Guillain-Barré syndrome

Mr G.B. presented to casualty with bilateral weakness in distal lower limbs which was progressive. He had a history of gastrointestinal illness with severe diarrhoea. On examination he had decreased deep tendon reflexes (ankle jerk) and an unsteady gait. A lumbar puncture was done and the findings were unremarkable. An EMG was also done and confirmed Guillain-Barré Syndrome. He was treated with intravenous immunoglobulin and physiotherapy and he is currently still in hospital recovering well.peer-reviewe

Formulating Update Messages

This paper presents a method with which we can generate update messages for use with Smalltalk's dependency mechanism. The basic idea is that any messages which cause an object to change are forwarded to the object's dependants. The method is perfectly general and future proofs objects against changes in their dependants

Structural variation in generated health reports

We present a natural language generator that produces a range of medical reports on the clinical histories of cancer patients, and discuss the problem of conceptual restatement in generating various textual views of the same conceptual content. We focus on two features of our system: the demand for 'loose paraphrases' between the various reports on a given patient, with a high degree of semantic overlap but some necessary amount of distinctive content; and the requirement for paraphrasing at primarily the discourse level

De-escalation of aggressive behaviour in healthcare settings:concept analysis

BACKGROUND: De-escalation is the recommended first-line response to potential violence and aggression in healthcare settings. Related scholarly activity has increased exponentially since the 1980s, but there is scant research about its efficacy and no guidance on what constitutes the gold standard for practice.OBJECTIVES: To clarify the concept of de-escalation of violence and aggression as described within the healthcare literature.DESIGN: Concept analysis guided by Rodgers' evolutionary approach.DATA SOURCES: Multiple nursing and healthcare databases were searched using relevant terms.REVIEW METHODS: High quality and/or highly cited, or otherwise relevant published empirical or theoretical English language literature was included. Information about surrogate terms, antecedents, attributes, consequences, and the temporal, environmental, disciplinary, and theoretical contexts of use were extracted and synthesised. Information about the specific attributes of de-escalation were subject to thematic analysis. Proposed theories or models of de-escalation were assessed against quality criteria.RESULTS: N=79 studies were included. Mental health settings were the most commonly reported environment in which de-escalation occurs, and nursing the disciplinary group most commonly discussed. Five theories of de-escalation were proposed; while each was adequate in some respects, all lacked empirical support. Based on our analysis the resulting theoretical definition of de-escalation in healthcare is "a collective term for a range of interwoven staff-delivered components comprising communication, self-regulation, assessment, actions, and safety maintenance which aims to extinguish or reduce patient aggression/agitation irrespective of its cause, and improve staff-patient relationships while eliminating or minimising coercion or restriction".CONCLUSIONS: While a number of theoretical models have been proposed, the lack of advances made in developing a robust evidence-base for the efficacy of de-escalation is striking and must, at least in part, be credited to the lack of a clear conceptualisation of the term. This concept analysis provides a framework for researchers to identify the theoretical model that they purport to use, the antecedents that their de-escalation intervention is targeting, its key attributes, and the key negative and positive consequences that are to be avoided or encouraged.</p

Is the US no longer the economy of first resort? Changing economic relationships in the Asia-Pacific region

This paper tests the hypothesis that the economic relationships between China and her major trading partners have changed over the past 20 years with the industrialisation of China, and the emergence of Japan as a source of investment and network trade in sophisticated manufactures, and the US as a source of finance and investment assets, supplier of services and an apparently inexhaustible demand for consumer and intermediate goods. Has this changed the size and direction of spillovers in the region, and has it curtailed or eliminated American economic leadership? We use time-varying spectral methods to decompose the links between the two leading Asian economies and the US. We find: (a) the links with the US have been weakening, while those based on China have strengthened; (b) that this is not new � it has been happening since the 1980s, but has now been reversed by the surge in trade; (c) that the links with the US have been rather complex, with the US able to shape the cycles elsewhere through her control of monetary conditions, but the China zone able to control the size of their cycles; (d) that Japan remains linked to (and dependent on) the US; and (e) there is no evidence that pegged exchange rates encourage convergence

Using \u27The Autobiography of Malcolm X\u27 to Teach Introductory Sociology

In this chapter, we make the case for using The Autobiography of Malcolm X to teach introductory sociology classes. While The Autobiography of Malcolm X is an autobiography and not a novel, we summarize the literature on using novels in sociology and compare this literature to our own experiences using autobiographies in the classroom. We then describe how autobiographies are particularly helpful for introducing students to the concept of the ‘‘sociological imagination’’ before highlighting this with an in-class exercise. Finally, we discuss student feedback and some of the drawbacks to using autobiographies and the extent to which these drawbacks can be mitigated. [excerpt

Summarisation and visualisation of e-Health data repositories

At the centre of the Clinical e-Science Framework (CLEF) project is a repository of well organised, detailed clinical histories, encoded as data that will be available for use in clinical care and in-silico medical experiments. We describe a system that we have developed as part of the CLEF project, to perform the task of generating a diverse range of textual and graphical summaries of a patient’s clinical history from a data-encoded model, a chronicle, representing the record of the patient’s medical history. Although the focus of our current work is on cancer patients, the approach we describe is generalisable to a wide range of medical areas

Towards evaluation design for smart city development

Smart city developments integrate digital, human, and physical systems in the built environment. With growing urbanization and widespread developments, identifying suitable evaluation methodologies is important. Case-study research across five UK cities - Birmingham, Bristol, Manchester, Milton Keynes and Peterborough - revealed that city evaluation approaches were principally project-focused with city-level evaluation plans at early stages. Key challenges centred on selecting suitable evaluation methodologies to evidence urban value and outcomes, addressing city authority requirements. Recommendations for evaluation design draw on urban studies and measurement frameworks, capitalizing on big data opportunities and developing appropriate, valid, credible integrative approaches across projects, programmes and city-level developments