The views of young people with congenital cardiac disease on designing the services for their treatment

Background and purpose: There is little documented evidence of young people with congenital cardiac disease being consulted as to what help, if any, they really need in relation to their condition. Most research concentrates on the medical aspects of the condition. There are studies of psychological and social functioning, but few have directly sought the opinions of the young people. More recent research has indicated a need for health professionals to develop services to meet both psychosocial and physical needs of young people with congenital cardiac disease. The findings of the recent Kennedy Report support this need. The purpose of this study was to explore the views of young people with a range of congenital cardiac conditions, on what would help them better deal with their condition, and when and how help might be provided. Methods: This was a qualitative study using semi-structured interviews. We interviewed 16 young people in their own home. Interviews were tape-recorded and transcribed. Analysis was conducted using the "Framework" method. Results: Whilst most of the young people interviewed actively manage their condition, they think more support from others would be beneficial. Issues of activity and communication were cited most often as areas requiring more understanding from people they interact with, for example teachers and peers. The discussion focuses on how health professionals might change or develop their practice to help young people better cope with their condition. Conclusions: Most of the young people interviewed in this study had developed their own strategies for coping with their condition. Although this is a small study, the young people provided important suggestions as to how health professionals could better develop current services

Factors associated with self-perceived state of health in adolescents with congenital cardiac disease attending paediatric cardiologic clinics

The purpose of our study was to determine the ways in which adolescents with congenital cardiac disease believed that the condition had affected their life, and how these views were related to their perceived health. Interviews were conducted with a series of 37 adolescents, 17 girls and 20 boys, aged from 11 to 18, as they attended the clinics of 4 paediatric cardiologists in a teaching hospital in the United Kingdom. Transcripts of the interviews were analysed for recurring themes. A questionnaire was formed consisting of a set of questions for each theme, and additional items eliciting “perceived health”, and administered to a second series of 74 adolescents, 40 boys and 34 girls, who were again aged from 11 to 18 years. Slightly less than half (46%) perceived their health as either “good” or “very good”, and one-third (33%) rated it as “average”. The majority (66%) felt themselves to be “the same” as, or only very slightly “different” from, their peers. The assessment of the seriousness of their condition by the adolescents, the degree to which they saw themselves as different from others, and their perceived health, were not related to the “complexity of the underlying medical condition” as rated by their physician. It was the psychosocial themes, such as exclusion from activities or the effect of the condition on relationships, that were most strongly related to the perception of their health by the adolescents. Improved education of parents, teachers and peers, and attendance at classes for cardiac rehabilitation, might help to ameliorate some of these problems

Serum antioxidants as predictors of the adult respiratory distress syndrome in septic patients

Adult respiratory distress syndrome (ARDS) can develop as a complication of various disorders, including sepsis, but it has not been possible to identify which of the patients at risk will develop this serious disorder. We have investigated the ability of six markers, measured sequentially in blood, to predict development of ARDS in 26 patients with sepsis. At the initial diagnosis of sepsis (6-24 h before the development of ARDS), serum manganese superoxide dismutase concentration and catalase activity were higher in the 6 patients who subsequently developed ARDS than in 20 patients who did not develop ARDS. These changes in antioxidant enzymes predicted the development of ARDS in septic patients with the same sensitivity, specificity, and efficiency as simultaneous assessments of serum lactate dehydrogenase activity and factor VIII concentration. By contrast, serum glutathione peroxidase activity and α1Pi-elastase complex concentration did not differ at the initial diagnosis of sepsis between patients who did and did not subsequently develop ARDS, and were not as effective in predicting the development of ARDS. Measurement of manganese superoxide dismutase and catalase, in addition to the other markers, should facilitate identification of patients at highest risk of ARDS and allow prospective treatment

Combining stable isotope analysis and conventional techniques to improve knowledge of the diet of the European Roller Coracias garrulus

Diet studies are crucial for understanding the ecology and evolution of species, as well as for establishing appropriate conservation and management strategies. However, they remain methodologically challenging due to variation between seasons, sites, sexes or age groups and even variation between individuals. Due to method-specific characteristics and biases, a combination of existing techniques can overcome the inherent limitations of each technique and provide a more accurate and broad picture of species’ food preferences. Here, we examine diet information obtained using three different assessment methods to better understand the trophic ecology of the European Roller Coracias garrulus, a species targeted by conservation measures in Europe. First, we analysed regurgitated pellets and video recordings to report the diet composition of adult and nestling Rollers, respectively. Secondly, we used stable isotope analysis (SIA) to investigate adult sexual diet segregation as well as to confirm the main findings regarding adult and nestling diets obtained through conventional methods. Based on the analysis of pellets, the diet of adult Rollers was dominated by Coleoptera, while camera images revealed that the diet of nestlings was dominated by Orthoptera, mainly grasshoppers and bush crickets. Blood isotopic signatures of adult and nestling Rollers confirmed the results obtained through pellet and video recording techniques. Of the 45 three methods, pellet analysis contained the most comprehensive trophic information regarding the detectable prey spectrum and prey species contribution, and also provided basic diet information to inform the SIA. Our results also highlight the potential of SIA for assessing intra-specific variation in diet by sampling individuals of known age and sex, which is often unfeasible through conventional approaches. SIA analysis showed no differences in δ13C and δ15N ratios of blood between males and females and a high degree of overlap amongst isotopic niches, suggesting no sex-specific partitioning in resource use. Overall, we showed that the combination of different methods could be used to gain new and clearer insights into avian trophic ecology that are essential for informing habitat management aiming to improve availability of foraging resources

Organ health and development in larval kingfish are unaffected by ocean acidification and warming

Anthropogenic CO₂ emissions are causing global ocean warming and ocean acidification. The early life stages of some marine fish are vulnerable to elevated ocean temperatures and CO₂ concentrations, with lowered survival and growth rates most frequently documented. Underlying these effects, damage to different organs has been found as a response to elevated CO₂ in larvae of several species of marine fish, yet the combined effects of acidification and warming on organ health are unknown. Yellowtail kingfish, Seriola lalandi, a circumglobal subtropical pelagic fish of high commercial and recreational value, were reared from fertilization under control (21 °C) and elevated (25 °C) temperature conditions fully crossed with control (500 µatm) and elevated (1,000 µatm) pCO₂ conditions. Larvae were sampled at 11 days and 21 days post hatch for histological analysis of the eye, gills, gut, liver, pancreas, kidney and liver. Previous work found elevated temperature, but not elevated CO₂, significantly reduced larval kingfish survival while increasing growth and developmental rate. The current histological analysis aimed to determine whether there were additional sublethal effects on organ condition and development and whether underlying organ damage could be responsible for the documented effects of temperature on survivorship. While damage to different organs was found in a number of larvae, these effects were not related to temperature and/or CO₂ treatment. We conclude that kingfish larvae are generally vulnerable during organogenesis of the digestive system in their early development, but that this will not be exacerbated by near-future ocean warming and acidification

Low-temperature spin relaxation in n-type GaAs

Low-temperature electron spin relaxation is studied by the optical orientation method in bulk n-GaAs with donor concentrations from 10^14 cm^{-3} to 5x10^17 cm^{-3}. A peculiarity related to the metal-to-insulator transition (MIT) is observed in the dependence of the spin lifetime on doping near n_D = 2x10^16 cm^{-3}. In the metallic phase, spin relaxation is governed by the Dyakonov-Perel mechanism, while in the insulator phase it is due to anisotropic exchange interaction and hyperfine interactio

Approximating the limit: the interaction between 'almost' and some temporal connectives in Italian

International audienceThis paper focuses on the interpretation of the Italian approximative adverb 'almost' by primarily looking at cases in which it modifies temporal connectives, a domain which, to our knowledge, has been largely unexplored thus far. Consideration of this domain supports the need for a scalar account of the semantics of (close in spirit to Hitzeman's semantic analysis of , in: Canakis et al. (eds) Papers from the 28th regional meeting of the Chicago Linguistic Society, 1992). When paired with suitable analyses of temporal connectives, such an account can provide a simple explanation of the patterns of implication that are observed when modifies locational (e.g. 'when'), directional (e.g. 'until' and 'since'), and event-sequencing temporal connectives (e.g. 'before' and 'after'). A challenging empirical phenomenon that is observed is a contrast between the modification of and by , on the one hand, and the modification of and by the same adverb, on the other. While and behave symmetrically, a puzzling asymmetry is observed between and . To explain the asymmetry, we propose an analysis of and on which the former has the meaning of the temporal comparative 'earlier', while the latter is seen as an atomic predicate denoting temporal succession between events (Del Prete, Nat Lang Semantics 16:157-203, 2008). We show that the same pattern of implication observed for is attested when modifies overt comparatives, and propose a pragmatic analysis of this pattern that uniformly applies to both cases, thus providing new evidence for the claim that is underlyingly a comparative. A major point of this paper is a discussion of the notion of scale which is relevant for the semantics of ; in particular, we show that the notion of Horn (entailment-based) scale is not well-suited for handling modification of temporal connectives, and that a more general notion of scale is required in order to provide a uniform analysis of as a cross-categorial modifier

Virtual Reflexes

Virtual Reality is used successfully to treat people for regular phobias. A new challenge is to develop Virtual Reality Exposure Training for social skills. Virtual actors in such systems have to show appropriate social behavior including emotions, gaze, and keeping distance. The behavior must be realistic and real-time. Current approaches consist of four steps: 1) trainee social signal detection, 2) cognitive-affective interpretation, 3) determination of the appropriate bodily responses, and 4) actuation. The "cognitive" detour of such approaches does not match the directness of human bodily reflexes and causes unrealistic responses and delay. Instead, we propose virtual reflexes as concurrent sensory-motor processes to control virtual actors. Here we present a virtual reflexes architecture, explain how emotion and cognitive modulation are embedded, detail its workings, and give an example description of an aggression training application