103 research outputs found
Recommended from our members
Comparisons of Animal “Smarts” Using the First Four Stages of the Model of Hierarchical Complexity
The Model of Hierarchical Complexity is a behavioral model of development and evolution of the complexity of behavior. It is based on task analysis. Tasks are ordered in terms of their hierarchical complexity, which is an ordinal scale that measures difficulty. The hierarchical difficulty of tasks is categorized as the order of hierarchical complexity. Successful performance on a task is called the behavioral stage. This model can be applied to non-human animals, and humans. Using data from some of the simplest animals and also somewhat more complex ones, this analysis describes the four lowest behavioral stages and illustrate them using the behaviors of a range of simple organisms. For example, Stage 1 tasks, and performance on them, are addressed with automatic unconditioned responses. Behavior at this Stage includes sensing, tropisms, habituation and, other automatic behaviors. Single cell organisms operate at this Stage. Stage 2 tasks include these earlier behaviors, but also include respondent conditioning but not operant conditioning. Animals such as some simple invertebrates have shown respondent conditioning, but not operant conditioning. Stage 3 tasks coordinate three instances of these earlier tasks to make possible operant conditioning. These stage 3 performances are similar to those of some invertebrates and also insects. Stage 4 tasks organisms coordinate 2 or more circular sensory-motor task actions into a superordinate “concept”. This explanation of the early stages of the Model of Hierarchical Complexity may help future research in animal behavior, and comparative psychology.
Efficient Activation of Reconstructed Rat Embryos by Cyclin-Dependent Kinase Inhibitors
This Article is brought to you for free and open access by the Molecular and Cellular Biochemistry at UKnowledge. It has been accepted for inclusion in Molecular and Cellular Biochemistry Faculty Publication by an authorized administrator of UKnowledge. For more information, please contac
Protocol for Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial: a randomised controlled trial to measure the effects and costs of a dental caries prevention regime for young children attending primary care dental services
<p>Abstract</p> <p>Background</p> <p>Dental caries is a persistent public health problem with little change in the prevalence in young children over the last 20 years. Once a child contracts the disease it has a significant impact on their quality of life. There is good evidence from Cochrane reviews including trials that fluoride varnish and regular use of fluoride toothpaste can prevent caries.</p> <p>The Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial will compare the costs and effects of a caries preventive package (fluoride varnish, toothpaste, toothbrush and standardised dental health education) with dental health education alone in young children.</p> <p>Methods/Design</p> <p>A randomised controlled trial on children initially aged 2 and 3 years old who are regular attenders at the primary dental care services in Northern Ireland. Children will be recruited and randomised in dental practices. Children will be randomised to the prevention package of both fluoride varnish (twice per year for three years), fluoride toothpaste (1,450 ppm F) (supplied twice per year), a toothbrush (supplied twice a year) or not; both test and control groups receive standardised dental health education delivered by the dentist twice per year. Randomisation will be conducted by the Belfast Trust Clinical Research Support Centre ([CRSC] a Clinical Trials Unit).</p> <p>1200 participants will be recruited from approximately 40 dental practices. Children will be examined for caries by independent dental examiners at baseline and will be excluded if they have caries. The independent dental examiners will examine the children again at 3 years blinded to study group.</p> <p>The primary end-point is whether the child develops caries (cavitation into dentine) or not over the three years. One secondary outcome is the number of carious surfaces in the primary dentition in children who experience caries. Other secondary outcomes are episodes of pain, extraction of primary teeth, other adverse events and costs which will be obtained from parental questionnaires.</p> <p>Discussion</p> <p>This is a pragmatic trial conducted in general dental practice. It tests a composite caries prevention intervention, which represents an evidence based approach advocated by current guidance from the English Department of Health which is feasible to deliver to all low risk (caries free) children in general dental practice. The trial will provide valuable information to policy makers and clinicians on the costs and effects of caries prevention delivered to young children in general dental practice.</p> <p>Trial registration</p> <p>EudraCT No: 2009 - 010725 - 39</p> <p>ISRCTN: <a href="http://www.controlled-trials.com/ISRCTN36180119">ISRCTN36180119</a></p> <p>Ethics Reference No: 09/H1008/93:</p
Palliative care in advanced dementia; A mixed methods approach for the development of a complex intervention
There is increasing interest in improving the quality of care that patients with advanced dementia receive when they are dying. Our understanding of the palliative care needs of these patients and the natural history of advanced disease is limited. Many people with advanced dementia have unplanned emergency admissions to the acute hospital; this is a critical event: half will die within 6 months. These patients have complex needs but often lack capacity to express their wishes. Often carers are expected to make decisions. Advance care planning discussions are rarely performed, despite potential benefits such more consistent supportive healthcare, a reduction in emergency admissions to the acute hospital and better resolution of carer bereavement
Recommended from our members
Think Again – Supplying War: Reappraising Military Logistics and Its Centrality to Strategy and War
This article argues that logistics constrains strategic opportunity while itself being heavily circumscribed by strategic and operational planning. With the academic literature all but ignoring the centrality of logistics to strategy and war, this article argues for a reappraisal of the critical role of military logistics, and posits that the study and conduct of war and strategy are incomplete at best or false at worst when they ignore this crucial component of the art of war. The article conceptualises the logistics–strategy nexus in a novel way, explores its contemporary manifestation in an age of uncertainty, and applies it to a detailed case study of UK operations in Iraq and Afghanistan since 2001
From design to operations: a process management life-cycle performance measurement system for Public-Private Partnerships
YesPublic–Private Partnerships (PPPs) have become a critical vehicle for delivering infrastructure worldwide. Yet, the use of such a procurement strategy has received considerable criticism, as they have been prone to experiencing time/cost overruns and during their operation poorly managed. A key issue contributing to the poor performance of PPPs is the paucity of an effective and comprehensive performance measurement system. There has been a tendency for the performance of PPPs to be measured based on their ex-post criteria of time, cost and quality. Such criteria do not accommodate the complexities and lifecycle of an asset. In addressing this problem, the methodology of sequential triangulation is used to develop and examine the effectiveness of a ‘Process Management Life Cycle Performance Measurement System’. The research provides public authorities and private-sector entities embarking on PPPs with a robust mechanism to effectively measure, control and manage their projects’ life cycle performances, ensuring the assets are ‘future proofed’
Rethinking Social Justice in Education: An Epistemological Approach
There are many different notions of social justice in education. For example, some argue that social justice in education means giving individuals the opportunity to succeed; for others, it means seeking equality of outcome so that everyone does succeed. So great is the diversity of views that it has been suggested the term has become meaningless, or that it can mean anything people want it to mean. This has led some to argue that trying to define social justice in education is a hopeless task. This chapter argues that an approach informed by the later philosophy of Wittgenstein can be helpful in dealing with such issues. In particular, attention is focussed on Wittgenstein’s epistemology and theory of meaning in the Philosophical Investigations. It is argued that these are helpful in understanding the multiplicity of meanings of the term social justice in education. This multiplicity however, it is argued, does not lead to a situation where the term can mean anything its users want it to mean. Nor does it lead to a situation where all attempts to define the term are ruled out, or where only one definition is acceptable, presumably to be imposed on all users of the term. Instead, the significance of contextual understanding and meaning in different language-games is highlighted. Wittgenstein’s theory of meaning is then allied to Gallie’s notion of an essentially contested concept to advance the idea of engagement between those with different views, and of the need to recontextualize rather than decontextualize the notion of social justice in education
The risk of Plasmodium vivax parasitaemia after P. falciparum malaria: An individual patient data meta-analysis from the WorldWide Antimalarial Resistance Network.
BACKGROUND: There is a high risk of Plasmodium vivax parasitaemia following treatment of falciparum malaria. Our study aimed to quantify this risk and the associated determinants using an individual patient data meta-analysis in order to identify populations in which a policy of universal radical cure, combining artemisinin-based combination therapy (ACT) with a hypnozoitocidal antimalarial drug, would be beneficial. METHODS AND FINDINGS: A systematic review of Medline, Embase, Web of Science, and the Cochrane Database of Systematic Reviews identified efficacy studies of uncomplicated falciparum malaria treated with ACT that were undertaken in regions coendemic for P. vivax between 1 January 1960 and 5 January 2018. Data from eligible studies were pooled using standardised methodology. The risk of P. vivax parasitaemia at days 42 and 63 and associated risk factors were investigated by multivariable Cox regression analyses. Study quality was assessed using a tool developed by the Joanna Briggs Institute. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42018097400). In total, 42 studies enrolling 15,341 patients were included in the analysis, including 30 randomised controlled trials and 12 cohort studies. Overall, 14,146 (92.2%) patients had P. falciparum monoinfection and 1,195 (7.8%) mixed infection with P. falciparum and P. vivax. The median age was 17.0 years (interquartile range [IQR] = 9.0-29.0 years; range = 0-80 years), with 1,584 (10.3%) patients younger than 5 years. 2,711 (17.7%) patients were treated with artemether-lumefantrine (AL, 13 studies), 651 (4.2%) with artesunate-amodiaquine (AA, 6 studies), 7,340 (47.8%) with artesunate-mefloquine (AM, 25 studies), and 4,639 (30.2%) with dihydroartemisinin-piperaquine (DP, 16 studies). 14,537 patients (94.8%) were enrolled from the Asia-Pacific region, 684 (4.5%) from the Americas, and 120 (0.8%) from Africa. At day 42, the cumulative risk of vivax parasitaemia following treatment of P. falciparum was 31.1% (95% CI 28.9-33.4) after AL, 14.1% (95% CI 10.8-18.3) after AA, 7.4% (95% CI 6.7-8.1) after AM, and 4.5% (95% CI 3.9-5.3) after DP. By day 63, the risks had risen to 39.9% (95% CI 36.6-43.3), 42.4% (95% CI 34.7-51.2), 22.8% (95% CI 21.2-24.4), and 12.8% (95% CI 11.4-14.5), respectively. In multivariable analyses, the highest rate of P. vivax parasitaemia over 42 days of follow-up was in patients residing in areas of short relapse periodicity (adjusted hazard ratio [AHR] = 6.2, 95% CI 2.0-19.5; p = 0.002); patients treated with AL (AHR = 6.2, 95% CI 4.6-8.5; p < 0.001), AA (AHR = 2.3, 95% CI 1.4-3.7; p = 0.001), or AM (AHR = 1.4, 95% CI 1.0-1.9; p = 0.028) compared with DP; and patients who did not clear their initial parasitaemia within 2 days (AHR = 1.8, 95% CI 1.4-2.3; p < 0.001). The analysis was limited by heterogeneity between study populations and lack of data from very low transmission settings. Study quality was high. CONCLUSIONS: In this meta-analysis, we found a high risk of P. vivax parasitaemia after treatment of P. falciparum malaria that varied significantly between studies. These P. vivax infections are likely attributable to relapses that could be prevented with radical cure including a hypnozoitocidal agent; however, the benefits of such a novel strategy will vary considerably between geographical areas
Assumption without representation: the unacknowledged abstraction from communities and social goods
We have not clearly acknowledged the abstraction from unpriceable “social goods” (derived from
communities) which, different from private and public goods, simply disappear if it is attempted to
market them. Separability from markets and economics has not been argued, much less established.
Acknowledging communities would reinforce rather than undermine them, and thus facilitate
the production of social goods. But it would also help economics by facilitating our understanding
of – and response to – financial crises as well as environmental destruction and many social problems,
and by reducing the alienation from economics often felt by students and the public
Haematological consequences of acute uncomplicated falciparum malaria: a WorldWide Antimalarial Resistance Network pooled analysis of individual patient data
Background: Plasmodium falciparum malaria is associated with anaemia-related morbidity, attributable to host, parasite and drug factors. We quantified the haematological response following treatment of uncomplicated P. falciparum malaria to identify the factors associated with malarial anaemia.
Methods: Individual patient data from eligible antimalarial efficacy studies of uncomplicated P. falciparum malaria, available through the WorldWide Antimalarial Resistance Network data repository prior to August 2015, were pooled using standardised methodology. The haematological response over time was quantified using a multivariable linear mixed effects model with nonlinear terms for time, and the model was then used to estimate the mean haemoglobin at day of nadir and day 7. Multivariable logistic regression quantified risk factors for moderately severe anaemia (haemoglobin < 7 g/dL) at day 0, day 3 and day 7 as well as a fractional fall ≥ 25% at day 3 and day 7.
Results: A total of 70,226 patients, recruited into 200 studies between 1991 and 2013, were included in the analysis: 50,859 (72.4%) enrolled in Africa, 18,451 (26.3%) in Asia and 916 (1.3%) in South America. The median haemoglobin concentration at presentation was 9.9 g/dL (range 5.0–19.7 g/dL) in Africa, 11.6 g/dL (range 5.0–20.0 g/dL) in Asia and 12.3 g/dL (range 6.9–17.9 g/dL) in South America. Moderately severe anaemia (Hb < 7g/dl) was present in 8.4% (4284/50,859) of patients from Africa, 3.3% (606/18,451) from Asia and 0.1% (1/916) from South America. The nadir haemoglobin occurred on day 2 post treatment with a mean fall from baseline of 0.57 g/dL in Africa and 1.13 g/dL in Asia. Independent risk factors for moderately severe anaemia on day 7, in both Africa and Asia, included moderately severe anaemia at baseline (adjusted odds ratio (AOR) = 16.10 and AOR = 23.00, respectively), young age (age < 1 compared to ≥ 12 years AOR = 12.81 and AOR = 6.79, respectively), high parasitaemia (AOR = 1.78 and AOR = 1.58, respectively) and delayed parasite clearance (AOR = 2.44 and AOR = 2.59, respectively). In Asia, patients treated with an artemisinin-based regimen were at significantly greater risk of moderately severe anaemia on day 7 compared to those treated with a non-artemisinin-based regimen (AOR = 2.06 [95%CI 1.39–3.05], p < 0.001).
Conclusions: In patients with uncomplicated P. falciparum malaria, the nadir haemoglobin occurs 2 days after starting treatment. Although artemisinin-based treatments increase the rate of parasite clearance, in Asia they are associated with a greater risk of anaemia during recovery
- …