The social cognition of medical knowledge, with special reference to childhood epilepsy

This paper arose out of an engagement in medical communication courses at a Gulf university. It deploys a theoretical framework derived from a (critical) sociocognitive approach to discourse analysis in order to investigate three aspects of medical discourse relating to childhood epilepsy: the cognitive processes that are entailed in relating different types of medical knowledge to their communicative context; the types of medical knowledge that are constituted in the three different text types analysed; and the relationship between these different types of medical knowledge and the discursive features of each text type. The paper argues that there is a cognitive dimension to the human experience of understanding and talking about one specialized from of medical knowledge. It recommends that texts be studied in medical communication courses not just in terms of their discrete formal features but also critically, in terms of the knowledge which they produce, transmit and reproduce

Targeted therapy in acute myeloid leukemia:current status and new insights from a proteomic perspective

Introduction: The biological heterogeneity of acute myeloid leukemia (AML) complicates personalized medicine. Individual prognosis is typically based on the presence of chromosomal and genetic lesions. Nevertheless, these classifications often lack a priori information about response to therapy. Since the protein expression landscape reflects the functional activity state of cells, we hypothesize that analyzing this can be used for the identification of protein activity markers to provide better risk stratification as well as may provide targeted therapeutic guidance in AML. Areas covered: Herein, we review recently new adopted drugs in the treatment for AML and discuss how quantitative proteomic techniques may contribute to better therapeutic selection in AML. Expert commentary: The net functional state of the cell is defined by the activity of protein within all the pathways that are active in the cell. Recognition of the proteomic profile of the leukemic blast could, therefore, complement current classification systems by providing a better a priori description of what pathways are important within a cell as a guide to the selection of therapy for the patient

‘Bring back Hitler’s gas chambers’: asylum seeking, Nazis and facebook – a discursive analysis

In this article, we explore how talk about Nazis is used in Internet discussions regarding asylum seeking, and the issue of whether or not opposition to asylum seeking is racist. Discursive analysis was conducted on discussions about asylum seeking from the social networking website Facebook, where references to Nazis were made. Three strategies were identified: (1) people supporting asylum seeking accuse asylum opponents of being racist by referring to Nazis; (2) opponents of asylum seeking deal with such accusations by arguing that the debate is being suppressed because of references to Nazis; (3) in the final, and most striking, strategy, opponents of asylum draw upon ideas associated with the Nazis and Hitler to bring about their anti-asylum position. These findings are discussed in relation to how the link between Nazis and racism is emerging in the asylum debat

Inflection point in the magnetic field dependence of the ordered moment of URu2Si2 observed by neutron scattering in fields up to 17 T

We have measured the magnetic field dependence of the ordered antiferromagnetic moment and the magnetic excitations in the heavy-fermion superconductor URu2Si2 for fields up to 17 Tesla applied along the tetragonal c axis, using neutron scattering. The decrease of the magnetic intensity of the tiny moment with increasing field does not follow a simple power law, but shows a clear inflection point, indicating that the moment disappears first at the metamagnetic transition at ~40 T. This suggests that the moment m is connected to a hidden order parameter Phi which belongs to the same irreducible representation breaking time-reversal symmetry. The magnetic excitation gap at the antiferromagnetic zone center Q=(1,0,0) increases continuously with increasing field, while that at Q=(1.4,0,0) is nearly constant. This field dependence is opposite to that of the gap extracted from specific-heat data.Comment: 10 pages, 5 figures, submitted to PR

Psychometric properties of the Chinese version of the Highly Sensitive Child scale across age groups, gender, and informants

Sensory Processing Sensitivity (SPS) is theorized to be a fundamental trait capturing children’s general sensitivity to the environment. Yet, scientific knowledge of SPS is mostly based on findings from Western cultures and few translated measures exist to assess children’s SPS outside of Western countries. Therefore, we developed the Chinese Highly Sensitive Child (HSC) scale. In Study 1, we investigated the scale’s psychometric properties for both self-reports (N = 2925, Mage = 11.74 years, 43.3% girls) and caregiver reports (n = 460, Mchild age = 9.02 years, 44.0% girls). Findings replicated most psychometric properties found in international studies including: (a) a bifactor structure with one general sensitivity component and three specific components, (b) acceptable internal consistency of the total scale (although not for self-report of elementary school children, and not for the subscales), and (c) at least partial invariance across age groups, gender, and informants. In Study 2, we investigated convergent validity with related temperament and personality measures using self-reports from both elementary school children (n = 845, Mage = 9.71 years, 41.9% girls) and middle school children (n = 563, Mage = 13.17 years, 43.2% girls). Findings replicated bivariate associations found in Western studies: Ease of Excitation (EOE) was associated with more positive traits, whereas Aesthetic Sensitivity (AES) was associated with more negative traits, suggesting that EOE and AES may capture the “dark” and “bright side” of sensitivity, respectively. We hope that our studies help spur research on SPS across western and Chinese cultures

Patient-tailored risk assessment of obstructive coronary artery disease using Rubidium-82 PET-based myocardial flow quantification with visual interpretation

Introduction: Our aim was to estimate the probability of obstructive CAD (oCAD) for an individual patient as a function of the myocardial flow reserve (MFR) measured with Rubidium-82 (Rb-82) PET in patients with a visually normal or abnormal scan. Materials and Methods: We included 1519 consecutive patients without a prior history of CAD referred for rest-stress Rb-82 PET/CT. All images were visually assessed by two experts and classified as normal or abnormal. We estimated the probability of oCAD for visually normal scans and scans with small (5%–10%) or larger defects (&gt; 10%) as function of MFR. The primary endpoint was oCAD on invasive coronary angiography, when available. Results: 1259 scans were classified as normal, 136 with a small defect and 136 with a larger defect. For the normal scans, the probability of oCAD increased exponentially from 1% to 10% when segmental MFR decreased from 2.1 to 1.3. For scans with small defects, the probability increased from 13% to 40% and for larger defects from 45% to &gt; 70% when segmental MFR decreased from 2.1 to 0.7. Conclusion: Patients with &gt; 10% risk of oCAD can be distinguished from patients with &lt; 10% risk based on visual PET interpretation only. However, there is a strong dependence of MFR on patient’s individual risk of oCAD. Hence, combining both visual interpretation and MFR results in a better individual risk assessment which may impact treatment strategy.</p

Impact of borderline personality disorder traits on the association between age and health-related quality of life:A cohort study in the general population

Background Increasing age as well as borderline personality pathology are associated with a lower level of health-related quality of life (HR-QoL). Our objective was to investigate whether the presence of borderline personality traits modifies the association between age and HR-QoL in the general population. Methods Cross-sectional data from 5,303 respondents (aged 21-72 years) of the Netherlands Mental Health Survey and Incidence Study-2 were analyzed. Borderline personality traits were assessed with the International Personality Disorder Examination questionnaire. Mental and physical HR-QoL were measured with the Medical Outcomes Study Short Form Health Survey. Multiple linear regression analysis was used to examine the association of borderline personality traits, age and their interaction on mental as well as physical HR-QoL, adjusted for demographic variables as well as somatic and mental disorders. Results A total of 1,520 (28.7%) respondents reported one or more borderline personality traits of which 58 (1.1%) reported five or more indicative of a borderline personality disorder. A higher age was associated with lower physical HR-QoL. This negative association became significantly stronger in the presence of borderline personality traits. The association between increasing age and mental HR-QoL was positive in the absence of borderline personality traits and negative in the presence of borderline personality traits. Conclusion Borderline personality traits negatively interfere with the association between age and HR-QoL irrespective of somatic and mental disorders. Attention of clinicians and researchers for subthreshold borderline personality pathology is needed in middle-aged and older persons

Clinical recommendations for pain, sedation, withdrawal and delirium assessment in critically ill infants and children: an ESPNIC position statement for healthcare professionals

Background: This position statement provides clinical recommendations for the assessment of pain, level of sedation, iatrogenic withdrawal syndrome and delirium in critically ill infants and children. Admission to a neonatal or paediatric intensive care unit (NICU, PICU) exposes a child to a series of painful and stressful events. Accurate assessment of the presence of pain and non-pain related distress (adequacy of sedation, iatrogenic withdrawal syndrome, and delirium) is essential to good clinical management and to monitoring the effectiveness of interventions to relieve or prevent pain and distress in the individual patient. Methods: A multidisciplinary group of experts was recruited from the members of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC). The group formulated clinical questions regarding assessment of pain and non-pain related distress in critically ill and non-verbal children, and searched the PubMed/Medline, Cinahl, and Embase databases for studies describing the psychometric properties of assessment instruments. Further, level of evidence of selected studies was assigned and recommendations were formulated, and grade or recommendations were added based on the level of evidence. Results: An ESPNIC Position Statement was drafted which provides clinical recommendations on assessment of pain (n=5), distress and/or level of sedation (n=4), iatrogenic withdrawal syndrome (n=3), and delirium (n=3). These recommendations were based on the available evidence and consensus amongst the experts and other members of the ESPNIC society. Conclusions: This multidisciplinary ESPNIC Position Statement guides professionals in the assessment and re-assessment of the effectiveness of treatment interventions for pain, distress, inadequate sedation, withdrawal syndrome and delirium

Big Five personality traits and medically unexplained symptoms in later life

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