Shone-Anomalie: Fallbericht und Hintergrund

Zusammenfassung: Die Shone-Anomalie wurde 1963 erstmals beschrieben und stellt eine seltene kongenitale kardiovaskuläre Missbildung mit verschiedenen linkskardialen stenotischen Läsionen dar. Die klassische Form besteht aus einem fibrösen supravalvulären Mitralring, einer fallschirmartigen Deformation der Mitralklappe mit nur einem Papillarmuskel ("parachute mitral valve"), einer subvalvulären Aortenstenose und einer Aortenisthmusstenose. Es gibt nur vereinzelte perioperative Fallberichte von erwachsenen Patienten mit dieser kardiovaskulären Missbildung. Allerdings können Patienten mit einer undiagnostizierten, inkompletten Form der Shone-Anomalie auch im Erwachsenenalter für nichtherzchirurgische Operationen vorgesehen sein. In dem vorliegenden Fallbericht wird das anästhesiologische Management einer Patientin, die für eine abdominale Hysterektomie vorgesehen war und an einer bisher nichtdiagnostizierten Shone-Anomalie litt, beschriebe

Lymphatic Leukemia in a Dog

A Scottish Terrier was presented to the clinic with the history that he had been ailing for about six weeks. The dog was examined and the following symptoms were noticed. All of the palpable lymph glands were enlarged. The abdomen felt full and hard. The dog had a peculiar type of breathing and his breath was very foul. There was a copious discharge from the purulent conjunctivitis. He was emaciated and did not exhibit the spirit of liveliness of a normal dog

Limits to sustained energy intake XXIV : impact of suckling behaviour on the body temperatures of lactating female mice

We would like to thank the animal house staff and all members of the Energetics group for their invaluable help at various stages throughout the project. This work was supported by Natural Environment Research Council grant (NERC, NE/C004159/1). YG was supported by a scholarship from the rotary foundation. LV was supported by a Rubicon grant from the Netherlands Scientific Organisation (NWO).Peer reviewedPublisher PD

The ontological status of bullies and victims

Thesis (Ph. D.)--Michigan State University. Department of Counseling, Educational Psychology and Special Education, 2005Includes bibliographical references (pages 70-76

iMAGINE - 7,500 Years of Sustainable Energy from Nuclear Waste

Though leadership article on a demand-driven, game-changing nuclear technology fit for challenges of the 21st centur

The effect of an icebreaker on collaborative performance across a video link

Analyses indicate that when the icebreaker took place, participants completed the task significantly faster, in significantly fewer words and negotiated turns during conversation more effectively. This chapter investigates the effect of an initial icebreaker on collaborative task performance across video-mediated communication. It was expected that performance would be enhanced when an icebreaker was used. Participants completed a “collaborative map-reading task,” which involves both participants having to plan a route together (on a map of a town centre with a number of shops), picking up five items from a shopping list along the way. After completing this task participants were given as long as they required to complete the map-reading task. Participants in the control condition completed the map-reading task without taking part in an icebreaker. Participants in the control condition spent on average 8.9% of the dialogue engaging in such activities, compared to 5.7% in the icebreaker condition

Is "No test is better than a bad test"? Impact of diagnostic uncertainty in mass testing on the spread of Covid-19

Testing is viewed as a critical aspect of any strategy to tackle epidemics. Much of the dialogue around testing has concentrated on how countries can scale up capacity, but the uncertainty in testing has not received nearly as much attention beyond asking if a test is accurate enough to be used. Even for highly accurate tests, false positives and false negatives will accumulate as mass testing strategies are employed under pressure, and these misdiagnoses could have major implications on the ability of governments to suppress the virus. The present analysis uses a modified SIR model to understand the implication and magnitude of misdiagnosis in the context of ending lockdown measures. The results indicate that increased testing capacity alone will not provide a solution to lockdown measures. The progression of the epidemic and peak infections is shown to depend heavily on test characteristics, test targeting, and prevalence of the infection. Antibody based immunity passports are rejected as a solution to ending lockdown, as they can put the population at risk if poorly targeted. Similarly, mass screening for active viral infection may only be beneficial if it can be sufficiently well targeted, otherwise reliance on this approach for protection of the population can again put them at risk. A well targeted active viral test combined with a slow release rate is a viable strategy for continuous suppression of the virus.</jats:p

An initial face-to-face meeting improves person perceptions of interviewees across VMC

This chapter investigates the effects of initial meeting context on future video-mediated impression formation. This initial meeting either took place over a video link or face-to-face. Participants who had met the interviewee face-to-face prior to the interview rated him significantly more favourably on a number of measures (friendliness, honesty, job suitability and employability) compared to when the initial meeting took place via a video link. Initial meeting context therefore impacted on person perceptions. Video-mediated communication (VMC) is increasingly used to support interviewing at a distance. Although on the one hand this means that individuals can be interviewed for jobs without travelling to the interview destination, research suggests that the presentation of an individual over a video link may result in less favourable impression formation. The consequence of this would be that people would appear “cold” when presenting themselves over VMC

Older people's family relationships in disequilibrium during the COVID-19 pandemic. What really matters?

Abstract Inter- and intragenerational relationships are known to be important in maintaining the wellbeing of older people. A key aspect of these relationships is the exchange of both emotional and instrumental social support. However, relatively little is known about how this exchange of support changes in the context of widespread disruption. The COVID-19 pandemic provides an opportunity to examine how older people's family relationships are impacted by such social change. The present qualitative study explores how older people in the United Kingdom experienced changes in inter- and intragenerational support during the COVID-19 pandemic. Participants (N = 33) were recruited through a large-scale nationally representative survey (https://www.sheffield.ac.uk/psychology-consortium-covid19). We asked how life had been pre-pandemic, how they experienced the first national lockdown and what the future might hold in store. The data were analysed using constructivist grounded theory. This paper focuses on the importance of family relationships and how they changed as a consequence of the pandemic. We found that the family support system had been interrupted, that there were changes in the methods of support and that feelings of belonging were challenged. We argue that families were brought into disequilibrium through changes in the exchange of inter- and intragenerational support. The important role of grandchildren for older adults was striking and challenged by the pandemic. The significance of social connectedness and support within the family had not changed during the pandemic, but it could no longer be lived in the same way. The desire to be close to family members and to support them conflicted with the risk of pandemic infection. Our study found support for the COVID-19 Social Connectivity Paradox: the need for social connectedness whilst maintaining social distance. This challenged family equilibrium, wellbeing and quality of life in older people.</jats:p

Mini-Mental State Examination (MMSE) for the detection of dementia in clinically unevaluated people aged 65 and over in community and primary care populations

BACKGROUND: The Mini Mental State Examination (MMSE) is a cognitive test that is commonly used as part of the evaluation for possible dementia. OBJECTIVES: To determine the diagnostic accuracy of the Mini‐Mental State Examination (MMSE) at various cut points for dementia in people aged 65 years and over in community and primary care settings who had not undergone prior testing for dementia. SEARCH METHODS: We searched the specialised register of the Cochrane Dementia and Cognitive Improvement Group, MEDLINE (OvidSP), EMBASE (OvidSP), PsycINFO (OvidSP), LILACS (BIREME), ALOIS, BIOSIS previews (Thomson Reuters Web of Science), and Web of Science Core Collection, including the Science Citation Index and the Conference Proceedings Citation Index (Thomson Reuters Web of Science). We also searched specialised sources of diagnostic test accuracy studies and reviews: MEDION (Universities of Maastricht and Leuven, www.mediondatabase.nl), DARE (Database of Abstracts of Reviews of Effects, via the Cochrane Library), HTA Database (Health Technology Assessment Database, via the Cochrane Library), and ARIF (University of Birmingham, UK, www.arif.bham.ac.uk). We attempted to locate possibly relevant but unpublished data by contacting researchers in this field. We first performed the searches in November 2012 and then fully updated them in May 2014. We did not apply any language or date restrictions to the electronic searches, and we did not use any methodological filters as a method to restrict the search overall. SELECTION CRITERIA: We included studies that compared the 11‐item (maximum score 30) MMSE test (at any cut point) in people who had not undergone prior testing versus a commonly accepted clinical reference standard for all‐cause dementia and subtypes (Alzheimer disease dementia, Lewy body dementia, vascular dementia, frontotemporal dementia). Clinical diagnosis included all‐cause (unspecified) dementia, as defined by any version of the Diagnostic and Statistical Manual of Mental Disorders (DSM); International Classification of Diseases (ICD) and the Clinical Dementia Rating. DATA COLLECTION AND ANALYSIS: At least three authors screened all citations.Two authors handled data extraction and quality assessment. We performed meta‐analysis using the hierarchical summary receiver‐operator curves (HSROC) method and the bivariate method. MAIN RESULTS: We retrieved 24,310 citations after removal of duplicates. We reviewed the full text of 317 full‐text articles and finally included 70 records, referring to 48 studies, in our synthesis. We were able to perform meta‐analysis on 28 studies in the community setting (44 articles) and on 6 studies in primary care (8 articles), but we could not extract usable 2 x 2 data for the remaining 14 community studies, which we did not include in the meta‐analysis. All of the studies in the community were in asymptomatic people, whereas two of the six studies in primary care were conducted in people who had symptoms of possible dementia. We judged two studies to be at high risk of bias in the patient selection domain, three studies to be at high risk of bias in the index test domain and nine studies to be at high risk of bias regarding flow and timing. We assessed most studies as being applicable to the review question though we had concerns about selection of participants in six studies and target condition in one study. The accuracy of the MMSE for diagnosing dementia was reported at 18 cut points in the community (MMSE score 10, 14‐30 inclusive) and 10 cut points in primary care (MMSE score 17‐26 inclusive). The total number of participants in studies included in the meta‐analyses ranged from 37 to 2727, median 314 (interquartile range (IQR) 160 to 647). In the community, the pooled accuracy at a cut point of 24 (15 studies) was sensitivity 0.85 (95% confidence interval (CI) 0.74 to 0.92), specificity 0.90 (95% CI 0.82 to 0.95); at a cut point of 25 (10 studies), sensitivity 0.87 (95% CI 0.78 to 0.93), specificity 0.82 (95% CI 0.65 to 0.92); and in seven studies that adjusted accuracy estimates for level of education, sensitivity 0.97 (95% CI 0.83 to 1.00), specificity 0.70 (95% CI 0.50 to 0.85). There was insufficient data to evaluate the accuracy of the MMSE for diagnosing dementia subtypes.We could not estimate summary diagnostic accuracy in primary care due to insufficient data. AUTHORS' CONCLUSIONS: The MMSE contributes to a diagnosis of dementia in low prevalence settings, but should not be used in isolation to confirm or exclude disease. We recommend that future work evaluates the diagnostic accuracy of tests in the context of the diagnostic pathway experienced by the patient and that investigators report how undergoing the MMSE changes patient‐relevant outcomes