Explore the vast range of titles available.

Young adults with high-functioning autism spectrum disorder (ASD) have low employment rates and job interviewing presents a critical barrier to employment for them. Results from a prior randomized controlled efficacy trial suggested virtual reality job interview training (VR-JIT) improved interviewing skills among trainees with ASD, but not controls with ASD. We conducted a brief survey with 23 of 26 participants from this study to evaluate their vocational outcomes at 6-month follow-up with a focus on whether or not they attained a competitive position (employment or competitive volunteering). Logistic regression indicated VR-JIT trainees had greater odds of attaining a competitive position than controls (OR 7.82, p  < 0.05). Initial evidence suggests VR-JIT is a promising intervention that enhances vocational outcomes among young adults with high-functioning ASD.

The feasibility and efficacy of virtual reality job interview training (VR-JIT) was assessed in a single-blinded randomized controlled trial. Adults with autism spectrum disorder were randomized to VR-JIT ( n  = 16) or treatment-as-usual (TAU) ( n  = 10) groups. VR-JIT consisted of simulated job interviews with a virtual character and didactic training. Participants attended 90 % of laboratory-based training sessions, found VR-JIT easy to use and enjoyable, and they felt prepared for future interviews. VR-JIT participants had greater improvement during live standardized job interview role-play performances than TAU participants ( p  = 0.046). A similar pattern was observed for self-reported self-confidence at a trend level ( p  = 0.060). VR-JIT simulation performance scores increased over time ( R 2  = 0.83). Results indicate preliminary support for the feasibility and efficacy of VR-JIT, which can be administered using computer software or via the internet.

Background: Health care providers have a critical opportunity to mitigate the public health problem of suicide. Virtual patient simulations (VPS) allow providers to learn and practice evidence-based suicide prevention practices in a realistic and risk-free environment. The purpose of this study was to test whether receiving VPS training increases the likelihood that providers will engage in effective suicide safer care practices. Methods: Behavioral health and non-behavioral health providers ( N  = 19) at a Federally Qualified Health Center who work with patients at risk for suicide received the VPS training on risk assessment, safety planning, and motivation to engage in treatment. Providers’ electronic health records were compared 6 months pre- and post-VPS training on their engagement in suicide safer care practices of screening, assessment, safety planning, and adding suicide ideation to the problem list. Results: Most behavioral health providers were already engaging in evidence-based suicide prevention care prior to the VPS training. Findings demonstrated the VPS training may impact the likelihood that non-behavioral health providers engage in suicide safer care practices. Conclusion: VPS training in evidence-based suicide prevention practices can optimize and elevate all health care providers’ skills in suicide care regardless of role and responsibility, demonstrating the potential to directly impact patient outcomes.

In 2009, three significant events related to family homelessness converged on the Massachusetts Department of Housing and Community Development (DHCD). First, the shelters for homeless families in Massachusetts were at capacity, and over 1,000 homeless families had been placed in hotels and motels across the state. Second, Article 87 of the Amendments to the Constitution transferred the Commonwealth's Emergency Assistance (EA) program to the Massachusetts Department of Housing and Community Development (DHCD), thereby designating DHCD to run the emergency shelter system for homeless families and individuals. Third, the United States Department of Housing and Urban Development granted Massachusetts $45 million to implement the Homelessness Prevention and Rapid Re-housing Program (HPRP), a part of the American Recovery and Reinvestment Act of 2009.With the newly acquired responsibility to run the EA program, put HPRP into practice, and rehouse the homeless families, especially those in hotels and motels, in Massachusetts, DHCD developed \"the Architecture.\" The Architecture introduced a new policy model for how to address homelessness in Massachusetts through prevention, diversion, rehousing, and stabilization. It also provided the narrative for the HPRP Request for Responses that DHCD released July 3 1, 2009.This thesis is an analysis of how two \"best practice\" agencies in Massachusetts put the HPRP policy into practice using the Architecture developed by DHCD. Those two agencies are Metropolitan Boston Housing Partnership (MBHP) in Boston and the Central Massachusetts Housing Alliance (CMHA) in Worcester. The agencies' practices upon which this research focuses are rehousing and stabilization programs for homeless families, including landlord outreach and support. This thesis provides an analysis of how the agencies incorporate this new HPRP policy into existing practice while coping with the challenges and dilemmas they encounter along the way.

Abstract Background Systemic hypertension (SH) is a potential complication of acute kidney injury (AKI) in dogs. Objective To describe the prevalence of SH and hypertensive retinopathy in dogs with AKI, to investigate the relationship between SH and severity of AKI and to assess possible factors associated with SH. Animals Fifty-two dogs with AKI. Methods Prospective observational study of dogs presenting to a tertiary referral center that fulfilled the International Renal Interest Society (IRIS) guidelines for the diagnosis of AKI. Systolic blood pressure measurement, urine protein/creatinine ratio (UPCR), urine output, presence of hypertensive retinopathy and fluid overload (FO), survival to discharge and duration of hospitalization were subsequently assessed. The prevalence of SH was calculated and the relationship between SH and recorded factors was examined by nonparametric statistics. Results The prevalence of SH (≥160 mm Hg) on admission or during hospitalization was 75% (39/52) and in 56% (22/39) of cases this was severe (≥180 mm Hg). Sixteen percent (7/43) of dogs had evidence of hypertensive retinopathy and 77% (24/31) dogs had UPCR >0.5. Forty-two percent (22/52) dogs had FO on admission or during hospitalization. There was no association between SH and IRIS AKI grade, oligo/anuria, survival to discharge, duration of hospitalization or proteinuria. Dogs with FO on presentation were more likely to be hypertensive at admission compared to dogs without FO (P = .02). Dogs that did not survive to discharge were more likely to have FO (P = .007). Conclusions and Clinical Importance Systemic hypertension is common in dogs with AKI. Systemic hypertension might be associated with FO, which itself is associated with nonsurvival. Monitoring for SH and FO is therefore warranted in dogs with AKI.

ObjectiveTo determine whether younger oocyte donor age is associated with better outcomes after in vitro fertilization (IVF) compared with older oocyte donor age.DesignA retrospective cohort study.SettingLarge academically affiliated infertility treatment center.PatientsWe included all women ≥ 18 years who started their first fresh cycle using donor oocytes at our center from January 2002 through October 2017; only the first oocyte recipient cycle was analyzed.InterventionLog-binomial regression was used to compare the incidence of clinical pregnancy and live birth among the following donor age groups: < 25 years, 25 to < 30 years, and 30 to <35 years.Main outcome measureIncidence of clinical pregnancy and live birth among donor age groups.ResultsWe included 774 donor cycles; 269 (34.8%) used donors < 25 years, 399 (51.6%) used donors 25 to < 30 years, and 106 (13.7%) used donors 30 to < 35 years. Median donor age was 26 years (range 18–34.5), and median recipient age and partner age were both 42 years. Per cycle start, after adjusting for recipient age, cycles using donors < 25 years were not associated with a higher incidence of clinical pregnancy (RR 0.90; 95% CI 0.77–1.06) or live birth (RR 0.87; 95% CI 0.72–1.04) compared with donors age 25–< 30 years.ConclusionsDonor age < 25 was not associated with better outcomes after IVF. Under the age of 30, the prioritization of <25 year old donors may not be recommended given the lack of evidence for superior pregnancy or live birth outcomes.

Post-mortem human subjects (PMHS) are frequently used to characterize biomechanical response and injury tolerance of humans to various types of loading by means of instrumentation installed directly on the skeleton. Data extracted from such tests are often used to develop and validate anthropomorphic test devices (ATDs), which function as human surrogates in tests for injury assessment. Given that the location and orientation of installed instrumentation differs between subjects, nominally similar measurements made on different PMHS must be transformed to standardized, skeletal-based local coordinate systems (LCS) before appropriate data comparisons can be made. Standardized PMHS LCS that correspond to ATD instrumentation locations and orientations have not previously been published. This paper introduces anatomically-defined PMHS LCS for body regions in which kinematic measurements are made using ATDs. These LCS include the head, sternum, single vertebrae, pelvis, femurs (distal and proximal), and tibiae (distal and proximal) based upon skeletal landmarks extracted from whole body CT scans. The proposed LCS provide a means to standardize the reporting of PMHS data, and facilitate both the comparison of PMHS impact data across institutions and the application of PMHS data to the development and validation of ATDs.