Care delivery and self-management strategies for adults with epilepsy

Background: Researchers have criticised epilepsy care for adults for its lack of impact, stimulating the development of various service models and strategies to respond to perceived inadequacies. Objectives: To assess the effects of any specialised or dedicated intervention beyond that of usual care in adults with epilepsy. Search methods: For the latest update of this review, we searched the Cochrane Epilepsy Group Specialized Register (9 December 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (2013, Issue 11), MEDLINE (1946 to June 2013), EMBASE (1988 to June 2013), PsycINFO (1887 to December 2013) and CINAHL (1937 to December 2013). In addition, we contacted experts in the field to seek information on unpublished and ongoing studies, checked the websites of epilepsy organisations and checked the reference lists of included studies. Selection criteria: We included randomised controlled trials, controlled or matched trials, cohort studies or other prospective studies with a control group, and time series studies. Data collection and analysis: Two review authors independently selected studies, extracted all data, and assessed the quality of all included studies. Main results: Our review included 18 different studies of 16 separate interventions, which we classified into seven distinct groups. Most of the studies have methodological weaknesses, and many results from other analyses within studies need to be interpreted with caution because of study limitations. Consequently, there is currently limited evidence for the effectiveness of interventions to improve the health and quality of life in people with epilepsy. It was not possible to combine study results in a meta-analysis because of the heterogeneity of outcomes, study populations, interventions and time scales across the studies. Authors' conclusions: Two intervention types, the specialist epilepsy nurse and self management education, have some evidence of benefit. However, we did not find clear evidence that other service models substantially improve outcomes for adults with epilepsy. It is also possible that benefits are situation specific and may not apply to other settings. These studies included only a small number of service providers whose individual competence or expertise may have had a significant impact on outcomes. At present it is not possible to advocate any single model of service provision

An inclusive design perspective on automotive HMI trends

This paper looks at recent trends in automotive human machine interfaces, with a lens of evaluation from an inclusive design perspective. The goal of Inclusive Design is to ensure that the population of potential users for a product or service is maximised. Until relatively recently, automotive human machine interfaces (HMI’s) have excluded and caused difficulties for users due to visibility, reach and force required to operate controls. Over the last 15 or so years however, there has been a significant increase in control and display location, interface types and integration of functions, as well as dramatically increased potential functionality due to in-vehicle emergent technologies. It is suggested that this increase in interface unfamiliarity for a driver will cause significant difficulty and potential exclusion, due to the demands of learning and conflicts in expectation. The effects on this trend in the context of an ageing population and automated driving technologies are discussed.This work was carried out at the University of Cambridge’s Engineering Design Centre, within the Inclusive Design Group. Sponsor: Jaguar Land Rover.This is the author accepted manuscript. The final version is available from Springer via http://dx.doi.org/10.1007/978-3-319-40238-3_5

Visualising the number of people who cannot perform tasks related to product interactions

Understanding the number of people who cannot perform particular tasks helps to inform design decisions for mainstream products, such as the appropriate size and contrast of visual features. Making such informed decisions requires a dataset that is representative at the level of a national population, with sufficient scope and granularity to cover the types of actions associated with product use. Furthermore, visualisations are needed to bring the dataset to life, in order to better support comparing the number of people who cannot perform different tasks. The 1996/97 Disability Follow-up Survey remains the most recent Great British dataset to cover all types of ability losses that may be relevant to using everyday products. This paper presents new visualisations derived from this dataset, which are related to vision, hearing, cognition, mobility, dexterity and reach. Compared to previous publications on this dataset, the new visualisations contain task descriptions that have been simplified, described pictorially and separated out into different categories. Furthermore, two-dimensional visualisations are used to present exclusion results for products that require vision and/or hearing and for tasks that require each hand to do different things. In order to produce these new visualisations, the publicly available version of this dataset had to be reanalysed and recoded, which is described here-in detail.This is the author accepted manuscript. The final version is available from Springer via http://dx.doi.org/10.1007/s10209-013-0297-

Ball pen probe in strongly magnetised RF plasmas

A study of ball pen probes (BPPs) in a rf strongly magnetised plasma is reported for the first time. These probes have been successfully used in fusion plasmas, with magnetic fields up to 2.5 T, to measure the plasma potential. In this paper experimental results of various ball pen designs (2 and 4 mm diameter with flat and conical collectors) are presented up to 0.5 T in a low pressure capacitively coupled rf plasma. A theory of the BPP is developed, showing that the increase of the collector potential and plateau region, with collector retraction, requires the electron current to decrease faster than the ion current. Experimentally, it is found that to develop effective electron screening the electron Larmor radius should be smaller than the tunnel internal diameter. Smaller tunnels improve screening due to the tunnel entrance wall sheaths. Inside the tunnel a plateau region forms at 81 mT reducing to a broad peak at higher field strengths. Ion shielding and surface losses (for small tunnel diameters) reduce the collector peak width and maximum potential with increasing magnetic field. Conical collectors were found to increase the length of the plateau region and broaden the peak. Particle in cell simulations were in good agreement with the experimental results. The electron shielding and plateau regions were reproduced but not the broad peak at higher field strengths. Good agreement between both 2 mm BPPs and an emissive probe was found only at 81 mT to within 3 V or 1.3 electron temperatures (T e). For all BPPs at higher field strengths (≥ 250 mT) the maximum collector potential underestimated the emissive probe by more than 2.7 T e (7 V). At these field strengths all BPPs agree with each other to within 1.5 T e (4.1 V). Possible reasons for these disagreements are discussed

Dermatological remedies in the traditional pharmacopoeia of Vulture-Alto Bradano, inland southern Italy

Dermatological remedies make up at least one-third of the traditional pharmacopoeia in southern Italy. The identification of folk remedies for the skin is important both for the preservation of traditional medical knowledge and in the search for novel antimicrobial agents in the treatment of skin and soft tissue infection (SSTI). Our goal is to document traditional remedies from botanical, animal, mineral and industrial sources for the topical treatment of skin ailments. In addition to SSTI remedies for humans, we also discuss certain ethnoveterinary applications. Field research was conducted in ten communities in the Vulture-Alto Bradano area of the Basilicata province, southern Italy. We randomly sampled 112 interviewees, stratified by age and gender. After obtaining prior informed consent, we collected data through semi-structured interviews, participant-observation, and small focus groups techniques. Voucher specimens of all cited botanic species were deposited at FTG and HLUC herbaria located in the US and Italy. We report the preparation and topical application of 116 remedies derived from 38 plant species. Remedies are used to treat laceration, burn wound, wart, inflammation, rash, dental abscess, furuncle, dermatitis, and other conditions. The pharmacopoeia also includes 49 animal remedies derived from sources such as pigs, slugs, and humans. Ethnoveterinary medicine, which incorporates both animal and plant derived remedies, is addressed. We also examine the recent decline in knowledge regarding the dermatological pharmacopoeia. The traditional dermatological pharmacopoeia of Vulture-Alto Bradano is based on a dynamic folk medical construct of natural and spiritual illness and healing. Remedies are used to treat more than 45 skin and soft tissue conditions of both humans and animals. Of the total 165 remedies reported, 110 have never before been published in the mainland southern Italian ethnomedical literature

Energy and angular momentum balance in wall-bounded superfluid turbulence

A superfluid in the absence of the viscous normal component should be the best realization of an ideal inviscid Euler fluid. As expressed by d'Alembert's famous paradox, an ideal fluid does not exert drag on bodies past which it flows, or in other words, it does not exchange momentum with them. Also, the flow of an ideal fluid does not dissipate kinetic energy. We study experimentally whether these properties apply to the flow of superfluid 3He-B in a rotating cylinder at low temperatures. It is found that ideal behavior is broken by quantum turbulence, which leads to substantial energy dissipation, as observed also earlier. Here we show that remarkably, nearly ideal behavior is preserved with respect to the angular-momentum exchange between the superfluid and its container, i.e., the drag almost disappears in the zero-temperature limit. This mismatch between energy and angular-momentum transfer results in a new physical situation where the proper description of wall-bounded quantum turbulence requires two effective friction parameters, one for energy dissipation and another for momentum coupling, which become substantially different at very low temperatures.Comment: 7 pages, 3 figure

Improved Understanding of the Ball-Pen Probe through Particle-In-Cell Simulations

Ball-pen probes (BPP)have been deployed in the SOL of numerous tokamak experiments and low-temperature magnetised plasmas to make direct measurements of the plasma potential and electron temperature. Despite strong empirical evidence for the success of the BPP it lacks a theoretical underpinning of its collection mechanism. In this paper we investigate the capability of the probe to measure the plasma potential by means of particle-in-cell simulations. The BPP is found to float at a potential offset from the plasma potential by a factor TₑαBPP. By simulating BPPs and Langmuir probes, excellent agreement has been found between the measured electron temperature and the specified source temperature. The transport mechanism for both ions and electrons has been determined.E×B drifts are observed to drive electrons and ions down the tunnel. This mechanism is sensitive to the diameter of the prob

The Explication Defence of Arguments from Reference

In a number of influential papers, Machery, Mallon, Nichols and Stich have presented a powerful critique of so-called arguments from reference, arguments that assume that a particular theory of reference is correct in order to establish a substantive conclusion. The critique is that, due to cross-cultural variation in semantic intuitions supposedly undermining the standard methodology for theorising about reference, the assumption that a theory of reference is correct is unjustified. I argue that the many extant responses to Machery et al.’s critique do little for the proponent of an argument from reference, as they do not show how to justify the problematic assumption. I then argue that it can in principle be justified by an appeal to Carnapian explication. I show how to apply the explication defence to arguments from reference given by Andreasen (for the biological reality of race) and by Churchland (against the existence of beliefs and desires)

Interpretation of ambiguous situations: evidence for a dissociation between social and physical threat in Williams syndrome

There is increasing evidence that Williams syndrome (WS) is associated with elevated anxiety that is non-social in nature, including generalised anxiety and fears. To date very little research has examined the cognitive processes associated with this anxiety. In the present research, attentional bias for non-social threatening images in WS was examined using a dot-probe paradigm. Participants were 16 individuals with WS aged between 13 and 34 years and two groups of typically developing controls matched to the WS group on chronological age and attentional control ability respectively. The WS group exhibited a significant attention bias towards threatening images. In contrast, no bias was found for group matched on attentional control and a slight bias away from threat was found in the chronological age matched group. The results are contrasted with recent findings suggesting that individuals with WS do not show an attention bias for threatening faces and discussed in relation to neuroimaging research showing elevated amygdala activation in response to threatening non-social scenes in WS

Racial/ethnic differences in job loss for women with breast cancer

IntroductionWe examined race/ethnic differences in treatment-related job loss and the financial impact of treatment-related job loss, in a population-based sample of women diagnosed with breast cancer.MethodsThree thousand two hundred fifty two women with non-metastatic breast cancer diagnosed (August 2005-February 2007) within the Los Angeles County and Detroit Metropolitan Surveillance Epidemiology and End Results registries, were identified and asked to complete a survey (mean time from diagnosis = 8.9 months). Latina and African American women were over-sampled (n = 2268, eligible response rate 72.1%).ResultsOne thousand one hundred eleven women (69.6%) of working age (<65 years) were working for pay at time of diagnosis. Of these women, 10.4% (24.1% Latina, 10.1% African American, 6.9% White, p < 0.001) reported that they lost or quit their job since diagnosis due to breast cancer or its treatment (defined as job loss). Latina women were more likely to experience job loss compared to White women (OR = 2.0, p = 0.013)), independent of sociodemographic factors. There were no significant differences in job loss between African American and White women, independent of sociodemographic factors. Additional adjustments for clinical and treatment factors revealed a significant interaction between race/ethnicity and chemotherapy (p = 0.007). Among women who received chemotherapy, Latina women were more likely to lose their job compared to White women (OR = 3.2, p < 0.001), however, there were no significant differences between Latina and White women among those who did not receive chemotherapy. Women who lost their job were more likely to experience financial strain (e.g. difficulty paying bills 27% vs. 11%, p < 0.001).ConclusionJob loss is a serious consequence of treatment for women with breast cancer. Clinicians and staff need to be aware of aspects of treatment course that place women at higher risk for job loss, especially ethnic minorities receiving chemotherapy