The motivating operation and negatively reinforced problem behavior. A systematic review.

The concept of motivational operations exerts an increasing influence on the understanding and assessment of problem behavior in people with intellectual and developmental disability. In this systematic review of 59 methodologically robust studies of the influence of motivational operations in negative reinforcement paradigms in this population, we identify themes related to situational and biological variables that have implications for assessment, intervention, and further research. There is now good evidence that motivational operations of differing origins influence negatively reinforced problem behavior, and that these might be subject to manipulation to facilitate favorable outcomes. There is also good evidence that some biological variables warrant consideration in assessment procedures as they predispose the person's behavior to be influenced by specific motivational operations. The implications for assessment and intervention are made explicit with reference to variables that are open to manipulation or that require further research and conceptualization within causal models

All coffee types decrease the risk of adverse clinical outcomes in chronic liver disease: A UK Biobank study

Abstract Background Chronic liver disease (CLD) is a growing cause of morbidity and mortality worldwide, particularly in low to middle-income countries with high disease burden and limited treatment availability. Coffee consumption has been linked with lower rates of CLD, but little is known about the effects of different coffee types, which vary in chemical composition. This study aimed to investigate associations of coffee consumption, including decaffeinated, instant and ground coffee, with chronic liver disease outcomes. Methods A total of 494,585 UK Biobank participants with known coffee consumption and electronic linkage to hospital, death and cancer records were included in this study. Cox regression was used to estimate hazard ratios (HR) of incident CLD, incident CLD or steatosis, incident hepatocellular carcinoma (HCC) and death from CLD according to coffee consumption of any type as well as for decaffeinated, instant and ground coffee individually. Results Among 384,818 coffee drinkers and 109,767 non-coffee drinkers, there were 3600 cases of CLD, 5439 cases of CLD or steatosis, 184 cases of HCC and 301 deaths from CLD during a median follow-up of 10.7 years. Compared to non-coffee drinkers, coffee drinkers had lower adjusted HRs of CLD (HR 0.79, 95% CI 0.72–0.86), CLD or steatosis (HR 0.80, 95% CI 0.75–0.86), death from CLD (HR 0.51, 95% CI 0.39–0.67) and HCC (HR 0.80, 95% CI 0.54–1.19). The associations for decaffeinated, instant and ground coffee individually were similar to all types combined. Conclusion The finding that all types of coffee are protective against CLD is significant given the increasing incidence of CLD worldwide and the potential of coffee as an intervention to prevent CLD onset or progression

Liberal intervention in the foreign policy thinking of Tony Blair and David Cameron

David Cameron was a critic of Tony Blair’s doctrine of the international community, which was used to justify war in Kosovo and more controversially in Iraq, suggesting caution in projecting military force abroad while in opposition. However, and in spite of making severe cuts to the defence budget, the Cameron-led Coalition government signed Britain up to a military intervention in Libya within a year of coming into office. What does this say about the place liberal interventionism occupies in contemporary British foreign policy? To answer this question, this article studies the nature of what we describe as the ‘bounded liberal’ tradition that has informed British foreign policy thinking since 1945, suggesting that it puts a distinctly UK national twist on conventional conservative thought about international affairs. Its components are: scepticism of grand schemes to remake the world; instinctive Atlanticism; security through collective endeavour; and anti-appeasement. We then compare and contrast the conditions for intervention set out by Tony Blair and David Cameron. We explain the similarities but crucially also the vital differences between the two leaders’ thinking on intervention, with particular reference to Cameron’s perception that Downing Street needed to loosen its control over foreign policy-making after Iraq. Our argument is that policy substance, policy style and party political dilemmas prompted Blair and Cameron to reconnect British foreign policy with its ethical roots, ingraining a bounded liberal posture to British foreign policy after the moral bankruptcy of the John Major years. This return to a patient, pragmatic and ethically informed foreign policy meant that military operations in Kosovo and Libya were undertaken in quite different circumstances, yet came to be justified by similar arguments from the two leaders

The early development of self-injurious behaviour: evaluating the role of social reinforcement

Background: The potential role of social reinforcement in the development of self‐injury has not yet been subjected to empirical analysis. In this 2‐year prospective study, the pattern of social interactions related to the early presentation of self‐injury were examined to identify a potential association with an increase in self‐injury. Methods: The self‐injurious behaviour and social contact with adults of 16 children with intellectual disability (ID) with self‐injury of recent onset were observed at 3‐month intervals over 2 years. Results: Increase in self‐injury over a 2‐year period was positively correlated with a distribution of social contact relative to episodes of self‐injury that is consistent with a mutual social reinforcement paradigm. When this paradigm was operative, self‐injury was evoked under stable antecedent conditions over time but tended to evoke increasing levels of social interaction. Conclusions: These results support the hypothesis that increases in the frequency of early self‐injury in children with ID may be determined by social reinforcement with implications for early intervention and proactive identification of children at risk for increases in self‐injury

The Intentional Use of Service Recovery Strategies to Influence Consumer Emotion, Cognition and Behaviour

Service recovery strategies have been identified as a critical factor in the success of. service organizations. This study develops a conceptual frame work to investigate how specific service recovery strategies influence the emotional, cognitive and negative behavioural responses of . consumers., as well as how emotion and cognition influence negative behavior. Understanding the impact of specific service recovery strategies will allow service providers' to more deliberately and intentionally engage in strategies that result in positive organizational outcomes. This study was conducted using a 2 x 2 between-subjects quasi-experimental design. The results suggest that service recovery has a significant impact on emotion, cognition and negative behavior. Similarly, satisfaction, negative emotion and positive emotion all influence negative behavior but distributive justice has no effect

The impact of non-alcoholic fatty liver disease and liver fibrosis on adverse clinical outcomes and mortality in patients with chronic kidney disease: a prospective cohort study using the UK Biobank

Abstract Background Chronic kidney disease (CKD) and non-alcoholic fatty liver disease (NAFLD) frequently co-exist. We assess the impact of having NAFLD on adverse clinical outcomes and all-cause mortality for people with CKD. Methods A total of 18,073 UK Biobank participants identified to have CKD (eGFR &lt; 60 ml/min/1.73 m2 or albuminuria &gt; 3 mg/mmol) were prospectively followed up by electronic linkage to hospital and death records. Cox-regression estimated the hazard ratios (HR) associated with having NAFLD (elevated hepatic steatosis index or ICD-code) and NAFLD fibrosis (elevated fibrosis-4 (FIB-4) score or NAFLD fibrosis score (NFS)) on cardiovascular events (CVE), progression to end-stage renal disease (ESRD) and all-cause mortality. Results 56.2% of individuals with CKD had NAFLD at baseline, and 3.0% and 7.7% had NAFLD fibrosis according to a FIB-4 &gt; 2.67 and NFS ≥ 0.676, respectively. The median follow-up was 13 years. In univariate analysis, NAFLD was associated with an increased risk of CVE (HR 1.49 [1.38–1.60]), all-cause mortality (HR 1.22 [1.14–1.31]) and ESRD (HR 1.26 [1.02–1.54]). Following multivariable adjustment, NAFLD remained an independent risk factor for CVE overall (HR 1.20 [1.11–1.30], p &lt; 0.0001), but not ACM or ESRD. In univariate analysis, elevated NFS and FIB-4 scores were associated with increased risk of CVE (HR 2.42 [2.09–2.80] and 1.64 [1.30–2.08]) and all-cause mortality (HR 2.82 [2.48–3.21] and 1.82 [1.47–2.24]); the NFS score was also associated with ESRD (HR 5.15 [3.52–7.52]). Following full adjustment, the NFS remained associated with an increased incidence of CVE (HR 1.19 [1.01–1.40]) and all-cause mortality (HR 1.31 [1.13–1.52]). Conclusions In people with CKD, NAFLD is associated with an increased risk of CVE, and the NAFLD fibrosis score is associated with an elevated risk of CVE and worse survival. </jats:sec

F901318 represents a novel class of antifungal drug that inhibits dihydroorotate dehydrogenase

There is an important medical need for new antifungal agents with novel mechanisms of action to treat the increasing number of patients with life-threatening systemic fungal disease and to overcome the growing problem of resistance to current therapies. F901318, the leading representative of a novel class of drug, the orotomides, is an antifungal drug in clinical development that demonstrates excellent potency against a broad range of dimorphic and filamentous fungi. In vitro susceptibility testing of F901318 against more than 100 strains from the four main pathogenic Aspergillus spp. revealed minimal inhibitory concentrations of ≤0.06 µg/mL—greater potency than the leading antifungal classes. An investigation into the mechanism of action of F901318 found that it acts via inhibition of the pyrimidine biosynthesis enzyme dihydroorotate dehydrogenase (DHODH) in a fungal-specific manner. Homology modeling of Aspergillus fumigatus DHODH has identified a predicted binding mode of the inhibitor and important interacting amino acid residues. In a murine pulmonary model of aspergillosis, F901318 displays in vivo efficacy against a strain of A. fumigatus sensitive to the azole class of antifungals and a strain displaying an azole-resistant phenotype. F901318 is currently in late Phase 1 clinical trials, offering hope that the antifungal armamentarium can be expanded to include a class of agent with a mechanism of action distinct from currently marketed antifungals

Liver fibrosis assessed via non-invasive tests is associated with incident heart failure in a general population cohort.

AimsTo determine whether liver fibrosis is associated with heart failure in a general population cohort, and if genetic polymorphisms (PNPLA3 rs738409; TM6SF2 rs58542926), linked to increased risk of liver fibrosis and decreased risk of coronary artery disease, modify this association.MethodsUsing UK Biobank data, we prospectively examined the relationship between non-invasive fibrosis markers [NAFLD fibrosis score (NFS), Fibrosis-4 (FIB-4) and AST to platelet ratio index (APRI)] and incident hospitalization/death from heart failure (n=413,860). Cox-regression estimated hazard ratios (HR) for incident heart failure. Effects of PNPLA3 and TM6SF2 on the association between liver fibrosis and heart failure were estimated by stratifying for genotype, and testing for an interaction between genotype and liver fibrosis using a likelihood ratio test.Results12,527 incident cases of heart failure occurred over a median of 10.7 years. Liver fibrosis was associated with an increased risk of hospitalization or death from heart failure (multivariable adjusted high risk NFS score HR 1.59 [1.47-1.76], pConclusionIn the general population, serum markers of liver fibrosis are associated with increased hospitalization/death from heart failure. Genetic polymorphisms associated with liver fibrosis were not positively associated with elevated heart failure risk

Apostrophe, witnessing and its essentially theatrical modes of address: Maria Dermôut on Pattimura and Kara Walker on the New Orleans flooding

Apostrophe is best known as a punctuation mark (') or as a key poetic figure (with a speaker addressing an imaginary or absent person or entity). In origin, however, it is a pivotal rhetorical figure that indicates a 'breaking away' or turning away of the speaker from one addressee to another, in a different mode. In this respect, apostrophe is essentially theatrical. To be sure, the turn away implies two different modes of address that may follow upon one another, as is hinted at by the two meanings of the verb 'to witness': being a witness and bearing witness. One cannot do both at the same time. My argument will be, however, that in order to make witnessing work ethically and responsibly, the two modes of address must take place simultaneously, in the coincidence of two modalities of presence: one actual and one virtual. Accordingly, I will distinguish between an address of attention and an address of expression. Whereas the witness is actually paying attention to that which she witnesses, she is virtually (and in the sense Deleuze intended, no less really) turning away in terms of expression. The two come together in what Kelly Oliver called the 'inner witness'. The simultaneous operation of two modes of address suggests that Caroline Nevejan's so-called YUTPA model would have to include two modalities of 'you'. Such a dual modality has become all the more important, in the context of the society of the spectacle. One text will help me first to explore two modes of address through apostrophe. I will focus on a story by Dutch author Maria Dermôut, written in the fifties of the twentieth century, reflecting on an uprising and the subsequent execution of its leader in the Dutch Indies in 1817. Secondly, I will move to American artist Kara Walker's response, in the shape of an installation and a visual essay, to the flooding of New Orleans in 2005. The latter will serve to illustrate a historic shift in the theatrical nature and status of 'presence' in the two modes of address. Instead of thinking of the convergence of media, of which Jenkins speaks, we might think of media swallowing up one another. For instance, the theatrical structure of apostrophe is swallowed up, and in a sense perverted, by the model of the spectacle in modern media. This endangers the very possibility of witnessing in any ethical sense of the word