Adult participation in children’s word searches: on the use of prompting, hinting, and supplying a model

Although word searching in children is very common, very little is known about how adults support children in the turns following the child’s search behaviours, an important topic because of the social, educational and clinical implications. This study characterises, in detail, teachers’ use of prompting, hinting and supplying a model. From a classroom dataset of 53 instances, several distinctive patterns emerged. A prompted completion sequence is initiated by a ‘word retrieval elicitor’ (‘fishing’) and is interpreted as a request to complete the phrase. Non-verbal prompting is accomplished through a combination of gaze and gesture and, also, as a series of prompts. Hinting supplies a verbal clue, typically via a wh-question, or by specifying the nature of the repairable. In contrast, the strategies that supply a linguistic model include both embedded and exposed corrections and offers of candidates. A sequential relationship was found between prompting, hinting and supplying a model which has implications for how clinicians and teachers can foster self-repair

Achieving Effective Antidepressant Pharmacotherapy in Primary Care: The Role of Depression Care Management in Treating Late-Life Depression

To estimate the effect of an evidence-based depression care management (DCM) intervention on the initiation and appropriate use of antidepressant in primary care patients with late-life depression. DESIGN : Secondary analysis of data from a randomized trial. SETTING : Community, primary care. PARTICIPANTS : Randomly selected individuals aged 60 and older with routine appointments at 20 primary care clinics randomized to provide a systematic DCM intervention or care as usual. METHODS : Rates of antidepressant use and dose adequacy of patients in the two study arms were compared at each patient assessment (baseline, 4, 8, and 12 months). For patients without any antidepressant treatment at baseline, a longitudinal analysis was conducted using multilevel logistic models to compare the rate of antidepressant treatment initiation, dose adequacy when initiation was first recorded, and continued therapy for at least 4 months after initiation between study arms. All analyses were conducted for the entire sample and then repeated for the subsample with major or clinically significant minor depression at baseline. RESULTS : Rates of antidepressant use and dose adequacy increased over the first year in patients assigned to the DCM intervention, whereas the same rates held constant in usual care patients. In longitudinal analyses, the DCM intervention had a significant effect on initiation of antidepressant treatment (adjusted odds ratio (OR)=5.63, P <.001) and continuation of antidepressant medication for at least 4 months (OR=6.57, P =.04) for patients who were depressed at baseline. CONCLUSIONS : Evidence-based DCM models are highly effective at improving antidepressant treatment in older primary care patients.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66406/1/j.1532-5415.2009.02226.x.pd

The bile duct ligated rat : a relevant model to study muscle mass loss in cirrhosis

Muscle mass loss and hepatic encephalopathy (complex neuropsychiatric disorder) are serious complications of chronic liver disease (cirrhosis) which impact negatively on clinical outcome and quality of life and increase mortality. Liver disease leads to hyperammonemia and ammonia toxicity is believed to play a major role in the pathogenesis of hepatic encephalopathy. However, the effects of ammonia are not brain-specific and therefore may also affect other organs and tissues including muscle. The precise pathophysiological mechanisms underlying muscle wasting in chronic liver disease remains to be elucidated. In the present study, we characterized body composition as well as muscle protein synthesis in cirrhotic rats with hepatic encephalopathy using the 6-week bile duct ligation (BDL) model which recapitulates the main features of cirrhosis. Compared to sham-operated control animals, BDL rats display significant decreased gain in body weight, altered body composition, decreased gastrocnemius muscle mass and circumference as well as altered muscle morphology. Muscle protein synthesis was also significantly reduced in BDL rats compared to control animals. These findings demonstrate that the 6-week BDL experimental rat is a relevant model to study liver disease-induced muscle mass loss

The relationship between mental disorders and actual and desired subjective social status

Mental disorders are associated with lower subjective social status (SSS), but a more nuanced understanding of this relationship is needed. We examined the influence of disorder age of onset and recency on SSS and studied whether mental disorders are also associated with the discrepancy between actual and desired SSS.Method Data are from the baseline and second wave of the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2). Mental disorders were assessed with the Composite International Diagnostic Interview (CIDI 3.0), while both actual and desired SSS were assessed with a ten-rung ladder. Linear regression was used to examine the association between mental disorders and SSS.Results Of 5303 participants, 2237 had a lifetime mental disorder at baseline. These participants reported significantly lower actual SSS (6.28) at follow-up than healthy participants (6.66, B = -0.38 [95% CI -0.48 to -0.27], p < 0.001) and a significantly greater actual-desired SSS discrepancy (1.14 v. 1.05 after controlling for actual SSS, B = 0.09 [0.01-0.17], p = 0.024). Lower age of onset of the first mental disorder was marginally significantly associated with lower actual SSS (B = 0.006 [0.000-0.012], p = 0.046). More recent disorders were also associated with lower actual SSS (B = 0.015 [0.005-0.026], p = 0.005), such that participants whose disorder remitted a ≥6 years before baseline were statistically indistinguishable from healthy participants.Conclusions Lifetime mental disorders are associated with lower actual SSS and a slightly greater discrepancy between actual and desired SSS. However, people with mental disorders in (long-term) remission have a similar social status as healthy participants

Demonstrating functional equivalence of pilot and production scale freeze-drying of BCG

Drug Delivery Technolog

‘What’s it like to have ME?’ The discursive construction of ME in computer-mediated communication and face-to-face interaction

ME/CFS (chronic fatigue syndrome) is a debilitating illness for which no cause or medical tests have been identified. Debates over its nature have generated interest from qualitative researchers. However, participants are difficult to recruit because of the nature of their condition. Therefore, this study explores the utility of the internet as a means of eliciting accounts. We analyse data from focus groups and the internet in order to ascertain the extent to which previous research findings apply to the internet domain. Interviews were conducted among 49 members of internet (38 chatline, 11 personal) and 7 members of two face-to-face support groups. Discourse analysis of descriptions and accounts of ME/CFS revealed similar devices and interactional concerns in both internet and face-to-face communication. Participants constructed their condition as serious, enigmatic and not psychological. These functioned to deflect problematic assumptions about ME/CFS and to manage their accountability for the illness and its effects

Parent-child interaction in Nigerian families: conversation analysis, context and culture

This paper uses a conversation analysis (CA) approach to explore parent child interaction (PCI) within Nigerian families. We illustrate how speech and language therapists (SLTs), by using CA, can tailor recommendations according to the interactional style of each individual family that are consonant with the family’s cultural beliefs. Three parent-child dyads were videoed playing and talking together in their home environments. The analysis uncovered a preference for instructional talk similar to that used in the classroom. Closer examination revealed that this was not inappropriate when considering the context of the activities and their perceived discourse role. Furthermore, this was not necessarily at the expense of responsivity or semantic contingency. The preference for instructional talk appeared to reflect deeply held cultural beliefs about the role of adults and children within the family and it is argued that the cultural paradigm is vitally important to consider when evaluating PCI. Given a potential risk that such young children may be vulnerable in terms of language difficulties, we offer an example of how PCI can be enhanced to encourage language development without disrupting the naturally occurring talk or the underlying purpose of the interaction

Non-ST-elevation myocardial infarction in the Netherlands: room for improvement!

Aim To analyse non-ST-elevation myocardial infarction (NSTEMI) care in the Netherlands and to identify modifiable factors to improve NSTEMI healthcare. Methods This retrospective cohort study analysed hospital and pharmacy claims data of all NSTEMI patients in the Netherlands in 2015. The effect of percutaneous coronary intervention (PCI) during hospitalisation on 1-year mortality was investigated in the subcohort alive 4 days after NSTEMI. The effect of medical treatment on 1-year mortality was assessed in the subcohort alive 30 days after NSTEMI. The effect of age, gender and co-morbidities was evaluated. PCI during hospitalisation was defined as PCI within 72x202f;h after NSTEMI and optimal medical treatment was defined as the combined use of an aspirin species, P2Y(12) inhibitor, statin, beta-blocker and angiotensin converting enzyme inhibitor/angiotensin II receptor blocker, started within 30 days after NSTEMI. Results Data from 17,997 NSTEMI patients (age 69.6 (SDx202f;= 12.8) years, 64% male) were analysed. Of the patients alive 4 days after NSTEMI, 43% had a PCI during hospitalisation and 1-year mortality was 10%. In the subcohort alive 30 days after NSTEMI, 47% of patients were receiving optimal medical treatment at 30 days and 1-year mortality was 7%. PCI during hospitalisation (odds ratio (OR) 0.42; 95% confidence interval (CI) 0.37-0.48) and optimal medical treatment (OR 0.59; 95% CI 0.51-0.67) were associated with a lower 1-year mortality. Conclusion In Dutch NSTEMI patients, use of PCI during hospitalisation and prescription of optimal medical treatment are modest. As both are independently associated with a lower 1-year mortality, this study provides direction on how to improve the quality of NSTEMI healthcare in the Netherlands.Cardiolog