component A stand alone intervention has no effect on the pain. The variables like graded, repetions etc. are not mentioned. Level of recommendation: grade 1 Transfer to daily practice Discussion/Conclusion Discussion/Conclusion level of evidence -> A1 Answer to PIO-question: - Most included RCT's reported that there was a pain reduction effect -Lumbar radiculopathy only had 6 studies included -Low AMSTAR-2 score -In this systematic review it is not clear how the therapist performed the intervention. So it is hard to tell how to perform the interpretate it.
Transcript: Internal change over engine rebuilds Laverton Trucks Campbell Grant 7/12/2017 Overview SUMMARY Process Outline, processes and benefits of the idea Customer Experience direct benefits for the customers and why it will make their experience with william adams more enjoyable Business exposure/ image Positive effects on the overall image of the business and effect on current products on the road Process Process Engines rebuilt at each branch Completely stripped down brought back to new condition Using all genuine new and reman parts Kept on hand and avalible or easily transportable between branches Fitted in place of old engine core change-over Core Change-over Works on core change over basis Rebuilt, run in and prepaired for fittment to a job imedietly Dealer based change over system to operate smoother Parts reman cores returned previous to engine being fitted reducing workload and paperwork on customers job Benefits Shorter repair time due to the complete access around the whole engine Higher standard of quality More consistent experience Ready to fit as soon as old engine is removed Less of a rush than doing a normal in-chassis Benefit Customer experience Customer Experience A more consistent experience across dealer network For customers with earlier less common engines, this system will be more beneficial Reduced waiting times with engines on hand Business Exposure Business Exposure Create more work Eextend life of products already on the road With appropriate experience rebuild and replace engines beyond Cat powered trucks Opportunity of repowers from compeditor engines increasing or share of the market
Transcript: Shin Bo Ra Thank you :) Square Jaw With Junggi, Song Who is she? ! Eye Disappearance KBS 25th comedian Very Promising! H 1987.3.17(25years old) Choir at Men's Qualifications A ! Recent Video Clip Superstar KBS Jung geun, Song ! Funny The Discovery of Life Thank You :-) GAG CONCERT Talented
Transcript: A domestic cats sense of smell is approximately fourteen times stronger than humans. Cats have more acute sense of smell than humans do. A cat has about 24 movable whiskers in four sets on the upper lip on either of its nose. There are also a few on each cheek, tufts over the eyes, bristles on the chin, the cats inner wrists and at the back of the legs. Rabies is a viral infection transmitted through a bite of an infected animal. This infection directly affects central nervous system. An infected cat may develop fever spikes and erratic behavior. Some of the major symptoms of cat rabies are excessive drooling, snapping at imaginary objects, dilated pupils, abnormal changes in cat's appetite. General Info. A key point to training a cat and understanding cat behavior is to make sure that whatever you want your cat to do is exceedingly rewarded and pleasurable. Whatever you don't want your cat to indulge it must never be rewarding or fun, it must be unpleasant. Sometimes we unintentionally reward our cat for obnoxious behavior. Feeding Advantages Vs. Disadvantages Siamese Cat Presentation Water On average, cats spend 2/3 of every day sleeping. That means a 9 year old cat has been awake for a third of its life. A group of cats is called a "Crowder". Cats make about 100 different sounds or noises, while dogs only make 10. Approximately 40,000 people are bitten by a cat in U.S. annually. The Siamese is one of the first distinctly reconized breeds of oriental cats. The breed orginated in Thailand. The Siamese is usually white an gray. They weigh between 8-12 pounds when their full grown. The Siamese is usually very affectionate and intelligent cats, renowned for their social nature. Many Siamese are extremely vocal, with a loud low-pitched voice. Grooming Male Vs. Female Cats were originally domesticated in Africa. The Cats Fanciers Association. CFA is now partners with Cat Shows US. Tests show that Cats eye sight is greater at night compared to humans and not as well in the daylight. Cats can see 200 degrees compared to humans of 180 degrees. Cats have a third eyelid that closes from the side and appears when the eyelid opens. Cats hearing is similar to humans but cats hear things in a much higher pitched sound. When listening for something a cats ears will swivel in the direction of the sound. Whether a cat is male or female usually doesn't make much of a difference once he is neutered and she is spayed- unless you plan on having more than one cat. The personality of the individual cat is more telling than the sex, although in general males are more outgoing than females. The behavior of unsterilized cats is more markedly different. An intact male for instance, will be more territorial, and more aggresive with other male cats. While an unspayed female is sexually receptive or "in heat" she will display annoying behaviors such as yowling, pacing anxiously in search for a mate. Interesting Facts on cats You have a great companion animal by owning a cat. You can make good and enjoyable memorizes with a cat, and you will have less rodents in your house and yard. Some Disadvantages of owning a cat would be it can be expensive to raise a cat and they can be a pest at times by biting or scratching, ripping up things their not suppose to such as the carpet or the furniture. Diseases Tanner Marquardt Cats are known for their cleanliness spending hours licking their coats. The cats tongue has backwards-facing spines about 500 micrometers long. These spines allow cats to groom themselves by liking their fur, with the rows of papillae acting like hairbrush. Rabies is a viral infection transmitted through a bite of an infected animal. This infection directly affects central nervous system. An infected cat may develop fever spikes and erratic behavior. Some of the major symptoms of cat rabies are excessive drooling, snapping at imaginary objects, dilated pupils, abnormal changes in cat's appetite. Cat senses Training The average monthly cost of a cat ranges roughly between 35-60 dollars whether thats toys, food, or vaccination shots and anything else. As your cat consumes more calories and produces more metabolic waste, he needs more water to maintain his body temperature. In general, an adult cat should drink roughly the same amount of water in millimeters as the number of kilocalories eaten per day. Female cats seasonally have periods of heat over the course of a year, while multiple males will be attracted to a female in heat. The Gestation period of cats is 64 to 67 days and the litter size is between five and three kittens. Kittens are usually weaned between six and seven weeks and reach maturity at 5-10 months Reproduction History,CFA, Cat Senses Dry Adult at food is more economical, its convenient because you can leave it out and it wont spoil easily. Its energy dense meaning a cat can consume lots of calories quickly. It has 10% of moisture. Canned Adult cat food is more expensive, can spoil easily, requires
Transcript: SGLT-2 inhibitor vs Metformin Research Question Research question Do SGLT-2 inhibitors provide a similar decrease in HbA1c and blood pressure in patients with Diabetes Mellitus type 2 compared to metformin treatment for 24 weeks? PICOT PICO GRADE GRADE D1: Random sequence generation (selection bias) D2: Allocation concealment (selection bias) D3: Blinding of participants and personnel (performance bias) D4: Blinding of outcome assessment (detection bias) (mortality) D5: Incomplete outcome data addressed (attrition bias) D6: Selective reporting (reporting bias) SoF table SoF table Results Results and Conclusion Henry (2012) - SGLT-2 (10 mg) > Metformin Difference 0.01% * not statistically significant SGLT2 5 mg not tested Hadjadj (2016) - Metformin > SGLT2 Difference 0.40% and 0.39% *not statistically significant Koshizaka (2019) - Metformin > SGLT2 Difference 4.03% Statistically significant Large 95% CI Conclusion Conclusion Henry (2012) and Hadjadj (2016) no significance Koshizaka (2019) significance No difference found between medications Recommendation Recommendation Similar effect First choice metformin Second option SGLT-2 inhibitor Case Metormin effective No SGLT-2 inhibitor
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