Changes in murine anorectum signaling across the life course

Background: Increasing age is associated with an increase in the incidence of chronic constipation and fecal impaction. The contribution of the natural aging process to these conditions is not fully understood. This study examined the effects of increasing age on the function of the murine anorectum.Methods: The effects of increasing age on cholinergic, nitrergic, and purinergic signaling pathways in the murine anorectum were examined using classical organ bath assays to examine tissue function and electrochemical sensing to determine age‐related changes in nitric oxide and acetylcholine release.Key Results: Nitrergic relaxation increased between 3 and 6 months, peaked at 12 months and declined in the 18 and 24 months groups. These changes were in part explained by an age‐related decrease in nitric oxide (NO) release. Cholinergic signaling was maintained with age by an increase in acetylcholine (ACh) release and a compensatory decrease in cholinesterase activity. Age‐related changes in purinergic relaxation were qualitatively similar to nitrergic relaxation although the relaxations were much smaller. Increasing age did not alter the response of the anorectum smooth muscle to exogenously applied ACh, ATP, sodium nitroprusside or KCl. Similarly, there was no change in basal tension developed by the anorectum.Conclusions and Inferences: The decrease in nitrergic signaling with increasing age may contribute to the age‐related fecal impaction and constipation previously described in this model by partially obstructing defecation

Do sixth-grade writers need process strategies?

Background: Strategy-focussed writing instruction trains students both to set explicit product goals and to adopt specific procedural strategies, particularly for planning text. A number of studies have demonstrated that strategy-focussed writing instruction is effective in developing writing performance. Aim: The present study aimed to determine whether teaching process strategies provides additional benefit over teaching students to set product goals. Sample: 94 typically developing Spanish sixth-grade (upper primary) students. Method: Students received 10 hours of instruction in one of three conditions: Strategy-focussed training in setting product goals and in writing procedures (planning and revision; Product-and-Process), strategy-focussed training in setting product goals (Product-Only), and product-focussed instruction (Control). Students' writing performance was assessed before, during, and after intervention with process measures based on probed self-report and holistic and text-analytic measures of text quality. Results: Training that included process instruction was successful in changing students' writing processes, with no equivalent process changes in the Product-Only or control conditions. Both Process-and-Product and Product-Only conditions resulted in substantial improvements in the quality of students' texts relative to controls, but with no evidence of benefits of process instruction over those provided by the Product-Only condition. Teaching process substantially increased time-on-task. Conclusions: Our findings confirm the value of strategy-focussed writing instruction, but question the value of training specific process strategies

Role of advanced technology in the detection of sight-threatening eye disease in a UK community setting.

Background/aims: To determine the performance of combinations of structural and functional screening tests in detecting sight-threatening eye disease in a cohort of elderly subjects recruited from primary care. Methods: 505 subjects aged ≥60 years underwent frequency doubling technology (FDT) perimetry, iVue optical coherence tomography (iWellness and peripapillary retinal nerve fibre layer (RNFL) scans) and intraocular pressure with the Ocular Response Analyzer, all performed by an ophthalmic technician. The reference standard was a full ophthalmic examination by an experienced clinician who was masked to the index test results. Subjects were classified as presence or absence of sight-threatening eye disease (clinically significant cataract, primary open-angle glaucoma, intermediate or advanced age-related macular degeneration and significant diabetic retinopathy). Univariate and multivariate logistic regression analyses were used to determine the association between abnormal screening test results and the presence of sight-threatening eye disease. Results: 171 subjects (33.8%) had one or more sight-threatening eye diseases. The multivariate analysis found significant associations with any of the target conditions for visual acuity of <6/12, an abnormal FDT and peripapillary RNFL thickness outside the 99% normal limit. The sensitivity of this optimised screening panel was 61.3% (95% CI 53.5 to 68.7), with a specificity of 78.8% (95% CI 74.0 to 83.1), a positive predictive value of 59.5% (95% CI 53.7 to 65.2) and an overall diagnostic accuracy of 72.9% (95% CI 68.8 to 76.8). Conclusions: A subset of screening tests may provide an accurate and efficient means of population screening for significant eye disease in the elderly. This study provides useful preliminary data to inform the development of further larger, multicentre screening studies to validate this screening panel

Acute impact of a national lockdown during the COVID-19 pandemic on wellbeing outcomes among individuals with chronic pain

Changes to wellbeing in a community- based sample of 638 adults with non-malignant chronic pain were assessed during a period of mandated lockdown measures in the UK to control the COVID-19 outbreak. Participants completed an online survey pre-lockdown and were followed up during lockdown. Multivariate analysis demonstrate that decreased ability to self-manage, restricted access to healthcare and increased dependence on others were associated with negative wellbeing outcomes related to sleep, anxiety and depression. Essential but nonurgent services are required during periods of lockdown to maintain independence and self-management in order to preserve wellbeing in this population

Effects of direct instruction and strategy modelling on upper-primary students' writing development

Strategy-focused instruction is one of the most effective approaches to improve writing skills. It aims to teach developing writers strategies that give them executive control over their writing processes. Programs under this kind of instruction tend to have multiple components that include direct instruction, modeling and scaffolded practice. This multi-component nature has two drawbacks: it makes implementation challenging due to the amount of time and training required to perform each stage, and it is difficult to determine the underlying mechanisms that contribute to its effectiveness. To unpack why strategy-focused instruction is effective, we explored the specific effects of two key components: direct teaching of writing strategies and modeling of strategy use. Six classes (133 students) of upper-primary education were randomly assigned to one of the two experimental conditions, in which students received instruction aimed at developing effective strategies for planning and drafting, or control group with no strategy instruction: Direct Instruction (N = 46), Modeling (N = 45), and Control (N = 42). Writing performance was assessed before the intervention and immediately after the intervention with two tasks, one collaborative and the other one individual to explore whether differential effects resulted from students writing alone or in pairs. Writing performance was assessed through reader-based and text-based measures of text quality. Results at post-test showed similar improvement in both intervention conditions, relatively to controls, in all measures and in both the collaborative and the individual task. No statistically significant differences were observed between experimental conditions. These findings suggest that both components, direct teaching and modeling, are equally effective in improving writing skills in upper primary students, and these effects are present even after a short training

The 2021 NICE guidelines for assessment and management of chronic pain: A cross-sectional study mapping against a sample of 1,000* in the community

Objectives To characterise the prevailing pharmacological and non-pharmacological pain management strategies among adults with chronic pain, comparing these against the newly published NICE guidelines NG-193, and examine these pre-NG-193 pain management strategies in relation to pain severity, pain interference, sleep quality and mental health outcomes. Design This study was conducted using a cross-sectional online survey study design. Setting This study was conducted on a community-dwelling cohort. Participants Adults aged 18+, living in the UK, with diagnosis of chronic pain by a health care professional. Main outcome measures Primary outcomes were characterisation of the pain management strategies utilised. Secondary outcomes were related to pain severity, pain interference, sleep quality, depression and anxiety via validated self-report measures. Results Several strategies were employed by respondents to manage their chronic pain condition including physical therapy, exercise, psychological therapy and pharmacological therapy. The data also indicated a high level of joint-care planning among patients and their clinicians. Some group differences were found in relation to pain, sleep and mental health outcomes. Conclusion This study set a comparative starting baseline to which the efficacy of the NG-193 may be compared in future years. There is evidence that NICE recommendations are being followed for the management of chronic primary pain conditions; however, pharmacological use of opioid drugs is still reported by 47%. Despite the confirmed evidence in this study of small efficacy of chronic pain by pharmacological agent, the reduction in the use of pain relief medications be it over the counter medications or prescription opioids, as recommended by NG-193, may be slow to be adopted. The data suggest that more care provision is needed to meet the recommendations around pharmacological management and review

Evaluating effects of different forms of revision instruction in upper-primary students

p. 1741-1767This study aimed to establish (a) whether teaching students revision skills provides beneft over and above teaching strategies for setting explicit goals for the communicative efect of their text, and (b) whether teaching students to adopt specifc revision strategies provides benefts over revision instruction that focusses on increasing students’ awareness of audience needs. Six classes of Spanish sixth-grade students (N=107, 11–12 years) were randomly assigned to one of three conditions. In all three conditions students were taught to set communicative goals. Students in the Strategy Focused condition were then taught a 6-step revision strategy. Students in the Reader Focused condition observed a reader trying to comprehend a text and suggesting ways in which it might be improved. Students in a control condition continued with goal-setting practice. Students’ writing performance was assessed through composition and revision tasks before and immediately after intervention, 2 months post-intervention, and for transfer to an untaught genre. Writing performance and revision skills improved more in the two revision-instruction conditions than for students in the control condition. The improvements were large, persistent and transferred to a diferent type of text. We found no statistically signifcant diferences between the two revision conditions. Findings suggest that specifc revision instruction benefts sixth-grade students’ writing performance and revision skills, but that strategy-focused and reader-focused approaches are similarly efectiveS

Stellate Ulceration in a Nonuremic Patient

info:eu-repo/semantics/publishedVersio