Getting the story from child witnesses : exploring the application of a story grammar framework

Investigative interviews with children about alleged abuse were analysed to determine the degree to which the child\u27s responses adhered to a story grammar framework, and whether the presence of story grammar elements was associated with interviewers\u27 adherence to best-practice (i.e. open-ended) questioning. The sample included 51 interviews with child witnesses from across Australia. The interviews were administered by a police officer with children (37 girls and 14 boys) aged 3-16 years (M age = 103.82 months, SD = 34.21 months). The interviewers\u27 questions were categorised as open-ended or specific and the children\u27s responses were classified as a story grammar element, context/background information, or \u27don\u27t know\u27 responses. The majority of interviewer questions were specific in nature and the majority of children\u27s responses were context/background details. Open-ended questions were more successful in eliciting story grammar from children. Of the story grammar elements, the interviewers\u27 specific questions usually targeted setting and attempt details. These findings suggest that improvement in the narrative coherence of children\u27s reports of abusive events can potentially be achieved by increasing interviewers\u27 use of open-ended questions.<br /

Cognitive function and mood at high altitude following acclimatization and use of supplemental oxygen and adaptive servoventilation sleep treatments.

Impairments in cognitive function, mood, and sleep quality occur following ascent to high altitude. Low oxygen (hypoxia) and poor sleep quality are both linked to impaired cognitive performance, but their independent contributions at high altitude remain unknown. Adaptive servoventilation (ASV) improves sleep quality by stabilizing breathing and preventing central apneas without supplemental oxygen. We compared the efficacy of ASV and supplemental oxygen sleep treatments for improving daytime cognitive function and mood in high-altitude visitors (N = 18) during acclimatization to 3,800 m. Each night, subjects were randomly provided with ASV, supplemental oxygen (SpO2 &gt; 95%), or no treatment. Each morning subjects completed a series of cognitive function tests and questionnaires to assess mood and multiple aspects of cognitive performance. We found that both ASV and supplemental oxygen (O2) improved daytime feelings of confusion (ASV: p &lt; 0.01; O2: p &lt; 0.05) and fatigue (ASV: p &lt; 0.01; O2: p &lt; 0.01) but did not improve other measures of cognitive performance at high altitude. However, performance improved on the trail making tests (TMT) A and B (p &lt; 0.001), the balloon analog risk test (p &lt; 0.0001), and the psychomotor vigilance test (p &lt; 0.01) over the course of three days at altitude after controlling for effects of sleep treatments. Compared to sea level, subjects reported higher levels of confusion (p &lt; 0.01) and performed worse on the TMT A (p &lt; 0.05) and the emotion recognition test (p &lt; 0.05) on nights when they received no treatment at high altitude. These results suggest that stabilizing breathing (ASV) or increasing oxygenation (supplemental oxygen) during sleep can reduce feelings of fatigue and confusion, but that daytime hypoxia may play a larger role in other cognitive impairments reported at high altitude. Furthermore, this study provides evidence that some aspects of cognition (executive control, risk inhibition, sustained attention) improve with acclimatization

Relationships Between Chemoreflex Responses, Sleep Quality, and Hematocrit in Andean Men and Women.

Andean highlanders are challenged by chronic hypoxia and many exhibit elevated hematocrit (Hct) and blunted ventilation compared to other high-altitude populations. While many Andeans develop Chronic Mountain Sickness (CMS) and excessive erythrocytosis, Hct varies markedly within Andean men and women and may be driven by individual differences in ventilatory control and/or sleep events which exacerbate hypoxemia. To test this hypothesis, we quantified relationships between resting ventilation and ventilatory chemoreflexes, sleep desaturation, breathing disturbance, and Hct in Andean men and women. Ventilatory measures were made in 109 individuals (n = 63 men; n = 46 women), and sleep measures in 45 of these participants (n = 22 men; n = 23 women). In both men and women, high Hct was associated with low daytime SpO2 (p &lt; 0.001 and p &lt; 0.002, respectively) and decreased sleep SpO2 (mean, nadir, and time &lt;80%; all p &lt; 0.02). In men, high Hct was also associated with increased end-tidal PCO2 (p &lt; 0.009). While ventilatory responses to hypoxia and hypercapnia did not predict Hct, decreased hypoxic ventilatory responses were associated with lower daytime SpO2 in men (p &lt; 0.01) and women (p &lt; 0.009) and with lower nadir sleep SpO2 in women (p &lt; 0.02). Decreased ventilatory responses to CO2 were associated with more time below 80% SpO2 during sleep in men (p &lt; 0.05). The obstructive apnea index and apnea-hypopnea index also predicted Hct and CMS scores in men after accounting for age, BMI, and SpO2 during sleep. Finally, heart rate response to hypoxia was lower in men with higher Hct (p &lt; 0.0001). These data support the idea that hypoventilation and decreased ventilatory sensitivity to hypoxia are associated with decreased day time and nighttime SpO2 levels that may exacerbate the stimulus for erythropoiesis in Andean men and women. However, interventional and longitudinal studies are required to establish the causal relationships between these associations

Nurses Alumni Association Bulletin, Fall 1994

1994-1995 Meeting Dates Calendar 1995 Annual Luncheon - Meeting Notice Officers and Committee Chairs Bulletin Publication Committee 1994-1995 Meeting Dates Calendar The President\u27s Message Treasurer\u27s Report News About Our Graduates Fiftieth Anniversary Resume of Minutes of Alumni Association Meetings Department of Nursing 1993-1994 Alumni Office News Jefferson 2000 Fund The Women\u27s Center for Health Promotion Discount Parking for Alumni Cadet Nurse Corps Medical Anecdotes of Faith Ukranian-American Teacher Exchange Happy Birthday Committee Reports In Memoriam, Names of Deceased Graduates Luncheon Photos Class News Jefferson Alumni Identification Card Relief Fund Application Scholarship Application Membership Application Pins, Transcripts, Class Address Lists, Change of address Forms Campus Ma

Effectiveness of an evidence-based curriculum module in nursing schools: Targeting safe patient handling and movement

Nursing schools in the United States have not been teaching evidence-based practices for safe patient handling, putting their graduates at risk for musculoskeletal disorders (MSDs). The specific aim of this study was to translate research related to safe patient handling into the curricula of nursing schools and evaluate the impact on nurse educators and students\u27 intentions to use safe patient handling techniques. Nurse educators at 26 nursing schools received curricular materials and training; nursing students received the evidence-based curriculum module. There were three control sites. Questionnaires were used to collect data on knowledge, attitudes, and beliefs about safe patient handling for both nurse educators and students, pre- and post-training. In this study, we found that nurse educator and student knowledge improved significantly at intervention schools, as did intention to use mechanical lifting devices in the near future. We concluded that the curriculum module is ready for wide dissemination across nursing schools to reduce the risk of MSDs among nurses

Biogeochemistry and microbial diversity in the marine cavity beneath the McMurdo Ice Shelf, Antarctica:Biogeochemistry under the MCM ice shelf

Ice shelves surround ~ 75% of Antarctica's coastline and are highly sensitive to climate change; several have recently collapsed and others are predicted to in the near future. Marine waters beneath ice shelves harbor active ecosystems, while adjacent seas can be important areas of bottom water formation. Despite their oceanographic significance, logistical constraints have resulted in few opportunities to directly sample sub-ice shelf cavities. Here, we present the first data on microbial diversity and biogeochemistry beneath the McMurdo Ice Shelf (MIS) near Ross Island, Antarctica. Physicochemical profiles obtained via a 56 m deep borehole through the MIS revealed three vertically layered water masses (Antarctic Surface Water [AASW], Ice Shelf Water [ISW], and modified High Salinity Shelf Water [mHSSW]). Metabolically active, moderately diverse (Shannon diversity from 2.06 to 5.74) microbial communities were detected in the AASW and mHSSW. Heterotrophic bacterial production and dissolved organic matter concentrations were higher (12-37% and 24%, respectively) in mHSSW relative to AASW. Chemoautotrophic production was 5.3 nmol C L-1 d-1 and 6.0 nmol C L-1 d-1 in the AASW and mHSSW, respectively. Phytoplankton cells were more abundant and larger in the mHSSW sample relative to the AASW, which indicates sinking of phytoplankton produced in surface waters and, together with southerly flowing currents (0.09-0.16 m s-1), horizontal advection of phytoplankton from McMurdo Sound. Advected phytoplankton carbon together with in situ chemoautotrophic production provide important sources of organic matter and other reduced compounds to support ecosystem processes in the dark waters in the ice shelf cavity

Nurses Alumni Association Bulletin, Fall 1995

1995-1996 Meeting Dates Calendar 1996 Annual Luncheon-Meeting Notice Officers and Committee Chairs Bulletin Publication Committee 1995-1996 Meeting Dates Calendar The President\u27s Message Financial Report What\u27s New Fiftieth Anniversary Resume of Minutes of Alumni Association Meetings Scholarship Funds at Work CAHS Alumni Board/Diploma School Alumni Office News Jefferson Health System Oldest Veteran Dies 1OOth Anniversary Pearl Harbor Remembered Memories Janet Hindson Retires Happy Birthday Scholarship Fund donors for 1994 Committee Reports By-Laws Development Bulletin Relief Fund Satellite Social Scholarship In Memoriam, Names of Deceased Graduates Class News Luncheon Photos Jefferson Alumni Identification Card The Diploma School of Nursing Alumni Association-Mabel C. Prevost Letter of Appreciation Tribute To a Mother An End Must Come Stuff For Senior Citizens to Chuckle Over Membership Application Relief Fund Application To Order: A Chronological History and Alumni Directory From TJU Bookstore Scholarship Fund Application Pins, Transcripts, Class Address List, Change of Address Forms, Alumni Identification Card Campus Map Picture - Class of 1893-189

Molecular Classification of the PORTEC-3 Trial for High-Risk Endometrial Cancer:Impact on Prognosis and Benefit From Adjuvant Therapy

PURPOSE The randomized Adjuvant Chemoradiotherapy Versus Radiotherapy Alone in Women With High-Risk Endometrial Cancer (PORTEC-3) trial investigated the benefit of combined adjuvant chemotherapy and radiotherapy (CTRT) versus radiotherapy alone (RT) for women with high-risk endometrial cancer (EC). Because The Cancer Genome Atlas defined an EC molecular classification with strong prognostic value, we investigated prognosis and impact of chemotherapy for each molecular subgroup using tissue samples from PORTEC-3 trial participants. METHODS Paraffin-embedded tissues of 423 consenting patients were collected. Immunohistochemistry for p53 and mismatch repair (MMR) proteins, and DNA sequencing for POLE exonuclease domain were done to classify tumors as p53 abnormal (p53abn), POLE-ultramutated (POLEmut), MMR-deficient (MMRd), or no specific molecular profile (NSMP). The primary end point was recurrence-free survival (RFS). Kaplan-Meier method, log-rank test, and Cox model were used for analysis. RESULTS Molecular analysis was successful in 410 high-risk EC (97%), identifying the 4 subgroups: P53abn EC (n = 93; 23%), POLEmut (n = 51; 12%), MMRd (n = 137; 33%), and NSMP (n = 129; 32%). Five-year RFS was 48% for patients with p53abn EC, 98% for POLEmut EC, 72% for MMRd EC, and 74% for NSMP EC (P <001). The 5-year RFS with CTRT versus RT for p53abn EC was 59% versus 36% (P =019); 100% versus 97% for patients with POLEmut EC (P =637); 68% versus 76% (P =428) for MMRd EC; and 80% versus 68% (P =243) for NSMP EC. CONCLUSION Molecular classification has strong prognostic value in high-risk EC, with significantly improved RFS with adjuvant CTRT for p53abn tumors, regardless of histologic type. Patients with POLEmut EC had an excellent RFS in both trial arms. EC molecular classification should be incorporated in the risk stratification of these patients as well as in future trials to target specific subgroups of patients

The structural plasticity of white matter networks following anterior temporal lobe resection

Anterior temporal lobe resection is an effective treatment for refractory temporal lobe epilepsy. The structural consequences of such surgery in the white matter, and how these relate to language function after surgery remain unknown. We carried out a longitudinal study with diffusion tensor imaging in 26 left and 20 right temporal lobe epilepsy patients before and a mean of 4.5 months after anterior temporal lobe resection. The whole-brain analysis technique tract-based spatial statistics was used to compare pre- and postoperative data in the left and right temporal lobe epilepsy groups separately. We observed widespread, significant, mean 7%, decreases in fractional anisotropy in white matter networks connected to the area of resection, following both left and right temporal lobe resections. However, we also observed a widespread, mean 8%, increase in fractional anisotropy after left anterior temporal lobe resection in the ipsilateral external capsule and posterior limb of the internal capsule, and corona radiata. These findings were confirmed on analysis of the native clusters and hand drawn regions of interest. Postoperative tractography seeded from this area suggests that this cluster is part of the ventro-medial language network. The mean pre- and postoperative fractional anisotropy and parallel diffusivity in this cluster were significantly correlated with postoperative verbal fluency and naming test scores. In addition, the percentage change in parallel diffusivity in this cluster was correlated with the percentage change in verbal fluency after anterior temporal lobe resection, such that the bigger the increase in parallel diffusivity, the smaller the fall in language proficiency after surgery. We suggest that the findings of increased fractional anisotropy in this ventro-medial language network represent structural reorganization in response to the anterior temporal lobe resection, which may damage the more susceptible dorso-lateral language pathway. These findings have important implications for our understanding of brain injury and rehabilitation, and may also prove useful in the prediction and minimization of postoperative language deficits