A national UK survey of peripatetic support teams for children and adults with intellectual and developmental disability who display challenging behaviour

Background: The service provision model of peripatetic support teams for people with intellectual disabilities who present challenging behaviour has been well established in the United Kingdom, with a small but growing evidence base. The current context in the UK would appear to indicate an ever-increasing role for such teams, in order to support people in their own communities and reduce the reliance on out-of-area placements. This study sought to establish the current position of such teams within the UK. Method and materials: 46 teams were given the opportunity to complete an online questionnaire regarding the team's day to day functioning. Results: 20 services responded to the survey providing a range of data. The results suggested that the services were mainly targeted towards adults, had a range of working practices and therapeutic orientations, with broadly successful outcomes (albeit self reported). The data would also suggest that this type of provision had diminished in recent years. Conclusions: The implications of the survey are discussed within the context of the current policy in the UK. In particular, the lack of provision for children, the use of evidence based practice and what appears to be a diminishing resource just at the time when it is most needed are explored

Questions of Swimming, 1935

In an eloquent meditative lyric, one of our leading poets pays tribute to a friend and mentor he knew from childhood

Can Protanopia Be Correctly Diagnosed in Clinical Practice? An Evaluation of Diagnosis by Four Screening Tests

SIGNIFICANCE Protanopia is a color vision deficiency (CVD) that is unacceptable for certain occupations. This study compares simultaneously for the first time the ability of three recently revised or developed clinical tests of color vision with the Ishihara test to diagnose protanopia from other color vision deficiencies. PURPOSE The objectives were to examine the ability of four clinical tests to differentiate (1) between protan and deutan CVDs in patients with protanopia and deuteranopia, and (2) protanopes and deuteranopes as “strong” deficiencies. METHODS The Hardy-Rand-Rittler (4th ed.), City University (3rd ed.), Ishihara, and Mollon-Reffin tests were evaluated against the Oculus Heidelberg Multi-Color anomaloscope for 18 protanopes and 9 deuteranopes. Diagnosis by anomaloscopy was subsequent to administration of screening tests. RESULTS The Ishihara test misdiagnosed all 18 protanopes as having a deutan deficiency. In contrast, the Hardy-Rand-Rittler and Mollon-Reffin tests correctly identified protan CVD in 100% of protanopes. No screening test was able to reliably diagnose protanopia on the basis of a strong protan CVD. CONCLUSIONS The Ishihara test is not suitable for screening for protanopia; its failure to diagnose protanopes as having a protan CVD was far greater than that in previous studies. The Hardy-Rand-Rittler and Mollon-Reffin are the most reliable tests for this purpose. None of the screening tests were able to reliably differentiate dichromacy from strongly anomalous trichromacy

School performance and undetected and untreated visual problems in schoolchildren in Ireland; a population-based cross-sectional study

This study explored the association between children’s vision and their school academic progress as reported by parents/guardians. Participants were 1,612 schoolchildren (722 6-7-year-olds, 890 12-13-year-olds) in randomly selected schools in Ireland. In advance of data collection, parents/guardians reported school performance as (a) much better than classmates (high-performance) (b) about the same as classmates (average-performance) (c) not as well as classmates (low-performance). Measurements included logMAR monocular visual acuities (with spectacles if worn, and pinhole) in the distance (3 m) and near (40 cm); the amplitude of accommodation; stereoacuity, colour vision assessment, and cyclopleged autorefraction. Controlling for confounders, children presenting with visual impairment (vision poorer than 0.3logMAR (6/12) in the ‘better eye’), amblyopia (‘lazy eye’), uncorrected refractive error (hyperopia ≥+3.50D and astigmatism ≥1.50DC), reduced for age ability to adjust focus from distance to near tasks (accommodation), impaired three-dimensional vision (stereoacuity), and defective colour vision were more likely to report low-performance in school. The majority of low-performing participants (68%) did not have an eye examination within the 12 months before data collection. Children with academic performance challenges ought to have a comprehensive eye examination, to detect potential vision problems for early intervention minimising any negative impact they may have on educational outcomes

Prevalence of colour vision deficiency in the Republic of Ireland schoolchildren and associated socio-demographic factors

Clinical relevance: Early screening is essential to counsel schoolchildren with congenital colour vision deficiency (CVD) in determining their future career path and to advise teachers of the impact of CVD on classroom difficulties. Background: Congenital CVD is an X-linked genetic abnormality relatively commonplace in humans. This study aimed to determine the prevalence of congenital CVD in the Republic of Ireland schoolchildren and associated socio-demographic factors. Methods: A total of 1,626 schoolchildren (882 boys and 744 girls), in two age groups (728 aged 6–7 years and 898 aged 12–13 years) were examined from randomly selected schools. Colour vision testing was carried out using the Richmond Hardy-Rand-Rittler pseudoisochromatic test for colour vision (fourth edition); diagnostic plates were used to determine CVD type and extent if participants failed to identify symbols on the screening plates. Results: CVD was detected in 73 boys (8.3 per cent, 95% confidence interval (CI) 6.6–10.3) and in 13 girls (1.8 per cent, 95% CI 1.0–3.1, p \u3c 0.001). As expected, deutan (boys 4.8 per cent, girls 0.8 per cent) was the most common type of CVD, followed by protan (boys 1.7 per cent, girls 0.1 per cent), unclassified red/green CVD (boys 1.2 per cent, girls 0.8 per cent) and then tritan (boys 0.5 per cent). One case of achromatopsia was detected based on failure on all diagnostic plates. Traveller participants (boys 21.0 per cent, girls 8.6 per cent) had a higher CVD prevalence than their White non-Traveller (boys 7.2 per cent, girls 1.0 per cent) and non-White (boys 5.4 per cent, girls 1.1 per cent) counterparts (odds ratio 3.00, 95% CI 1.1–8.1, p = 0.006). In boys, CVD was also associated with twin birth (odds ratio 2.7, 95% CI 1.1–6.7, p = 0.03) and low birthweight (p = 0.04). Conclusion: This investigation of CVD in the Republic of Ireland schoolchildren should alert clinicians to the association between CVD and Traveller ethnicity, twin birth and lower birthweight. The prevalence of CVD found was similar to previous studies involving predominantly White populations and higher among Traveller participants; hence, counselling regarding inherited anomalies in the Traveller community is recommended. Early screening is essential to counsel schoolchildren with CVD in determining their future career path and to advise teachers of the impact of CVD on classroom difficulties

Koordinationschemie perhalogenierter Cyclopentadiene und Alkine, X

Coordination Chemistry of Perhalogenated Cyclopentadienes and Alkynes, X[1]. - Synthesis and Molecular Structure of a Cyclopentadienyl-1,3-dithiol Complex, [C5Cl3(SH)2]Mn(CO)3 The reaction of [C5Cl4Li]Mn(CO)3 with elemental sulfur leads to [C5Cl4SLi]Mn(CO)3 (1), which is easily oxidized by air to the disulfide (OC)3Mn[C5Cl4S-SCl4C5]Mn(CO)3 (2). Addition of one equivalent of BuLi, followed by an excess of S8 produces the dithiolate [C5Cl3(SLi)2]Mn(CO)3 (3), which yields the dithiol [C5Cl3(SH)2]Mn(CO)3 (5) upon hydrolysis. The molecular structures of 2 and 5 have been determined by X-ray diffraction

Technology Portfolio Planning by Weighted Graph Analysis of System Architectures

Many systems undergo significant architecture-level change throughout their lifecycles in order to adapt to new operating and funding contexts, to react to failed technology development, or to incorporate new technologies. In all cases early architecture selection and technology investment decisions will constrain the system to certain regions of the tradespace, which can limit the evolvability of the system and its robustness to exogenous changes. In this paper we present a method for charting development pathways within a tradespace of potential architectures, with a view to enabling robustness to technology portfolio realization and later architectural changes. The tradespace is first transformed into a weighted, directed graph of architecture nodes with connectivity determined by relationships between technology portfolios and functional architecture. The tradespace exploration problem is then restated as a shortest path problem through this graph. This method is applied to the tradespace of in-space transportation architectures for missions to Mars, finding that knowledge of pathways through the tradespace can identify negative coupling between functional architectures and particular technologies, as well as identify ways to prioritize future technology investments.Skolkovo Institute of Science and Technolog

Impact of Macular Pigment on Visual Performance

PURPOSE. To investigate changes in macular pigment optical density (MPOD) and visual performance following supplementation with different macular carotenoid formulations. METHODS. Thirty-six subjects (19 male, 17 female; mean 6 SD, age 51 6 13 years) were recruited into this single-masked placebo-controlled study, and were randomly assigned to one of the following three intervention (supplementation) groups: (1) group 1 (20 mg lutein [L] and 2 mg zeaxanthin [Z]); (2) group 2 (10 mg L, 2 mg Z, and 10 mg meso-zeaxanthin [MZ]); and group 3 (placebo). Outcomes measures included visual performance and MPOD response. Data were collected at baseline, at 3 months, and at 6 months. RESULTS. At 3 and 6 months, a statistically significant increase in MPOD was found at all eccentricities (other than the most peripheral 38 location) in group 2 (P \u3c 0.05 for all), whereas no significant increase in MPOD was demonstrable at any eccentricity for subjects in groups 1 and 3. Statistically significant improvements in visual performance measures including visual acuity and contrast sensitivity with and without glare were observed for group 2 only. Only mesopic contrast sensitivity at one spatial frequency improved significantly by 6 months (P \u3c 0.05) for group 1. No improvements in any parameters of visual performance were observed for subjects supplemented with placebo (P \u3e 0.05 for all). CONCLUSIONS. These results suggest that supplementation with all three macular carotenoids potentially offered advantages over preparations lacking MZ, both in terms of MPOD response and visual performance enhancement. (Invest Ophthalmol Vis Sci. 2012;53:7871–7880) DOI:10.1167/iovs.12-10690

An evaluation of dynamic thermal ratings for load accommodation in power distribution networks

PhD ThesisThis thesis presents an evaluation of the use of Dynamic Thermal Ratings (DTRs) to provide additional network headroom for load consumer connections in electrical power distribution networks. The requirement for additional headroom can come from a number of sources including, limitations in the current network configuration, the need to provide connections to new consumers at minimal cost and to provide additional capacity in the transition to the low carbon economy. DTRs are a method by which the current carrying capacity of power system components such as transformers and overhead lines can be estimated in real-time through analysis of the surrounding meteorological conditions. The use of this technique has typically shown significant increases in available network capacity, however much of this work has considered such benefits in the context of increasing the capacity for wind generation connections. This research differs in its analysis of such benefits with regards to customer connection. Analysis of the present overhead line rating standards in the UK has shown that the system potentially over estimates the level of risk at which the network is operated. A set of adjusted ratings which meet these criteria are presented in this thesis. A generic, temperature sensitive load synthesis method is presented in order to estimate the benefits of DTRs within distribution networks. Through the use of such time-series load profiles the additional requirements of such an approach are exposed and analysed. Implementation of such a system has been shown to deliver additional network capacity for customer connections in both fit and forget and active network management scenarios