2,404 research outputs found
Quantifying the Quiet Epidemic: Diagnosing Dementia in Twentieth Century Britain
During the late 20(th) century numerical rating scales became central to the diagnosis of dementia and helped transform attitudes about its causes and prevalence. Concentrating largely on the development and use of the Blessed Dementia Scale, I argue that rating scales served professional ends during the 1960s and 1970s. They helped old age psychiatrists establish jurisdiction over conditions such as dementia and present their field as a vital component of the welfare state, where they argued that ‘reliable modes of diagnosis’ were vital to the allocation of resources. I show how these arguments appealed to politicians, funding bodies and patient groups, who agreed that dementia was a distinct disease and claimed research on its causes and prevention should be designated ‘top priority’. But I also show that worries about the replacement of clinical acumen with technical and depersonalized methods, which could conceivably be applied by anyone, led psychiatrists to stress that rating scales had their limits and could be used only by trained experts
Microbiological evaluation of endodontic files after cleaning and steam sterilization procedures
The document attached has been archived with permission from the Australian Dental Association. An external link to the publisher’s copy is included.Background: Infection control procedures are essential for modern dental practice and they are continually evolving to meet the dental profession’s high standards. The present study evaluated the efficacy of two cleaning procedures to reduce bacterial numbers on endodontic files, and evaluated the effect of biological debris on the subsequent sterilization of files. Methods: Stainless steel and nickel-titanium (NiTi) files were examined upon removal from the manufacturer’s packaging, after instrumentation in root canals of human teeth inoculated with a broth containing two anaerobic species and one facultative anaerobic species of bacteria, and after instrumentation and cleaning with either an ultrasonic bath or a thermal disinfector. For each file, the bacterial numbers were quantified using routine microbiological techniques in an anaerobic chamber. Results: No bacteria were detected from files direct from their packets. The size, taper and type of file did not affect the ability of either of the cleaning procedures to reduce bacterial numbers. However, an absence of bacteria was more likely when files were cleaned in the thermal disinfector. No bacteria were detected from files that were subjected to steam sterilization irrespective of the type of prior cleaning procedure. Conclusions: Steam sterilization eliminated all bacteria from the endodontic files irrespective of the presence of biological debris. The majority of bacteria were eliminated from endodontic files after either ultrasonic cleaning or using a thermal disinfector.DA Van Eldik, PS Zilm, AH Rogers and PD Mari
Entry Assessment in Community Colleges: Tracking or Facilitating?
Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66989/2/10.1177_009155219302100302.pd
Troubling the exclusive privileges of citizenship: mobile solidarities, asylum seekers, and the right to work
This article discusses asylum seekers and the right to work in the UK. Differential access to the labour market is one of the ways in which the state maintains a distinction between British citizens, who ‘belong’, and non-citizens who do not. While such a policy approach garners widespread support amongst the general public of citizens, it does not go uncontested. This article discusses a UK-based campaign, ‘Let Them Work’, which has sought to influence the government in extending the right to work to asylum seekers. In doing so, it demonstrates the ways in which the stratified regime of citizenship rights is contested politically, and explores how such contestation troubles the exclusive privileges of citizenship by enacting mobile solidarities from marginalised spaces
Teaching and learning about dementia in UK medical schools: a national survey
Background: Dementia is an increasingly common condition and all doctors, in both primary and secondary care
environments, must be prepared to competently manage patients with this condition. It is unclear whether medical
education about dementia is currently fit for purpose. This project surveys and evaluates the nature of teaching and
learning about dementia for medical students in the UK.
Methods: Electronic questionnaire sent to UK medical schools.
Results: 23/31 medical schools responded. All provided some dementia-specific teaching but this focussed more
on knowledge and skills than behaviours and attitudes. Only 80% of schools described formal assessment of
dementia-specific learning outcomes. There was a widespread failure to adequately engage the multidisciplinary
team, patients and carers in teaching, presenting students with a narrow view of the condition. However, some
innovative approaches were also highlighted.
Conclusions: Although all schools taught about dementia, the deficiencies identified represent a failure to
sufficiently equip medical students to care for patients with dementia which, given the prevalence of the condition,
does not adequately prepare them for work as doctors. Recommendations for improving undergraduate medical
education about dementia are outline
Real-Time Hypoglycemia Prediction Suite Using Continuous Glucose Monitoring: A safety net for the artificial pancreas
Comparison of a Multiple Daily Insulin Injection Regimen (Basal Once-Daily Glargine Plus Mealtime Lispro) and Continuous Subcutaneous Insulin Infusion (Lispro) in Type 1 Diabetes: A randomized open parallel multicenter study
A randomised controlled trial of a tele-based lifestyle intervention for colorectal cancer survivors ('CanChange'): study protocol
Background Colorectal cancer survivors may suffer from a range of ongoing psychosocial and physical problems that negatively impact on quality of life. This paper presents the study protocol for a novel telephone-delivered intervention to improve lifestyle factors and health outcomes for colorectal cancer survivors. Methods/Design Approximately 350 recently diagnosed colorectal cancer survivors will be recruited through the Queensland Cancer Registry and randomised to the intervention or control condition. The intervention focuses on symptom management, lifestyle and psychosocial support to assist participants to make improvements in lifestyle factors (physical activity, healthy diet, weight management, and smoking cessation) and health outcomes. Participants will receive up to 11 telephone-delivered sessions over a 6 month period from a qualified health professional or 'health coach'. Data collection will occur at baseline (Time 1), post-intervention or six months follow-up (Time 2), and at 12 months follow-up for longer term effects (Time 3). Primary outcome measures will include physical activity, cancer-related fatigue and quality of life. A cost-effective analysis of the costs and outcomes for survivors in the intervention and control conditions will be conducted from the perspective of health care costs to the government. Discussion The study will provide valuable information about an innovative intervention to improve lifestyle factors and health outcomes for colorectal cancer survivors
Systemic hydrocortisone to prevent bronchopulmonary dysplasia in preterm infants (the SToP-BPD study); a multicenter randomized placebo controlled trial
<p>Abstract</p> <p>Background</p> <p>Randomized controlled trials have shown that treatment of chronically ventilated preterm infants after the first week of life with dexamethasone reduces the incidence of the combined outcome death or bronchopulmonary dysplasia (BPD). However, there are concerns that dexamethasone may increase the risk of adverse neurodevelopmental outcome. Hydrocortisone has been suggested as an alternative therapy. So far no randomized controlled trial has investigated its efficacy when administered after the first week of life to ventilated preterm infants.</p> <p>Methods/Design</p> <p>The SToP-BPD trial is a randomized double blind placebo controlled multicenter study including 400 very low birth weight infants (gestational age < 30 weeks and/or birth weight < 1250 grams), who are ventilator dependent at a postnatal age of 7 - 14 days. Hydrocortisone (cumulative dose 72.5 mg/kg) or placebo is administered during a 22 day tapering schedule. Primary outcome measure is the combined outcome mortality or BPD at 36 weeks postmenstrual age. Secondary outcomes are short term effects on the pulmonary condition, adverse effects during hospitalization, and long-term neurodevelopmental sequelae assessed at 2 years corrected gestational age. Analysis will be on an intention to treat basis.</p> <p>Discussion</p> <p>This trial will determine the efficacy and safety of postnatal hydrocortisone administration at a moderately early postnatal onset compared to placebo for the reduction of the combined outcome mortality and BPD at 36 weeks postmenstrual age in ventilator dependent preterm infants.</p> <p>Trial registration number</p> <p>Netherlands Trial Register (NTR): <a href="http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2768">NTR2768</a></p
The impact of books on social inclusion and development and well‐being among children and young people with severe and profound learning disabilities: Recognising the unrecognised cohort
This paper presents the findings of an original research project commissioned by BookTrust, a respected UK charity that gifts books to children, young people (CYP) and their families. It explored the impact and modus of pleasurable engagement with books among CYP with severe and profound learning disabilities and applied a critical, phenomenological stance on what it means to read through drawing on “inclusive literacy” as a conceptual framework. Data were collected from four local areas in England and included 43 CYP aged 4–14. In keeping with a phenomenological stance, it employed interpretivist methods involving 13 deep‐level interviews with families to include observations and structured play; 13 observations of CYP sharing books with others in home, play or school settings, and interviews with 27 practitioners working in a range of organisations (e.g., Portage service and advisory teams). Findings were that books had a positive impact on well‐being, social inclusion and development. CYP were engaged in enjoying the content of books through personalisation, sensory stimulation, social stimulation and repetition. This affirmed the theoretical and practical approaches espoused by “inclusive literacy” but made a critical and original contribution to our understanding of the special place that books occupy as ordinary artefacts of literary citizenship among this cohort. The benefits of volitional reading among CYP who do not have learning disabilities are well known, but the authors urge publishers and policymakers to recognise CYP with severe and profound learning disabilities as equally important, active consumers of books who have much to gain from reading for pleasure
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