The Identification of Characteristics of the Hyperactive Child Through Objective Evaluation

For many years adults have been concerned about the hyperactive child, who acts out in a boisterous manner, who is perhaps too physically stimulated and who is often perceived as not meeting adult expectations. It seems important to identify the characteristics of the hyperactive child in an objective and understandable manner so that parents, teachers, medical doctors, and mental health practitioners can determine more adequate prescriptive treatment programs. The purpose of this study was to adjudge whether children referred for psychoeducational evaluation by pediatricians as hyperactive exhibit behavioral characteristics which, when evaluated by standardized tests, are significantly different from those characteristics exhibited by normal children. Any such behavioral differences could then allow for the development of a characteristic profile for the hyperactive child. An attempt was made to discover whether children referred for hvperactivity would be significantly different from normal children when using the WISC-R subtests to measure the following traits: level of general information (Information subtest); logical and abstract verbal reasoning (Similarities subtest); concentration and number skills (Arithmetic subtest); the amount o verbal information that the child possesses (Vocabulary subtest); practical knowledge and social judgment (Comprehension subtest); immediate auditory recall and attention span (Digit Span subtest); ability to isolate essential from run-essential details (Picture Completion subtest); adequate judgment in interpreting social situations (Picture Arrangement subtest); visual-motor coordination (Block Design subtest); visual-motor organization (Object Assembly subtest); and any unique or consistent pattern of characteristics based on all of the WISC-R subtests, with the exception of Object Assembly as compared to the WJSC-R Object Assembly subtest measuring attentional behavior. Attempt was also made to discover whether children referred for hyperactivity would be significantly different from normal children when using the PIAT subtests of math and reading recognition to measure skill acquisition in math and reading. A functional analysis of 40 children was conducted, with 20 children between the ages of 6 to 12 years in a control group, referred by pediatricians as normal, and 20 children between the ages of 6 to 12 years in an experimental group, referred by pediatricians as hyperactive. The results were statistically analyzed using the Kruskal-Wallis one-way analysis of variance by ranks. The results showed no significant differences between the control and experimental groups. Thus the attempt of the present study to identify characteristics of the hyperactive child through use of the Wechsler Intelligence Scale for Children-Revised and the Peabody Individual Achievement Test indicated that control and experimental groups appeared to be from the same population. The following conclusions were drawn from the results of this study: (1) Children referred for hyperactivity could not be identified through the use of the WISC-Rand PIA T math and reading subtests as differing from the control or normal population, (2) It was, therefore, not possible to establish a characteristic profile for identifying the hyperactive child by using the WISC-Rand PIA T tests alone, (3) At the present time a behavioral checklist employed by a trained practitioneer may still be the best process for identifying specific behaviors of the hyperactive child, and (4) A prescriptive diagnostic and treatment program based upon observed behaviors may provide one method for identifying and remediating deviant behavior of the overly active child

Supporting newly qualified nurses in the UK: a systematic literature review

Aim: This is a systematic literature review of the existing published research related to the development of preceptorship to support newly qualified nurses in the United Kingdom (UK). Background: It has been known for some time that newly qualified nurses experience a period of unsettling transition at the point of registration. In the UK, preceptorship has been the professional body’s recommended solution to this for over 20 years. Data Sources: Searches were made of the CINAHL Plus and MEDLINE databases. Review Methods: A systematic review was carried out in August 2011. Twelve separate searches were conducted generating 167 articles, of which 24 were finally reviewed. Papers were critically reviewed and relevant data were extracted and synthesised using an approach based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis ( PRISMA). Results and Discussion: A results table is presented of the twenty-four sources generated by the systematic search. Three themes were identified from the empirical evidence base: ‘Managerial Support Framework’; ‘Recruitment and Retention’; and ‘Reflection and Critical Thinking in Action’;. Conclusion: There is strong evidence that the newly qualified nurse benefits from a period of supported and structured preceptorship, which translates to improved recruitment and retention for the employing organisations. Recommendations for Further Research and Practice: The existing literature provides an evidence base upon which to construct a preceptorship programme and a means by which to measure its efficacy and monitor its future development. Case study research projects should be considered for future preceptorship programmes in order to find the most effective methods of delivery.Research funded by Chesterfield Royal Hospital NHS Trus

A preceptorship toolkit for nurse managers, teams and healthcare organisations

The transition from student to newly qualified nurse can be challenging. A period of preceptorship is recommended to support newly qualified nurses in their new work environment, and to give them time to adapt and gain confidence. Researchers have developed a toolkit based on previous research that contains several resources that nurse managers, teams and organisations can use to develop and improve preceptorship for newly qualified nurses. The toolkit includes an organisational support tool, a managerial support framework, a supernumerary time tool and a local culture of support tool. This article describes these resources and gives an example of how the toolkit can be adapted locally.Chesterfield Royal Hospital funded the original research project upon which this is base

Factors influencing multiple sclerosis disease-modifying treatment prescribing decisions in the United Kingdom: A qualitative interview study

Background The proportion of people with relapsing-remitting multiple sclerosis prescribed disease modifying treatments (DMTs) in the United Kingdom (UK) is considered low compared with other countries. There are differences in DMT prescription rates between UK nations (England, Wales, Scotland, Northern Ireland). Despite this, there has been little research into decision-making processes and prescribing practices. Objective To investigate views and experiences of neurologists prescribing DMTs and MS specialist nurses to identify factors influencing prescribing. Methods Semi-structured interviews with 18 consultant neurologists and 16 specialist nurses from diverse settings across the four UK nations. Data were analysed using thematic framework analysis. Results Prescribing practices are influenced by organisational prescribing “cultures”, informal “benchmarking” within peer networks, and prior experience with different DMTs. Health professionals differ in their perceptions of benefits and risks of DMTs and personal “thresholds” for discerning relapses and determining eligibility for DMTs. Prescribers in England felt most constrained by guidelines. Conclusion To achieve equity in access to DMTs for people with MS eligible for treatment, there is a need for public discussion acknowledging differences in health professionals’ interpretations of “relapses” and guidelines and perceptions of DMTs, variation in organisational prescribing “cultures”, and whether the prevailing culture sufficiently meets patients’ needs

Un processus d'admission aux programmes de médecine basé sur la localisation géographique n'influence pas les résultats académiques avant l'externat ni ceux à l'examen menant à l’obtention du permis d'exercice

Background: Students are selected for admission to the Northern Ontario School of Medicine University (NOSM U) MD degree program using criteria aiming to maximize access of persons thought most likely to practice in the region, including use of a geographic context score (GCS) which ranks those with lived experience in northern Ontario and/or rurality most highly. This study investigates the effect of this admissions process upon medical school academic performance.  Methods: We used a retrospective cohort design combined with multiple linear regression analysis to investigate the relationship between admission scores and performance on pre-clerkship courses, and the Medical Council of Canada Qualifying Exam Part 1 (MCCQE1). The GCS did not significantly explain performance variance on any pre-clerkship course, nor on the MCCQE1, while the undergraduate Grade Point Average correlated with most assessment scores.  The number of prior undergraduate biomedical courses predicted science and clinical skills performance, particularly in Year 1, but not with MCCQE1 scores. Performance on Year 2 courses, particularly foundational sciences and clinical skills, significantly predicted MCCQE1 scores. Results: Our data suggest that admission geographic context scoring is unrelated to future academic performance. Further, students with fewer prior undergraduate biomedical courses may benefit from increased support and/or a modified program during the early years. Contexte : La sélection étudiants à l'École de médecine du Nord de l'Ontario est fondée sur des critères visant à faciliter l’admission de candidats qu’on estime susceptibles de pratiquer dans la région. Un de ces critères est le score de contexte géographique (SCG) qui classe au premier rang les personnes ayant déjà vécu dans le Nord de l'Ontario ou en milieu rural. Cette étude examine l'effet de ce processus d'admission sur les résultats académiques des étudiants en médecine. Méthodes : Nous avons utilisé un modèle de cohorte rétrospective et une analyse par régression linéaire multiple pour étudier la relation entre les scores d'admission et les résultats obtenus aux cours avant l’externat et à l'examen d'aptitude du Conseil médical du Canada (EACMC), partie 1. Le SCG n'explique pas de manière significative la variance des résultats dans les cours pré-cliniques, ni à l'EACMC1, tandis que la moyenne pondérée cumulative au premier cycle est en corrélation avec la plupart des scores d'évaluation. Le nombre de cours en sciences biomédicales suivis dans un programme de premier cycle ont permis de prédire les résultats en sciences et en compétences cliniques, en particulier en première année, mais pas les résultats à l'EACMC1. Les résultats aux cours de deuxième année, en particulier de sciences fondamentales et de compétences cliniques, ont permis de prédire de manière significative les résultats à l'EACMC1. Résultats : Nos données portent à croire que le score de contexte géographique au moment de l'admission est sans lien avec les résultats académiques subséquents. En outre, les étudiants ayant suivi moins de cours en sciences biomédicales au premier cycle pourraient bénéficier d’un soutien plus important ou d'un programme adapté au cours des premières années

Outcomes of a research project to identify the enablers and barriers to effective preceptorship for newly qualified nurses

Poster presentationFunded by Chesterfield Royal Hospital NHS Trus

A systematic review of the effects of arbuscular mycorrhizal fungi on root-lesion nematodes Pratylenchus spp.

Root-lesion nematodes (Pratylenchus spp.) and arbuscular mycorrhizal fungi (AMF) occupy the same ecological niche in the phytobiome of many agriculturally important crops. Arbuscular mycorrhizal fungi can enhance the resistance or tolerance of a plant to Pratylenchus and previous studies have been undertaken to investigate the relationship between these organisms. A restructuring of the AMF phylum Glomeromycota has reallocated the species into genera according to molecular analysis. A systematic review of the literature was synthesized to assess the interaction between Pratylenchus spp. and AMF using the revised classification. Plants inoculated with AMF generally exhibited greater tolerance as demonstrated by increased biomass under Pratylenchus pressure. Species of AMF fromthe order Diversisporales tended to increase Pratylenchus population densities compared to those from the order Glomerales. Species from the genera Funneliformis and Glomus had a reductive effect on Pratylenchus population densities. The interaction between AMF and Pratylenchus spp. showed variation in responses as a result of cultivar, crop species, and AMF species. Putative mechanisms involved in these interactions are discussed

Effects of Noise Exposure on the Vestibular System: A Systematic Review

Despite our understanding of the impact of noise-induced damage to the auditory system, much less is known about the impact of noise exposure on the vestibular system. In this article, we review the anatomical, physiological, and functional evidence for noise-induced damage to peripheral and central vestibular structures. Morphological studies in several animal models have demonstrated cellular damage throughout the peripheral vestibular system and particularly in the otolith organs; however, there is a paucity of data on the effect of noise exposure on human vestibular end organs. Physiological studies have corroborated morphological studies by demonstrating disruption across vestibular pathways with otolith-mediated pathways impacted more than semicircular canal-mediated pathways. Similar to the temporary threshold shifts observed in the auditory system, physiological studies in animals have suggested a capacity for recovery following noise-induced vestibular damage. Human studies have demonstrated that diminished sacculo-collic responses are related to the severity of noise-induced hearing loss, and dose-dependent vestibular deficits following noise exposure have been corroborated in animal models. Further work is needed to better understand the physiological and functional consequences of noise-induced vestibular impairment in animals and humans

What do older people do when sitting and why? Implications for decreasing sedentary behaviour

Background and Objectives: Sitting less can reduce older adults’ risk of ill health and disability. Effective sedentary behavior interventions require greater understanding of what older adults do when sitting (and not sitting), and why. This study compares the types, context, and role of sitting activities in the daily lives of older men and women who sit more or less than average. Research Design and Methods: Semistructured interviews with 44 older men and women of different ages, socioeconomic status, and objectively measured sedentary behavior were analyzed using social practice theory to explore the multifactorial, inter-relational influences on their sedentary behavior. Thematic frameworks facilitated between-group comparisons. Results: Older adults described many different leisure time, household, transport, and occupational sitting and non-sitting activities. Leisure-time sitting in the home (e.g., watching TV) was most common, but many non-sitting activities, including “pottering” doing household chores, also took place at home. Other people and access to leisure facilities were associated with lower sedentary behavior. The distinction between being busy/not busy was more important to most participants than sitting/not sitting, and informed their judgments about high-value “purposeful” (social, cognitively active, restorative) sitting and low-value “passive” sitting. Declining physical function contributed to temporal sitting patterns that did not vary much from day-to-day. Discussion and Implications: Sitting is associated with cognitive, social, and/or restorative benefits, embedded within older adults’ daily routines, and therefore difficult to change. Useful strategies include supporting older adults to engage with other people and local facilities outside the home, and break up periods of passive sitting at home