Randomized, Controlled Trial Evaluating a Baby Wash Product on Skin Barrier Function in Healthy, Term Neonates

Objectives To examine the hypothesis that the use of a wash product formulated for newborn (<1 month of age) bathing is not inferior (no worse) to bathing with water only. Design Assessor‐blinded, randomized, controlled, noninferiority trial. Setting A teaching hospital in the Northwest of England and in participants’ homes. Participants Three‐hundred‐and‐seven healthy, term infants recruited within 48 hours of birth. Method We compared bathing with a wash product (n = 159) to bathing with water alone (n = 148). The primary outcome was transepidermal water loss (TEWL) at 14 days postbirth; the predefined difference deemed to be unimportant was 1.2. Secondary outcomes comprised changes in stratum corneum hydration, skin surface pH, clinical observations of the skin, and maternal views. Results Complete TEWL data were obtained for 242 (78.8%) infants. Wash was noninferior to water alone in terms of TEWL (intention‐to‐treat analysis: 95% confidence interval [CI] for difference [wash–water, adjusted for family history of eczema, neonate state, and baseline] −1.24, 1.07; per protocol analysis: 95% CI −1.42, 1.09). No significant differences were found in secondary outcomes. Conclusion We were unable to detect any differences between the newborn wash product and water. These findings provide reassurance to parents who choose to use the test newborn wash product or other technically equivalent cleansers and provide the evidence for health care professionals to support parental choice

‘”Hearing Voices” and Performing the Mind in debbie tucker green’s Dramatic-Poetics’

This chapter explores tucker green’s unique dramatic idiom through her distinctive play ‘text’ which produces opportunities for audiences and readers to relish the ways in which language can be sounded – as it is seen, heard and uttered. Framed by Charles Bernstein’s distinctions between orality and aurality, the chapter examines tucker green’s technique for making the mind physically (en)actable through her non-naturalistic methods for staging a character’s thoughts. dirty butterfly (2003), stoning mary (2005) and nut (2013) exemplify a noteworthy aesthetic for ‘performing the mind’ — be it as a borderless aesthesia, a sensory space shared by multiple characters’ perceptions (dirty butterfly) or as an individually, physically embodied, character in mimetic stage space (stoning mary, nut). The chapter proposes that three socio-cultural acknowledgements are requisite for examining tucker green’s creative impact. These emphasize the considerable influences of post-war Caribbean poetic heritage, the ongoing after-shock of colonization as being crucial to conceptions of contemporary British culture, and the ‘right to opacity’ (Édouard Glissant 1997) as a counter-stance to the hegemonic critical and aesthetic frameworks that are habitually applied to (and even ‘post-colonize’) black British writers and their writing

Little monsters: gothic children and contemporary theatrical performance

The Gothic, in literature, in film, and on the stage, seems to possess a particular fascination with children. This chapter, in the first instance, introduces an exploration of the representations of children in the post-war British theatre, as both objects and agents of horror, from Kane’s Blasted to McPherson’s The Weir. Secondly, the chapter will examine the emerging appeal of plays such as Jack Thorne’s adaptation of John Lindqviste’s Let the Right One In, and Phillip Pullman’s Grimm Tales which use the tropes, aesthetics and properties of the Gothic as fertile ground for making theatre for young audiences

High dose methylphenidate treatment in adult Attention Deficit Hyperactivity Disorder: a case report

INTRODUCTION: Stimulant medication improves hyperactivity, inattention, and impulsivity in both pediatric and adult populations with Attention Deficit Hyperactivity Disorder (ADHD). However, data regarding the optimal dosage in adults is still limited. CASE PRESENTATION: We report the case of a 38-year-old Caucasian patient who was diagnosed with ADHD when he was nine years old. He then received up to 10mg Ritalinand 20mg Ritalin SR daily. When he was 13, his medication was changed to desipramine (Norpramin), and both Ritalin and Ritalin SR were discontinued; and at age 18, when he developed obsessive-compulsive symptoms, his medication was changed to clomipramine (Anafranil) 75mg/d. Still suffering from inattention and hyperactivity, the patient began college when he was 19, but did not receive stimulant medication until three years later, when Ritalin 60mg/d was re-established. During the 14 months that followed, he began to use Ritalin excessively, both orally and rectally, in dosages from 4800-6000mg/d. Four years ago, he was referred to our outpatient service, where his ADHD was re-evaluated. At that point, the patient's daily Ritalin dosage was reduced to 200mg/d orally, but he still experienced pronounced symptoms of ADHD, so this dosage was raised again. The patient's plasma levels consistently remained between 60-187 nmol/l--within the recommended range--and signs of his obsessive-compulsive symptoms diminished with fluoxetine 40mg/d. Finally, on a dosage of 378mg Concerta, his symptoms of ADHD have improved dramatically and no further use of methylphenidate has been recorded during the 24 months preceding this report. CONCLUSION: Symptoms of ADHD in this adult patient, who also manifested a co-occurring obsessive compulsive disorder, dramatically improved only after application of a higher-than-normal dose of methylphenidate. We therefore suggest that clinicians consider these findings in relation to their adherence to current therapeutic guidelines