873 research outputs found

    An assessment of anxiety levels in dyslexic students in higher education

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    Background: It has long been hypothesized that children with learning disabilities, including dyslexia, may be highly vulnerable to emotional consequences such as anxiety. However, research has centred on school aged children. Aims: The present study aimed to clarify these findings with dyslexic students in higher education. Samples: 16 students with dyslexia were compared to 16 students with no history of learning difficulties. Methods: Students were asked to complete a verbal questionnaire concerning trait anxiety levels. They were then told that they would be given a timed reading test and their state anxiety levels were measured using the State‐Trait Anxiety Inventory (STAI; Spielberger, Gorsuch, & Lushene, 1983). Finally their reading was assessed using the Test of Word Reading Efficiency (Torgesen, Wagner & Rashotte, 1999). Results: Dyslexic students showed slower reading speeds than controls. They also had higher levels of state anxiety and elevated levels of academic and social, but not appearance anxiety. Conclusions: Dyslexic students in higher education show anxiety levels that are well above what is shown by students without learning difficulties. This anxiety is not limited to academic tasks but extends to many social situations. It is proposed that assessment of emotional well‐being should form part of the assessment of need for dyslexic students entering higher education

    Early Glycemic Control in Critically Ill Emergency Department Patients: Pilot Trial

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    Objective: Glycemic control in the critically ill intensive care unit (ICU) patient has been shown to improve morbidity and mortality. We sought to investigate the effect of early glycemic control in critically ill emergency department (ED) patients in a small pilot trial.Methods: Adult non-trauma, non-pregnant ED patients presenting to a university tertiary referral center and identified as critically ill were eligible for enrollment on a convenience basis. Critical illness was determined upon assignment for ICU admission. Patients were randomized to either ED standard care or glycemic control. Glycemic control involved use of an insulin drip to maintain blood glucose levels between 80-140 mg/dL. Glycemic control continued until ED discharge. Standard patients were managed at ED attending physician discretion. We assessed severity of illness by calculation of APACHE II score. The primary endpoint was in-hospital mortality. Secondary endpoints included vasopressor requirement, hospital length of stay, and mechanical ventilation requirement.Results: Fifty patients were randomized, 24 to the glycemic group and 26 to the standard care cohort. Four of the 24 patients (17%) in the treatment arm did not receive insulin despite protocol requirements. While receiving insulin, three of 24 patients (13%) had an episode of hypoglycemia. By chance, the patients in the treatment group had a trend toward higher acuity by APACHE II scores. Patient mortality and morbidity were similar despite the acuity difference.Conclusion: There was no difference in morbidity and mortality between the two groups. The benefit of glycemic control may be subject to source of illness and to degree of glycemic control, or have no effect. Such questions bear future investigation. [West J Emerg Med. 2010; 11(1):20-23]

    Habitat Segregation among Trophic Morphs of the Cuatro Ciénegas Cichlid (Herichthys minckleyi

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    Herichthys minckleyi is an endangered, trophically polymorphic cichlid endemic to the Cuatro Ciénegas basin of Coahuila, Mexico. A molariform morph has stout pharyngeal teeth whereas a papilliform morph has numerous fine pharyngeal teeth. Individuals with intermediate pharyngeal dentition also exist, as does yet another morph, called piscivore. Previous studies indicated that morphs utilize different food sources, thus suggesting morph-specific spatial segregation, since food resource availability is spatially heterogeneous. We present data from an observational study of all morphs (but focusing on the three most common, normal-bodied ones molariform, papilliform and intermediate) in a single spring pool, Poza Mojarral Oeste. We analyzed morph distribution in relation to habitat types, and document morph-specific differences in feeding behavior. Spatio-temporal habitat partitioning was also investigated. Habitat use by molariform, papilliform, and intermediate morphs was found to be non-random. Morphs differed in habitat use, albeit with considerable overlap. Strong segregation among morphs was not detected in any season or time of day, but habitat use patterns varied seasonally within each morph and were consistently different among morphs. All morphs behave basically as feeding generalists. This endangered species may prove more difficult to manage than other, non-polymorphic species. It is clearly important to manage not only for the maintenance of the species, but also for maintenance of its different morphs, which our study indicates may each require different mixes of habitat types. We thus hypothesize that any changes in habitat heterogeneity will lead to altered proportions of the different morphs of the species

    Formation and Evolution of Planetary Systems: Cold Outer Disks Associated with Sun-like stars

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    We present the discovery of debris systems around three solar mass stars based upon observations performed with the Spitzer Space Telescope as part of a Legacy Science Program, ``the Formation and Evolution of Planetary Systems'' (FEPS). We also confirm the presence of debris around two other stars. All the stars exhibit infrared emission in excess of the expected photospheres in the 70 micron band, but are consistent with photospheric emission at <= 33 micron. This restricts the maximum temperature of debris in equilibrium with the stellar radiation to T < 70 K. We find that these sources are relatively old in the FEPS sample, in the age range 0.7 - 3 Gyr. Based on models of the spectral energy distributions, we suggest that these debris systems represent materials generated by collisions of planetesimal belts. We speculate on the nature of these systems through comparisons to our own Kuiper Belt, and on the likely planet(s) responsible for stirring the system and ultimately releasing dust through collisions. We further report observations of a nearby star HD 13974 (d =11 pc) that is indistinguishable from a bare photosphere at both 24 micron and 70 micron. The observations place strong upper limits on the presence of any cold dust in this nearby system (L_IR/L_* < 10^{-5.2}).Comment: 31 pages, 9 figures, accepted for publication in Ap

    A theory of mobile library service delivery

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    Research indicates there is widespread acceptance that nomadicity of library users is a phenomenon that will continue to increase; however, mobile learning is a resource that relatively few academic libraries appear to be taking advantage of. This paper presents a model developed during an investigation using a grounded theory approach into factors that may contribute to the delivery of library services to mobile technologies. A sample of 42 professionally qualified library staff from the Australasian vocational education and training (VET) sector was investigated to determine how confident and capable library staff believed they were to respond to technology advancement challenges and the training and support required for that response. The resulting theoretical model explains the impact of mobile technologies on library services and highlights the complex factors contributing to mobile technology acceptance at both an organisational and individual level. The presence of a series of catalysing impacts forms a central core and their management can enable an organisation to move from a position of uncertainty to one where the consequences of mobile technologies have been normalised

    Dendritic Cell-Derived TSLP Negatively Regulates HIF-1α and IL-1ÎČ during Dectin-1 signaling

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    This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Thymic stromal lymphopoietin (TSLP) is a functionally pleotropic cytokine important in immune regulation, and TSLP dysregulation is associated with numerous diseases. TSLP is produced by many cell types, but has predominantly been characterized as a secreted factor from epithelial cells which activates dendritic cells (DC) that subsequently prime T helper (TH) 2 immunity. However, DC themselves make significant amounts of TSLP in response to microbial products, but the functional role of DC-derived TSLP remains unclear. We show that TSLPR signaling negatively regulates IL-1ÎČ production during dectin-1 stimulation of human DC. This regulatory mechanism functions by dampening Syk phosphorylation and is mediated via NADPH oxidase-derived ROS, HIF-1α and pro-IL-1ÎČ expression. Considering the profound effect TSLPR signaling has on the metabolic status and the secretome of dectin-1 stimulated DC, these data suggest that autocrine TSLPR signaling could have a fundamental role in modulating immunological effector responses at sites removed from epithelial cell production of TSLP

    Development of a Management Algorithm for Post-operative Pain (MAPP) after total knee and total hip replacement: study rationale and design.

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    BACKGROUND: Evidence from clinical practice and the extant literature suggests that post-operative pain assessment and treatment is often suboptimal. Poor pain management is likely to persist until pain management practices become consistent with guidelines developed from the best available scientific evidence. This work will address the priority in healthcare of improving the quality of pain management by standardising evidence-based care processes through the incorporation of an algorithm derived from best evidence into clinical practice. In this paper, the methodology for the creation and implementation of such an algorithm that will focus, in the first instance, on patients who have undergone total hip or knee replacement is described. METHODS: In partnership with clinicians, and based on best available evidence, the aim of the Management Algorithm for Post-operative Pain (MAPP) project is to develop, implement, and evaluate an algorithm designed to support pain management decision-making for patients after orthopaedic surgery. The algorithm will provide guidance for the prescription and administration of multimodal analgesics in the post-operative period, and the treatment of breakthrough pain. The MAPP project is a multisite study with one coordinating hospital and two supporting (rollout) hospitals. The design of this project is a pre-implementation-post-implementation evaluation and will be conducted over three phases. The Promoting Action on Research Implementation in Health Services (PARiHS) framework will be used to guide implementation. Outcome measurements will be taken 10 weeks post-implementation of the MAPP. The primary outcomes are: proportion of patients prescribed multimodal analgesics in accordance with the MAPP; and proportion of patients with moderate to severe pain intensity at rest. These data will be compared to the pre-implementation analgesic prescribing practices and pain outcome measures. A secondary outcome, the efficacy of the MAPP, will be measured by comparing pain intensity scores of patients where the MAPP guidelines were or were not followed. DISCUSSION: The outcomes of this study have relevance for nursing and medical professionals as well as informing health service evaluation. In establishing a framework for the sustainable implementation and evaluation of a standardised approach to post-operative pain management, the findings have implications for clinicians and patients within multiple surgical contexts

    Not all coping strategies are created equal: a mixed methods study exploring physicians' self reported coping strategies

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    <p>Abstract</p> <p>Background</p> <p>Physicians experience workplace stress and draw on different coping strategies. The primary goal of this paper is to use interview data to explore physicians' self reported coping strategies. In addition, questionnaire data is utilized to explore the degree to which the coping strategies are used and are associated with feelings of emotional exhaustion, a key symptom of burnout.</p> <p>Methods</p> <p>This mixed methods study explores factors related to physician wellness within a large health region in Western Canada. This paper focuses on the coping strategies that physicians use in response to work-related stress. The qualitative component explores physicians' self reported coping strategies through open ended interviews of 42 physicians representing diverse medical specialties and settings (91% response rate). The major themes extracted from the qualitative interviews were used to construct 12 survey items that were included in the comprehensive quantitative questionnaire. Questionnaires were sent to all eligible physicians in the health region with 1178 completed surveys (40% response rate.) Questionnaire items were used to measure how often physicians draw on the various coping strategies. Feelings of burnout were also measured in the survey by 5 items from the Emotional Exhaustion subscale of the revised Maslach Burnout Inventory.</p> <p>Results</p> <p>Major themes identified from the interviews include coping strategies used at work (e.g., working through stress, talking with co-workers, taking a time out, using humor) and after work (e.g., exercise, quiet time, spending time with family). Analysis of the questionnaire data showed three often used workplace coping strategies were positively correlated with feeling emotionally exhausted (i.e., keeping stress to oneself (r = .23), concentrating on what to do next (r = .16), and going on as if nothing happened (r = .07)). Some less often used workplace coping strategies (e.g., taking a time out) and all those used after work were negatively correlated with frequency of emotional exhaustion.</p> <p>Conclusions</p> <p>Physicians' self reported coping strategies are not all created equal in terms of frequency of use and correlation with feeling emotionally exhausted from one's work. This knowledge may be integrated into practical physician stress reduction interventions.</p
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