The effects of color reversal on the maze performance of learning disabled and normal children

Recent studies examining the performance of braininjured children (specifically, cerebral palsied children) reported improvement of perceptual-motor abilities on graphic tests with figure-ground reversals (Uhlin & Dickinson, 1970; May, 1978). A pilot study was done to ascertain whether this facilitative effect of color manipulation would be demonstrated with hyperactive children also classified as perceptually impaired. A significant difference in performance was found between the white background/black figure manipulation and the black background/white figure manipulation by age (5-10 year olds). Normal children did not demonstrate this facilitative effect. It was postulated that this effect would generalize to learning disabled children. In the present study, twenty-four children between the ages of 9 and 12 years served as subjects. Twelve children made up the control group of normals and twelve children, diagnosed as learning disabled, comprised the experimental group. A three factor Latin square design was utilized. WISC-R mazes were used to measure performance. It was hypothesized that learning disabled children would perform better when presented with a task on the black background and that there would be no difference in the performance of normal children on either background. Homogeneity of variance was not satisfied so subsequent results were viewed with caution. Two findings of significance were noted as hypothesized, normal Color Reversal 2 and learning disabled children did not exhibit performance differences on the black background. In addition, a significant difference between performance on the black background versus white background was found for both groups when the black background was presented on the second trial

Woodland clearance in west-central Scotland during the past 3000 years

Pollen diagrams were produced from peat profiles taken from four raised bogs in west- central Scotland: Walls Hill Bog, Lochend Loch Bog, Lenzie Moss and Gartlea Bog. These sites have produced a detailed overview of the vegetation changes brought about by human impact in the area over the last three thousand years. This picture has been enhanced by peat stratigraphy diagrams, charcoal estimations and suites of accelerator radiocarbon dates from three of the four sites. Pollen influx data was also collected but not used in the final interpretations as it added little of value to the results from the relative pollen diagrams. The evidence is for low levels of woodland clearance in the Bronze Age followed by an increase to extensive clearance in the late pre-Roman Iron Age at Walls Hill Bog and Lochend Loch Bog. Lenzie Moss and Gartlea Bog show clearance to be slightly later, around the time of the Roman invasion and occupation. Clearance is maintained throughout the Roman period and for several centuries after the Roman withdrawal at all the sites, except for Walls Hill Bog. All the clearance activity seems to have been to produce pastoral rather than arable agricultural land. Throughout the Dark Ages agriculture declined and there was extensive woodland regeneration, first of Betula and then the other major tree taxa. Extensive clearance is next apparent between 800 - 1000 cal AD (perhaps slightly earlier at Gartlea Bog) with the cleared land again used for grazing. There is then a short period of woodland regeneration at all but one of the sites before the more extensive clearances of the Medieval and post-Medieval period are seen. These are again characterised by pastoral indicators although cereal cultivation may have become more important during this period. Evidence for modern tree planting is evident at some of the sites and all but Gartlea Bog show some truncation of the top of the peat profile

Compliance: Effects of Stress and Social Support Within a Hemodialysis Population

This review sets out to consider selected literature in relation to End-Stage Renal Disease (ESRD) populations, specifically focusing on hemodialysis patients. The relationship between social support and outcome, with special consideration given to compliance, is outlined, and a theoretical model of support discussed. Compliance within hemodialysis populations is considered in detail and associated methodological problems highlighted. Studies evaluating the stress-buffering model of social support in relation to stress and compliance are outlined and implications for future research briefly highlighted

Drafting a Code of Conduct for Research under the Protection of Personal Information Act No. 4 of 2013

No abstrac

Long slit spectroscopy of NH2 in comets Halley, Wilson, and Nishikawa-Takamizawa-Tago

Long-slit spectra of comets Halley, Wilson and Nishikawa-Takamizawa-Tago were obtained with the 3.9 meter Anglo-Australian Telescope. Spectra of comets Halley and Wilson were obtained with the IPCS at a spectral resolution of 0.5 A and a spatial resolution of 10(exp 3) km. Spectra of comets Wilson and Nishikawa-Takamizawa-Tago were obtained with a CCD at a spectral resolution of 1.5 A and a spatial resolution of approximately 3 x 10(exp 3) km. Surface brightness profiles for NH2 were extracted from the long-slit spectra of each comet. The observed surface brightness profiles extend along the slit to approximately 6 x 10(exp 4) km from the nucleus in both sunward and tailward directions. By comparing surface distribution calculated from an appropriate coma model with observed surface brightness distributions, the photodissociation timescale of the parent molecule of NH2 can be inferred. The observed NH2 surface brightness profiles in all three comets compares well with a surface brightness profile calculated using the vectorial model, an NH3 photodissociation timescale of 7 x 10(exp 3) seconds, and an NH2 photodissociation timescale of 34,000 seconds

The Isom Report - Fall 2016

The official newsletter of the Sarah Isom Center for Women and Gender Studies.https://egrove.olemiss.edu/isom_report/1003/thumbnail.jp

Bowel dysfunction after transposition of intestinal segments into the urinary tract : 8-year prospective cohort study

Purpose Bowel function may be disturbed after intestinal segments are transposed into the urinary tract to reconstruct or replace the bladder. In 1997, our group were the first to report major bowel dysfunction in a cohort of such patients: up to 42% of those who were asymptomatic preoperatively describing new bowel symptoms postoperatively including explosive diarrhoea, nocturnal diarrhoea, faecal urgency, faecal incontinence and flatus leakage . We now describe bowel symptoms in this same cohort eight years later (2005). Materials and Methods 116 patients were evaluable. Of the remaining 37 from the original report: 30 had died, five no longer wished to be involved, and two could not be traced. Patients were asked to complete postal questionnaires identical to those used in the first follow-up, assessing the severity of bowel symptoms and quality of life using two validated instruments. Responses were compared with those from the original study. The Nottingham Health Profile quality of life scores were also compared to age and sex matched norms. Results 96 (83%) completed eight-year follow-up questionnaires: 43 after ileal conduit diversion (Group 1), 17 after clam enterocystoplasty for overactive bladder (Group 2), 18 after reconstructed bladder for neurogenic bladder dysfunction (Group 3), and 18 with bladder replacement for non-neurogenic causes (Group 4). High prevalence rates of bowel symptoms persisted with no statistically significant differences between the two time points. Of those with symptoms in 2005, around 50% had reported similar symptoms in 1997. Clam enterocystoplasty patients (Group 2) still reported the highest prevalence (59%) of troublesome diarrhoea with one in two on regular anti-diarrhoeal medication. They also had high rates of faecal incontinence (47%), faecal urgency (41%) and nocturnal bowel movement (18%); with high proportions reporting a moderate or severe adverse effect on work (36%), social life (50%) and sex life (43%). High rates were also reported by neurogenic bladder dysfunction patients, including 50% with troublesome diarrhoea. This symptom was reported by 19% after ileal conduit and by 17% after bladder replacement for non-neurogenic causes. The impact of bowel symptoms on every-day activities and quality of life persisted, remaining most severe after clam enterocystoplasty, with 24% regretting undergoing the procedure because of subsequent bowel symptoms. Conclusions: After more than eight years, operations involving transposition of intestinal segments continue to be associated with high rates of bowel symptoms, which impact on everyday activities. These are particularly troublesome following enterocystoplasty for overactive bladder and bladder reconstruction for neurogenic bladder dysfunction. These risks should influence patient selection and potential patients should be warned prior to surgery

Bowel dysfunction after transposition of intestinal segments into the urinary tract : 8-year prospective cohort study

Purpose Bowel function may be disturbed after intestinal segments are transposed into the urinary tract to reconstruct or replace the bladder. In 1997, our group were the first to report major bowel dysfunction in a cohort of such patients: up to 42% of those who were asymptomatic preoperatively describing new bowel symptoms postoperatively including explosive diarrhoea, nocturnal diarrhoea, faecal urgency, faecal incontinence and flatus leakage . We now describe bowel symptoms in this same cohort eight years later (2005). Materials and Methods 116 patients were evaluable. Of the remaining 37 from the original report: 30 had died, five no longer wished to be involved, and two could not be traced. Patients were asked to complete postal questionnaires identical to those used in the first follow-up, assessing the severity of bowel symptoms and quality of life using two validated instruments. Responses were compared with those from the original study. The Nottingham Health Profile quality of life scores were also compared to age and sex matched norms. Results 96 (83%) completed eight-year follow-up questionnaires: 43 after ileal conduit diversion (Group 1), 17 after clam enterocystoplasty for overactive bladder (Group 2), 18 after reconstructed bladder for neurogenic bladder dysfunction (Group 3), and 18 with bladder replacement for non-neurogenic causes (Group 4). High prevalence rates of bowel symptoms persisted with no statistically significant differences between the two time points. Of those with symptoms in 2005, around 50% had reported similar symptoms in 1997. Clam enterocystoplasty patients (Group 2) still reported the highest prevalence (59%) of troublesome diarrhoea with one in two on regular anti-diarrhoeal medication. They also had high rates of faecal incontinence (47%), faecal urgency (41%) and nocturnal bowel movement (18%); with high proportions reporting a moderate or severe adverse effect on work (36%), social life (50%) and sex life (43%). High rates were also reported by neurogenic bladder dysfunction patients, including 50% with troublesome diarrhoea. This symptom was reported by 19% after ileal conduit and by 17% after bladder replacement for non-neurogenic causes. The impact of bowel symptoms on every-day activities and quality of life persisted, remaining most severe after clam enterocystoplasty, with 24% regretting undergoing the procedure because of subsequent bowel symptoms. Conclusions: After more than eight years, operations involving transposition of intestinal segments continue to be associated with high rates of bowel symptoms, which impact on everyday activities. These are particularly troublesome following enterocystoplasty for overactive bladder and bladder reconstruction for neurogenic bladder dysfunction. These risks should influence patient selection and potential patients should be warned prior to surgery

Poor outcomes in patients with sepsis undergoing emergency laparotomy and laparoscopy are attenuated by faster time to care measures

ACKNOWLEDGEMENTS NE received the University of Aberdeen Innes Will Endowed Research Scholarship 2022 to carry out the research. FUNDING INFORMATION The Emergency Laparotomy and Laparoscopic Scottish Audit (ELLSA) is a Scottish Government initiative supported via the Modernising Patient Pathways Programme (MPPP).Peer reviewedPublisher PD

Interventions to improve antibiotic prescribing practices for hospital inpatients

Background Antibiotic resistance is a major public health problem. Infections caused by multidrug-resistant bacteria are associated with prolonged hospital stay and death compared with infections caused by susceptible bacteria. Appropriate antibiotic use in hospitals should ensure effective treatment of patients with infection and reduce unnecessary prescriptions. We updated this systematic review to evaluate the impact of interventions to improve antibiotic prescribing to hospital inpatients. Objectives To estimate the effectiveness and safety of interventions to improve antibiotic prescribing to hospital inpatients and to investigate the effect of two intervention functions: restriction and enablement. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library), MEDLINE, and Embase. We searched for additional studies using the bibliographies of included articles and personal files. The last search from which records were evaluated and any studies identified incorporated into the review was January 2015. Selection criteria We included randomised controlled trials (RCTs) and non-randomised studies (NRS). We included three non-randomised study designs to measure behavioural and clinical outcomes and analyse variation in the effects: non- randomised trials (NRT), controlled before-after (CBA) studies and interrupted time series (ITS) studies. For this update we also included three additional NRS designs (case control, cohort, and qualitative studies) to identify unintended consequences. Interventions included any professional or structural interventions as defined by the Cochrane Effective Practice and Organisation of Care Group. We defined restriction as 'using rules to reduce the opportunity to engage in the target behaviour (or increase the target behaviour by reducing the opportunity to engage in competing behaviours)'. We defined enablement as 'increasing means/reducing barriers to increase capability or opportunity'. The main comparison was between intervention and no intervention. Data collection and analysis Two review authors extracted data and assessed study risk of bias. We performed meta-analysis and meta-regression of RCTs and meta-regression of ITS studies. We classified behaviour change functions for all interventions in the review, including those studies in the previously published versions. We analysed dichotomous data with a risk difference (RD). We assessed certainty of evidence with GRADE criteria. Main results This review includes 221 studies (58 RCTs, and 163 NRS). Most studies were from North America (96) or Europe (87). The remaining studies were from Asia (19), South America (8), Australia (8), and the East Asia (3). Although 62% of RCTs were at a high risk of bias, the results for the main review outcomes were similar when we restricted the analysis to studies at low risk of bias. More hospital inpatients were treated according to antibiotic prescribing policy with the intervention compared with no intervention based on 29 RCTs of predominantly enablement interventions (RD 15%, 95% confidence interval (CI) 14% to 16%; 23,394 participants; high-certainty evidence). This represents an increase from 43% to 58% .There were high levels of heterogeneity of effect size but the direction consistently favoured intervention. The duration of antibiotic treatment decreased by 1.95 days (95% CI 2.22 to 1.67; 14 RCTs; 3318 participants; high-certainty evidence) from 11.0 days. Information from non-randomised studies showed interventions to be associated with improvement in prescribing according to antibiotic policy in routine clinical practice, with 70% of interventions being hospital-wide compared with 31% for RCTs. The risk of death was similar between intervention and control groups (11% in both arms), indicating that antibiotic use can likely be reduced without adversely affecting mortality (RD 0%, 95% CI -1% to 0%; 28 RCTs; 15,827 participants; moderate-certainty evidence). Antibiotic stewardship interventions probably reduce length of stay by 1.12 days (95% CI 0.7 to 1.54 days; 15 RCTs; 3834 participants; moderate-certainty evidence). One RCT and six NRS raised concerns that restrictive interventions may lead to delay in treatment and negative professional culture because of breakdown in communication and trust between infection specialists and clinical teams (low-certainty evidence). Both enablement and restriction were independently associated with increased compliance with antibiotic policies, and enablement enhanced the effect of restrictive interventions (high-certainty evidence). Enabling interventions that included feedback were probably more effective than those that did not (moderate-certainty evidence). There was very low-certainty evidence about the effect of the interventions on reducing Clostridium difficile infections (median -48.6%, interquartile range -80.7% to -19.2%; 7 studies). This was also the case for resistant gram-negative bacteria (median -12.9%, interquartile range -35.3% to 25.2%; 11 studies) and resistant gram-positive bacteria (median -19.3%, interquartile range -50.1% to +23.1%; 9 studies). There was too much variance in microbial outcomes to reliably assess the effect of change in antibiotic use. Heterogeneity of intervention effect on prescribing outcomes We analysed effect modifiers in 29 RCTs and 91 ITS studies. Enablement and restriction were independently associated with a larger effect size (high-certainty evidence). Feedback was included in 4 (17%) of 23 RCTs and 20 (47%) of 43 ITS studies of enabling interventions and was associated with greater intervention effect. Enablement was included in 13 (45%) of 29 ITS studies with restrictive interventions and enhanced intervention effect. Authors' conclusions We found high-certainty evidence that interventions are effective in increasing compliance with antibiotic policy and reducing duration of antibiotic treatment. Lower use of antibiotics probably does not increase mortality and likely reduces length of stay. Additional trials comparing antibiotic stewardship with no intervention are unlikely to change our conclusions. Enablement consistently increased the effect of interventions, including those with a restrictive component. Although feedback further increased intervention effect, it was used in only a minority of enabling interventions. Interventions were successful in safely reducing unnecessary antibiotic use in hospitals, despite the fact that the majority did not use the most effective behaviour change techniques. Consequently, effective dissemination of our findings could have considerable health service and policy impact. Future research should instead focus on targeting treatment and assessing other measures of patient safety, assess different stewardship interventions, and explore the barriers and facilitators to implementation. More research is required on unintended consequences of restrictive interventions