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IQ, non-cognitive and social-emotional parameters influencing education in speech- and languageimpaired children
Get PDFThis open access article is distributed under a Creative Commons Attribution (CC-BY) 4.0 license.Speech-/language-impaired (SL)-children face problems in school and later life. The significance of “non-cognitive, social-emotional skills” (NCSES) in these children is often underestimated.
Aim: Present study of affected SL-children was assessed to analyse the influence of NCSES for long-term school education.
Methods: Nineteen severely SL-impaired children (7 girls, 12 boys) from a specialised kindergarten were followed; follow-up period: Up to 12 years; the different skills or parameters were known.
Results: Fourteen children visited successfully a regular secondary school (RS), five children a "school focussing on learning problems" (SFL). SL-differences between the children attending RS and SFL were small; differences in “IQ” and “self-confidence” were significant, smaller differences were observed concerning “skills at crafts/construction” and "auditory-visual perception".
Summary: Although the study group is small, results give evidence that beside SL- and "cognitive” skills "non-cognitive, social-emotional skills" are of major importance for long-term school education of SL-impaired children. These soft skills seem to be particularly important for “special need children” with SL-impairment
Swyer–James–MacLeod syndrome—a rare diagnosis presented through two adult patients
Get PDFThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.Swyer–James–MacLeod syndrome (SJMS) is a rare syndrome of acute obliterative bronchiolitis following an early childhood infective insult to the lungs. This causes arrest of alveolarization, affecting lung development with hypoplasia of the ipsilateral pulmonary artery and results in a characteristic radiological pattern, such as a unilateral hyperlucent lung with expiratory air-trapping and pruned-tree appearance on pulmonary angiogram. The clinical presentation is either recurrent chest infections, exertional dyspnoea or it may be an incidental finding. Management involves early prevention of infection, airway clearance, and regular vaccinations.
We describe two adult patients with SJMS: A 51-year-old female of Indian ethnicity presenting with recurrent haemoptysis and a 40-year-old Indigenous male presenting acutely with sepsis and background history of recurrent chest infections.
These cases highlight the importance of being aware of and accurately recognizing this rare condition, to be able to manage patients appropriately and avoid incorrect and unnecessary treatment
Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis
Get PDFThis is an Open Access article under the CC BY 4.0 license.Background
Global and regional prevalence estimates for blindness and vision impairment are important for the development of public health policies. We aimed to provide global estimates, trends, and projections of global blindness and vision impairment.
Methods
We did a systematic review and meta-analysis of population-based datasets relevant to global vision impairment and blindness that were published between 1980 and 2015. We fitted hierarchical models to estimate the prevalence (by age, country, and sex), in 2015, of mild visual impairment (presenting visual acuity worse than 6/12 to 6/18 inclusive), moderate to severe visual impairment (presenting visual acuity worse than 6/18 to 3/60 inclusive), blindness (presenting visual acuity worse than 3/60), and functional presbyopia (defined as presenting near vision worse than N6 or N8 at 40 cm when best-corrected distance visual acuity was better than 6/12).
Findings
Globally, of the 7·33 billion people alive in 2015, an estimated 36·0 million (80% uncertainty interval [UI] 12·9–65·4) were blind (crude prevalence 0·48%; 80% UI 0·17–0·87; 56% female), 216·6 million (80% UI 98·5–359·1) people had moderate to severe visual impairment (2·95%, 80% UI 1·34–4·89; 55% female), and 188·5 million (80% UI 64·5–350·2) had mild visual impairment (2·57%, 80% UI 0·88–4·77; 54% female). Functional presbyopia affected an estimated 1094·7 million (80% UI 581·1–1686·5) people aged 35 years and older, with 666·7 million (80% UI 364·9–997·6) being aged 50 years or older. The estimated number of blind people increased by 17·6%, from 30·6 million (80% UI 9·9–57·3) in 1990 to 36·0 million (80% UI 12·9–65·4) in 2015. This change was attributable to three factors, namely an increase because of population growth (38·4%), population ageing after accounting for population growth (34·6%), and reduction in age-specific prevalence (−36·7%). The number of people with moderate and severe visual impairment also increased, from 159·9 million (80% UI 68·3–270·0) in 1990 to 216·6 million (80% UI 98·5–359·1) in 2015.
Interpretation
There is an ongoing reduction in the age-standardised prevalence of blindness and visual impairment, yet the growth and ageing of the world's population is causing a substantial increase in number of people affected. These observations, plus a very large contribution from uncorrected presbyopia, highlight the need to scale up vision impairment alleviation efforts at all levels
An Anti–VEGF-B Antibody Fragment Induces Regression of Pre-Existing Blood Vessels in the Rat Cornea
Get PDFThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.Purpose: We tested the ability of an antibody fragment with specificity for vascular endothelial growth factor-B (VEGF-B) to regress nascent and established corneal blood vessels in the rat.
Methods: A single chain variable antibody fragment (scFv) with specificity for VEGF-B was engineered from the 2H10 hybridoma. Binding to rat, mouse, and human VEGF-B was confirmed by surface plasmon resonance. Activity of the anti–VEGF-B scFv on developing and established corneal blood vessels was assessed following unilateral superficial cautery in male and female outbred Sprague Dawley rats. Groups (untreated, control scFv-treated, or anti–VEGF-B scFv-treated) comprised 6 to 22 rats. Treatment consisted of 5 μL scFv, 1 mg/mL, applied topically five times per day for 14 days, or two subconjunctival injections, 50 μg scFv each, applied 7 days apart, or combined topical and subconjunctival treatment. Corneal vessel area was quantified on hematoxylin-stained corneal flat-mounts, and groups were compared using the Mann-Whitney U test, with post hoc Bonferroni correction. Immunohistochemistry for cleaved caspase-3 was performed.
Results: Topical anti–VEGF-B scFv therapy alone did not regress corneal blood vessels significantly (P > 0.05). Subconjunctival injection and combined treatment regressed 14-day established corneal blood vessels (25% reduction in vessel area [P = 0.04] and 37% reduction in vessel area [P < 0.001], respectively, compared to results in untreated controls). Cleaved caspase-3 was identified in vascular endothelial cells of anti–VEGF-B scFv-treated corneas. In scFv-treated rats, corneal endothelial cell function was maintained to 12 weeks after treatment and a normal blink reflex was present.
Conclusions: The anti–VEGF-B scFv significantly regressed established but not developing corneal blood vessels in rats
The Prospective Evaluation of the Net Effect of Red Blood Cell Transfusions in Routine Provision of Palliative Care.
Get PDF"Final publication is available from Mary Ann Liebert, Inc., publishers http://dx.doi.org/10.1089/jpm.2017.0072”
This author accepted manuscript is made available following 12 month embargo from date of publication (June 2017) in accordance with the publisher’s archiving policyBackground
Red Blood Cell (RBC) transfusions are commonly used in palliative care. RBCs are a finite resource, transfusions carry risks, and the net effect (benefits and harms) is poorly defined for people with life-limiting illnesses.
Aim
The aim of this study was to examine the indications and the effects of RBC transfusion in palliative care patients.
Design
This international, multisite, prospective consecutive cohort study assessed target symptoms (fatigue, breathlessness, generalised weakness, or dizziness) prior to transfusion and at day 7 by treating clinicians, using National Cancer Institute Common Terminology Criteria for Adverse Events. Assessment of harms was made at day 2.
Setting/participants
One-hundred and one transfusions with day 7 followup were collected. Median age was 72·0 (IQR 61·5-83·0) years, 58% male, and mean Australian-modified Karnofsky Performance Status of 48 (SD 17).
Results
A mean 2·1 (SD 0·6) units was transfused. The target symptom was fatigue (61%), breathlessness (16%), generalized weakness (12%), dizziness (6%) or other (5%). Forty-nine percent of transfusions improved the primary target symptom, and 78% of transfusions improved at least one of the target symptoms. Harms were infrequent and mild. An AKPS of 40-50% was associated with higher chances of symptomatic benefit in the target symptom, however no other predictors of response were identified.
Conclusions
In the largest prospective consecutive case series to date, clinicians generally reported benefit, with minimal harms. Ongoing work is required to define the optimal patient- and clinician-reported haematological and functional outcome measures to optimise the use of donor blood and minimise transfusion-associated risk
Integrative health care - Toward a common understanding: A mixed method study
Get PDF© 2017 Elsevier. This manuscript version is made available under the CC-BY-NC-ND 4.0 license: http://creativecommons.org/licenses/by-nc-nd/4.0/Objective
To generate a multidisciplinary stakeholder-informed definition of integrative health care (IHC).
Methods
A mixed-method study design was used, employing the use of focus groups/semi-structured interviews (phase-1) and document analysis (phases 2 and 3). Phase-1 recruited a purposive sample of Australian health consumers/health providers. Phase-2 interrogated websites of international IHC organisations for definitions of IHC. Phase-3 systematically searched bibliographic databases for articles defining IHC. Data were analysed using thematic analysis.
Results
Data were drawn from 54 health consumers/providers (phase-1), 23 IHC organisation webpages (phase-2) and 23 eligible articles (phase-3). Seven themes emerged from the data. Consensus was reached on a single, 65-word definition of IHC.
Conclusion
An unambiguous definition of IHC is critical to establishing a clearer identity for IHC, as well as providing greater clarity for consumers, health providers and policy makers. In recognising the need for a clearer description, we propose a scientifically-grounded, multi-disciplinary stakeholder-informed definition of IHC
Assessing the controls and uncertainties on mean transit times in contrasting headwater catchments
Get PDF© 2017 Elsevier. This manuscript version is made available under the CC-BY-NC-ND 4.0 license: http://creativecommons.org/licenses/by-nc-nd/4.0/
This author accepted manuscript is made available following 24 month embargo from date of publication (Dec 2017) in accordance with the publisher’s archiving policyEstimating the time required for water to travel through headwater catchments from where it recharges to where it discharges into streams (the transit time) is important for understanding catchment behaviour. This study uses tritium (3H) activities of stream water to estimate the mean transit times of water in the upper Latrobe and Yarra catchments, southeast Australia, at different flow conditions. The 3H activities of the stream water were between 1.26 and 1.99 TU, which are lower than those of local rainfall (2.6 to 3.0 TU). 3H activities in individual subcatchments are almost invariably lowest at low streamflows. Mean transit times calculated from the 3H activities using a range of lumped parameter models are between 7 and 62 years and are longest during low streamflows. Uncertainties in the estimated mean transit times result from uncertainties in the geometry of the flow systems, uncertainties in the 3H input, and macroscopic mixing. In addition, simulation of 3H activities in FEFLOW indicates that heterogeneous hydraulic conductivities increase the range of mean transit times corresponding to a specific 3H activity. The absolute uncertainties in the mean transit times may be up to ±30 years. However, differences between mean transit times at different streamflows in the same catchment or between different subcatchments in the same area are more reliably estimated. Despite the uncertainties, the conclusions that the mean transit times are years to decades and decrease with increasing streamflow are robust. The seasonal variation in major ion geochemistry and 3H activities indicate that the higher general streamflows in winter are sustained by water displaced from shallower younger stores (e.g., soils or regolith). Poor correlations between 3H activities and catchment area, drainage density, mean slope, distance to stream, and landuse, imply that mean transit times are controlled by a variety of factors including the hydraulic properties of the soils and aquifers that are difficult to characterise spatially. The long mean transit times imply that there are long-lived stores of water in these catchments that may sustain streamflow over drought periods. Additionally, there may be considerable delay in contaminants reaching the stream
Evidence for spatiotemporally distinct effects of image repetition and perceptual expectations as measured by event-related potentials
Get PDF© 2017 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Repeated stimulus presentation leads to reductions in responses of cortical neurons, known as repetition suppression or stimulus-specific adaptation. Circuit-based models of repetition suppression provide a framework for investigating patterns of repetition effects that propagate through cortical hierarchies. To further develop such models it is critical to determine whether (and if so, when) repetition effects are modulated by factors such as expectation and attention. We investigated whether repetition effects are influenced by perceptual expectations, and whether the time courses of each effect are similar or distinct, by presenting pairs of repeated and alternating face images and orthogonally manipulating expectations regarding the likelihood of stimulus repetition. Event-related potentials (ERPs) were recorded from n = 39 healthy adults, to map the spatiotemporal progression of stimulus repetition and stimulus expectation effects, and interactions between these, using mass univariate analyses. We also tested for another expectation effect that may contribute to repetition effects in many previous experiments: that repeated stimulus identities are predictable after seeing the first stimulus in a trial, but unrepeated stimulus identities cannot be predicted. Separate blocks were presented with predictable and unpredictable alternating face identities. Multiple repetition and expectation effects were identified between 99 and 800ms from stimulus onset, which did not statistically interact at any point and exhibited distinct spatiotemporal patterns of effects. Repetition effects in blocks with predictable alternating faces were smaller than in unpredictable alternating face blocks between 117-179 ms and 506–652ms, and larger between 246 and 428ms. The distinct spatiotemporal patterns of repetition and expectation effects support separable mechanisms underlying these phenomena. However, previous studies of repetition effects, in which the repeated (but not unrepeated) stimulus was predictable, are likely to have conflated repetition and stimulus predictability effects
Comparisons between Cambrian Lagerstätten assemblages using multivariate, parsimony and Bayesian methods
Get PDF© 2017 Elsevier. This manuscript version is made available under the CC-BY-NC-ND 4.0 license: http://creativecommons.org/licenses/by-nc-nd/4.0/
This author accepted manuscript is made available following 24 month embargo from date of publication (Dec 2017) in accordance with the publisher’s archiving policyExceptional fossil deposits exhibiting soft-part preservation, or Konservat-Lagerstätten, are prevalent in Cambrian rocks and provide detailed information on fossil assemblages not available from conventional deposits. It has long been recognised that many of these assemblages exhibit certain taxonomic similarities, with many elements seemingly having cosmopolitan distributions. These types of assemblages, particularly those of Cambrian age, have become known as Burgess Shale-type (BST) biotas, named for the famous deposit in the Canadian Rocky Mountains where fossils preserved in this way were first discovered. This study provides the first broad-scale analysis of the assemblage relationships between all major BST biotas. We compiled a database of the presences and absences of over 600 genera within 12 Lagerstätten from Laurentia, Siberia, South China and East Gondwana, ranging in age from Cambrian Series 2 through Series 3 (late-early to middle Cambrian; c. 518–502 Ma), and analysed this using a variety of quantitative methods in order to investigate the relationships between these sites. Non-metric multidimensional scaling (NMDS) ordination, cluster analysis and Parsimony Analysis of Endemicity (PAE) were used to group localities and examine relationships. We also used Bayesian inference and illustrate the benefits of this approach to biogeographic studies. Results suggest that both space and time have important effects on the taxonomic constitution of BST biotas, and that the similarity of these assemblages appears to increase from Series 2 through Series 3, largely driven by increases in cosmopolitanism of biomineralised taxa such as trilobites and brachiopods. There is also evidence of higher-level taxonomic turnover across this period. Endemic taxa help amplify these patterns, despite their frequent exclusion from biogeographic analyses
The Library at Soho Square: Matthew Flinders, Sir Joseph Banks and the Publication of A Voyage to Terra Australis.
Get PDFAn account of Matthew Flinders' research and writing of the introduction to his Voyage to Terra Australis, including his use of London libraries like that of Sir Joseph Banks