In Vivo Age Dependency of Unfractionated Heparin in Infants and Children

Introduction
Unfractionated Heparin (UFH) is used widely in paediatrics. Paediatric specific recommendations for UFH therapy are few, with the majority of recommendations being extrapolated from adult practice. In vitro studies have shown that this practice may be suboptimal. This study aimed to improve the understanding of the impact of age upon UFH response in vivo.

Materials and Methods
This prospective, observational study, conducted in the Paediatric Intensive Care Unit (PICU), included: patients 16 years or younger; treated with UFH of at least 10 U/Kg/hr. Laboratory analysis included: Antithrombin, APTT, Anti-Xa, Anti-IIa and thrombin generation expressed as the Endogenous Thrombin Potential. Results were grouped according to patient age (i.e. < 1, 1-5, 6-10 and 11-16 years).

Results
85 patients received an equivalent mean UFH dose with a median duration of 3 days. Antithrombin levels were decreased compared to age-related norms in children up to 11 years of age. APTT results were comparable across the age-groups. The Anti-Xa results using two different assays showed a trend for lower values in younger children. All children less than one year old recorded Anti-Xa values outside the therapeutic range for heparin therapy, for both assays. There was a trend for decreased Anti-IIa activity in younger children. Endogenous Thrombin Potential showed a significant trend for increased inhibition in older children. In vitro Antithrombin supplementation did not change the Anti-Xa or thrombin generation.

Conclusions
This study confirms that, in vivo, for the same dose of UFH, the anti Xa and anti IIa effect, as well as the inhibition of endogenous thrombin potential is age dependent and that these differences are not purely AT dependent. The implication is that the anticoagulant and antithrombotic effect of a given dose of UFH differs with age. Clinical outcome studies to determine the optimal dosing for each age group are warranted.

Abbreviations
UFH, Unfractionated Heparin; ETP, Endogenous Thrombin Potential; AT, Antithrombin; APTT, Activated Partial Thromboplastin Time

A Context-Dependent Algorithm for Merging Uncertain Information in Possibility Theory

The need to merge multiple sources of uncertaininformation is an important issue in many application areas,especially when there is potential for contradictions betweensources. Possibility theory offers a flexible framework to represent,and reason with, uncertain information, and there isa range of merging operators, such as the conjunctive anddisjunctive operators, for combining information. However, withthe proposals to date, the context of the information to be mergedis largely ignored during the process of selecting which mergingoperators to use. To address this shortcoming, in this paper,we propose an adaptive merging algorithm which selects largelypartially maximal consistent subsets (LPMCSs) of sources, thatcan be merged through relaxation of the conjunctive operator, byassessing the coherence of the information in each subset. In thisway, a fusion process can integrate both conjunctive and disjunctiveoperators in a more flexible manner and thereby be morecontext dependent. A comparison with related merging methodsshows how our algorithm can produce a more consensual result.

Are Shy Adults Really Bolder Online? It Depends on the Context

We examined whether individual differences in shyness and context influenced the amount of computer-mediated self-disclosure and use of affective language during an unfamiliar dyadic social interaction. Unfamiliar young adults were selected for high and low self-reported shyness and paired in mixed dyads (one shy and one nonshy). Each dyad was randomly assigned to either a live webcam or no webcam condition. Participants then engaged in a 20-minute online free chat over the Internet in the laboratory. Free chat conversations were archived, and the transcripts were objectively coded for traditional communication variables, conversational style, and the use of affective language. As predicted, shy adults engaged in significantly fewer spontaneous self-disclosures than did their nonshy counterparts only in the webcam condition. Shy versus nonshy adults did not differ on spontaneous self-disclosures in the no webcam condition. However, context did not influence the use of computer-mediated affective language. Although shy adults used significantly less active and pleasant words than their nonshy counterparts, these differences were not related to webcam condition. The present findings replicate and extend earlier work on shyness, context, and computer-mediated communication to a selected sample of shy adults. Findings suggest that context may influence some, but not all, aspects of social communication in shy adults.

Is shyness context specific? Relation between shyness and online self-disclosure with and without a live webcam in young adults

The Internet provides a new tool to investigate old questions in experimental social psychology regarding Person x Context interaction. We examined the interaction of self-reported shyness and context on computer-mediated communication measures. Sixty female undergraduates unfamiliar were paired in dyads and engaged in a 10 min free chat conversation on the Internet with and without a live webcam. Free chat conversations were archived, transcripts were objectively coded for communication variables, and a linear mixed model used for data analysis of dyadic interaction was performed on each communication measure. As predicted, increases in self-reported shyness were significantly related to decreases in the number of prompted self-disclosures (after controlling for the number of opportunities to self-disclose) only in the webcam condition. Self-reported shyness was not related to the number of prompted self-disclosures in the no webcam condition, suggesting that shyness was context dependent. The present study appears to be the first to objectively code measures of Internet behaviour in relation to the study of personality in general and shyness in particular. Theoretical and clinical implications for understanding the contextual nature of shyness are discussed. (C) 2006 Elsevier Inc. All rights reserved.

An experience of attempting to apply the randomised controlled trial (RCT) design in a ‘real world’ community-based clinical setting – one family therapist’s current journey. Context, 99, 6-9.

This paper describes an early career researcher's expereince of using randomised controlled trial methodology to investigarte the effectiveness of psychotherapeutic interventions for traumatised families in a 'real world' setting.

Understanding marine reserve function in a seascape genetics context: Nucella lapillus in Strangford Lough (Northern Ireland) as an example

A conservation priority in the marine environment is the establishment of ecologically coherent reserve networks. Since these networks will integrate existent reserves, an understanding of spatial genetic diversity and genetic connectivities between areas is necessary. Using Strangford Lough marine nature reserve (MNR) as a model, spatial genetic analyses were employed to evaluate the function of the lough. Samples of the marine gastropod Nucella lapillus (L.) from 7 locations in the reserve and adjacent areas were screened at 6 microsatellites. Genetic variation was temporally stable. Significant genetic structuring (F-ST = 0.133) was observed among samples. Genetic divergence and isolation by distance indicated reduced gene flow between the marine reserve and coastal samples relative to that between adjacent coastal samples. Partitioning of genetic variation between the reserve and coast was significant (AMOVA, 7.45%, p