Propofol and children--what we know and what we do not know.

The pharmacokinetics of propofol are relatively well described in the pediatric population. Recent work has confirmed the validity of allometric scaling for predicting propofol disposition across different species and for describing pediatric ontogenesis. In the first year of life, allometric models require adjustment to reflect ontogeny of maturation. Pharmacodynamic data for propofol in children are scarcer, because of practical difficulties in data collection and the limitations of currently available depth of anesthesia monitors for pediatric use. Hence, questions relating to the comparative sensitivity of children to propofol, and differences in time to peak effect relative to adults, remain unanswered. K(eo) half-lives have been determined for pediatric kinetic models using time to peak effect techniques but are not currently incorporated into commercially available target-controlled infusion pumps

Everyday ecocide, toxic dwelling, and the inability to mourn: a speculative response to geographies of extinction

In responding to the spatiotemporally specific geographies of extinction charted in the articles in this special section, this article reflects on the sociocultural factors that inform the ways in which extinction is framed and impede recognition of the enormity of the anthropogenic extinction event in which we are all bound. This article argues that we are living in an era of ecocide, where the degradation of biodiversity and eradication of species go hand-in-hand with the degradation and eradication of nonmodern culture and identity, and it explores some possible reasons why modern society is failing to respond to impending crisis. Fine-grained stories of spatiotemporally specific geographies of extinction can help to counter the logic of colonization and bring everyday ecocide into view. For the particular multispecies communities they concern, they can also feed into the creation of ritual practices of penitential mourning in ways that enable a collective grieving process poised to activate an ecosocial transformation. The authors consider the implications of grief and mourning—and of not mourning—in what can be seen as not only a terrible time but also the end of (lived) time. They conclude with some reflections of local acts of resistance, witnessing, and narrative

A real-time test of food hazard awareness

Purpose - Food poisoning attributable to the home generates a large disease burden, yet is an unregulated and largely unobserved domain. Investigating food safety awareness and routine practices is fraught with difficulties. The purpose of this paper is to develop and apply a new survey tool to elicit awareness of food hazards. Data generated by the approach are analysed to investigate the impact of oberservable heterogeneity on food safety awareness. Design/methodology/approach - The authors develop a novel Watch-and-Click survey tool to assess the level of awareness of a set of hazardous food safety behaviours in the domestic kitchen. Participants respond to video footage stimulus, in which food hazards occur, via mouse clicks/screen taps. This real-time response data is analysed via estimation of count and logit models to investigate how hazard identification patterns vary over observable characteristics. Findings - User feedback regarding the Watch-and-Click tool approach is extremely positive. Substantive results include significantly higher hazard awareness among the under 60s. People who thought they knew more than the average person did indeed score higher but people with food safety training/experience did not. Vegetarians were less likely to identify four of the five cross-contamination hazards they observed. Originality/value - A new and engaging survey tool to elicit hazard awareness with real-time scores and feedback is developed, with high levels of user engagement and stakeholder interest. The approach may be applied to elicit hazard awareness in a wide range of contexts including education, training and research

Type 2 Diabetes and Memory: Using Neuroimaging to Understand the Mechanisms

The most robust and frequently reported cognitive deficits in type 2 diabetes (DM2) are those that relate to memory. Behavioural research has identified a number of potential contributory physiological factors, including abnormalities in glucose metabolism, such as hyperglycaemia and hypoglycaemia. The impact of these mechanisms on memory has been further investigated through the use of both structural and functional neuroimaging. Structural brain imaging has indicated that memory impairments in DM2 are associated with global atrophy of the brain. Further data suggest that localised atrophy in the hippocampal area, a brain region critical to memory formation and consolidation, may be primarily responsible for the memory deficits seen in this population. Functional imaging data has corroborates these findings, with functional magnetic resonance imaging (fMRI) suggesting reduced connectivity between the hippocampus and surrounding brain regions, particularly the frontal and temporal gyri. Despite this, little functional neuroimaging research has directly investigated differences in regional brain activity between healthy and DM2 participants whilst memory tasks are being performed. By using neuroimaging techniques to their full potential, we can acquire a fuller, more comprehensive picture of the impact that DM2 has on memory

Pilot investigation of a virtual gastric band hypnotherapy intervention

This was a pilot investigation of 30 men and women with a BMI > 27kg/m² over a 24 week period. It aimed to determine whether virtual gastric band (VGB) hypnotherapy has an effect on weight loss in overweight adults, compared to relaxation hypnotherapy and a self-directed diet. Levels of weight loss and gain ranged from -17kg to +4.7kg in the VGB hypnotherapy group and -9.3kg to +7.8kg in the relaxation group. There was no significant difference between VGB hypnotherapy as a main effect on weight loss (Chi²=0.67, p=0.41, df=1) and there was no evidence of differential weight loss over time (Chi²=4.2, p=0.64, df=6). Therefore, this study concludes that there was no significant difference between VGB hypnotherapy and the relaxation hypnotherapy

Bringing the doctoral thesis by published papers to the Social Sciences and the Humanities: A quantitative easing? A small study of doctoral thesis submission rules and practice in two disciplines in the UK

From Springer Nature via Jisc Publications RouterHistory: received 2019-12-23, registration 2020-04-16, pub-electronic 2020-05-15, online 2020-05-15, pub-print 2020-08Publication status: PublishedFunder: Higher Education Funding Council for England; doi: http://dx.doi.org/10.13039/100011722Abstract: This paper examines how an alternative to the traditional monograph form of the doctoral thesis is emerging that reflects a new approach to the valuation and designation of scientific outputs. This new approach, based on co-citation as underpinning principle for the measurement of knowledge structures, values knowledge and knowledge producers in increasingly quantitative terms. Such a change aligns with wider institutional market-based approaches that have been transforming higher education sectors world-wide. Under these influences, which prioritize quantification and tangibility of output, with quality equated with citation, the thesis, a key institution of the university, is now subject to pressures to transform and be constituted by a series of publishable papers, referred to by a variety of terms, the most common being ‘Thesis by Published Papers’, although ‘Journal Format Thesis’, ‘Alternative Format Thesis’, and ‘Integrated Thesis’ are also used. While the scientific disciplines have traditionally been closer to this paper-based model, albeit with significant national variations, Social Sciences and Humanities subjects are now being affected. We present evidence from a small study of the UK higher education sector of organisational regulations in 54 departments concerning doctoral degree submission formats in two disciplines in the Humanities and Social Sciences (History and Sociology). We investigate the prevalence of this new practice, investigate some of its key aspects, and identify a number of questions for future research on this emerging and important topic

Pharmacokinetics of propofol in severely obese surgical patients

BACKGROUND: Existing PK models of propofol include sparse data from very obese patients. The aim of this study was to develop a PK model based on standardised surgical conditions and spanning from normal-weight up to, and including, a high number of very obese patients. METHODS: Adult patients scheduled for laparoscopic cholecystectomy or bariatric surgery were studied. Anaesthesia was induced with propofol 2 mg/kg adjusted body weight over 2 min followed by 6 mg/kg/h adjusted body weight over 30 min. For the remainder of the operation anaesthesia was maintained with sevoflurane. Remifentanil was dosed according to clinical need. Eight arterial samples were drawn in a randomised block sampling regimen over a span of 24 h. Time-concentration data were analysed by population PK modelling using non-linear mixed-effects modelling. RESULTS: Four hundred and seventy four serum propofol concentrations were collected from 69 patients aged 19-60 years with a BMI 21.6-67.3 kg/m2 . Twenty one patients had a BMI above 50 kg/m2 . A 3-compartment PK model was produced wherein three different body weight descriptors and sex were included as covariates in the final model. Total body weight was found to be a covariate for clearance and Q3; lean body weight for V1, V2 and Q2; predicted normal weight for V3 and sex for V1. The fixed allometric exponent of 0.75 applied to all clearance parameters improved the performance of the model. Accuracy and precision were 1.4% and 21.7% respectively in post-hoc performance evaluation. CONCLUSION: We have developed a new PK model of propofol that is suitable for all adult weight classes. Specifically, it is based on data from an unprecedented number of individuals with very high BMI