Object Usage Processing Improves Memory

JOSEPH C. TANN: Usage as a Beneficial Method of Encoding Many psychologists have attempted to find the most effective method of processing information in human memory. For years, the pleasantness method of processing was considered to be among the best methods for enhancing memory performance. One recent theory (Nairne, 2007) has suggested that processing items in terms oftheir survival value may be an even more proficient method of processing. Another theory (Reysen & Adair, 2008) attempted to prove that survival may not be the reason for the enhanced performance, but the individual’s connection with the specific object’s usage. My experiment was designed to expand upon the recent research supporting a processing advantage for object usage. In this experiment, participants were presented with thirty words, given a briefdistracter task, and then given a free recall test. The only difference between the two conditions was one sentence ofthe instructions. One group was given instructions that enabled participants to think about items in terms oftheir uses, while the other group’s instructions did not. It was observed that participants fared significantly better when given the set of instructions with a connection to object usage

Development and validation of a simplified score to predict neonatal mortality risk among neonates weighing 2000 g or less (NMR-2000): an analysis using data from the UK and The Gambia.

BACKGROUND: 78% of neonatal deaths occur in sub-Saharan Africa and southern Asia, among which, more than 80% are in low birthweight babies. Existing neonatal mortality risk scores have primarily been developed for high-resource settings. The aim of this study was to develop and validate a score that is practicable for low-income and middle-income countries to predict in-hospital mortality among neonates born weighing 2000 g or less using datasets from the UK and The Gambia. METHODS: This analysis used retrospective data held in the UK National Neonatal Research Database from 187 neonatal units, and data from the Edward Francis Small Teaching Hospital (EFSTH), Banjul, The Gambia. In the UK dataset, neonates were excluded if birthweight was more than 2000 g; if the neonate was admitted aged more than 6 h or following discharge; if the neonate was stillborn; if the neonate died in delivery room; or if they were moribund on admission. The Gambian dataset included all neonates weighing less than 2000 g who were admitted between May 1, 2018, and Sept 30, 2019, who were screened for but not enrolled in the Early Kangaroo Mother Care Trial. 18 studies were reviewed to generate a list of 84 potential parameters. We derived a model to score in-hospital neonatal mortality risk using data from 55 029 admissions to a random sample of neonatal units in England and Wales from Jan 1, 2010, to Dec 31, 2016. All candidate variables were included in a complete multivariable model, which was progressively simplified using reverse stepwise selection. We validated the new score (NMR-2000) on 40 329 admissions to the remaining units between the same dates and 14 818 admissions to all units from Jan 1, to Dec 31, 2017. We also validated the score on 550 neonates admitted to the EFSTH in The Gambia. FINDINGS: 18 candidate variables were selected for inclusion in the modelling process. The final model included three parameters: birthweight, admission oxygen saturation, and highest level of respiratory support within 24 h of birth. NMR-2000 had very good discrimination and goodness-of-fit across the UK samples, with a c-index of 0·8859-0·8930 and a Brier score of 0·0232-0·0271. Among Gambian neonates, the model had a c-index of 0·8170 and a Brier score of 0·1688. Predictive ability of the simplified integer score was similar to the model using regression coefficients, with c-indices of 0·8903 in the UK full validation sample and 0·8082 in the Gambian validation sample. INTERPRETATION: NMR-2000 is a validated mortality risk score for hospitalised neonates weighing 2000 g or less in settings where pulse oximetry is available. The score is accurate and simplified for bedside use. NMR-2000 requires further validation using a larger dataset from low-income and middle-income countries but has the potential to improve individual and population-level neonatal care resource allocation. FUNDING: Bill & Melinda Gates Foundation; Eunice Kennedy Shriver National Institute of Child Health & Human Development; Wellcome Trust; and Joint Global Health Trials scheme of Department of Health and Social Care, Department for International Development, Medical Research Council, and Wellcome Trust

Which doctors and with what problems contact a specialist service for doctors? A cross sectional investigation

Background: In the United Kingdom, specialist treatment and intervention services for doctors are underdeveloped. The MedNet programme, created in 1997 and funded by the London Deanery, aims to fill this gap by providing a self-referral, face-to-face, psychotherapeutic assessment service for doctors in London and South-East England. MedNet was designed to be a low-threshold service, targeting doctors without formal psychiatric problems. The aim of this study was to delineate the characteristics of doctors utilising the service, to describe their psychological morbidity, and to determine if early intervention is achieved. Methods: A cross-sectional study including all consecutive self-referred doctors (n = 121, 50% male) presenting in 2002–2004 was conducted. Measures included standardised and bespoke questionnaires both self-report and clinician completed. The multi-dimensional evaluation included: demographics, CORE (CORE-OM, CORE-Workplace and CORE-A) an instrument designed to evaluate the psychological difficulties of patients referred to outpatient services, Brief Symptom Inventory to quantify caseness and formal psychiatric illness, and Maslach Burnout Inventory. Results: The most prevalent presenting problems included depression, anxiety, interpersonal, self-esteem and work-related issues. However, only 9% of the cohort were identified as severely distressed psychiatrically using this measure. In approximately 50% of the sample, problems first presented in the preceding year. About 25% were on sick leave at the time of consultation, while 50% took little or no leave in the prior 12 months. A total of 42% were considered to be at some risk of suicide, with more than 25% considered to have a moderate to severe risk. There were no significant gender differences in type of morbidity, severity or days off sick. Conclusion: Doctors displayed high levels of distress as reflected in the significant proportion of those who were at some risk of suicide; however, low rates of severe psychiatric illness were detected. These findings suggest that MedNet clients represent both ends of the spectrum of severity, enabling early clinical engagement for a significant proportion of cases that is of importance both in terms of personal health and protecting patient care, and providing a timely intervention for those who are at risk, a group for whom rapid intervention services are in need and an area that requires further investigation in the UK

Rethinking Design Standards as Learning Frameworks

Standards align practice across the supply network whilst putting in place basic constraints to ensure quality, safety, compatibility, interoperability, and economy. In the construction industry, design standards are used to verify the adequacy of designs to meet fundamental requirements for safety, serviceability, durability and robustness. There are very few opportunities to prototype; thus design in the construction industry is fundamentally code or standard-driven. In the highly diverse built environment, design standards will never cover all possible situations encountered by designers. Hence, standard writers are expected to select, capture and codify technical knowledge, separate best practice from unsuccessful practice, and share the lessons learnt across the professional community. In this context, standards are representations of a community’s mental model about what ‘good’ looks like, and they serve powerfully to reinforce a particular way of doing things. However, in times of rapid change and increasing complexity, these mental models may no longer be fit for purpose. They need to be re-examined and modified in the light of new challenges and demands. The core argument of this White Paper is that design standards in the construction industry need to be explicitly reconceptualised, re-evaluated and redeveloped as learning frameworks, which encourage users’ adaptability and collaborative learning and improvement, as well as foster creativity and innovation. To support this statement, fundamental notions of contemporary learning theory are presented and key challenges in the way design standards are currently developed and used are discussed. The importance of considering standards from a learning perspective is emphasised by looking at mental models underlying the way design standards are developed and used and recognising the learning power of different users explicitly

Cosmological spacetimes balanced by a scale covariant scalar field

A scale invariant, Weyl geometric, Lagrangian approach to cosmology is explored, with a a scalar field phi of (scale) weight -1 as a crucial ingredient besides classical matter \cite{Tann:Diss,Drechsler:Higgs}. For a particularly simple class of Weyl geometric models (called {\em Einstein-Weyl universes}) the Klein-Gordon equation for phi is explicitly solvable. In this case the energy-stress tensor of the scalar field consists of a vacuum-like term Lambda g_{mu nu} with variable coefficient Lambda, depending on matter density and spacetime geometry, and of a dark matter like term. Under certain assumptions on parameter constellations, the energy-stress tensor of the phi-field keeps Einstein-Weyl universes in locally stable equilibrium. A short glance at observational data, in particular supernovae Ia (Riess ea 2007), shows interesting empirical properties of these models.Comment: 28 pages, 1 figure, accepted by Foundations of Physic

Protocol for a randomised trial of early kangaroo mother care compared to standard care on survival of pre-stabilised preterm neonates in The Gambia (eKMC).

BACKGROUND: Complications of preterm birth cause more than 1 million deaths each year, mostly within the first day after birth (47%) and before full post-natal stabilisation. Kangaroo mother care (KMC), provided as continuous skin-to-skin contact for 18 h per day to fully stabilised neonates ≤ 2000 g, reduces mortality by 36-51% at discharge or term-corrected age compared with incubator care. The mortality effect of starting continuous KMC before stabilisation is a priority evidence gap, which we aim to investigate in the eKMC trial, with a secondary aim of understanding mechanisms, particularly for infection prevention. METHODS: We will conduct a single-site, non-blinded, individually randomised, controlled trial comparing two parallel groups to either early (within 24 h of admission) continuous KMC or standard care on incubator or radiant heater with KMC when clinically stable at > 24 h of admission. Eligible neonates (n = 392) are hospitalised singletons or twins < 2000 g and 1-24 h old at screening who are mild to moderately unstable as per a trial definition using cardio-respiratory parameters. Randomisation is stratified by weight category (< 1200 g; ≥ 1200 g) and in random permuted blocks of varying sizes with allocation of twins to the same arm. Participants are followed up to 28 ± 5 days of age with regular inpatient assessments plus criteria-led review in the event of clinical deterioration. The primary outcome is all-cause neonatal mortality by age 28 days. Secondary outcomes include the time to death, cardio-respiratory stability, hypothermia, exclusive breastfeeding at discharge, weight gain at age 28 days, clinically suspected infection (age 3 to 28 days), intestinal carriage of extended-spectrum beta-lactamase producing (ESBL) Klebsiella pneumoniae (age 28 days), and duration of the hospital stay. Intention-to-treat analysis will be applied for all outcomes, adjusting for twin gestation. DISCUSSION: This is one of the first clinical trials to examine the KMC mortality effect in a pre-stabilised preterm population. Our findings will contribute to the global evidence base in addition to providing insights into the infection prevention mechanisms and safety of using this established intervention for the most vulnerable neonatal population. TRIAL REGISTRATION: ClinicalTrials.gov NCT03555981. Submitted 8 May 2018 and registered 14 June 2018. Prospectively registered

Investing in urban underground space: maximising the social benefits

With increasing pressure on space in cities, we are seeing greater development underground. Despite the multiple benefits of underground space, its social value is underappreciated and no market for underground space utilisation exists. The result is that underground space is not planned, engineered or managed in a way to realise its potential value. This paper presents findings from a Think Deep UK initiative which explored the social value of underground space and evaluated the UK’s Social Value Act which embraces social, economic and environmental benefits. It was found that the main drivers to evaluate social value for infrastructure projects are cost and risk which are intimately linked with the scheme’s design life. As such, only tractable, evidence-based benefits are easily accounted for. It is suggested that social value frameworks should be flexible and incorporate qualitative measures of value across different timescales so that long-term benefits for future generations are planned

Update of the European Association of Cardiovascular Imaging (EACVI) Core Syllabus for the European Cardiovascular Magnetic Resonance Certification Exam

An updated version of the European Association of Cardiovascular Imaging (EACVI) Core Syllabus for the European Cardiovascular Magnetic Resonance (CMR) Certification Exam is now available online. The syllabus lists key elements of knowledge in CMR. It represents a framework for the development of training curricula and provides expected knowledge-based learning outcomes to the CMR trainees, in particular those intending to demonstrate CMR knowledge in the European CMR exam, a core requirement in the CMR certification process

Community-based family and carer-support programmes for children with disabilities

This is the author accepted manuscript. The final version is available from the publisher via the DOI in this recordChildren and young people (CYP) with disabilities face multiple challenges and unmet health needs. There is considerable variability in quality of health services across the UK for these children. Families report that they experience lack of information or misinformation about health, social care and education of their child. They also highlight a desire to engage with other families of CYP with disabilities. There is growing evidence that community-based group interventions in under-resourced settings are effective at improving quality of life for both CYP with disabilities and caregivers. Few similar interventions or evidence exists in the UK. This article provides an overview of relevant evidence and, using cerebral palsy as an exemplar, discusses the potential for group-based programmes for parent carers in the UK. Groups would aim to address information needs, support providers to deliver evidence-based care, and thereby improve the health and wellbeing of CYP with disabilities