The Effects of Posture on Quantitative EEG and End Tidal CO2 duringStandardised Optimal Hyperventiation in Healthy Adults and in Patients with Childhood Absence Epilepsy and Attack Disorders

Hyperventilation is used as an activation procedure during EEG. It induces hypocapnia, which elicits changes in brain wave activity that may be diagnostically useful. The mechanism of action by which Hyperventilation (HV) produces slow theta/delta waves on EEG remains conjectural. Four criteria determine the magnitude of HV response: vigorous exchange of air, blood glucose levels, age of subject, and posture. Effects of posture are poor studied quantitatively. Objective: A Standardised Optimal Hyperventilation Protocol (SOHVP), which elicited Hyperventilation Induced High Amplitude Rhythmic Slow activity (HIHARS) during EEG controlling for posture seated (stOHV) and supine (spOHV) is presented and validated. Method: Respiratory rate 30/min, producing three fold elevation in total expiratory vol/min (VE), duration 4 minutes. Cohort of 22 healthy adults subjects, 14 females, 8 males, mean age 29.5 years recruited. Digital video EEG, EOG, EMG, Respiration Rate, Heart Rate,pO2, end tidal pCO2 and Cerebral Blood Flow are monitored before, during and after OHV performed in sitting (st) and supine (sp) position. Results: StOHV is more effective than spOHV in eliciting Hyperventilation Induced High Amplitude Rhythmic Slow activity (HIHARS) on EEG or normal adults, significantly reducing pETCO2 power density of slow EEG frequencies and vCBF. Significance: The role of posture is confirmed as one of the factors influencing magnitude of the HV response. The seated posture is significantly more effective than the supine in developing a standardised hyperventilation response. A prospective clinical trial commenced. Objective: Is seated standardized optimal hyperventilation (StOHV) more effective in eliciting positive EEG findings in patients with Childhood Absence Epilepsy (CAE) and Attack Disorders (AD). Method: Two cohorts, a group of patients with Childhood Absence Epilepsy matched for age and sex with a group of patients with undiagnosed events. 37 patients recruited 19 female 18 male. Mean age 9.7 years. Comparing the number of absence seizures + HIHARS in HV during non standardised (nsHV) and StOHV protocol with those spontaneously occurring during resting, wakefulness and sleep, using 8-minute epochs as denominators. Results: 7 spontaneous CAE events captured at rest, 10 during nsHV and 27 during StOHV. Mean PDR 1.61 Hz slower during STOHV. Discussion: 8.1% patients (18.75% of CAE group) would not have been diagnosed with CAE if STOHV exercise not performed. Significance: The StOHV method is statistically and clinically, more effective than nsHV at eliciting diagnostic epileptiform abnormalities on EEG. Adoption of standardised operational protocol (SOP) recommended as guideline for best practice for EEG testing in clinical practice. Standardized hyperventilation response can separate seizures from other forms of idiopathic changes in metal status in children. A hypothesis for HV induced EEG rhythmogenesis of slow theta and delta is discussed with a role for neuronal-glial interaction at the network level

Interdisciplinary Communication Skills - Facilitating Students from Different Disciplines to Learn with, from and about each other

Our group project involves exploring interdisciplinary communication skills and collaborative learning across STEM disciplines. In order to examine the topic we completed a literature review and surveyed staff about their views on interdisciplinary communication and collaborative learning at undergraduate level. We also held two focus group sessions on the topic with staff from three institutions. Though one of our intended project outcomes was a design model for interdisciplinary approaches to communication skills, as a result of the literature review we have redefined our purposes and will instead, in the first instance, present guiding principles for the effective integration of interdisciplinary communication skills training into existing and future programmes. In this paper we outline the first draft of these principles which recognise interdisciplinary collaboration as a pedagogical ‘trading zone’ and see the development of communications between the disciplines as a necessary response to the realities of world complexity, the dissolving of boundaries between subjects, the need to combat excessive specialisation, the drive for rounded graduates who possess scientific literacy, critical and creative thinking, and expanded expertise, vocabulary and tool sets, in addition to the ability to communicate to wider audiences. In this context we report on how these principles have been impacted by the very recent moves to integrate arts-based subjects with STEM disciplines - moving from STEM to STEAM. We suggest that this is an important transition from which benefits for the student should arise

Cosmological Implications of Dynamical Supersymmetry Breaking

We provide a taxonomy of dynamical supersymmetry breaking theories, and discuss the cosmological implications of the various types of models. Models in which supersymmetry breaking is produced by chiral superfields which only have interactions of gravitational strength (\eg\ string theory moduli) are inconsistent with standard big bang nucleosynthesis unless the gravitino mass is greater than \CO(3) \times 10^4 GeV. This problem cannot be solved by inflation. Models in which supersymmetry is dynamically broken by renormalizable interactions in flat space have no such cosmological problems. Supersymmetry can be broken either in a hidden or the visible sector. However hidden sector models suffer from several naturalness problems and have difficulties in producing an acceptably large gluino mass.Comment: 24 pages (uses harvmac) UCSD/PTH 93-26, RU-3

The importance of communication and involvementin decision-making: A study in Ireland exploring birthsatisfaction using the Birth Satisfaction Scale-Revised (BSS-R)

Introduction:Evaluation in healthcare services has become a priority, globally1. The Government of Ireland has highlighted the importance of stakeholder engagement to identify the needs of women in the design and delivery of high-quality health services, driven by necessity rather than financial ability2. The Birth Satisfaction Scale-Revised (BSS-R), an internationally validated tool, and recommended for measuring childbirth satisfaction by the International Consortium for Health Outcomes Measurement (ICHOM)3; however, it has yet to be considered in the Irish context. The aim of the study was to explore birth satisfaction with a sample of new mothers in Ireland.Methods:A mixed-methods study was conducted including a survey that involved collection of data from the BSS-R 10-item questionnaire from 307 mothers over an 8-week period in 2019, in one urban maternity hospital in Ireland. Quantitative and qualitative data were collected. Qualitative data from the free-text comments of the survey questions were analyzed using content analysis.Results:Overall, women reported positive relationships with their care providers and were satisfied with the communication and support they received, as well as high levels of control and choice. Postnatal care, however, was highlighted as being less satisfactory with staffing levels described as inadequate.Conclusions:Understanding women’s birth experiences and what is important to them could facilitate midwives and other health professionals to improve the quality of their care and develop guidelines and policies that focus on women and their families’ needs. The vast majority of women rated their birthing experience as extremely positive. The main elements of care that contributed to a positive birthing experience for women were quality relationships with clinicians, choice and control, and emotional safety

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Juxtaposing BTE and ATE – on the role of the European insurance industry in funding civil litigation

One of the ways in which legal services are financed, and indeed shaped, is through private insurance arrangement. Two contrasting types of legal expenses insurance contracts (LEI) seem to dominate in Europe: before the event (BTE) and after the event (ATE) legal expenses insurance. Notwithstanding institutional differences between different legal systems, BTE and ATE insurance arrangements may be instrumental if government policy is geared towards strengthening a market-oriented system of financing access to justice for individuals and business. At the same time, emphasizing the role of a private industry as a keeper of the gates to justice raises issues of accountability and transparency, not readily reconcilable with demands of competition. Moreover, multiple actors (clients, lawyers, courts, insurers) are involved, causing behavioural dynamics which are not easily predicted or influenced. Against this background, this paper looks into BTE and ATE arrangements by analysing the particularities of BTE and ATE arrangements currently available in some European jurisdictions and by painting a picture of their respective markets and legal contexts. This allows for some reflection on the performance of BTE and ATE providers as both financiers and keepers. Two issues emerge from the analysis that are worthy of some further reflection. Firstly, there is the problematic long-term sustainability of some ATE products. Secondly, the challenges faced by policymakers that would like to nudge consumers into voluntarily taking out BTE LEI

Penilaian Kinerja Keuangan Koperasi di Kabupaten Pelalawan

This paper describe development and financial performance of cooperative in District Pelalawan among 2007 - 2008. Studies on primary and secondary cooperative in 12 sub-districts. Method in this stady use performance measuring of productivity, efficiency, growth, liquidity, and solvability of cooperative. Productivity of cooperative in Pelalawan was highly but efficiency still low. Profit and income were highly, even liquidity of cooperative very high, and solvability was good