After critical care: Challenges in the transition to inpatient rehabilitation.

PURPOSE/OBJECTIVE: The aftermath of treatment for critical illness and/or critical injury in the intensive care unit (ICU) often includes persisting cognitive and emotional morbidities as well as severe physical deconditioning (a constellation termed post-intensive care syndrome, or PICS), but most patients do not receive psychological services before they enter the inpatient rehabilitation facility (IRF). Although a burgeoning literature guides the efforts of critical care providers to reduce risk factors for PICS - for example, reducing the use of sedatives and enacting early mobilization, there is need for a corresponding awareness among IRF psychologists and other providers that the post-ICU patient often arrives in a state of significantly reduced capacity, with persisting cognitive impairments and acute psychological distress. Many are at risk for long-term complications of posttraumatic stress disorder, general anxiety and/or clinical depression, and assuredly all have experienced a profound life disruption. This paper offers a multilevel perspective on the adaptation of post-ICU patients during inpatient rehabilitation, with discussion of the psychologist's role in education and intervention. RESEARCH METHOD/DESIGN: Clinical review paper. RESULTS: NA. CONCLUSIONS: To optimize response to rehabilitation, it is important to understand the behavior of post-ICU patients within a full biopsychosocial context including debility, cognitive and emotional impairment, disruption of role identities, and environmental factors. The psychologist can provide education about predictable barriers to participation for the post-ICU patient, and guide individual, family and team interventions to ameliorate those barriers. (PsycINFO Database Record

On Terms: Frequency and Rate in Applied Behavior Analysis.

The term "frequency" in applied behavior analysis and behavior measurement generally refers to cycles per unit time, or a count (usually of behavior) divided by the time during which it occurred. In statistics, however, the term refers to a count of items in a data set. This meaning of "frequency" as synonymous with "count" has been adopted by one major text and the Behavior Analyst Certification Board®. Another major text uses "frequency" and "rate" interchangeably when referring to behaviors per unit time. Both texts advise readers not to use counts of behavior without reference to the time base of the observation, and in the context of that advice, the count and time information thus provide rate data. We suggest that within applied behavior analysis (ABA) and behavior measurement the term "frequency" should not refer to "count" but instead to "rate," and that references to counts without information about observation time should be avoided.