Pre-Columbian Tuberculosis: An Epidemiological Approach

In this study we have combined both biological and cultural data in the investigation of resorptive pathology in Woodland and Mississippian skeletal series from west-central Illinois. Information concerning the types of lesions and their distribution confirms the presence of a previously unknown disease in Mississippian populations. Adults and adolescents from Yokem and Schild Mississippian components clearly display cystic vertebral pathology, which in association with other peripheral osseous lesions distinguishes them from earlier groups. This idea is supported indirectly by evidence from both infants and children of the Schild sample

Friendships of children with disabilities in the home environment

Friendships are a valued aspect of life. Understanding the family and home aspects of friendships can help special educators to develop a broader understanding of issues supporting friendships for young children with disabilities. In this exploratory study, family interviews and home observations were used to examine friendships of children with disabilities (3 to 10 years old) at home. Results suggest many children with disabilities spend limited time with friends or peers in the home environment. In this sample, children with the greatest amount of contact with friends had disabilities that were mainly physical in nature, while children with behavior problems and cognitive limitations were among the children who experienced the fewest peer interactions. Children living in isolated areas and/or off busy roads had more limited contact with friends than children residing in neighborhoods. Living in close proximity of other children, however, did not guarantee frequent peer interactions or friendships. Characteristics of the home and neighborhood and parents\u27 roles in initiating and supervising friendships are examined. Implications for special educators are discussed for increasing opportunities for children with disabilities to interact with peers and develop friendships in their home and neighborhood

Challenges in evaluating surgical innovation

Research on surgical interventions is associated with several methodological and practical challenges of which few, if any, apply only to surgery. However, surgical evaluation is especially demanding because many of these challenges coincide. In this report, the second of three on surgical innovation and evaluation, we discuss obstacles related to the study design of randomised controlled trials and non-randomised studies assessing surgical interventions. We also describe the issues related to the nature of surgical procedures—for example, their complexity, surgeon-related factors, and the range of outcomes. Although difficult, surgical evaluation is achievable and necessary. Solutions tailored to surgical research and a framework for generating evidence on which to base surgical practice are essential.The Balliol Colloquium has been supported by Ethicon UK with unrestricted educational grants and by the National Institute of Health Research Health Technology Assessment Programme. The Balliol Colloquium was administratively and financially supported by the Nuffield Department of Surgery at the University of Oxford and the Department of Surgery at McGill University. JAC holds a Medical Research Council UK special training fellowship. The University of Aberdeen’s Health Services Research Unit is core funded by the Chief Scientist Offi ce of the Scottish Government Health Directorates. IB is supported by a grant from the Société Française de Rhumatologie and Lavoisier Program (Ministère des Aff aires Etrangères et Européennes). PLE is a DPhil Candidate in Evidence-Based Health Care at Oxford University

Understanding Self-Determination and Families of Young Children with Disabilities in Home Environments

This article is about emergent self-determination for young children with disabilities in their home environments. The purpose of this study was to better understand family and home characteristics and how they influence the ways in which families can support the development of self-determination for their children with disabilities. Thirty families of young children with disabilities were interviewed, and their homes were systematically observed. Using a grounded theory design, an emergent model was developed that examined family and home context and the influence of context on the strategies that families used to support self-determination. Future research and practice implications of this research for supporting families are discussed

Corneal Microlayer Optical Tomography Review

Anterior segment ultra-high resolution OCT (UHR-OCT) uses a resolution of 1–4 μm to provide non-invasive imaging of the tear film and cornea. This new high definition imaging technology increases our understanding of normal structure and pathological changes in the cornea, and resolution has continued to improve over time. UHR-OCT is useful in the treatment of disease such as dry eye, subclinical keratoconus, keratoconus, and ocular surface pathology. It also aids clinicians in fitting contact lenses and screening tissue for corneal transplantation. In this review, we summarize applications of imaging the normal and pathologic ocular surface and cornea. Novel developments, such as the new-generation micro-OCT, Anterior segment OCT angiography and artificial intelligence have the potential to continue to increase our knowledge

How can we confidently judge the extent to which student voice in higher education has been genuinely amplified? A proposal for a new evaluation framework

This article aims to contribute to the development of frameworks for evaluating student voice projects in higher education by offering a critically evaluative account of two student voice projects. Although both projects had been underpinned by the principles of participatory (inclusive) research, one appeared to be more successful than the other in engaging students in a productive or meaningful way. In order to confirm and explain these perceived differences, this paper draws on both student voice and participatory research literature to identify two potentially useful evaluation criteria: reach and fitness for purpose. These criteria are applied to three project factors: aims and assumptions, processes and outcomes to produce an amplitude framework for evaluating student voice in higher education. It is argued that this framework has the potential to enable a rich account of the relative successes and failures of student voice initiatives in higher education

Home Screening for Bacterial Vaginosis to Prevent Sexually Transmitted Diseases

Background. Longitudinal studies have consistently found a significant association between bacterial vaginosis (BV) and acquisition of sexually transmitted diseases. However, there are limited prospective data to confirm these findings

Application of pharmacogenomics and bioinformatics to exemplify the utility of human <i>ex vivo</i> organoculture models in the field of precision medicine

Here we describe a collaboration between industry, the National Health Service (NHS) and academia that sought to demonstrate how early understanding of both pharmacology and genomics can improve strategies for the development of precision medicines. Diseased tissue ethically acquired from patients suffering from chronic obstructive pulmonary disease (COPD), was used to investigate inter-patient variability in drug efficacy using ex vivo organocultures of fresh lung tissue as the test system. The reduction in inflammatory cytokines in the presence of various test drugs was used as the measure of drug efficacy and the individual patient responses were then matched against genotype and microRNA profiles in an attempt to identify unique predictors of drug responsiveness. Our findings suggest that genetic variation in CYP2E1 and SMAD3 genes may partly explain the observed variation in drug response

A trial like ALIC4E: why design a platform, response-adaptive, open, randomised controlled trial of antivirals for influenza-like illness?

ALIC4E is the first publicly funded, multicountry, pragmatic study determining whether antivirals should be routinely prescribed for influenza-like illness in primary care. The trial aims to go beyond determining the average treatment effect in a population to determining effects in patients with combinations of participant characteristics (age, symptom duration, illness severity, and comorbidities). It is one of the first platform, response-adaptive, open trial designs implemented in primary care, and this article aims to provide an accessible description of key aspects of the study design. 1) The platform design allows the study to remain relevant to evolving circumstances, with the ability to add treatment arms. 2) Response adaptation allows the proportion of participants with key characteristics allocated to study arms to be altered during the course of the trial according to emerging outcome data, so that participants' information will be most useful, and increasing their chances of receiving the trial intervention that will be most effective for them. 3) Because the possibility of taking placebos influences participant expectations about their treatment, and determining effects of the interventions on patient help seeking and adherence behaviour in real-world care is critical to estimates of cost-effectiveness, ALIC4E is an open-label trial