Effects of non-pharmacological interventions for insomnia in children with Autistic Spectrum Condition

Autism Spectrum Condition (ASC) is the name for a range of similar conditions that affect a person's social interaction, communication, interests and behaviour. In most cases many of the features of Autism can be recognised during early childhood. It is estimated that about 1 in every 160 children has an Autism Spectrum Condition (World Health Organisation). Further to this it is thought that between 40-80% of children with Autism have difficulties relating to sleep (Polimeni et al., 2005). Such sleep problems have been linked to a range of serious implications for the child's wellbeing. This review will explore the effects of non-pharmacological interventions for insomnia in children with autistic spectrum condition

Altered locus coeruleus–norepinephrine function following single prolonged stress

Data from preclinical and clinical studies have implicated the norepinephrine system in the development and maintenance of post‐traumatic stress disorder. The primary source of norepinephrine in the forebrain is the locus coeruleus ( LC ); however, LC activity cannot be directly measured in humans, and previous research has often relied upon peripheral measures of norepinephrine to infer changes in central LC –norepinephrine function. To directly assess LC –norepinephrine function, we measured single‐unit activity of LC neurons in a validated rat model of post‐traumatic stress disorder – single prolonged stress ( SPS ). We also examined tyrosine hydroxylase mRNA levels in the LC of SPS and control rats as an index of norepinephrine utilisation. For electrophysiological recordings, 92 LC neurons were identified from 19 rats ( SPS , 12; control, 7), and spontaneous and evoked responses to a noxious event (paw compression) were recorded. Baseline and restraint stress‐evoked tyrosine hydroxylase mRNA expression levels were measured in SPS and control rats ( n  = 16 per group) in a separate experiment. SPS rats showed lower spontaneous activity but higher evoked responses, leading to an enhanced signal‐to‐noise ratio of LC neurons, accompanied by impaired recovery from post‐stimulus inhibition. In concert, tyrosine hydroxylase mRNA expression in the LC of SPS rats tended to be lower at baseline, but was exaggerated following restraint stress. These data demonstrate persistent changes in LC function following stress/trauma in a rat model of post‐traumatic stress, as measured by differences in both the electrophysiological properties of LC neurons and tyrosine hydroxylase mRNA transcription. Single unit activity of LC neurons and TH mRNA levels were measured in the S ingle P rolonged S tress model of P ost‐traumatic stress disorder. SPS decreased rates of spontaneous discharge, exaggerated phasic responses of LC neurons and augmented stress‐enhanced TH mRNA expression. These data demonstrate sustained LC ‐ NE system abnormalities in SPS , providing an opportunity to study the interaction between LC ‐ NE system, and other PTSD ‐like physiological and behavioral changes seen in this model.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/97273/1/ejn12095.pd

Harm Reduction Developments 2008: Countries With Injection-Driven HIV Epidemics

Examines trends in HIV cases among injecting drug users in Eastern Europe and Central Asia, and outlines OSI and its partners' efforts to reduce drug-related harms fueling HIV epidemics. Includes country analyses and descriptions of prevention services

Feasibility of Prehospital Emergency Anesthesia in the Cabin of an AW169 Helicopter Wearing Personal Protective Equipment During Coronavirus Disease 2019

OBJECTIVE: Pre-hospital emergency anaesthesia in the form of rapid sequence intubation (RSI) is a critical intervention delivered by advanced pre-hospital critical care teams. Our previous simulation study determined the feasibility of in-aircraft RSI. We now examine whether this feasibility is preserved in a simulated setting, when clinicians wear personal protective equipment (PPE) for aerosol-generating procedures (AGP) for in-aircraft, on-the-ground RSI. METHODS: Air Ambulance Kent Surrey Sussex is a Helicopter Emergency Medical Service (HEMS) which utilises an AW169 cabin simulator. Wearing full AGP PPE (eye protection, FFP3 mask, gown, gloves), 10 doctor-paramedic teams performed RSI in a standard “can intubate, can ventilate” scenario and a “can't intubate, can't oxygenate” (CICO) scenario. Pre-specified timings were reported, and participant feedback was sought by questionnaire. RESULTS: RSI was most commonly performed by direct laryngoscopy and was successfully achieved in all scenarios. Time to completed endotracheal intubation (ETI) was fastest (287s) in the standard scenario and slower (370s, p=.01) in the CICO scenario. Time to ETI was not significantly delayed by wearing PPE in the standard (p=.19) or CICO variant (p=.97). Communication challenges, equipment complications and PPE difficulties were reported, but ways to mitigate these also reported. CONCLUSION: In-aircraft RSI (aircraft on-the-ground) whilst wearing PPE for AGPs had no significant impact on time to successful completion of ETI in a simulated setting. Patient safety is paramount in civilian HEMS, but the adoption of in-aircraft RSI could confer significant patient benefit in terms of pre-hospital time saving and further research is warranted

Low incidence of inflammatory bowel disease adverse events in adalimumab clinical trials across nine different diseases

OBJECTIVE: Adalimumab is approved for treatment of Crohn's disease and ulcerative colitis. Thus, we postulated that exacerbation or new-onset of inflammatory bowel disease (IBD) would be rare events in patients treated with adalimumab for non-IBD indications. This analysis evaluated the incidence of IBD adverse events (AEs) across adalimumab trials. METHODS: IBD AE rates in 75 adalimumab clinical trials in rheumatoid arthritis, polyarticular juvenile idiopathic arthritis, pediatric enthesitis-related arthritis, uveitis, hidradenitis suppurativa, adult and pediatric psoriasis, psoriatic arthritis, non-psoriatic arthritis peripheral spondyloarthritis (pSpA), axial spondyloarthritis (axSpA), including non-radiographic axSpA and ankylosing spondylitis, were analyzed. Search terms for IBD AEs (new onset or worsening/flare) included IBD, ulcerative colitis, Crohn's disease, and ulcerative proctitis. RESULTS: This analysis included 24,114 patients, representing 36,508 patient-years (PY) of adalimumab exposure. The overall rate (95% CI) of IBD AEs in adalimumab-treated patients was 0.1 (0.1-0.2)/100 PY (41 events), ranging from no events (psoriatic arthritis, uveitis, and pediatric trials) to 0.8 (0.2-2.2)/100 PY in pSpA; the rate of IBD in axSpA was 0.6 (0.4-1.0)/100 PY. During placebo-controlled trials, the overall IBD rate was 0.1 (0.0-0.3)/100 PY for adalimumab (3 events in 6781 patients; 2752 PY of exposure) and 0.1 (0.0-0.4)/100 PY for placebo (1 event in 3493 patients; 1246 PY of exposure) groups; IBD rates in axSpA were 0.5 (0.1-1.4)/100 PY and 0.6 (0.0-3.1)/100 PY, respectively. CONCLUSION: The rates of IBD AEs in adalimumab clinical trials were generally low across the evaluated diseases, including axSpA; all events occurred in adult patients

The mongrel mob or head hunters? The association between neighbourhood-level factors on different types of gang membership in Aotearoa/New Zealand

Previous research has shown that gang members typically emerge from more socially disorganised neighbourhoods. What is less known however is whether members of different types of gangs emerge from the same types of neighbourhoods. In this study, we use the social disorganisation theory as a framework to examine the spatial risk factors associated with two different types of gangs in New Zealand: Outlaw Motorcycle Gangs and New Zealand Adult Gangs. Overall, we found some consistency in spatial risk factors associated with gang membership by type in New Zealand; however, certain variables were significantly predictive of one type of gang membership but not of the other. The overall performance of our models also differed marginally depending on the type of gang being examined. In fact, our findings suggest some non-uniformity in the extent to which the various social disorganisation factors impact gang membership rates by type. The implications of this finding are discussed in the context of an ever-changing gang landscape in the country.https://journals.sagepub.com/home/ANJhj2023Geography, Geoinformatics and Meteorolog

A framework for estimating crime location choice based on awareness space

This paper extends Crime Pattern Theory, proposing a theoretical framework which aims to explain how offenders’ previous routine activity locations influence their future offence locations. The framework draws on studies of individual level crime location choice and location choice in non-criminal contexts, to identify attributes of prior activities associated with the selection of the location for future crime. We group these attributes into two proposed mechanisms: reliability and relevance. Offenders are more likely to commit crime where they have reliable knowledge that is relevant to the particular crime. The perceived reliability of offenders’ knowledge about a potential crime location is affected by the frequency, recency and duration of their prior activities in that location. Relevance reflects knowledge of a potential crime location’s crime opportunities and is affected by the type of behaviour, type of location and timing of prior activities in that location. We apply the framework to generate testable hypotheses to guide future studies of crime location choice and suggest directions for further theoretical and empirical work. Understanding crime location choice using this framework could also help inform policing investigations and crime prevention strategies.</jats:p

A new Geographic Profiling Suspect Mapping And Ranking Technique for crime investigations: GP-SMART

This study developed and tested a new geographic profiling method for automating suspect prioritisation in crime investigations. The Geographic Profiling Suspect Mapping And Ranking Technique (GP-SMART) maps suspects' activity locations available in police records—such as home addresses, family members' home addresses, prior offence locations, locations of non-crime incidents, and other contacts with police—and ranks suspects based on both the proximity and nature of these locations, relative to an input crime. In accuracy tests using solved burglary, robbery and extra-familial sex offence cases in New Zealand (n = 4511), GP-SMART ranked the offender at or near the top of the suspect list at rates greatly exceeding chance. Highlighting the benefit of its novel inclusion and differentiation of many different types of activity location, GP-SMART also outperformed baseline methods—approximating existing algorithms—that ranked suspects using only the proximity of their activity locations, or home addresses, to the input crime