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We shall denote the collection of rules at the jth level as Rj Given values for the input variables, V x and W y , and applying the standard fuzzy inference to the rules at level j, we can obtain a fuzzy subset Fj over the universe of U, where nj nj X X 1 lji Dji z with lji Aji x* ^Bji y* and T lji Alternatively, we Fj z T can also calculate Fj z Maxi lji ^Dji z We denote the application of the basic fuzzy inference process with a given input, V x and W y , to this sub-rule base as Fj Rj Input In the HPS model, the output of level j is a combination of Fj and output of the preceding level We denote the output of the jth level of the HPS as Gj.

vb.net upc-a reader

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Flowing from the biobehavioral model, Varni and his colleagues (1995) recommend that interventions move beyond narrowly focused strategies aimed at decreasing reports of pain To enhance effectiveness, interventions must target pain perception, pain behaviors, and the intervening variables (Varni, 1999; Varni et al, 1995) Modifying pain perception involves self-regulatory mechanisms such as self-hypnosis, meditative breathing, progressive muscle relaxation, and guided imagery Manne (1999) emphasizes the need to address cognitive appraisal of painful procedures as part of interventions for procedure-related pain by helping children and their parents to perceive the procedure as less threatening Furthermore, by targeting intervening variables such as coping strategies, children and their parents may be supported in managing adaptively aspects of treatment or of the illness, thereby improving functional status outcomes as well as reducing pain perception.

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to secure the command neuron status of the LGI comes from the observation that in addition to controlling the onset of tail ipping, it also controls the inhibition of a range of other behaviors that would be incompatible with a ip.

Gj is obtained by combining the output the previous level, Gj 1, with Fj using the hierarchical updation (HEU) aggregation operator subsequently to be de ned The output of the last level, Gn, is the overall model output E We initialize the process by assigning G0 The key to inference mechanism in the HPS is the HEU aggregation operator Gj g(Gj 1, Fj), where Gj z Gj 1 z 1 aj 1 Fj z Here, aj 1 Maxz[Gj 1(z)], the largest membership grade in Gj 1 See Figure 11 Let us look at the functioning of this operator First we see that it is not pointwise in that the value of Gj(z) depends, through the function aj 1, on the membership grade of elements other than z We also note that if aj 1 1, no change occurs.

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Coping strategies such as seeking social support, active behavioral distraction, problem solving, and self-instruction or self-talk may be most adaptive for children with chronic medical conditions To this point, the role of the family in pain perception and behaviors and in functional status outcomes has not been clearly delineated While many disease-related pain interventions invite family participation (eg, Dinges et al, 1997), the family s role is not addressed directly Models for intervening in procedure-related pain are useful because they integrate family Varni et al (1995) summarize this literature by noting that parent appraisals of the illness and of pain, parent coping, and family functioning will in uence parent interactions with their children during painful procedures (and painful crises) as expressed through parent distress and anxietypromoting behaviors These parent behaviors will, in turn, impact children s coping and children s pain perception and behaviors.

More generally, the larger aj 1 the less the effect of the current level Thus, we see that aj 1 acts as a kind of choking function In particular, if for some level j we obtain a situation in which Gj is normal, and has an element with membership grade one, the process of aggregation stops..

As such, parent or family factors must be addressed as an integral element of effective interventions Interventions for Procedure-Related Pain Childhood cancer is life threatening and experienced by children and their parents with fear, horror, and helplessness (Kazak, Stuber, Barakat, & Meeske, 1996; Smith, Redd, Peyser, & Vogl, 1999) It is not a discrete trauma but is repetitive (diagnosis and treatments) and chronic (in the form of follow-up visits, medical late effects, and the risk of recurrence or second cancers; Nir, 1985; Smith et al, 1999; Stuber, Kazak, Meeske, & Barakat, 1998) Given this traumatic experience, short- and long-term responses to childhood cancer can be understood as trauma responses Studies have found that mothers and fathers of survivors of childhood cancer report signi cantly more symptoms of posttraumatic.

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