Do Infants Using Baby Walkers Suffer Developmental Delays in Acquisition of Motor Skills?

AbstractObjectiveDevelopment is a complex process, completed over a specific period of time, through the maturation of the nervous system. It is affected by genetic, ethnic, nutritional, social, and economic factors; one of the environmental factors affecting the acquisition of motor skills in infants is the use of baby walkers. Since this device is very commonly used for infants in our country, we conducted this study to evaluate its effects on the acquisition of motor skills in this age group of children.Materials & MethodsThis longitudinal study was conducted in 2005 on 300 infants referring to the Primary Health Care Centers of Kashan district in 1384; the infants were divided into two groups of 150 babies each, with the case group using baby walkers, while the other 150, the controls, did not. All babies were followed for two years, and the ages for acquisition of motor skills were documented during face-to face or telephone interviews with the parents. Data were analyzed using the T-test and the Chi Square test.ResultsOf the study population, 175 babies (58.33%) were male. The mean age of acquisition of motor skills including rolling, crawling, moving on hands and feet, sitting without and with help, standing and walking dependently and independently were found to be delayed in infants using baby walkers, a difference between the two groups of walker users and non- walker users that was statistically significant (P<0.001).ConclusionConsidering the adverse effects that walkers have on the acquisition of motor skills in infants, as demonstrated by the results of this study, we do not recommend the use of baby walkers in infants

Going beyond audit and feedback: towards behaviour-based interventions to change physician laboratory test ordering behaviour

Studies indicate there are a variety of contributing factors affecting physician test ordering behaviour. Identifying these behaviours allows development of behaviour-based interventions. Methods Through a pilot study, the list of contributing factors in laboratory tests ordering, and the most ordered tests, were identified, and given to 50 medical students, interns, residents and paediatricians in questionnaire form. The results showed routine tests and peer or supervisor pressure as the most influential factors affecting physician ordering behaviour. An audit and feedback mechanism was selected as an appropriate intervention to improve physician ordering behaviour. The intervention was carried out at two intervals over a three-month period. Findings There was a large reduction in the number of laboratory tests ordered; from 908 before intervention to 389 and 361 after first and second intervention, respectively. There was a significant relationship between audit and feedback and the meaningful reduction of 7 out of 15 laboratory tests including complete blood count (p = 0.002), erythrocyte sedimentation rate (p = 0.01), C-reactive protein (p = 0.01), venous blood gas (p = 0.016), urine analysis (p = 0.005), blood culture (p = 0.045) and stool examination (p = 0.001). Conclusion The audit and feedback intervention, even in short duration, affects physician ordering behaviour. It should be designed in terms of behaviour-based intervention and diagnosis of the contributing factors in physicians’ behaviour. Further studies are required to substantiate the effectiveness of such behaviour-based intervention strategies in changing physician behaviour

Rheological, physicochemical, and microstructural properties of asphalt binder modified by fumed silica nanoparticles

Warm mix asphalt (WMA) is gaining increased attention in the asphalt paving industry as an eco-friendly and sustainable technology. WMA technologies are favorable in producing asphalt mixtures at temperatures 20–60 °C lower in comparison to conventional hot mix asphalt. This saves non-renewable fossil fuels, reduces energy consumption, and minimizes vapors and greenhouse gas emissions in the production, placement and conservation processes of asphalt mixtures. At the same time, this temperature reduction must not reduce the performance of asphalt pavements in-field. Low aging resistance, high moisture susceptibility, and low durability are generally seen as substantial drawbacks of WMA, which can lead to inferior pavement performance, and increased maintenance costs. This is partly due to the fact that low production temperature may increase the amount of water molecules trapped in the asphalt mixture. As a potential remedy, here we use fumed silica nanoparticles (FSN) have shown excellent potential in enhancing moisture and aging susceptibility of asphalt binders. In this study, asphalt binder modification by means of FSN was investigated, considering the effects of short-term and long-term aging on the rheological, thermal, and microstructural binder properties. This research paves the way for optimizing WMA by nanoparticles to present enhanced green asphalt technology

The Evolution of Cognitive Load Theory and the Measurement of Its Intrinsic, Extraneous and Germane Loads: A Review

Cognitive Load Theory has been conceived for supporting instructional design through the use of the construct of cognitive load. This is believed to be built upon three types of load: intrinsic, extraneous and germane. Although Cognitive Load Theory and its assumptions are clear and well-known, its three types of load have been going through a continuous investigation and re-definition. Additionally, it is still not clear whether these are independent and can be added to each other towards an overall measure of load. The purpose of this research is to inform the reader about the theoretical evolution of Cognitive Load Theory as well as the measurement techniques and measures emerged for its cognitive load types. It also synthesises the main critiques of scholars and the scientific value of the theory from a rationalist and structuralist perspective

Validation of the western ontario rotator cuff index in patients with arthroscopic rotator cuff repair: A study protocol

<p>Abstract</p> <p>Background</p> <p>Arthroscopic rotator cuff repair is described as being a successful procedure. These results are often derived from clinical general shoulder examinations, which are then classified as 'excellent', 'good', 'fair' or 'poor'. However, the cut-off points for these classifications vary and sometimes modified scores are used.</p> <p>Arthroscopic rotator cuff repair is performed to improve quality of life. Therefore, disease specific health-related quality of life patient-administered questionnaires are needed. The WORC is a quality of life questionnaire designed for patients with disorders of the rotator cuff. The score is validated for rotator cuff disease, but not for rotator cuff repair specifically.</p> <p>The aim of this study is to investigate reliability, validity and responsiveness of WORC in patients undergoing arthroscopic rotator cuff repair.</p> <p>Methods/Design</p> <p>An approved translation of the WORC into Dutch is used. In this prospective study three groups of patients are used: 1. Arthroscopic rotator cuff repair; 2. Disorders of the rotator cuff without rupture; 3. Shoulder instability.</p> <p>The WORC, SF-36 and the Constant Score are obtained twice before therapy is started to measure reliability and validity. Responsiveness is tested by obtaining the same tests after therapy.</p

An Evolutionary Upgrade of Cognitive Load Theory: Using the Human Motor System and Collaboration to Support the Learning of Complex Cognitive Tasks

Cognitive load theory is intended to provide instructional strategies derived from experimental, cognitive load effects. Each effect is based on our knowledge of human cognitive architecture, primarily the limited capacity and duration of a human working memory. These limitations are ameliorated by changes in long-term memory associated with learning. Initially, cognitive load theory's view of human cognitive architecture was assumed to apply to all categories of information. Based on Geary's (Educational Psychologist 43, 179-195 2008; 2011) evolutionary account of educational psychology, this interpretation of human cognitive architecture requires amendment. Working memory limitations may be critical only when acquiring novel information based on culturally important knowledge that we have not specifically evolved to acquire. Cultural knowledge is known as biologically secondary information. Working memory limitations may have reduced significance when acquiring novel

The global distribution of lymphatic filariasis, 2000–18: a geospatial analysis

Background Lymphatic filariasis is a neglected tropical disease that can cause permanent disability through disruption of the lymphatic system. This disease is caused by parasitic filarial worms that are transmitted by mosquitos. Mass drug administration (MDA) of antihelmintics is recommended by WHO to eliminate lymphatic filariasis as a public health problem. This study aims to produce the first geospatial estimates of the global prevalence of lymphatic filariasis infection over time, to quantify progress towards elimination, and to identify geographical variation in distribution of infection. Methods A global dataset of georeferenced surveyed locations was used to model annual 2000–18 lymphatic filariasis prevalence for 73 current or previously endemic countries. We applied Bayesian model-based geostatistics and time series methods to generate spatially continuous estimates of global all-age 2000–18 prevalence of lymphatic filariasis infection mapped at a resolution of 5 km2 and aggregated to estimate total number of individuals infected. Findings We used 14 927 datapoints to fit the geospatial models. An estimated 199 million total individuals (95% uncertainty interval 174–234 million) worldwide were infected with lymphatic filariasis in 2000, with totals for WHO regions ranging from 3·1 million (1·6–5·7 million) in the region of the Americas to 107 million (91–134 million) in the South-East Asia region. By 2018, an estimated 51 million individuals (43–63 million) were infected. Broad declines in prevalence are observed globally, but focal areas in Africa and southeast Asia remain less likely to have attained infection prevalence thresholds proposed to achieve local elimination. Interpretation Although the prevalence of lymphatic filariasis infection has declined since 2000, MDA is still necessary across large populations in Africa and Asia. Our mapped estimates can be used to identify areas where the probability of meeting infection thresholds is low, and when coupled with large uncertainty in the predictions, indicate additional data collection or intervention might be warranted before MDA programmes cease

Signal transduction-related responses to phytohormones and environmental challenges in sugarcane

BACKGROUND: Sugarcane is an increasingly economically and environmentally important C4 grass, used for the production of sugar and bioethanol, a low-carbon emission fuel. Sugarcane originated from crosses of Saccharum species and is noted for its unique capacity to accumulate high amounts of sucrose in its stems. Environmental stresses limit enormously sugarcane productivity worldwide. To investigate transcriptome changes in response to environmental inputs that alter yield we used cDNA microarrays to profile expression of 1,545 genes in plants submitted to drought, phosphate starvation, herbivory and N(2)-fixing endophytic bacteria. We also investigated the response to phytohormones (abscisic acid and methyl jasmonate). The arrayed elements correspond mostly to genes involved in signal transduction, hormone biosynthesis, transcription factors, novel genes and genes corresponding to unknown proteins. RESULTS: Adopting an outliers searching method 179 genes with strikingly different expression levels were identified as differentially expressed in at least one of the treatments analysed. Self Organizing Maps were used to cluster the expression profiles of 695 genes that showed a highly correlated expression pattern among replicates. The expression data for 22 genes was evaluated for 36 experimental data points by quantitative RT-PCR indicating a validation rate of 80.5% using three biological experimental replicates. The SUCAST Database was created that provides public access to the data described in this work, linked to tissue expression profiling and the SUCAST gene category and sequence analysis. The SUCAST database also includes a categorization of the sugarcane kinome based on a phylogenetic grouping that included 182 undefined kinases. CONCLUSION: An extensive study on the sugarcane transcriptome was performed. Sugarcane genes responsive to phytohormones and to challenges sugarcane commonly deals with in the field were identified. Additionally, the protein kinases were annotated based on a phylogenetic approach. The experimental design and statistical analysis applied proved robust to unravel genes associated with a diverse array of conditions attributing novel functions to previously unknown or undefined genes. The data consolidated in the SUCAST database resource can guide further studies and be useful for the development of improved sugarcane varieties