Development of the ASQoL: a quality of life instrument specific to ankylosing spondylitis

Background: Although disease-specific health status measures are available for ankylosing spondylitis (AS), no instrument exists for assessing quality of life (QoL) in the condition. Objective: To produce an AS-specific QoL measure that would be relevant and acceptable to respondents, valid, and reliable. Methods: The ASQoL employs the needs-based model of QoL and was developed in parallel in the UK and the Netherlands (NL). Content was derived from interviews with patients in each country. Face and content validity were assessed through patient field test interviews (UK and NL). A postal survey in the UK produced a more efficient version of the ASQoL, which was tested for scaling properties, reliability, internal consistency, and validity in a further postal survey in each country. Results: A 41 item questionnaire was derived from interview transcripts. Field testing interviews confirmed acceptability. Rasch analysis of data from the first survey (n=121) produced a 26 item questionnaire. Rasch analysis of data from the second survey (UK: n=164; NL: n=154) showed some item misfit, but showed that items formed a hierarchical order and were stable over time. Problematic items were removed giving an 18 item scale. Both language versions had excellent internal consistency (α=0.89–0.91), test-retest reliability (r(s)=0.92 UK and r(s)=0.91 NL), and validity. Conclusions: The ASQoL provides a valuable tool for assessing the impact of interventions for AS and for evaluating models of service delivery. It is well accepted by patients, taking about four minutes to complete, and has excellent scaling and psychometric properties

End of Life Care and Do Not Resuscitate Orders: How Much Does Age Influence Decision Making? A Systematic Review and Meta-analysis

With population aging, “do not resuscitate” (DNAR) decisions, pertaining to the appropriateness of attempting resuscitation following a cardiac arrest, are becoming commoner. It is unclear from the literature whether using age to make these decisions represents “ageism.” We undertook a systematic review of the literature using CINAHL, Medline, and the Cochrane database to investigate the relationship between age and DNAR. All 10 studies fulfilling our inclusion criteria found that “do not attempt resuscitation” orders were more prevalent in older patients; eight demonstrated that this was independent of other mediating factors such as illness severity and likely outcome. In studies comparing age groups, the adjusted odds of having a DNAR order were greater in patients aged 75 to 84 and ≥85 years (adjusted odds ratio [AOR] 1.70, 95% confidence interval [CI] = [1.25, 2.33] and 2.96, 95% CI = [2.34, 3.74], respectively), compared with those <65 years. In studies treating age as a continuous variable, there was no significant increase in the use of DNAR with age (AOR 0.98, 95% CI = [0.84, 1.15]). In conclusion, age increases the use of “do not resuscitate” orders, but more research is needed to determine whether this represents “ageism.

Collaborative International Research in Clinical and Longitudinal Experience Study in NMOSD

Objective To develop a resource of systematically collected, longitudinal clinical data and biospecimens for assisting in the investigation into neuromyelitis optica spectrum disorder (NMOSD) epidemiology, pathogenesis, and treatment. Methods To illustrate its research-enabling purpose, epidemiologic patterns and disease phenotypes were assessed among enrolled subjects, including age at disease onset, annualized relapse rate (ARR), and time between the first and second attacks. Results As of December 2017, the Collaborative International Research in Clinical and Longitudinal Experience Study (CIRCLES) had enrolled more than 1,000 participants, of whom 77.5% of the NMOSD cases and 71.7% of the controls continue in active follow-up. Consanguineous relatives of patients with NMOSD represented 43.6% of the control cohort. Of the 599 active cases with complete data, 84% were female, and 76% were anti-AQP4 seropositive. The majority were white/Caucasian (52.6%), whereas blacks/African Americans accounted for 23.5%, Hispanics/ Latinos 12.4%, and Asians accounted for 9.0%. The median age at disease onset was 38.4 years, with a median ARR of 0.5. Seropositive cases were older at disease onset, more likely to be black/African American or Hispanic/Latino, and more likely to be female. Conclusions Collectively, the CIRCLES experience to date demonstrates this study to be a useful and readily accessible resource to facilitate accelerating solutions for patients with NMOSD

Maternal and child health after injuries: a two-year follow-up of a nationally representative sample

Objective: The objective of this study was to examine the association between childhood injury and health outcomes among survivors and their mothers using a national survey in the United States (US). Study design: This was a longitudinal analysis of a nationally representative sample. Methods: Secondary analysis of the 1997–2013 Medical Expenditure Panel Survey (MEPS) was performed. Children (aged 2–18 years) with or without injuries were followed up for two years. Injuries captured in the study were those associated with at least one hospitalization, emergency department visit, or office-based visit. Outcome measures were child and maternal general and mental health status. Multiple mixed-logistic regressions were used with suboptimal health defined as the response of poor or fair health versus good, very good, or excellent health. Results: Of the 63,422 children analyzed, 3251 (4.9%) were injured, representing 3.6 million US children. Injured children were more likely to be male, white, and older than those without injuries (P < 0.01). About a fifth of injured children suffered head injuries. Injuries were strongly associated with suboptimal general and mental health status in children (adjusted odds ratios [AORs], 1.35 and 1.36, respectively, P < 0.05). Mothers of children with injuries were also more likely to report suboptimal mental health (AOR, 1.30, P < 0.05). Conclusion: Injuries among children are associated with lasting adverse effects in general and mental health. To improve health outcomes of pediatric injuries, further follow-up care may be needed to ensure that they return to pre-injury health levels. These results highlight the importance of primary prevention and the long-term impact of injuries on the health of children and their mothers

Supporting learning with 3D interactive applications in early years

Early years education is an key element for the introduction of children in the education system. In order to improve this process, the aim of this study was to explore how guided interaction with 3D apps can fit into a preschool setting, how it can help children learn through playing and how it can improve their learning outcomes. A study was conducted with six classes of 87 students aged between 3 years to 6 years, over a 12-week period. Children used 10 inch Android tablets with a series of apps developed by our research team, about houses of the world, the skeleton & five senses and, animals. A quasi-experimental design based on a nonequivalent groups pretest and posttest de-sign revealed that an active behavior and better learning outcomes are obtained by children participating in the experimental groupCascales Martínez, A.; Martínez Segura, MJ.; Laguna- Segobia, M.; Pérez Lopez, DC.; Contero, M. (2014). Supporting learning with 3D interactive applications in early years. Lecture Notes in Computer Science. 8524:11-22. doi:10.1007/978-3-319-07485-6_2S11228524Plowman, L., Stephen, C.: Children, Play and Computers in Preschool Education. British Journal of Educational Technology 36(2), 145–157 (2005)Tootell, H., Plumb, M., Hadfield, C., Dawson, L.: Gestural Interface Technology in early childhood education: A framework for fully-engaged communication. In: Proceedings of the Annual Hawaii International Conference on System Sciences, art. no. 6479836, pp. 13–20 (2013)Marco, J., Cerezo, E.: Bringing Tabletop Technologies to Kindergarten Children. In: HCI 2009 International Conference on Human-Computer Interaction–Celebrating People and Technology, pp. 103–111. Springer, Heidelberg (2009)Heft, T.M., Swaminathan, S.: Using Computers in Early Childhood Classrooms: Teachers’ Attitudes, Skills and Practices. Journal of Early Childhood Research 6(4), 169–188 (2006)Wang, X.C., Ching, C.C.: Social Construction of Computer Experience in a First-Grade Classroom: Social Processes and Mediating Artifacts. Early Education and Development 14(3), 335–361 (2003)Couse, L.J., Chen, D.W.: A Tablet Computer for Young Children? Exploring Its Viability for Early Childhood Education. Journal of Research on Technology in Education 43(1), 75–98 (2012)Kearney, J.: Educating Young Children - Learning and Teaching in the Early Childhood Years. Early Childhood Teachers’ Association (ECTA Inc.) 3(18) (2012)Rankothge, W.H., Sendanayake, S.V., Sudarshana, R.G.P., Balasooriya, B.G.G.H., Alahapperuma, D.R., Mallawarachchi, Y.: Technology Assisted Tool for Learning Skills Development in Early Childhood. In: Proc. of 2012 International Conference on Advances in ICT for Emerging Regions (ICTer), pp. 165–168 (2012)Sandvik, M., Smørdal, O., Østerud, S.: Exploring iPads in Practitioners’ Repertoires for Language Learning and Literacy Practices In Kindergarten. Nordic Journal of Digital Literacy 3(7), 204–221 (2012)Priyankara, K.W.T.G.T., Mahawaththa, D.C., Nawinna, D.P., Jayasundara, J.M.A., Tharuka, K.D.N., Rajapaksha, S.K.: Android Based e-Learning Solution for Early Childhood Education in Sri Lanka. In: Proceedings of the 8th International Conference on Computer Science & Education (ICCSE), pp. 715–718 (2013)Zanchi, C., Presser, A.L., Vahey, P.: Next Generation Preschool Math Demo: Tablet Games for Preschool Classrooms. In: Proceedings of the 12th International Conference on Interaction Design and Children, IDC 2013, pp. 527–530 (2013)Meyer, B.: Game-based Language Learning for Pre-School Children: A Design Perspective. Electronic Journal of e-Learning 11(1), 39–48 (2013)Straub, D.W.: Validating Instruments in MIS Research. MIS Quarterly 13(2), 147–169 (1989)Cook, T.D., Campbell, D.T., Day, A.: Quasi-experimentation: Design and Analysis Issues for Field Settings, pp. 19–21. Houghton Mifflin, Boston (1979)Buendía, L., Y Berrocal, E.: La Ética de la Investigación Educativa. Ágora Digital 1 (2011)Tojar, J., Serrano, J.: Ética e Investigación Educativa. RELIEVE 6(2) (2000)Cascales, A., Laguna, I., Pérez-López, D., Perona, P., Contero, M.: 3D Interactive Applications on Tablets for Preschoolers: Exploring the Human Skeleton and the Senses. In: Hernández-Leo, D., Ley, T., Klamma, R., Harrer, A. (eds.) EC-TEL 2013. LNCS, vol. 8095, pp. 71–83. Springer, Heidelberg (2013

Adult attachment style across individuals and role-relationships: Avoidance is relationship-specific, but anxiety shows greater generalizability

A generalisability study examined the hypotheses that avoidant attachment, reflecting the representation of others, should be more relationship-specific (vary across relationships more than across individuals), while attachment anxiety, reflecting self-representation, should be more generalisable across a person’s relationships. College students responded to 6-item questionnaire measures of these variables for 5 relationships (mother, father, best same-gender friend, romantic partner or best opposite-gender friend, other close person), on 3 (N = 120) or 2 (N = 77) occasions separated by a few weeks. Results supported the hypotheses, with the person variance component being larger than the relationship-specific component for anxiety, and the opposite happening for avoidance. Anxiety therefore seems not to be as relationship-specific as previous research suggested. Possible reasons for discrepancies between the current and previous studies are discussed

Distributional impact of taxes and social transfers in Russia over the downturn

Low oil prices and the recession in Russia which started in 2014 are increasing pressures for fiscal consolidation, after more than a decade of prosperity. This paper assesses the distributional impact of the main tax and social spending programs in Russia in 2014 by applying a state-of-the-art incidence analysis. Overall, the Russian welfare state achieves a moderate reduction in inequality through tax-benefit policies by international standards. Most redistribution occurs through pensions. Major limits on the redistributive effect of tax-benefit policy include the large share of tax revenues that come from (regressive) indirect taxes, the neutral impact of personal income taxes and the low share of spending that goes on social assistance targeted to low-income groups. Tax-benefit policy also has an important impact on the age distribution of income, as households of working-age people (with and without children) subsidize pensioner households

Energy landscape of relaxed amorphous silicon

We analyze the structure of the energy landscape of a well-relaxed 1000-atom model of amorphous silicon using the activation-relaxation technique (ART nouveau). Generating more than 40,000 events starting from a single minimum, we find that activated mechanisms are local in nature, that they are distributed uniformly throughout the model and that the activation energy is limited by the cost of breaking one bond, independently of the complexity of the mechanism. The overall shape of the activation-energy-barrier distribution is also insensitive to the exact details of the configuration, indicating that well-relaxed configurations see essentially the same environment. These results underscore the localized nature of relaxation in this material.Comment: 8 pages, 12 figure

eggNOG 5.0: a hierarchical, functionally and phylogenetically annotated orthology resource based on 5090 organisms and 2502 viruses

eggNOG is a public database of orthology relationships, gene evolutionary histories and functional annotations. Here, we present version 5.0, featuring a major update of the underlying genome sets, which have been expanded to 4445 representative bacteria and 168 archaea derived from 25 038 genomes, as well as 477 eukaryotic organisms and 2502 viral proteomes that were selected for diversity and filtered by genome quality. In total, 4.4M orthologous groups (OGs) distributed across 379 taxonomic levels were computed together with their associated sequence alignments, phylogenies, HMM models and functional descriptors. Precomputed evolutionary analysis provides fine-grained resolution of duplication/speciation events within each OG. Our benchmarks show that, despite doubling the amount of genomes, the quality of orthology assignments and functional annotations (80% coverage) has persisted without significant changes across this update. Finally, we improved eggNOG online services for fast functional annotation and orthology prediction of custom genomics or metagenomics datasets. All precomputed data are publicly available for downloading or via API queries at http://eggnog.embl.de

Requirements of leaf wetness and temperature for infection of groundnut by rust

Experiments are described to quantify the effects of temp. and duration of leaf wetness on infection of groundnut by Puccinia arachidis. After inoculation, a min. period of leaf wetness, m, was necessary for infection. When leaf wetness duration was >m, lesion density increased with increasing wetness duration to an asymptote, Dmax. The principal effects of temp. were on m and Dmax. The value of m decreased linearly from 6 h, as temp. increased from 15 to 25°C and increased slightly at temp. >25°. Dmax increased with temp. from zero at 8° to a max. at 22°, and decreased to zero again at c. 30°. The experimental results were used to produce a set of curves relating an infection index to leaf wetness duration at different temp. The implications for infection of groundnut crops are discussed in relation to the climate at Patancheru in southern India