Randomised controlled trial of atraumatic versus standard needles for diagnostic lumbar puncture

OBJECTIVE: To compare the ease of use of atraumatic needles with standard needles for diagnostic lumbar puncture and the incidence of headache after their use. DESIGN: Double blind, randomised controlled trial. SETTING: Investigation ward of a neurology unit in a university hospital. PARTICIPANTS: 116 patients requiring elective diagnostic lumbar puncture. INTERVENTIONS: Standardised protocol for lumbar puncture with 20 gauge atraumatic or standard needles. Outcome measures: The primary end point was intention to treat analysis of incidence of moderate to severe headache, assessed at one week by telephone interview. Secondary end points were incidence of headache at one week analysed by needle type, ease of use by operator according to a visual analogue scale, incidence of backache, and failure rate of puncture. RESULTS: Valid outcome data were available for 97 of 101 patients randomised. Baseline characteristics were matched except for higher body mass index in the standard needle group. By an intention to treat analysis the absolute risk of moderate to severe headache with atraumatic needles was reduced by 26% (95% confidence interval 6% to 45%) compared with standard needles, but there was a non-significantly greater absolute risk of multiple attempts at lumbar puncture (14%, -4% to 32%). Higher body mass index was associated with an increased failure rate with atraumatic needles, but the reduced incidence of headache was maintained. The need for medical interventions was reduced by 20% (1% to 40%). CONCLUSIONS: Atraumatic needles significantly reduced the incidence of moderate to severe headache and the need for medical interventions after diagnostic lumbar punctures, but they were associated with a higher failure rate than standard needles

Book Review: Researching Internet Governance: Methods, Frameworks, Futures. Laura DeNardis, Derrick Cogburn, Nanette S. Levinson, and Francesca Musiani (eds.). Cambridge, MA: MIT Press.

Laura DeNardis, Derrick L. Cogburn, Nanette S. Levinson, and Francesca Musiani (Eds.), Researching Internet Governance: Methods, Frameworks, Futures, Cambridge, MA: MIT Press, 2020, 324 pp., $35.00 (paperback). Reviewed by Thomas Jamieson University of Nebraska at Omaha, USA In January 2021, pro-Trump protesters forced their way into the U.S. Capitol building, inspired by White supremacist and conspiracy theories spread on Twitter, Facebook, 4chan, TheDonald.win, Parler, 8kun, Telegram, and far-right message boards (Harwell, Stanley-Becker, Nakhlawi, & Timberg, 2021). Twitter and Facebook belatedly banned thousands of accounts, including the sitting president’s accounts, sparking an ongoing debate about the limits of free speech, tech companies’ power, the responsibility to regulate hateful and violent rhetoric, and how the Internet should governed and by who

“Go Hard, Go Early”: Preliminary Lessons From New Zealand’s Response to COVID-19

Although the full impact of the novel coronavirus (COVID-19) pandemic is yet to be realized, New Zealand has suffered comparatively less than other countries, and there were no active cases in the country by June 8, 2020. Building from best practices in emergency management research, several preliminary lessons emerge from the country’s response to the crisis that could be adapted for other settings. In particular, the government acted early and decisively, developed national unity to combat the virus, communicated effectively with the public, and adapted to changing circumstances, especially to address shortcomings in the response. These preliminary lessons provide some guidance in how to effectively respond to the virus through proactive, evidence-based, well-communicated policies

Tropical Abscess of the Liver in the Straits Settlements, with note of fifteen cases

In this thesis I propose to deal with the so-called solitary abscess of the liver as it occurs in the tropics, and not with hepatic abscesses due to pyaemia, or secondary septic infections from other foci of disease, such as may occur following appendicular abscess, or other lesions in the stomach, bowel, gall-bladder or pelvis. Nor do I include abscesses following an injury to the liver, or in connection with hydatid disease. An experience of general practice in the Straits Settlements, extending over twelve years, goes to prove that liver abscess is fairly common in that part of the world, though Scheube (1) says that "a few tropical regions such as Singapore are free of it". During the last twelve years I have had fifteen cases of liver abscess under my care in Penang, which has a European population of about five hundred and a native population of over ninety thousand, of whom only a small proportion have adopted European methods of treatment. The average annual admission rate of such cases to the General Hospital, Penang, has been from three to five cases, whilst in Singapore with a population of about a hundred and fifty thousand, from twelve to fifteen cases have been admitted yearly to the General Hospital there. These figures do not include cases occurring in the troops which are treated in the military hospitals, nor cases admitted to the Pauper Hospital, Penang or to the Tan LTock Seng Hospital, Singapore, A certain number of cases undoubtedly occur amongst the Chinese and other natives, who are treated by their own doctors and priests. Cases of liver abscess are also not uncommon amongst the planters in the Federated Malay States, and, these caseshave been more frequent during the last four or five years, since the enormous spread of the rubber-growing industry has attracted to the country a rapidly increasing number of Europeans of an age between twenty and forty-five, which seems to be the most favourable time for the development of this disease. This is not to be wondered at, when one considers that the conditions of a planter's life are such as to expose him to greater risks from sun-stroke, from chills either after perspiring profusely, or after being soaked with rain, and from drinking contaminated water, than fall to the lot of the dweller in towns where the water supply is good, and where there is no necessity for one to-be exposed either to the sun or to rain

The Effects of Certain and Uncertain Incentives on Effort and Knowledge Accuracy

In many situations, incentives exist to acquire knowledge and make correct political decisions. We conduct an experiment that contributes to a small but growing literature on incentives and political knowledge, testing the effect of certain and uncertain incentives on knowledge. Our experiment builds on the basic theoretical point that acquiring and using information is costly, and incentives for accurate answers will lead respondents to expend greater effort on the task and be more likely to answer knowledge questions correctly. We test the effect of certain and uncertain incentives and find that both increase effort and accuracy relative to the control condition of no incentives for accuracy. Holding constant the expected benefit of knowledge, we do not observe behavioral differences associated with the probability of earning an incentive for knowledge accuracy. These results suggest that measures of subject performance in knowledge tasks are contingent on the incentives they face. Therefore, to ensure the validity of experimental tasks and the related behavioral measures, we need to ensure a correspondence between the context we are trying to learn about and our experimental design

Protecting Human Subjects in the Digital Age: Issues and Best Practices of Data Protection

Public opinion and survey researchers must protect the privacy and confidentiality of human subjects. However, scholars are often not trained in the best practices of data storage, and there is a serious risk that survey data might be compromised by pernicious actors. In an era when it is becoming increasingly difficult to recruit participants, breaches could further challenge our ability to conduct surveys if we cannot guarantee that participants’ data will remain confidential and private. While any computer-based data has some vulnerability, we introduce simple measures that will better protect the confidentiality and privacy of human subjects. We hope these could become standard practice to protect human subjects in the future

RCN Sexual Health Strategy - Guidance for Nursing Staff

This RCN sexual health strategy has been developed to help nurses work effectively in the challenging and sensitive field of sexuality and sexual health. It is aimed at nursing staff working across a range of settings from hospital to care home, and is intended to help shape and inform their nursing practice. The document provides recommendations for future practice development, education, policy implementation and research.These will act as the foundation for the RCN Sexual Health Programme

Incorporating Research Design in Public Diplomacy: The Role of Listening to Foreign Publics

Research design involves a set of decisions regarding what or who will be studied and the procedures in acquiring and analyzing information. In this article, we apply lessons from research design to public diplomacy, a field focused on engaging with foreign publics. Much prior scholarship sheds light on what PD is and its programs, but less attention has been given to the role of listening to understand what foreign publics think and believe. We propose three interrelated recommendations to improve the quality of implementing PD programs. First, before any program is implemented, we need to correctly identify a perceived issue that requires a program. Once we confirm if the issue exists, we also need to understand why it exists. Second, designing PD programs with clear goals increases the effectiveness of the program and the ability to confirm its success. This requires designing programs unique to each case. Third, public opinion data should be collected at several points—taking advantage of time—to confirm the effectiveness of programs. Our recommendations are particularly valuable for policy makers

Resilience-Focused Journalism: The Motivations, Tactics, and Impact of the Los Angeles Times Coverage of Earthquake Risk

As disasters and climate change threaten more and more people around the world, it is increasingly important for communities to adopt resilience policies. However, despite considerable benefits and the high probability of a return on investment, resilience policies are often neglected. In this article, we examine the agenda setting campaign by the Los Angeles Times that helped create the conditions for mandatory retrofitting ordinances to succeed where previous attempts failed. Through in-depth interviews with journalists and editors at the Times, and policymakers involved in the debate, we illustrate the motivations, tactics, and impact of their coverage of earthquake risk in Southern California. The article contributes to the understanding of agenda setting, risk communication, and local news production by demonstrating why and how journalists can effectively communicate risks and enable policy change, which could apply to a range of environmental threats

Parallel LISP

Projects in the past few years have looked into the problem of automatic parallelization of the Lisp programming language. Since it appears to be feasible to adapt Lisp to run on a general parallel computer, an implementation will be developed. This implementation will be as general as possible in order to locate the tradeoffs between implementing Lisp on a general parallel computer versus having an efficient interpreter. This implementation can be used to study the execution characteristics of Lisp in a parallel environment. It can also be used to derive information about architectural features which affect the performance of Lisp on parallel machines. This implementation will use a multitasking system and interprocess communication to simulate an MIMD machine. The implementation will include the formation, queuing, distribution, and execution of dataflow frames. Realistic Lisp application programs will be used with the implementation to examine the feasibility and efficiency of parallel Lisp. Measurements derivable from the simulator include number of processor cycles, processor utilization, memory requirements, and speedup. These tests will provide two main results. First, they will indicate possibilities for further gains by illustrating the bottlenecks in such a scheme. Second, they will help determine if it is indeed feasible to run Lisp on a parallel machine or if instead the overhead is too high for the application to be profitable. Most likely, some parallelism will be profitable. The simulation will provide information on the extent to which parallelism can be utilized