Exploring the psychosocial experiences of adolescents with sequential cochlear implants

Section A is a review of the literature on the psychological and social implications of cochlear implants (CIs) in deaf children and adolescents. The literature is critically evaluated in relation to health-related quality of life, quality of life, psychological and emotional well-being, social well-being and identity. Relevant theories are outlined and discussed. Methodological limitations and gaps in the literature are discussed, and the review concludes with recommendations for further research. Section B describes a study using Interpretative Phenomenological Analysis to explore adolescent experiences of receiving and living with sequential cochlear implants (SCIs). Semi-structured interviews were conducted with eleven adolescents. The master and sub-themes are presented and the results are discussed with consideration of previous research findings and theoretical, clinical and research implications. Most participants enjoyed improved confidence and social well-being following their SCI, and felt that two CIs were superior to one. The majority identified themselves as hearing and deaf, but not culturally Deaf, as they strived to live in the hearing world. However, this was not without challenges and many young people experienced feelings of difference in the hearing world. These findings have clinical implications in terms of the role of clinical psychologists in CI clinics, and in providing information to families making decisions about CIs. These findings add to the emergent deaf identity development literature in young people with CIs

Effect of sterilization by gamma radiation on nano-mechanical properties of teeth

NOTICE: this is the author’s version of a work that was accepted for publication in Dental Materials. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Dental Materials, [VOL 24, ISSUE 8, (2008)] DOI: 10.1016/j.dental.2008.02.016.Objectives: Extracted teeth used in dental research need to be considered infective and hence be sterilized without the materials' properties being altered. This study examined the effect of gamma radiation on the nano-mechanical properties of dentin and enamel of extracted human third molars. Methods: Whole teeth were sterilized using gamma radiation doses of 7kGy and 35kGy, respectively; teeth of the control group were not treated with gamma radiation. Crowns were sectioned occlusally and polished. Elastic modulus and hardness were tested using atomic force microscopy with nano-indentations under wet conditions. Results: The authors found no significant dose-response relationship in elastic modulus or hardness in either dentin or enamel. Significance: Nano-indentation is a common technique for the determination of local mechanical properties in biological hard tissues. Gamma radiation is an efficient way to sterilize extracted teeth while alteration of dentin and enamel mechanical properties are minimized

The tandem radical route to indole alkaloids: an unusual rearrangement reaction

Cyclisation of the precursor 6 under standard radical conditions yields the tetracyclic structure 7 which represents the core of a number of indole alkaloids along with the novel tetracycle 13

Totem and Taboo: Fluids in sepsis

The need for early, rapid, and substantial fluid resuscitation in septic patients has long been an article of faith in the intensive care community, a tribal totem that is taboo to question. The results of a recent multicenter trial in septic children in Africa, published in The New England Journal of Medicine, powerfully challenge the fluid paradigm. The salient aspects of the trial need to be understood and reflected upon. In this commentary, we discuss the background to and findings of the trial and explain why they will likely trigger a re-evaluation of our thinking about fluids in sepsis, a re-evaluation that is already happening in the treatment of acute respiratory distress syndrome and acute kidney injury and in postoperative care

Teenagers’ understandings of and attitudes towards vaccines and vaccine-preventable diseases: a qualitative study

<p>Background: To examine immunisation information needs of teenagers we explored understandings of vaccination and vaccine-preventable diseases, attitudes towards immunisation and experiences of immunisation. Diseases discussed included nine for which vaccines are currently offered in the UK (human papillomavirus, meningitis, tetanus, diphtheria, polio, whooping cough, measles, mumps and rubella), and two not currently included in the routine UK schedule (hepatitis B and chickenpox).</p> <p>Methods Twelve focus groups conducted between November 2010 and March 2011 with 59 teenagers (29 girls and 30 boys) living in various parts of Scotland.</p> <p>Results Teenagers exhibited limited knowledge and experience of the diseases, excluding chickenpox. Measles, mumps and rubella were perceived as severe forms of chickenpox-like illness, and rubella was not associated with foetal damage. Boys commonly believed that human papillomavirus only affects girls, and both genders exhibited confusion about its relationship with cancer. Participants considered two key factors when assessing the threat of diseases: their prevalence in the UK, and their potential to cause fatal or long-term harm. Meningitis was seen as a threat, but primarily to babies. Participants explained their limited knowledge as a result of mass immunisation making once-common diseases rare in the UK, and acknowledged immunisation's role in reducing disease prevalence.</p> <p>Conclusions While it is welcome that fewer teenagers have experienced vaccine-preventable diseases, this presents public health advocates with the challenge of communicating benefits of immunisation when advantages are less visible. The findings are timely in view of the Joint Committee on Vaccination and Immunisation's recommendation that a booster of meningitis C vaccine should be offered to teenagers; that teenagers did not perceive meningitis C as a significant threat should be a key concern of promotional information. While teenagers’ experiences of immunisation in school were not always positive, they seemed enthusiastic at the prospect of introducing more vaccines for their age group.</p&gt

Use of multiple primers in RAPD analysis of clonal organisms provides limited improvement in discrimination

Randomly amplified polymorphic DNA (RAPD) analysis using two or more primers has been reported to provide additional discriminatory ability over one primer used individually. This may be of particular application in epidemiological typing of clonal organisms, such as Shiga toxin-producing E. coli O157, where strain differentiation can be difficult. Using four arbitrary primers individually, and in all possible permutations, E. coli O157 isolates and other arbitrarily chosen E. coli strains were typed using RAPD analysis. For most nonclonal strains, the use of two primers resulted in increased differentiation between isolates; however, more than two primers did not increase further the discriminatory capacity. E. coli O157 isolates that produced virtually identical profiles using one primer did not show increased differentiation when using two or more primers, demonstrating that in some cases, where strains of an organism are highly related, there is limited advantage to using more than one primer in RAPD analysis