Haematalogical investigations in children

The haematology laboratory is able to perform a number of tests to help establish the cause of illness in children. The full blood count (FBC, also known as a complete blood count, CBC) is one of the most basic blood tests performed on children attending hospital or a primary care clinic. All doctors should therefore have an understanding of how the test is performed, possible pitfalls, be able to interpret results and know when more specialised testing or advice is required. Other haematological investigations in routine use include coagulation screens, blood film examination, reticulocyte counts and methods for estimation of iron stores and detection of abnormal haemoglobins. This section will focus on these basic tests and simple algorithms for the subsequent investigation and differential diagnosis of the commonest haemato-logical abnormalities encountered in general paediatric practice. The reader is referred to Chapter 15 for an account of the clinical presentation and management of primary haematological disorders in children

Caring for continence in stroke care settings: a qualitative study of patients’ and staff perspectives on the implementation of a new continence care intervention

Objectives: Investigate the perspectives of patients and nursing staff on the implementation of an augmented continence care intervention after stroke. Design: Qualitative data were elicited during semi-structured interviews with patients (n = 15) and staff (14 nurses; nine nursing assistants) and analysed using thematic analysis. Setting: Mixed acute and rehabilitation stroke ward. Participants: Stroke patients and nursing staff that experienced an enhanced continence care intervention. Results: Four themes emerged from patients’ interviews describing: (a) challenges communicating about continence (initiating conversations and information exchange); (b) mixed perceptions of continence care; (c) ambiguity of focus between mobility and continence issues; and (d) inconsistent involvement in continence care decision making. Patients’ perceptions reflected the severity of their urinary incontinence. Staff described changes in: (i) knowledge as a consequence of specialist training; (ii) continence interventions (including the development of nurse-led initiatives to reduce the incidence of unnecessary catheterisation among patients admitted to their ward); (iii) changes in attitude towards continence from containment approaches to continence rehabilitation; and (iv) the challenges of providing continence care within a stroke care context including limitations in access to continence care equipment or products, and institutional attitudes towards continence. Conclusion: Patients (particularly those with severe urinary incontinence) described challenges communicating about and involvement in continence care decisions. In contrast, nurses described improved continence knowledge, attitudes and confidence alongside a shift from containment to rehabilitative approaches. Contextual components including care from point of hospital admission, equipment accessibility and interdisciplinary approaches were perceived as important factors to enhancing continence care

EFFICIENT ANALYTIC COMPUTATION OF HIGHER-ORDER QCD AMPLITUDES

We review techniques simplifying the analytic calculation of one-loop QCD amplitudes with many external legs, for use in next-to-leading-order corrections to multi-jet processes. Particularly useful are the constraints imposed by perturbative unitarity, collinear singularities and a supersymmetry-inspired organization of helicity amplitudes. Certain sequences of one-loop helicity amplitudes with an arbitrary number of external gluons have been obtained using these constraints.Comment: Talk given at Beyond the Standard Model IV, December 13-18 1994, Lake Tahoe, CA. Latex, 4 pages, no figures

Supporting ethnographic studies of ubiquitous computing in the wild

Ethnography has become a staple feature of IT research over the last twenty years, shaping our understanding of the social character of computing systems and informing their design in a wide variety of settings. The emergence of ubiquitous computing raises new challenges for ethnography however, distributing interaction across a burgeoning array of small, mobile devices and online environments which exploit invisible sensing systems. Understanding interaction requires ethnographers to reconcile interactions that are, for example, distributed across devices on the street with online interactions in order to assemble coherent understandings of the social character and purchase of ubiquitous computing systems. We draw upon four recent studies to show how ethnographers are replaying system recordings of interaction alongside existing resources such as video recordings to do this and identify key challenges that need to be met to support ethnographic study of ubiquitous computing in the wild

Educational interventions to improve people's understanding of key concepts in assessing the effects of health interventions: a systematic review

Abstract Background Health information is readily accessible but is of variable quality. General knowledge about how to assess whether claims about health interventions are trustworthy is not common, so people’s health decisions can be ill-informed, unnecessarily costly and even unsafe. This review aims to identify and evaluate studies of educational interventions designed to improve people’s understanding of key concepts for evaluating claims about the effects of health interventions. Methods/Design We searched multiple electronic databases and sources of grey literature. Inclusion criteria included all study types that included a comparison, any participants (except health professionals or health professional students) and educational interventions aimed at improving people’s understanding of one or more of the key concepts considered necessary for assessing health intervention claims. Knowledge and/or understanding of concepts or skills relevant to evaluating health information were our primary outcome measures. Secondary outcomes included behaviour, confidence, attitude and satisfaction with the educational interventions. Two authors independently screened search results, assessed study eligibility and risk of bias and extracted data. Results were summarised using descriptive synthesis. Results Among 24 eligible studies, 14 were randomised trials and 10 used other study designs. There was heterogeneity across study participants, settings and educational intervention type, content and delivery. The risk of bias was high in at least one domain for all randomised studies. Most studies measured outcomes immediately after the educational intervention, with few measuring later. In most of the comparisons, measures of knowledge and skills were better among those who had received educational interventions than among controls, and some of these differences were statistically significant. The effects on secondary outcomes were inconsistent. Conclusions Educational interventions to improve people’s understanding of key concepts for evaluating health intervention claims can improve people’s knowledge and skills, at least in the short term. Effects on confidence, attitude and behaviour are uncertain. Many of the studies were at moderate or greater risk of bias. Improvements in study quality, consistency of outcome measures and measures of longer-term effects are needed to improve confidence in estimates of the effects of educational interventions to improve people’s understanding of key concepts for evaluating health intervention claims. Systematic review registration PROSPERO CRD4201603310