bluuebunny/crossref_metadata_2025 huggingface dataset:
Topical Mitomycin C Application in Pediatric Patients with Recurrent Esophageal Strictures—Report on Unfavorable Results
Authors: Zimmer Julia , Gosemann Jan-Hendrik , Ure Benno , Lacher Martin , Boehm Roland , Madadi-Sanjani Omid
Published: December 2017

Objective Recurrent esophageal strictures (ESs) following esophageal atresia repair or caustic ingestion represent a common clinical problem. Recently, Mitomycin C was reported to improve the outcome of patients by reducing the number of endoscopic dilatations. However, other groups failed to exhibit a beneficial effect. We report on our experience with topic Mitomycin C application following endoscopic dilatation for recurrent ES.

Methods Retrospective chart review of patients with ES treated at the Hannover Medical School (Location A) and the University of Leipzig (Location B) between 2009 and 2015. A Mitomycin C-soaked cotton swab was endoscopically placed at the area of stricture in all subjects. Successful treatment was defined as resolution of stricture after Mitomycin C therapy with not more than three dilatations thereafter. Our results were compared with published outcomes of alternative studies that involved 10 or more patients.

Results A total of 11 children received Mitomycin C concurrently with endoscopic dilatations. Seven children (64%) had gross type C esophageal atresia, two patients (18%) gross type A esophageal atresia, and two children (18%) caustic injury.

After a median follow-up of 34 months (range, 14–75 months) and a median number of 3 ± 2.5 dilatations with Mitomycin C application per patient (range, 1–9), 6 of 11 patients (55%) achieved a resolution of their strictures. Five patients (45%) did not respond to Mitomycin C therapy, of which two needed esophageal redo-surgery.

Conclusion We failed to confirm the high success rates of Mitomycin C treatment for recurrent ESs. Given the fact that there is limited data to prove the beneficial effect of Mitomycin C treatment, pediatric surgeons should carefully consider whether the advantages of this therapy outweigh the necessity of life-long endoscopic follow-ups. Further randomized controlled studies are recommended.
Day of Week and Surgery Location Effects on Stay Length and Cost for Total Joint Arthroplasty: Academic versus Orthopaedic-Specific Hospital
Authors: Peterson Blake , Thompson Samuel , Cook James , Aggarwal Ajay , Martino John
Published: December 2017

Demand for total hip (THA) and knee arthroplasties (TKA) is expected to rise sharply by 2030. Increasing demand in conjunction with financial pressure requires the use of cost-effective total joint arthroplasty (TJA) strategies. This study examined the effects that day of week and surgery location [academic (AH) versus orthopaedic-specific (OsH) hospital] have on length of stay (LOS) and cost for primary TJA patients in one multihospital university-based medical center. An Institutional Review Board-approved database of adult patients undergoing primary THA or TKA from June 2013 to December 2014 was constructed. Surgery location, day of procedure, age, American Society of Anesthesiologists (ASA) classification, LOS, and cost were recorded for each patient. Data were compared for significant differences using analysis of variance, t-Test or rank sum and for strength of correlations using Pearson's or Spearman's tests. A total of 1,291 patients met inclusion criteria. OsH showed significantly lower cost and shorter LOS than AH. Wednesday surgeries had significantly higher cost and longer LOS than all other days. Friday surgeries had significantly lower cost and shorter LOS than other days. ASA 3 and 4 were associated with the highest cost and longest LOS. LOS had a moderately strong direct correlation to cost. ASA did not have a strong correlation with LOS or cost. Data separated for THA and TKA showed similar results. At our institution, OsH provides more consistent and lower LOS and cost across all ASA classes. Wednesday and Thursday surgeries have increased LOS and cost than other days, which may be due to weekend discharge difficulties (average LOS is 3.0 days).
Physiotherapeutische Werkzeuge zur funktionellen Mobilisation von Narben und Bindegewebe sowie Dosierung bei
großflächigen Narbenplatten
Authors: Koller T , Ruegg C , Gut V
Published: December 2017

Die jährlichen Statistiken zeigen eine zunehmende Anzahl an Operationen. Aus diesem Grund werden Physiotherapeuten in ihrer täglichen Praxis
mit einer Fülle von Narben konfrontiert. Bei einem großen Teil dieser Narben verläuft die Wundheilung asymptomatisch, ohne die
Funktionalität einzuschränken. Aber wie sieht die richtige und funktionsverbessernde Behandlung von symptomatischen und mit einer massiven
Funktionseinschränkung einhergehenden Narben aus?

Diese Arbeit gibt einen Überblick über gewebephysiologische Aspekte der Wund- und Narbenheilung und beleuchtet mögliche Behandlungsansätze
bei Komplikationsnarben.
Clinical outcomes of endoscopic submucosal dissection for superficial esophageal neoplasms extending to the cervical esophagus
Authors: Ariyoshi Ryusuke , Toyonaga Takashi , Tanaka Shinwa , Abe Hirofumi , Ohara Yoshiko , Kawara Fumiaki , Ishida Tsukasa , Morita Yoshinori , Umegaki Eiji , Azuma Takeshi
Published: December 2017

Background The feasibility and safety of endoscopic submucosal dissection (ESD) for superficial esophageal neoplasms extending to the cervical esophagus currently remain unknown because of the limited number of cases. We aimed to clarify the clinical outcomes of these cases.

Methods This was a case series study conducted at a single institution that enrolled 26 consecutive patients with superficial esophageal neoplasms extending to the cervical esophagus who underwent ESD between July 2003 and December 2015.

Results En bloc and complete resection rates were both 100 % and no major intraprocedural complications occurred. Thirteen patients were treated with prophylactic steroid therapy. The incidence of postoperative stricture in patients with a circumferential mucosal defect of more than three-quarters was 72.7 %. Four patients required entire circumferential resection, with perforation occurring after endoscopic balloon dilation (EBD) in two and EBD being required for more than 1 year in the other two.

Conclusions ESD including the cervical esophagus is technically feasible. Circumferential resection may cause refractory postoperative stricture or post-EBD perforation, so needs to be avoided where possible.
Watching ultrafast responses of structure and magnetism in condensed matter with momentum-resolved probes
Authors: Johnson S. L. , Savoini M. , Beaud P. , Ingold G. , Staub U. , Carbone F. , Castiglioni L. , Hengsberger M. , Osterwalder J.
Published: December 2017

We present a non-comprehensive review of some representative experimental studies in crystalline condensed matter systems where the effects of intense ultrashort light pulses are probed using x-ray diffraction and photoelectron spectroscopy. On an ultrafast (sub-picosecond) time scale, conventional concepts derived from the assumption of thermodynamic equilibrium must often be modified in order to adequately describe the time-dependent changes in material properties. There are several commonly adopted approaches to this modification, appropriate in different experimental circumstances. One approach is to treat the material as a collection of quasi-thermal subsystems in thermal contact with each other in the so-called “N-temperature” models. On the other extreme, one can also treat the time-dependent changes as fully coherent dynamics of a sometimes complex network of excitations. Here, we present examples of experiments that fall into each of these categories, as well as experiments that partake of both models. We conclude with a discussion of the limitations and future potential of these concepts.
Implications of short time scale dynamics on long time processes
Authors: El Hage Krystel , Brickel Sebastian , Hermelin Sylvain , Gaulier Geoffrey , Schmidt Cédric , Bonacina Luigi , van Keulen Siri C. , Bhattacharyya Swarnendu , Chergui Majed , Hamm Peter , Rothlisberger Ursula , Wolf Jean-Pierre , Meuwly Markus
Published: December 2017

This review provides a comprehensive overview of the structural dynamics in topical gas- and condensed-phase systems on multiple length and time scales. Starting from vibrationally induced dissociation of small molecules in the gas phase, the question of vibrational and internal energy redistribution through conformational dynamics is further developed by considering coupled electron/proton transfer in a model peptide over many orders of magnitude. The influence of the surrounding solvent is probed for electron transfer to the solvent in hydrated I−. Next, the dynamics of a modified PDZ domain over many time scales is analyzed following activation of a photoswitch. The hydration dynamics around halogenated amino acid side chains and their structural dynamics in proteins are relevant for iodinated TyrB26 insulin. Binding of nitric oxide to myoglobin is a process for which experimental and computational analyses have converged to a common view which connects rebinding time scales and the underlying dynamics. Finally, rhodopsin is a paradigmatic system for multiple length- and time-scale processes for which experimental and computational methods provide valuable insights into the functional dynamics. The systems discussed here highlight that for a comprehensive understanding of how structure, flexibility, energetics, and dynamics contribute to functional dynamics, experimental studies in multiple wavelength regions and computational studies including quantum, classical, and more coarse grained levels are required.
Direct evidence for the source of reported magnetic behavior in “CoTe”
Authors: Zhang Zhiwei , Hines William A. , Budnick Joseph I. , Perry David M. , Wells Barrett O.
Published: December 2017

In order to unambiguously identify the source of magnetism reported in recent studies of the Co-Te system, two sets of high-quality, epitaxial CoTex films (thickness ≈ 300 nm) were prepared by pulse laser deposition (PLD). X-ray diffraction (XRD) shows that all of the films are epitaxial along the [001] direction and have the hexagonal NiAs structure. There is no indication of any second phase metallic Co peaks (either fcc or hcp) in the XRD patterns. The two sets of CoTex films were grown on various substrates with PLD targets having Co:Te in the atomic ratio of 50:50 and 35:65. From the measured lattice parameters c = 5.396 Å for the former and c = 5.402 Å for the latter, the compositions CoTe1.71 (63.1% Te) and CoTe1.76 (63.8% Te), respectively, are assigned to the principal phase. Although XRD shows no trace of metallic Co second phase, the magnetic measurements do show a ferromagnetic contribution for both sets of films with the saturation magnetization values for the CoTe1.71 films being approximately four times the values for the CoTe1.76 films. 59Co spin-echo nuclear magnetic resonance (NMR) clearly shows the existence of metallic Co inclusions in the films. The source of weak ferromagnetism reported in several recent studies is due to the presence of metallic Co, since the stoichiometric composition “CoTe” does not exist.
Is light narrowing possible with dense-vapor paraffin coated cells for atomic magnetometers?
Authors: Han Runqi , Balabas Mikhail , Hovde Chris , Li Wenhao , Roig Hector Masia , Wang Tao , Wickenbrock Arne , Zhivun Elena , You Zheng , Budker Dmitry
Published: December 2017

We investigated the operation of an all-optical rubidium-87 atomic magnetometer with amplitude-modulated light. To study the suppression of spin-exchange relaxation, three schemes of pumping were implemented with room-temperature and heated paraffin coated vacuum cells. Efficient pumping and accumulation of atoms in the F=2 ground state were obtained. However, the sought-for narrowing of the resonance lines has not been achieved. A theoretical analysis of the polarization degree is presented to illustrate the absence of light narrowing due to radiation trapping at high temperature.
Phasor based single-molecule localization microscopy in 3D (pSMLM-3D): An algorithm for MHz localization rates using standard CPUs
Authors: Martens Koen J. A. , Bader Arjen N. , Baas Sander , Rieger Bernd , Hohlbein Johannes
Published: December 2017

We present a fast and model-free 2D and 3D single-molecule localization algorithm that allows more than 3 × 106 localizations per second to be calculated on a standard multi-core central processing unit with localization accuracies in line with the most accurate algorithms currently available. Our algorithm converts the region of interest around a point spread function to two phase vectors (phasors) by calculating the first Fourier coefficients in both the x- and y-direction. The angles of these phasors are used to localize the center of the single fluorescent emitter, and the ratio of the magnitudes of the two phasors is a measure for astigmatism, which can be used to obtain depth information (z-direction). Our approach can be used both as a stand-alone algorithm for maximizing localization speed and as a first estimator for more time consuming iterative algorithms.
Hybrid grid/basis set discretizations of the Schrödinger equation
Authors: White Steven R.
Published: December 2017

We present a new kind of basis function for discretizing the Schrödinger equation in electronic structure calculations, called a gausslet, which has wavelet-like features but is composed of a sum of Gaussians. Gausslets are placed on a grid and combine advantages of both grid and basis set approaches. They are orthogonal, infinitely smooth, symmetric, polynomially complete, and with a high degree of locality. Because they are formed from Gaussians, they are easily combined with traditional atom-centered Gaussian bases. We also introduce diagonal approximations that dramatically reduce the computational scaling of two-electron Coulomb terms in the Hamiltonian.
The magnetic properties of (La,Ce)Co5 ((La,Ce)=La0.35Ce0.65, La-Ce mischmetal) nanoflakes prepared by surfactant-assisted ball milling
Authors: Zhao X. , Zuo W. L. , Liu D. , Xiong J. F. , Zuo S. L. , Zhang Y. , Zheng X. Q. , Hu F. X. , Zhao T. Y. , Sun J. R. , Shen B. G.
Published: December 2017

The hard magnetic (La,Ce)Co5 nanoflakes with high coercivity and narrow thickness distribution have been successfully obtained by surfactant-assisted ball milling (SABM). The magnetic properties, morphology and interaction of (La,Ce)Co5 nanoflakes are studied in this work. The coercivity and remanence ratio of (La,Ce)Co5 nanoflakes are 5.48 kOe and 0.71, respectively. The X-ray powder diffraction (XRD) patterns indicate that the (La,Ce)Co5 nanoflakes are CaCu5-type hexagonal crystal structure. The average thickness and aspect ratio are 47 nm and 40, respectively. The intergrain interaction of the (La,Ce)Co5 nanoflakes is studied using the δm(H)-curves technique which shows the magnetostatic-dominated particle interaction. The high coercivity and narrow thickness distribution of (La,Ce)Co5 nanoflakes could be promising for the future development of the high performance soft/hard exchange spring magnets.
Influence of the electromagnetic parameters on the surface wave attenuation in thin absorbing layers
Authors: Li Yinrui , Li Dongmeng , Wang Xian , Nie Yan , Gong Rongzhou
Published: December 2017

This paper describes the relationships between the surface wave attenuation properties and the electromagnetic parameters of radar absorbing materials (RAMs). In order to conveniently obtain the attenuation constant of TM surface waves over a wide frequency range, the simplified dispersion equations in thin absorbing materials were firstly deduced. The validity of the proposed method was proved by comparing with the classical dispersion equations. Subsequently, the attenuation constants were calculated separately for the absorbing layers with hypothetical relative permittivity and permeability. It is found that the surface wave attenuation properties can be strongly tuned by the permeability of RAM. Meanwhile, the permittivity should be appropriate so as to maintain high cutoff frequency. The present work provides specific methods and designs to improve the attenuation performances of radar absorbing materials.
Saturation of VCMA in out-of-plane magnetized CoFeB/MgO/CoFeB magnetic tunnel junctions
Authors: Williamson M. , de Rozieres M. , Almasi H. , Chao X. , Wang W. , Wang J.-P. , Tsoi M.
Published: December 2017

Voltage controlled magnetic anisotropy (VCMA) currently attracts considerable attention as a novel method to control and manipulate magnetic moments in high-speed and low-power spintronic applications based on magnetic tunnel junctions (MTJs). In our experiments, we use ferromagnetic resonance (FMR) to study and quantify VCMA in out-of-plane magnetized CoFeB/MgO/CoFeB MTJ pillars. FMR is excited by applying a microwave current and detected via a small rectified voltage which develops across MTJ at resonance. The VCMA effective field can be extracted from the measured resonance field and was found to vary as a function of electrical bias applied to MTJ. At low applied biases, we observe a linear shift of the VCMA field as a function of the applied voltage which is consistent with the VCMA picture based on the bias-induced electron migration across the MgO/CoFeB interface. At higher biases, both positive and negative, we observe a deviation from the linear behavior which may indicate a saturation of the VCMA effect. These results are important for the design of MTJ-based applications.
Toward nanoscale multiferroic devices: Magnetic field-directed self-assembly and chaining in Janus nanofibers
Authors: Chavez Bryan L. , Sosnowski Kevin C. , Bauer Matthew J. , Budi Maeve A. K. , Andrew Jennifer S. , Crawford Thomas M.
Published: December 2017

Optical microscopy is used to observe magnetic field driven chaining of Janus nanofibers electrospun from CoFe2O4 and BaTiO3 sol-gel precursors. Chaining as a function of applied field strength follows the expected power law for diffusion limited chaining at low concentrations. At higher concentrations chain length increases rapidly at low fields but more slowly at higher fields, with a transition at 100 Oe. This change in dynamics means field-dependent scaling exponents, suggesting mass-dependent chaining for low fields and diffusion limited chaining for higher fields. The angular dispersion of the chains relative to the external field direction also shows a transition near 100 Oe, decreasing monotonically at higher fields. These results suggest that assembly models developed for nanoparticles need to be modified to properly describe assembly in nanorods and nanofibers.
Spectra of confined positronium
Authors: Munjal D. , Silotia P. , Prasad V.
Published: December 2017

Positronium is studied under the effect of spherically confined plasma environment. Exponentially Cosine Screened Coulomb potential (ECSC) has been used to include the dense plasma screening effect on positronium. Time independent Schrodinger equation is solved numerically. Various physical parameters such as energy eigenvalues, radial matrix elements, oscillator strengths, and polarizability are well explored as a function of confinement parameters. Oscillator strength gets drastically modified under confinement. We have also obtained the results for Ps confined under spherically confined Debye potential and compared with results of ECSC potential. Also incidental degeneracy for different values of confinement parameters has been reported for the first time for positronium.
Theoretical study of platonic crystals with periodically structured N-beam resonators
Authors: Gao Penglin , Climente Alfonso , Sánchez-Dehesa José , Wu Linzhi
Published: December 2017

A multiple scattering theory is applied to study the properties of flexural waves propagating in a plate with periodically structured N-beam resonators. Each resonator consists of a circular hole containing an inner disk connected to background plate with N rectangular beams. The Bloch theorem is employed to obtain the band structure of a two-dimensional lattice containing a single resonator per unit cell. Also, a numerical algorithm has been developed to get the transmittance through resonator slabs infinitely long in the direction perpendicular to the incident wave. For the numerical validation, a square lattice of 2-beam resonators has been comprehensively analyzed. Its band structure exhibits several flat bands, indicating the existence of local resonances embedded in the structure. Particularly, the one featured as the fundamental mode of the inner disk opens a bandgap at low frequencies. This mode has been fully described in terms of a simple spring-mass model. As a practical application of the results obtained, a homogenization approach has been employed to design a focusing lens for flexural waves, where the index gradient is obtained by adjusting the orientation of the resonators beams. Numerical experiments performed within the framework of a three-dimensional finite element method have been employed to discuss the accuracy of the models described here.
Crystallization of Lennard-Jones liquids under dynamic compression: Heterogeneous and homogeneous nucleation
Authors: Cai Jin , E J. C. , Tang M. X. , Zhu X. R. , Cai Y. , Luo S. N.
Published: December 2017

We investigate crystallization of Lennard-Jones liquids on substrates under dynamic compression with large-scale molecular dynamics simulations. The substrates examined include single crystals and bicrystals with different crystallographic orientations, and the loading paths include shock and quasi-isentropic loading. Microstructure is characterized with simulated x-ray diffraction and orientation mapping. For shock loading, only heterogeneous nucleation occurs at the simulation scales. Quasi-isentropic loading induces less heating and larger supercooling; as a result, heterogeneous nucleation occurs at low loading strengths, and both heterogeneous and homogeneous nucleation occur at high loading strengths, despite the crystalline substrates. Crystallization depends on the substrate structure (crystal orientation and grain boundary) and loading characteristics. Deformation may induce grain structure change (e.g., reorientation and twinning) of substrates and affect subsequent crystallization. Crystallization rate is anisotropic, inversely proportional to the cosine of the dihedral angle between the substrate plane and a main {111} growth plane.
Image quality assessment using deep convolutional networks
Authors: Li Yezhou , Ye Xiang , Li Yong
Published: December 2017

This paper proposes a method of accurately assessing image quality without a reference image by using a deep convolutional neural network. Existing training based methods usually utilize a compact set of linear filters for learning features of images captured by different sensors to assess their quality. These methods may not be able to learn the semantic features that are intimately related with the features used in human subject assessment. Observing this drawback, this work proposes training a deep convolutional neural network (CNN) with labelled images for image quality assessment. The ReLU in the CNN allows non-linear transformations for extracting high-level image features, providing a more reliable assessment of image quality than linear filters. To enable the neural network to take images of any arbitrary size as input, the spatial pyramid pooling (SPP) is introduced connecting the top convolutional layer and the fully-connected layer. In addition, the SPP makes the CNN robust to object deformations to a certain extent. The proposed method taking an image as input carries out an end-to-end learning process, and outputs the quality of the image. It is tested on public datasets. Experimental results show that it outperforms existing methods by a large margin and can accurately assess the image quality on images taken by different sensors of varying sizes.
Magnetron sputtering cathode for low power density operation
Authors: Motomura T. , Tabaru T.
Published: December 2017

A novel magnetron sputtering cathode with a magnetic mirror configuration is proposed, for low power density operation. The magnetic field profiles are simply constructed using two cylindrical permanent magnets positioned behind the disk-shaped sputtering target of 50 mm in diameter. The magnetic mirror configuration near the center and the outer edges of the target enables low power density operation up to 0.25 W/cm2 in the case of DC input power of 5 W. A sputtering rate of ∼0.2 nm/min was obtained under experimental conditions with target-substrate distance of 280 mm, Ar gas pressure of 0.1 Pa, and DC input power of 15 W.
Experimental evaluation of predation of stocked salmon by riparian wildlife: effects of prey size and predator behaviours
Authors: Miyamoto Kouta , Squires Theodore E. , Araki Hitoshi
Published: December 2017

Predation after release is one of the major concerns of hatchery fish conservation and propagation. However, the relationships between the size of hatchery fish, the predator species and their behaviours in natural environments are largely unknown. To understand these relationships, we conducted predation experiments in outdoor tanks and a seminatural stream with exposure to local predators. Masu salmon (Oncorhynchus masou) of two different size classes were used as experimental prey fish in the present study. Camera trap data showed that grey herons (Ardea cinerea) were the primary predator in the experimental system, and that most herons used shallow areas in the morning or evening while feeding. Increasing the density of stocked salmon led to increases in the number of occurrences of grey heron. More importantly, predation by grey herons resulted in a significantly lower survival rate of larger salmon compared with smaller salmon. The results indicate that it is important to understand local predators, adjust the optimum body size of hatchery fish at release and choose the appropriate stocking site and time of day for maximising the effectiveness of fish stocking.
Short-term stem mortality of 10 deciduous broadleaved species following prescribed burning in upland forests of the Southern US
Authors: Keyser Tara L. , McDaniel Virginia L. , Klein Robert N. , Drees Dan G. , Burton Jesse A. , Forder Melissa M.
Published: December 2017

In upland forests of the Southern US, management is increasingly focussed on the restoration and maintenance of resilient structures and species compositions, with prescribed burning being the primary tool used to achieve these goals and objectives. In this study, we utilised an extensive dataset comprising 91 burn units and 210 plots across 13 National Park Service lands to examine the relationships between the probability of stem mortality (P(m)) 2 years after prescribed fire and stem size and direct fire effects for 10 common deciduous broadleaved species. Post-fire stem mortality ranged from 6.9% for Quercus alba to 58.9% for Sassafras albidum. The probability of stem mortality was positively associated with maximum bole char height (CHAR) and inversely related to diameter at breast height (DBH) for all 10 deciduous broadleaved species. Model goodness-of-fit varied, with the poorest fit generally associated with fire-tolerant species and best fit generally associated with fire sensitive species. The information presented contributes to our understanding of post-fire stem mortality and may contribute to the development of fire-related stem mortality models following prescribed burning for eastern tree species. Models should be validated with independent datasets across upland forests types to test for spatial relationships before widespread application.
The two TRAPP complexes of metazoans have distinct roles and act on different Rab GTPases
Authors: Riedel Falko , Galindo Antonio , Muschalik Nadine , Munro Sean
Published: December 2017

Originally identified in yeast, transport protein particle (TRAPP) complexes are Rab GTPase exchange factors that share a core set of subunits. TRAPPs were initially found to act on Ypt1, the yeast orthologue of Rab1, but recent studies have found that yeast TRAPPII can also activate the Rab11 orthologues Ypt31/32. Mammals have two TRAPP complexes, but their role is less clear, and they contain subunits that are not found in the yeast complexes but are essential for cell growth. To investigate TRAPP function in metazoans, we show that Drosophila melanogaster have two TRAPP complexes similar to those in mammals and that both activate Rab1, whereas one, TRAPPII, also activates Rab11. TRAPPII is not essential but becomes so in the absence of the gene parcas that encodes the Drosophila orthologue of the SH3BP5 family of Rab11 guanine nucleotide exchange factors (GEFs). Thus, in metazoans, Rab1 activation requires TRAPP subunits not found in yeast, and Rab11 activation is shared by TRAPPII and an unrelated GEF that is metazoan specific.
Screening, Assessment, and Diagnosis of Substance Use Disorders among Emerging Adults
Authors: Smith Douglas C. , Bennett Kyle M. , Dennis Michael L. , Funk Rodney
Published: December 2017

Several challenges may hinder accurate screening for and assessment of substance use disorders among emerging adults ages 18–29. This chapter discusses emerging adult–specific research on diagnosing substance use disorders and several empirically supported screeners and assessments that may be useful to those working with emerging adults. First, emerging adult–specific research supporting changes to the most recent version of the Diagnostic and Statistical Manual for Mental Disorders, the DSM-5, is reviewed, and nuances in using the DSM-5 with emerging adults are discussed. The chapter highlights idiosyncrasies in emerging adult symptom patterns using data from large national surveys. Finally, a practice-friendly review of screening and assessment instruments commonly used with emerging adults is provided. For screening instruments, administration time, the instrument’s ability to discern which emerging adults exhibit substance use problems, and emerging adult–specific cutoff points in the literature are addressed. For assessment tools, comprehensiveness of the instrument, administration time, and contexts in which the instrument has been used with emerging adults are discussed.
The Potential for Delivering Substance Use Disorder Treatments to Emerging Adults in Child Welfare Settings
Authors: Havlicek Judy , Braciszewski Jordan
Published: December 2017

Foster youth exiting child welfare systems through emancipation or aging out are at elevated risk for substance use disorders. Many may experience challenges to accessing substance use disorder treatment after foster care. This chapter explores the potential for delivering substance use disorder treatments to emerging adults in the context of federal policy, which has expanded over the past three decades to better support the transition that foster youth make to adulthood. First, background information on aging-out foster youth is provided, and what is known about alcohol and substance use disorders and associated treatment is reviewed. The chapter also discusses potential barriers to treatment engagement and offers considerations for developing programs that address population-specific needs. This review of substance use and aging-out foster youth comes at a time when the transition to adulthood is increasingly considered an important developmental period to target interventions aimed at promoting positive health behaviors.
Self-System Therapy for Depression
Authors: Eddington Kari M. , Strauman Timothy J. , Vieth Angela Z. , Kolden Gregory G.
Published: December 2017

Self-system therapy (SST) for depression is a structured, short-term, evidence-based treatment approach that targets motivational deficits in depression. The treatment is grounded in an extensive research literature on self-regulation, and it translates that empirical work into therapeutic strategies aimed at enhancing effective goal pursuit in clients with depression. Studies have shown that SST is superior to cognitive therapy for depressed clients with specific self-regulatory deficits and that SST works in part by restoring adaptive self-regulation. Presented in a simplified format, the Therapist Guide provides clinicians with the critical theoretical background that forms the foundation of SST. It includes worksheets to aid therapists in treatment planning. Detailed descriptions of the core SST interventions, which are conducted during a 16-week course of therapy, are provided along with an optional module for managing perfectionism, which is prevalent among clients with depression. The accompanying Client Workbook explains the core SST concepts using concrete examples; it includes worksheets that can be used by the client to enhance learning and at-home application of the skills.
Orientation Phase Goal 1
Authors: Eddington Kari M. , Strauman Timothy J. , Vieth Angela Z. , Kolden Gregory G.
Published: December 2017

During the orientation phase of self-system therapy (SST), the therapist familiarizes the client with the structure and focus of SST and establishes a strong, collaborative working alliance that supports the client’s efforts to identify and address underlying sources of problems in self-regulation. The first goal after beginning the program is to learn about self-regulation and how it is related to problems with depression. Self-regulation is the process of setting and pursuing goals that help people become who they want to be. Chapter 2 introduces the concepts of self-regulation and promotion and prevention goals, and it examines how these concepts are connected to emotions. Clients are encouraged to think about why they place importance on certain goals.
Exploration Phase Goal 1
Authors: Eddington Kari M. , Strauman Timothy J. , Vieth Angela Z. , Kolden Gregory G.
Published: December 2017

In addressing the first goal of the exploration phase of self-system therapy (SST), Chapter 5 focuses on helping clients identify self-beliefs and self-guides. Self-beliefs are characteristics that describe people as they actually are. Ideal self-guides are characteristics that clients would like to have, and ought self-guides are characteristics clients think they should have. Discrepancies can exist between the actual self and the client’s own expectations and standards and those that come from other people. Chronic self-discrepancies can lead to or exacerbate depression. Self-belief analysis is used to examine the content, function, origins, and adaptiveness of clients’ beliefs about themselves in relation to others. A worksheet that is designed to be completed with the help of the therapist or counselor is included.
Efficacious Treatments for Common Psychiatric Challenges in Adolescents with Autism Spectrum Disorder
Authors: Nowinski Lisa A. , Milot Alyssa , Gold Alanna , McDougle Christopher J.
Published: December 2017

The adolescent period presents a unique and challenging time for individuals with Autism Spectrum Disorder (ASD). Common psychiatric problems such as mood disorder, anxiety, ADHD, and disruptive behaviors commonly co-occur in adolescents with ASD. Other clinical considerations such as sleep difficulties, catatonia, sexuality and related behaviors, gender identity, and adaptive and vocational skill issues are also prominent in the adolescent period. Research suggests that there are effective drug and non-drug treatment options available for these commonly co-occurring psychiatric challenges. In this chapter, we describe the clinical presentation and both drug and non-drug treatment options for each condition, as well as review the other unique clinical considerations in the treatment of adolescents with ASD.
Anxiety in Adolescents and Adults with Autism Spectrum Disorder
Authors: Mazurek Micah O.
Published: December 2017

Adolescents and adults with ASD are at high risk for clinically significant symptoms of anxiety. Accurate symptom identification and differential diagnosis can be challenging due to the similarity of presentation of many anxiety and ASD symptoms. Although there are no gold-standard tools for assessment of anxiety in individuals with ASD, clinicians are encouraged to use a comprehensive multi-informant, multi-modal assessment approach. Research supports the use of cognitive behavioral therapy (CBT) for treatment of anxiety in ASD, particularly in high-functioning adolescents. ASD-specific treatment modifications may be helpful for achieving optimal treatment response. There is limited available evidence regarding the effectiveness or potential adverse effects of pharmacological treatments for anxiety in this population. Future research is needed to understand the etiology and mechanisms of anxiety in individuals with ASD and to examine short- and long-term efficacy and effectiveness of a range of treatments.
A Population Approach to Evidence-Based Parenting Support
Authors: Sanders Matthew R.
Published: December 2017

This introductory section of the book lays the theoretical and empirical foundations for the adoption of a population-based approach to parenting support that incorporates promotion, prevention, and treatment activities into one comprehensive multilevel system of intervention. An empirically supported system of parenting support incorporates knowledge of the role of parenting in influencing the course of human development. The system integrates principles and techniques of positive parenting, behavioral, cognitive, and affective change with principles and techniques derived from the broader field of public health intervention. This introductory section of the book makes the case for the importance of parenting programs that tackle all three domains if children’s developmental and mental health outcomes are to be substantially improved. The Triple P—Positive Parenting Program is a multilevel system of parenting support that recognizes this importance.
Children with Peer Relationship Difficulties
Authors: Healy Karyn L.
Published: December 2017

Friendships are an important source of support for children, and problems with peers can be detrimental to well-being. Of all peer problems, involvement in bullying has the most serious outcomes for both victims and perpetrators. Whole-school interventions alone make insufficient impact on the issue. Research shows that parenting influences children’s peer skills and relationships. Children first learn skills for relating to peers through interactions with their parents and siblings and through opportunities orchestrated by parents. Facilitative parenting describes strategies that support children’s development of peer skills and relationships. This chapter describes a trial of Resilience Triple P, a family intervention utilizing facilitative parenting. It reviews recent evidence that suggests that parenting interventions might also reduce bullying behavior. Future research could explore the effectiveness of parenting interventions in reducing bullying and test the combined influence of school and family interventions in improving children’s peer relationships.
Working with Fathers
Authors: Keown Louise J.
Published: December 2017

The potential benefits of including fathers in parenting programs is increasingly recognized. Evidence suggests that key aspects of child behavior, fathering, and partner relationships can be positively affected by interventions if fathers are included. This chapter discusses the role of fathers in children’s development and why father-inclusive parenting programs are needed. Next, there is an examination of how the Triple P—Positive Parenting Program has engaged fathers to support the success of Triple P interventions. Research findings illustrate the importance of engaging fathers and co-parenting couples and addressing the needs and interests of both parents in program design and content.
Parenting Support in the Context of Primary Health Care
Authors: Turner Karen M. T. , Metzler Carol W.
Published: December 2017

Primary care providers such as family doctors, pediatricians, and community child health nurses are a trusted first port of call for parents seeking advice on parenting issues, and routine well-child visits provide multiple opportunities for screening, support, and intervention. Pediatric practices and family-centered health settings are an ideal, nonstigmatized context for providing integrated care, including parenting support, as part of universal prevention and early intervention. This chapter describes how Triple P can be applied in brief interventions through the primary health care system to prevent and reduce social, emotional, and behavioral problems in children. Workforce development, clinic management support, and sustainable funding models are discussed as key implementation factors that require careful planning if there is to be widespread dissemination of evidence-based parenting support in pediatric primary care settings.
Training a Workforce to Implement Evidence-Based Parenting Programs
Authors: Ralph Alan , Dittman Cassandra K.
Published: December 2017

The Triple P training model has been carefully developed to maintain the fidelity of the program, that is, to maximize the probability that the suite of programs delivered to parents globally closely matches those described and evaluated in the research literature. Three main areas of challenge are discussed: the recruitment, training, and support of Triple P trainers; the development, revision, and quality management of the training courses offered to practitioners; and the development, revision, and quality control of the resources provided to practitioners to support their delivery of the programs. Additional challenges are discussed, including adapting training protocols to changes in the workforce, ensuring practitioners maintain delivery fidelity over time, and exploring opportunities provided by developments in technology, particularly the potential for online training.
Shifting the Needle on Child Maltreatment
Authors: Prinz Ronald J. , Shapiro Cheri J.
Published: December 2017

Evidence-based parenting and family support can play a major role in the prevention of child maltreatment. This chapter provides a basis for the adoption and refinement of a population approach to child maltreatment prevention; the approach is built on a parenting intervention strategy, with the Triple P system of interventions serving as a useful example. The chapter discusses parenting risk for child maltreatment, the rationales for taking a population approach to child maltreatment prevention, the emerging evidence for evidence-based parenting and family support in a population context, measurement and design issues, and factors associated with quality of implementation. Community-wide application of an evidence-based parenting and family support intervention system like Triple P has the potential to address multiple problems concurrently, including but not limited to the prevention of child maltreatment, thereby capitalizing on the efficiency and utility of this public health strategy.
C Skill: Consider How I Feel
Authors: Ehrenreich-May Jill , Kennedy Sarah M. , Sherman Jamie A. , Bilek Emily L. , Barlow David H.
Published: December 2017

Chapter 3 of the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children: Workbook (UP-C) teaches child clients the strategy of “acting opposite” with emotional behaviors. This chapter also presents another overarching concept, the “science experiment,” and how to do one to help learn more about acting opposite. Activities children can do to act opposite when feeling sad are presented.
U Skill: Use Detective Thinking and Problem Solving
Authors: Ehrenreich-May Jill , Kennedy Sarah M. , Sherman Jamie A. , Bilek Emily L. , Barlow David H.
Published: December 2017

Chapter 6 of the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children: Workbook (UP-C) introduces the skill of cognitive reappraisal, referred to as “detective thinking” (e.g. coming up with an idea or a “best guess” of what might happen in a situation that elicits strong emotions, gathering facts and clues to find out whether this best guess is likely to be true, going over the clues, and coming to a final decision about what might happen and how likely the initial best guess is to be true). Children practice using detective thinking to help climb out of thinking traps and become more flexible thinkers.
Experience My Emotions for Parents
Authors: Jill Ehrenreich-May , Kennedy Sarah M. , Sherman Jamie A. , Bilek Emily L. , Barlow David H.
Published: December 2017

Chapter 16 covers a number of sessions, all of which focus on teaching parents to help their children experience their emotions without using unhelpful emotional behaviors. Session 8 teaches parents to understand the importance of experiencing emotions rather than avoiding or suppressing them. Parents learn about and practice present-moment awareness and non-judgmental awareness. In Session 9, parents learn about situational emotion exposures as a different type of science experiment, as well as their role in helping their child practice exposures at home. This session also covers the emotional parenting behavior of excessive modeling of intense emotions and avoidance and the opposite parenting behavior of healthy emotional modeling. Session 10 teaches about using situational emotion exposure to face various strong emotions. During Session 10 parents also learn about safety behaviors and how to reduce their child’s use of them. Importantly, this session teaches parents how to use their opposite parenting behaviors to support their children during situational emotion exposures. In Sessions 11 through 14, parents learn what to expect as their child begins situational emotion exposures and how to manage common challenges that arise during exposure activities.
Introduction to Emotion-Focused Behavioral Experiments
Authors: Ehrenreich-May Jill , Kennedy Sarah M. , Sherman Jamie A. , Bennett Shannon M. , Barlow David H.
Published: December 2017

Chapter 3 teaches the concepts of opposite action and emotion-focused behavioral experiments. Opposite action means both noticing what the emotion wants you to do and acting in a different or opposite way. Adolescent clients learn about different types of activities and come up with a list of ones they enjoy. They practice tracking emotions and activity levels and try a behavioral experiment for sadness. They are also encouraged to continue to do emotion-focused behavioral experiments for sadness or other emotions.
Being Flexible in Your Thinking
Authors: Ehrenreich-May Jill , Kennedy Sarah M. , Sherman Jamie A. , Bennett Shannon M. , Barlow David H.
Published: December 2017

Chapter 5 teaches adolescents how common it is to interpret emotional situations quickly and automatically, without thinking much about it. However, these automatic interpretations are not always accurate or helpful. There may be other, more accurate or more helpful interpretations that we miss because our brains are taking a type of shortcut associated with strong emotions, called a thinking trap. Adolescents are encouraged to be flexible in their thinking and to understand common thinking traps like Thinking the Worst, Jumping to Conclusions, and Ignoring the Positive when they arise. Adolescents are taught to use Detective Thinking to challenge their automatic thoughts. They also learn the steps of Problem Solving to further encourage flexible thinking and begin to apply them to their own problems.
Core Module 1: Building and Keeping Motivation
Authors: Ehrenreich-May Jill , Kennedy Sarah M. , Sherman Jamie A. , Bilek Emily L. , Buzzella Brian A. , Bennett Shannon M. , Barlow David H.
Published: December 2017

Chapter 1 covers how the therapist should orient the adolescent and family to treatment concepts and structure (including the level of parent involvement). One of the early tasks is to identify the adolescent’s three top problems to be worked on throughout therapy. Motivational enhancement strategies (such as motivational interviewing, emotional avoidance, home learning assignment compliance) are introduced as the primary means of building both the adolescent’s and the parent’s motivation for change. This chapter links to the overall theory and case conceptualization model of the Unified Protocols.