Safe and effective prescribing with dyslexia

Background: The term ‘dyslexia’ refers to a condition that impacts upon reading and writing abilities whilst not altering intelligence. Individuals with dyslexia may have difficulties with the speed and accuracy and their reading and writing, amongst other issues. Dyslexia is not automatically considered a disability but is a protected characteristic under the UK Equality Act (2010), and therefore employers and educational institutions are required to provide ‘reasonable adjustments’ in order to allow individuals to reach their full potential. There is a lack of research on this issue, but what little there is suggests that doctors feel as though any support they received ended when they graduated from medical school. Main body: A core distinction between medical school and medical practice is the requirement to prescribe medicines as registered medical practitioners. Junior doctors have to master this complex and potentially hazardous skill “on the job”, with a perceived lack of support. Here, we open up a debate about the potential impact of dyslexia on prescribing, and the need to find supports that may be effective in enabling doctors with dyslexia prescribe medicines safely and effectively – and thus reach their full potential as medical practitioners and promote patient safety. Conclusion: We argue that medical schools and hospitals could immediately provide dyslexia awareness training in both undergraduate and postgraduate settings. We discuss electronic prescribing systems, and conclude that research is required to identify effective supports for junior doctors with dyslexia

A Guyon's canal ganglion presenting as occupational overuse syndrome: A case report

<p>Abstract</p> <p>Background</p> <p>Occupational overuse syndrome (OOS) can present as Guyon's canal syndrome in computer keyboard users. We report a case of Guyon's canal syndrome caused by a ganglion in a computer user that was misdiagnosed as OOS.</p> <p>Case presentation</p> <p>A 54-year-old female secretary was referred with a six-month history of right little finger weakness and difficulty with adduction. Prior to her referral, she was diagnosed by her general practitioner and physiotherapist with a right ulnar nerve neuropraxia at the level of the Guyon's canal. This was thought to be secondary to computer keyboard use and direct pressure exerted on a wrist support. There was obvious atrophy of the hypothenar eminence and the first dorsal interosseous muscle. Both Froment's and Wartenberg's signs were positive. A nerve conduction study revealed that both the abductor digiti minimi and the first dorsal interosseus muscles showed prolonged motor latency. Ulnar conduction across the right elbow was normal. Ulnar sensory amplitude across the right wrist to the fifth digit was reduced while the dorsal cutaneous nerve response was normal. Magnetic resonance imaging of the right wrist showed a ganglion in Guyon's canal. Decompression of the Guyon's canal was performed and histological examination confirmed a ganglion. The patient's symptoms and signs resolved completely at four-month follow-up.</p> <p>Conclusion</p> <p>Clinical history, occupational history and examination alone could potentially lead to misdiagnosis of OOS when a computer user presents with these symptoms and we recommend that nerve conduction or imaging studies be performed.</p

Human Factors Certification of Advanced Aviation Technologies

Proceedings of the Human Factors Certification of Advanced Aviation Technologies Conference held at the Chateau de Bonas, near Toulouse, France, 19-23 July 1993

Three-dimensional laser surface imaging and geometric morphometrics resolve frontonasal dysmorphology in schizophrenia.

BACKGROUND: Although a role for early developmental disturbance(s) in schizophrenia is postulated, it has proved difficult to identify hard, biological evidence. The brain and face emerge in embryologic intimacy, such that in neurodevelopmental disorders, brain dysmorphogenesis is accompanied by facial dysmorphogenesis. METHODS: Three-dimensional (3D) laser surface imaging was used to capture the facial surface of patients and control subjects in 37 male and 32 female patients who satisfied DSM-IV criteria for schizophrenia in comparison with 58 male and 34 female control subjects. Surface images were analyzed using geometric morphometrics and 3D visualizations to identify domains of facial shape that distinguish patients from control subjects. RESULTS: Both male and, particularly, female patients evidenced significant facial dysmorphology. There was narrowing and reduction of the mid to lower face and frontonasal prominences, including reduced width and posterior displacement of the mouth, lips, and chin; increased width of the upper face, mandible, and skull base, with lateral displacement of the cheeks, eyes, and orbits; and anterior displacement of the superior margins of the orbits. CONCLUSIONS: The frontonasal prominence, which enjoys the most intimate embryologic relationship with the anterior brain and also orchestrates aspects of development in maxillary and mandibular domains, evidences a characteristic topography of dysmorphogenesis in schizophrenia

Cavity Quantum Electrodynamics with Anderson-localized Modes

A major challenge in quantum optics and quantum information technology is to enhance the interaction between single photons and single quantum emitters. Highly engineered optical cavities are generally implemented requiring nanoscale fabrication precision. We demonstrate a fundamentally different approach in which disorder is used as a resource rather than a nuisance. We generate strongly confined Anderson-localized cavity modes by deliberately adding disorder to photonic crystal waveguides. The emission rate of a semiconductor quantum dot embedded in the waveguide is enhanced by a factor of 15 on resonance with the Anderson-localized mode and 94 % of the emitted single-photons couple to the mode. Disordered photonic media thus provide an efficient platform for quantum electrodynamics offering an approach to inherently disorder-robust quantum information devices

Physicochemical properties of whole milk powder derived from cows fed pasture or total mixed ration diets

peer-reviewedThis study examined the effect of dietary factors on compositional and functional properties of whole milk powder (WMP) produced from bovine milk. Raw milk samples were obtained from 3 groups of 18 Holstein Friesian spring-calving cows randomly assigned to diets based on perennial ryegrass (GRS), perennial ryegrass/white clover sward (CLV), and total mixed ration (TMR). Raw milks obtained in late lactation were subsequently standardized for fat, heat-treated (90°C for 30 s), evaporated, and homogenized before spray drying. The WMP produced from each diet were analyzed to determine differences in color, particle size distribution, heat coagulation time, yogurt gelation, texture profile, and protein profile due to each diet. Significant differences in heat coagulation time were observed between the CLV and TMR samples, whereas color values were significantly different between GRS and TMR samples. No significant differences in gross composition, protein profile, or whey protein nitrogen index were found between the 3 WMP samples. Average D90 values (the particle size at which 90% of the particles were smaller than the specified size) for fat globules were significantly lower in the TMR sample compared with the GRS and CLV samples. Yogurts produced from GRS- and CLV-derived WMP had significantly higher elastic moduli (G′) than those produced from TMR-derived WMP. Similarly, texture profile analysis revealed significantly higher firmness values in yogurt samples derived from CLV compared with TMR samples. Our data characterize the effect of these diets on the composition and functional properties of fat-standardized WMP, suggesting better yogurt functionality and thermal stability in WMP derived from pasture-based bovine diets

The learning experiences of dyslexic medical students during the COVID‑19 pandemic: a phenomenological study

Dyslexia is a Specific Learning Difficulty that impacts on reading and writing abilities. During the COVID-19 pandemic, medical schools have been forced to undertake distance learning and assessment. The wider literature suggested that e-learning might pose additional challenges for dyslexic students. Here we explore their overall experiences of learning/studying during this time in a phenomenological study. Five medical students were interviewed in depth and the audio-recordings were transcribed verbatim. Transcripts then underwent an interpretive phenomenological analysis. Our results highlighted a largely positive experience, with an improved culture of togetherness, freedom and sense of control. They also revealed issues with a lack of clinical exposure, potential negative impacts on ranking positions for those with dyslexia, and possible cheating in exams. There are some surprising results—in particular the positive responses to how remote learning was delivered. These seemed to put our participants more on a par with their non-dyslexic colleagues—except in some examinations. It is our hope that medical educators may resist a return to ‘the way things have always been done’ when the pandemic has resolved, and by doing so, continue to foster this new, positive culture and paradigm shift

Medical students’ attitudes towards and beliefs about dyslexia: a single-centre survey study

Dyslexia impacts upon reading and writing, but not upon intelligence. Little research has explored dyslexia in medicine. An online questionnaire was emailed to all medical students within a single medical school, inviting them to participate. Results were analysed using descriptive statistics. Statistical significance was calculated for any differences between gender, age group, or year-group cohorts. 123 individuals responded. Most reported a good understanding of dyslexia, and feelings that their peers with it should be supported. However, a minority reported feelings of jealously, and dissatisfaction – feeling that students with dyslexia should not be supported, as this gives them an unfair advantage. In some, this seemed to stem from a belief that dyslexia were not real, or that their peers were “faking it”. “I think it is a poor excuse for students to be favoured advantageously and receive tremendous benefits. It is certainly not a medical problem.

Predicting three-dimensional ground reaction forces in running by using artificial neural networks and lower body kinematics

This study explored the use of artificial neural networks in the estimation of runners' kinetics from lower body kinematics. Three supervised feed-forward artificial neural networks with one hidden layer each were modelled and assigned individually with the mapping of a single force component. Number of training epochs, batch size and dropout rate were treated as modelling hyper-parameters and their values were optimised with a grid search. A public data set of twenty-eight professional athletes containing running trails of different speeds (2.5 m/sec, 3.5 m/sec and 4.5 m/sec) was employed to train and validate the networks. Movements of the lower limbs were captured with twelve motion capture cameras and an instrumented dual-belt treadmill. The acceleration of the shanks was fed to the artificial neural networks and the estimated forces were compared to the kinetic recordings of the instrumented treadmill. Root mean square error was used to evaluate the performance of the models. Predictions were accompanied with low errors: 0.134 BW for the vertical, 0.041 BW for the anteroposterior and 0.042 BW for the mediolateral component of the force. Vertical and anteroposterior estimates were independent of running speed (p=0.233 and p=.058, respectively), while mediolateral results were significantly more accurate for low running speeds (p=0.010). The maximum force mean error between measured and estimated values was found during the vertical active peak (0.114 ± 0.088 BW). Findings indicate that artificial neural networks in conjunction with accelerometry may be used to compute three-dimensional ground reaction forces in running