Shake, rattle, \u27n\u27 roll: The representation of motion in language and cognition

Languages vary strikingly in how they encode motion events. In some languages (e.g. English), manner of motion is typically encoded within the verb, while direction of motion information appears in modifiers. In other languages (e.g. Greek), the verb usually encodes the direction of motion, while the manner information is encoded in modifiers. We designed two studies to investigate whether these language-specific patterns affect speakers’ reasoning about motion. We compared the performance of English and Greek children and adults (a) in non-linguistic (memory and categorization) tasks involving motion events, and (b) in their linguistic descriptions of these same motion events. Even though the two linguistic groups differed significantly in terms of their linguistic preferences, their performance in the non-linguistic tasks was identical. More surprisingly, the linguistic descriptions given by subjects within language also failed to correlate consistently with their memory and categorization performance in the relevant regards. For the domain studied, these results are consistent with the view that conceptual development and organization are largely independent of language-specific labeling practices. The discussion emphasizes that the necessarily sketchy nature of speech assures that it will be at best a crude index of thought

From walls to windows : healing through self-revision in Dorothy Allison's nonfiction

In the following pages, I explore the connection between recovering from trauma and autobiographical writing. Using Dorothy Allison’s nonfiction, various trauma theorists, and my own experiences writing nonfiction, I show how vital the role of writing the trauma is to the trauma sufferer. Trauma negatively effects identification with the self and causes memory of the event to become fragmented, instead of following the narrative form of other memories. This negative sense of self and the incoherence of traumatic memories disallows the trauma sufferer to make sense and come to terms with painful events. Writing the trauma can be a way of formulating it into a coherent narrative. Writing can organize the disorganized pieces of traumatic memory; once a narrative is created, understanding of the event can begin, and emotional recovery can occur. While writing the trauma story is imperative, the trauma victim must first overcome roadblocks which prevent telling the tale. Telling can be difficult and painful, and I explore many of the aspects which prevent telling. I argue that the need to tell becomes so strong, not telling is no longer an option, as Allison continually proves in her work

The anxious wait: assessing the impact of patient accessible EHRs for breast cancer patients

<p>Abstract</p> <p>Background</p> <p>Personal health records (PHRs) provide patients with access to personal health information (PHI) and targeted education. The use of PHRs has the potential to improve a wide range of outcomes, including empowering patients to be more active participants in their care. There are a number of widespread barriers to adoption, including privacy and security considerations. In addition, there are clinical concerns that patients could become anxious or distressed when accessing complex medical information. This study assesses the implementation of a PHR, and its impact on anxiety levels and perceptions of self-efficacy in a sample of breast cancer patients.</p> <p>Methods</p> <p>A quasi-experimental pre-test/post-test design was used to collect data from participants to evaluate the use of the PHR. Study participants completed background and pre-assessment questionnaires and were then registered into the portal. By entering an activation key, participants were then able to review their lab results and diagnostic imaging reports. After six weeks, participants completed post-assessment questionnaires and usability heuristics. All data were collected using an online survey tool. Data were cleaned and analyzed using SAS v9.1.</p> <p>Results</p> <p>A total of 311 breast cancer patients completed demographic and pre-assessment questionnaires, 250 registered to use the online intervention, and 125 participants completed all required study elements. Matching the pre- and post-anxiety scores demonstrated a decrease in mean anxiety scores (-2.2, p = 0.03); the chemotherapy sub-group had a statistically insignificant mean increase (1.8, p = .14). There was no mean change in self-efficacy scores.</p> <p>Conclusions</p> <p>Participants generally found the portal easy to use; however, the perceived value of improved participation was not detected in the self-efficacy scores. Having access to personal health information did not increase anxiety levels. While these results suggest that the use of this PHR may be of benefit for informing patients, further research is required to investigate the impact on the patients experiences, their participation in their care, their relationships with the health care team, and their health outcomes.</p

Northern Neck Regional Shallow Draft Channel Dredging Plan: Initial Phase

The purpose of this project is to develop a regional dredging program for the localities of the Northern Neck. This report encompasses Phase 1 of the project, which included creating a database of waterbodies in Lancaster, Northumberland, Richmond, and Westmoreland Counties and the Town of Colonial Beach along the Potomac and Rappahannock Rivers and Chesapeake Bay. Generally, these waterbodies can be categorized into three basic types of shallow draft channels: federally-authorized to include aids to navigation (ATONS), non-federal with ATONS, and non-federal without ATONs. Along the Northern Neck, presently identified, are 13 federal channels, 37 non-federal channels in creeks with ATONs, and 92 in creeks without defined channels or ATONs, for a total of 142 waterbodies. Additional non-federal creeks, coves, branches, and ponds (all are interchangeably identified as waterbodies in this report) occur in these localities, but the analysis was limited to waterbodies that had some residential or economic usage. These waterbodies occur in Lancaster (35 waterbodies), Northumberland (67 waterbodies), Richmond (4 waterbodies), and Westmoreland (31 waterbodies) counties. To avoid double counting of waterbodies, 5 additional waterbodies that are located on the boundaries of these counties were attributed to just one county for this report. These waterbodies have been grouped within one of their boundary counties bringing the number of waterbodies in Lancaster to 38 and Westmoreland to 33. Physical parameter data was collected or created for each of these waterbodies. These data included creek mouth morphology, amount of shoaling in the waterbody mouth, waterbody type (primary, secondary, etc.), water surface area, combined shoreline length, historical (1971- 2020) and current (2016-2020) SAV presence, private and public oyster lease presence and the amount of area they cover, number of remotely-sensed coastal structures such as piers, marinas, boat ramps, and verified economic facilities such as marinas and other mooring places, resource, seafood related, and transportation facilities that impact the locality’s economics. Utilizing the collected data, the steps that localities need to take for additional data collection to develop a dredging project were outlined, and recommendations were made for additional regional management considerations for use in Phases 2 and 3. Finally, next steps were suggested. By creating a regional program for dredging of shallow water, localities can save time, effort, and money. Such a program also provides ways for localities to plan for the utilization of dredge material to combat repetitive flooding and improve coastal resiliency

Atypical Reactivation of Varicella Zoster Virus Associated with Pancreatitis in a Heart Transplant Patient.

BACKGROUND Acute pancreatitis is rare following solid organ transplantation but is associated with high mortality. It has been most commonly reported following renal transplant but can occur with other solid organ transplantations. CASE REPORT A 46-year-old male who had an orthotopic heart transplant 6 months ago presented with a 3-week history of abdominal pain. The patient described it as intermittent, sharp, and stabbing, originating in the periumbilical area and radiating to the back. His lipase was elevated at 232 U/L. Given that the patient\u27s symptoms and lipase were elevated to greater than three times the upper limit of normal, he patient was diagnosed with acute pancreatitis. The patient also mentioned a diffuse itchy rash that started a few days prior to admission. Dermatology was consulted, and given the man\u27s clinical presentation, there was concern for atypical reactivation of varicella zoster virus (VZV). VZV polymerase chain reaction of the vesicles returned positive. The patient was started on acyclovir and his symptoms improved. CONCLUSIONS This is the first reported case of VZV-associated pancreatitis in a heart transplant patient. Our patient presented with acute pancreatitis and was treated supportively. However, he did not receive antiviral treatment until his rash was discovered. Timely treatment of VZV resulted in resolution of both the rash and pancreatitis. Timely diagnosis of pancreatitis and VZV is important to prevent development of multiorgan failure and death

Massive stars in the Cl 1813-178 Cluster. An episode of massive star formation in the W33 complex

Young massive (M >10^4 Msun) stellar clusters are a good laboratory to study the evolution of massive stars. Only a dozen of such clusters are known in the Galaxy. Here we report about a new young massive stellar cluster in the Milky Way. Near-infrared medium-resolution spectroscopy with UIST on the UKIRT telescope and NIRSPEC on the Keck telescope, and X-ray observations with the Chandra and XMM satellites, of the Cl 1813-178 cluster confirm a large number of massive stars. We detected 1 red supergiant, 2 Wolf-Rayet stars, 1 candidate luminous blue variable, 2 OIf, and 19 OB stars. Among the latter, twelve are likely supergiants, four giants, and the faintest three dwarf stars. We detected post-main sequence stars with masses between 25 and 100 Msun. A population with age of 4-4.5 Myr and a mass of ~10000 Msun can reproduce such a mixture of massive evolved stars. This massive stellar cluster is the first detection of a cluster in the W33 complex. Six supernova remnants and several other candidate clusters are found in the direction of the same complex.Comment: 11 Figures. Accepted for publication in Ap

‘Keeping Birth Normal’: Exploratory evaluation of a training package for midwives in an inner-city, alongside midwifery unit

Objectives to gain understanding about how participants perceived the value and effectiveness of ‘Keeping Birth Normal’ training, barriers to implementing it in an along-side midwifery unit, and how the training might be enhanced in future iterations. Design exploratory interpretive. Setting inner-city maternity service. Participants 31 midwives attending a one-day training package on one of three occasions. Methods data were collected using semi-structured observation of the training, a short feedback form (23/31 participants), and focus groups (28/31 participants). Feedback form data were analysed using summative content analysis, following which all data sets were pooled and thematically analysed using a template agreed by the researchers. Findings We identified six themes contributing to the workshop's effectiveness as perceived by participants. Three related to the workshop design: (1) balanced content, (2) sharing stories and strategies and (3) ‘less is more.’ And three related to the workshop leaders: (4) inspiration and influence, (5) cultural safety and (6) managing expectations. Cultural focus on risk and low prioritisation of normal birth were identified as barriers to implementing evidence-based practice supporting normal birth. Building a community of practice and the role of consultant midwives were identified as potential opportunities. Key conclusions and implications for practice a review of evidence, local statistics and practical skills using active educational approaches was important to this training. Two factors not directly related to content appeared equally important: catalysing a community of practice and the perceived power of workshop leaders to influence organisational systems limiting the agency of individual midwives. Cyclic, interactive training involving consultant midwives, senior midwives and the multidisciplinary team may be recommended to be most effective

Protocol for a cluster randomised controlled trial to determine the effectiveness and cost-effectiveness of independent pharmacist prescribing in care home: the CHIPPS study

Background: Prescribing, monitoring and administration of medicines in care homes could be improved. Research has identified the need for one person to assume overall responsibility for the management of medicines within each care home. and shown that a pharmacist independent prescriber service is feasible in this context. Aims and objectives: To conduct a cluster randomised controlled trial to determine the effectiveness and cost-effectiveness of a pharmacist-independent prescribing service in care homes compared to usual general practitioner (GP)-led care. Objectives: To perform a definitive randomised controlled trial (RCT) with an internal pilot to determine the intervention’s effectiveness and cost-effectiveness and enable modelling beyond the end of the trial. Methods: This protocol is for a cluster RCT with a 3-month internal pilot to confirm that recruitment is achievable, and there are no safety concerns. The unit of randomisation is a triad comprising a pharmacist-independent prescriber (PIP) based in a GP practice with sufficient registered patients resident in one or more care homes to allow recruitment of an average of 20 participants. In the intervention group, the PIP will, in collaboration with the GP: assume responsibility for prescribing and managing residents’ medicines including medication review and pharmaceutical care planning; support systematic ordering and administration in the care home, GP practice and supplying pharmacy; train care home and GP practice staff; communicate with GP practice, care home, supplying community pharmacy and study team. The intervention will last 6 months. The primary outcome will be resident falls at 6 months. Secondary outcomes include resident health-related quality of life, falls at 3 months, medication burden, medication appropriateness, mortality and hospitalisations. A full health economic analysis will be undertaken. The target sample size is 880 residents (440) in each arm) from 44 triads. This number is sufficient to detect a decrease in fall rate from 1.5 per individual to 1.178 (relative reduction of 21%) with 80% power and an ICC of 0.05 or less. Discussion: Recruitment is on-going and the trial should complete in early 2020. The trial results will have implications for the future management of residents in care homes and the ongoing implementation of independent pharmacist prescribing. Trial registration: ISRCTN, ID: 17847169. Registered on 15 December 2017

Characterisation of retinoblastomas without RB1 mutations: genomic, gene expression, and clinical studies

SummaryBackgroundRetinoblastoma is the childhood retinal cancer that defined tumour-suppressor genes. Previous work shows that mutation of both alleles of the RB1 retinoblastoma suppressor gene initiates disease. We aimed to characterise non-familial retinoblastoma tumours with no detectable RB1 mutations.MethodsOf 1068 unilateral non-familial retinoblastoma tumours, we compared those with no evidence of RB1 mutations (RB1+/+) with tumours carrying a mutation in both alleles (RB1−/−). We analysed genomic copy number, RB1 gene expression and protein function, retinal gene expression, histological features, and clinical data.FindingsNo RB1 mutations (RB1+/+) were reported in 29 (2·7%) of 1068 unilateral retinoblastoma tumours. 15 of the 29 RB1+/+ tumours had high-level MYCN oncogene amplification (28–121 copies; RB1+/+MYCNA), whereas none of 93 RB1−/− primary tumours tested showed MYCN amplification (p<0·0001). RB1+/+MYCNA tumours expressed functional RB1 protein, had fewer overall genomic copy-number changes in genes characteristic of retinoblastoma than did RB1−/− tumours, and showed distinct aggressive histological features. MYCN amplification was the sole copy-number change in one RB1+/+MYCNA retinoblastoma. One additional MYCNA tumour was discovered after the initial frequencies were determined, and this is included in further analyses. Median age at diagnosis of the 17 children with RB1+/+MYCNA tumours was 4·5 months (IQR 3·5–10), compared with 24 months (15–37) for 79 children with non-familial unilateral RB1−/− retinoblastoma.InterpretationAmplification of the MYCN oncogene might initiate retinoblastoma in the presence of non-mutated RB1 genes. These unilateral RB1+/+MYCNA retinoblastomas are characterised by distinct histological features, only a few of the genomic copy-number changes that are characteristic of retinoblastoma, and very early age of diagnosis.FundingNational Cancer Institute–National Institutes of Health, Canadian Institutes of Health Research, German Research Foundation, Canadian Retinoblastoma Society, Hyland Foundation, Toronto Netralaya and Doctors Lions Clubs, Ontario Ministry of Health and Long Term Care, UK-Essen, and Foundations Avanti-STR and KiKa