Paper 99: design guidelines versus practices for the Upper Seascheldt, the inland waterway connection between Antwerp and Ghent

Design guidelines for inland waterways are so far a national matter. PIANC InCom Working Group 141 "Design Guidelines for Inland Waterways" is nevertheless working on a report with a summary of existing guidelines and a methodology for the concept and detailed design of canals and rivers. For tidal rivers the design is a difficult process and an example is given through the accessibility of the Upper-Seascheldt for CEMT class IV and Va inland vessels between the port of Antwerp and the locks in Merelbeke. A combined evaluation based on concept design guidelines for canals, practices measured during a full-scale voyage and detailed design using ship handling simulators is discussed and illustrated

Two cases of feline pyothorax : medical versus surgical treatment and associated challenges

Pyothorax is a rare disease in cats. Underlying causes and treatment recommendations vary greatly between cases. In this case series, the management of two challenging cases of feline pyothorax is discussed. In the first case, a nine-year-old female spayed European shorthair cat with pyothorax caused by Bacteroides fragilis is described. At the time of presentation, she was diagnosed with feline immunodeficiency virus as well. The pyothorax was succesfully managed medically. Unfortunately, the cat relapsed after three months and the owner elected euthanasia. The second case involved a ten-year-old male castrated British shorthair cat with identification of filamentous bacteria on pleural fluid cytology. This cat underwent surgical intervention because thoracic drainage was very difficult. Eventually, he recovered well and did not relapse up to two months postoperatively. The challenges in the decision process and treatment complications are discussed

Lack of trust in maternal support is associated with negative interpretations of ambiguous maternal behavior

Attachment theory assumes that children who lack trust in maternal availability for support are more inclined to interpret maternal behavior in congruence with their expectation that mother will remain unavailable for support. To provide the first test of this assumption, early adolescents (9-13 years old) were asked to assess whether ambiguous interactions with mother should be interpreted in a positive or a negative way. In our sample (n = 322), results showed that early adolescents' lack of trust in their mother's availability for support was related to more negative interpretations of maternal behavior. The associations remained significant after controlling for depressive mood. The importance of these findings for our understanding of attachment theory, attachment stability, and clinical practice are discussed

Cost-utility of transcatheter aortic valve implantation for inoperable patients with severe aortic stenosis treated by medical management: a UK cost-utility analysis based on patient-level data from the ADVANCE study.

OBJECTIVE: To use patient-level data from the ADVANCE study to evaluate the cost-effectiveness of transcatheter aortic valve implantation (TAVI) compared to medical management (MM) in patients with severe aortic stenosis from the perspective of the UK NHS. METHODS: A published decision-analytic model was adapted to include information on TAVI from the ADVANCE study. Patient-level data informed the choice as well as the form of mathematical functions that were used to model all-cause mortality, health-related quality of life and hospitalisations. TAVI-related resource use protocols were based on the ADVANCE study. MM was modelled on publicly available information from the PARTNER-B study. The outcome measures were incremental cost-effectiveness ratios (ICERs) estimated at a range of time horizons with benefits expressed as quality-adjusted life-years (QALY). Extensive sensitivity/subgroup analyses were undertaken to explore the impact of uncertainty in key clinical areas. RESULTS: Using a 5-year time horizon, the ICER for the comparison of all ADVANCE to all PARTNER-B patients was £13 943 per QALY gained. For the subset of ADVANCE patients classified as high risk (Logistic EuroSCORE >20%) the ICER was £17 718 per QALY gained). The ICER was below £30 000 per QALY gained in all sensitivity analyses relating to choice of MM data source and alternative modelling approaches for key parameters. When the time horizon was extended to 10 years, all ICERs generated in all analyses were below £20 000 per QALY gained. CONCLUSION: TAVI is highly likely to be a cost-effective treatment for patients with severe aortic stenosis

Predictors of mortality following corevalve transcatheter aortic valve implantation: results from the ADVANCE study

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Sub-optimal presentation of painful facial expressions enhances readiness for action and pain perception following electrocutaneous stimulation

Observation of others’ painful facial expressions has been shown to facilitate behavioral response tendencies and to increase pain perception in the observer. However, in previous studies, expressions were clearly visible to the observer and none of those studies investigated the effect of presence of peripheral stimulation on response tendencies. This study focuses on the effect of sub-optimal presentation of painful facial expressions in the presence and absence of an electrocutaneous stimulus. Twenty-two healthy individuals categorized arrow targets which were preceded by a sub-optimally presented facial expression (painful, happy, or neutral in different blocks). On half of the trials, aversive electrocutaneous stimulation was delivered to the wrist of the non-dominant hand between the presentation of facial expression and target (an arrow directing to right or left). Participants’ task was to indicate direction of the arrow as soon as it appears on the screen by pressing the corresponding key on the keyboard and to rate their pain at the end of block. Analysis showed that responses were faster to targets preceded by aversive stimulation than to targets not preceded by stimulation, especially following painful expressions. Painfulness ratings were higher following painful expressions than following happy expressions. These findings suggest that sub-optimally presented painful expressions can enhance readiness to act to neutral, non-pain-related targets after aversive stimulation and can increase pain perception

Report of Climate Sub Group 2004 Climate Sub-group

Attachment theory implies the causal influence of interpretation bias on the attachment-related expectations. Previous research demonstrated that training children to interpret maternal behavior as more supportive increased their trust in maternal support. The current study explored possible training effects on two attachment script-related processes: recollection of attachment-related memories and secure base script knowledge. Children (9–12 years old; N = 84) were assigned to either a secure training condition, training children to interpret mother's behavior as supportive, or a neutral placebo condition, where interpretations about maternal behavior were unrelated to support. Findings replicated the training effect on interpretation bias and trust. Furthermore, children's recollection of attachment-related memories became more positive. No training effect was found for secure base script knowledg