Real-life Social Attention in Children with Autism Spectrum Disorders

Autism is a neuro-developmental disorder defined by atypical social behaviour, of which atypical social attention behaviours are among the earliest clinical markers (Volkmar et al., 1997). Eye tracking studies using still images and movie clips have provided a method for the precise quantification of atypical social attention in ASD. This is generally characterised by diminished viewing of the most socially pertinent regions (eyes), and increased viewing of less socially informative regions (body, background, objects) (Klin et al., 2002; Riby & Hancock, 2008, 2009). Ecological validity within eye tracking studies has become an increasingly important issue. As of yet, however, little is known about the precise nature of the atypicalities of social attention in ASD in real-life. Objectives: To capture and quantify gaze patterns for children with an ASD within a real life setting, compared to two Typically Developing (TD) comparison groups. Methods: Nine children with an ASD were compared to two age matched TD groups – a verbal (N=9) and a non-verbal (N=9) comparison group. A real-life scenario was created involving an experimenter posing as a magician, and consisted of 3 segments: a conversation segment; a magic trick segment; and a puppet segment. The first segment explored children’s attentional preferences during a real-life conversation; the magic trick segment explored children’s use of the eyes as a communicative cue, and the puppet segment explored attention capture. Finally, part of the puppet section explored children’s use of facial information in response to an unexpected event. Results: The most striking difference between the groups was the diminished viewing of the eyes by the ASD group in comparison to both control groups. This was found particularly during the conversation segment, but also during the magic trick segment, and during the puppet segment. When in conversation, participants with ASD were found to spend a greater proportion time looking off-screen, in comparison to TD participants. There was also a tendency for the ASD group to spend a greater proportion of time looking to the mouth of the experimenter. During the magic trick segment, despite the fact that the eyes were not predictive of a correct location, both TD comparison groups continued to use the eyes as a communicative cue, whereas the ASD group did not. In the puppet segment, all three groups spent a similar amount of time looking between the puppet and regions of the experimenter’s face. However, in response to an unexpected event, the ASD group were significantly slower to fixate back on the experimenter’s face. Conclusions: The results demonstrate the reduced salience of socially pertinent information for children with ASD in real life, and they provide support for the findings from previous eye tracking studies involving scene viewing. However, the results also highlight a pattern looking off-screen for both the TD and ASD groups. This eye movement behaviour is likely to be associated specifically with real-life interaction, as it has functional relevance (Doherty-Sneddon et al., 2002). However, the fact that it is significantly increased in the ASD group has implications for their understanding of real life social interactions.

Resource utilization and cost analyses of home-based palliative care service provision:The Niagara West End-of-Life Shared-Care Project

Background: Increasing emphasis is being placed on the economics of health care service delivery - including home-based palliative care. Aim: This paper analyzes resource utilization and costs of a shared-care demonstration project in rural Ontario (Canada) from the public health care system's perspective. Design: To provide enhanced end-of-life care, the shared-care approach ensured exchange of expertise and knowledge and coordination of services in line with the understood goals of care. Resource utilization and costs were tracked over the 15 month study period from January 2005 to March 2006. Results: Of the 95 study participants (average age 71 years), 83 had a cancer diagnosis (87%); the non-cancer diagnoses (12 patients, 13%) included mainly advanced heart diseases and COPD. Community Care Access Centre and Enhanced Palliative Care Team-based homemaking and specialized nursing services were the most frequented offerings, followed by equipment/transportation services and palliative care consults for pain and symptom management. Total costs for all patient-related services (in 2007 CAN) were 1,625,658.07 - or 17,112.19 per patient/117.95 per patient day. Conclusion: While higher than expenditures previously reported for a cancer-only population in an urban Ontario setting, the costs were still within the parameters of the US Medicare Hospice Benefits, on a par with the per diem funding assigned for long-term care homes and lower than both average alternate level of care and hospital costs within the Province of Ontario. The study results may assist service planners in the appropriate allocation of resources and service packaging to meet the complex needs of palliative care populations. © 2012 The Author(s).

Using mixed-methods to examine teachers’ attitudes to educational change:The case of the Skills for Life strategy for improving adult literacy and numeracy skills in England.

This paper reports on a longitudinal study that examines how a national reform introduced in England in the field of adult literacy, language, and numeracy is affecting teachers. The paper focuses on the use of a mixed methodology to explore teachers' attitudes to the reform and how these change over time. The quantitative strand includes the construction and use of a Likert-type instrument for measuring the attitudes of a panel of 1,500 teachers. The qualitative strand builds on the quantitative results and includes focus groups and in-depth interviews with a subsample of teachers in the panel. As the study is still in its initial phase, the purpose is not to present findings, but to discuss how quantitative and qualitative evidence can be combined in evaluation research.

Anatomical study comparing the thickness of the volar and dorsal cortex of cadaveric adult distal radii using digital photography

INTRODUCTION:

Dorsally displaced fractures of the distal radius fractures are one of the commonest in day-to-day practice. There is still no consensus among surgeons regarding the suitability of using volar or the dorsal cortex as basis for internal fixation for dorsally displaced fractures.

BACKGROUND:

We report an anatomical study, which compares the thickness of the volar and dorsal cortices of cadaveric adult radii using digital photography.

RESULTS:

Results of this study show that the volar cortex was statistically, significantly thicker than the dorsal cortex. We believe that the volar cortex may behave as the calcar of the distal radius and hence internal fixation devices applied to the volar cortex may provide a more stable internal fixation compared to those based on the dorsal cortex.

Still Unequal at Birth: Birth Weight, Socioeconomic Status and Outcomes at Age 9

The prevalence of low birth weight is an important aspect of public health which has been linked to increased risk of infant death, increased cost of care, and a range of later life outcomes. Using data from a new Irish cohort study, I document the relationship between birth weight and socio-economic status. The association of maternal education with birth weight does not appear to be due to the timing of birth or complications during pregnancy, even controlling for a wide range of background characteristics. However, results do suggest intergenerational persistence in the transmission of poor early life conditions. Birth weight predicts a number of outcomes at age 9, including test scores, hospital stays and health. An advantage of the data is that I am able to control for a number of typically unmeasured variables. I determine whether parental investments (as measured by the quality of interaction with the child, parenting style, or school quality) mediate the association between birth weight and later indicators. For test scores, there is evidence of non-linearity, and boys are more adversely affected than girls. I also consider whether there are heterogeneous effects by ability using quantile regression. These results are consistent with a literature which finds that there is a causal relationship between early life conditions and later outcomes.

A Systematic Review of End-of-Life Visual Impairment in Open-Angle Glaucoma: An Epidemiological Autopsy

PURPOSE: Glaucoma patients are still at risk of becoming blind. It is of clinical significance to determine the risk of blindness and its causes to prevent its occurrence. This systematic review estimates the number of treated glaucoma patients with end-of-life visual impairment (VI) and blindness and the factors that are associated with this.

METHODS: A systematic literature search in relevant databases was conducted in August 2014 on end-of-life VI. A total of 2574 articles were identified, of which 5 on end-of-life VI. Several data items were extracted from the reports and presented in tables.

RESULTS: All studies had a retrospective design. A considerable number of glaucoma patients were found to be blind at the end of their life; with up to 24% unilateral and 10% bilateral blindness. The following factors were associated with blindness: (1) baseline severity of visual field loss: advanced stage of glaucoma or substantial visual field loss at the initial visit; (2) factors influencing progression: fluctuation of intraocular pressure (IOP) during treatment, presence of pseudoexfoliation, poor patient compliance, higher IOP; (3) longer time period: longer duration of disease and older age at death because of a longer life expectancy; and (4) coexistence of other ocular pathology.

CONCLUSIONS: Further prevention of blindness in glaucoma patients is needed. To reach this goal, it is important to address the risk factors for blindness identified in this review, especially those that can be modified, such as advanced disease at diagnosis, high and fluctuating IOP, and poor compliance.

Ecology of the early life-history stages of shad Alosa fallax fallax (Lacépède, 1803) in the River Mira, with a note on Alosa spp. larvae in the River Guadiana

Tese dout., Ecologia, Universidade do Algarve, 2006

Contributos maternos para a auto-regulação do bebé na situação experimental face-to-face still-face

Dissertação apresentada na Escola Superior de Educação de Lisboa para obtenção do grau de Mestre em Intervenção Precoce

Health-related quality of life among patients attending cardiovascular rehabilitation

Purpose: f i rst , an investigation of baseline differences in Health-Related Quality of l i fe (HRQOl) among adhere and non-adhere patients of Phase III cardiac rehabilitation (CR) was examined. Second, among patients who adhered to the program, effectiveness of t reatment based on HRQOl was evaluated. Methods: Data was collected by the Brock University Heart Institute. Participants completed a questionnaire battery at baseline and again at six months i f they were still a client. Results: The physical dimension of HRQOl differed at baseline between the adhere and non-adhere groups. for everyone point increase in physical HRQOl scores there was an associated 1.06 times greater likelihood that an individual would adhere to the program. Second, in those who adhered to the program for six months, physical HRQOl scores improved 3.18 points. Conclusions: Phase III CR significant improves HRQOl in patients suffering f rom cardiovascular disease.

Why are we still at war? : or, The American question considered ; in a series of essays rejected by the journalists as unpopular ; recommended to a candid perusal

In the Pamphleteer, vol. 4, p. 551-576. London, 1814

A randomized follow-up study of the general health and quality of life of an elderly edentulous population wearing either mandibular two-implant overdentures or conventional dentures

L’augmentation de la population âgée dans la société indique que les systèmes de soins de la santé font face à de nouveaux défis. Les hauts niveaux d’incapacité qui en résultent peuvent être réduits par les nouvelles technologies, la promotion de la santé ainsi que des stratégies de prévention. Les écrits scientifiques récents soulignent la supériorité des prothèses dentaires implanto-portées par rapport aux prothèses conventionnelles en termes de satisfaction et de qualité de la vie des patients. Cependant, il n'est toujours pas clair si ces avantages ont des effets positifs à long terme sur la santé orale et générale ainsi que sur la qualité de vie des populations âgées. Objectifs, Hypothèses : Notre but était de mesurer l’impact des prothèses mandibulaires retenues par 2 implants sur la qualité de vie associée à la santé bucco-dentaire et générale ainsi que sur la santé orale et la qualité du sommeil des aînés édentés. Nous avons évalué les hypothèses nulles suivantes : il n'y a aucune différence entre les individus portants des prothèses mandibulaires retenues par 2 implants (IODs) et ceux qui portent des prothèses conventionnelles (CDs), par rapport à la qualité de vie reliée à la santé bucco-dentaire et générale, la santé orale et la qualité du sommeil, un an après avoir reçu leurs nouvelles prothèses. Méthodes : Dans cette étude randomisée contrôlée, 255 aînés ont reçu au hasard IODs ou les CDs, les deux types de prothèses étant opposés à des prothèses maxillaires conventionnelles. La qualité de la vie reliée à la santé bucco-dentaire (OHRQoL) et la santé générale subjective ont été mesurées avec les questionnaires Oral Health Impact Profile (OHIP-20) et Short Form-36 (SF-36) en condition pré-traitement et après un an. La qualité du sommeil et la somnolence diurne ont été mesurées à l’aide du questionnaire Qualité de Sommeil de Pittsburg et de l'Échelle de Somnolence Epworth. La santé orale a été évaluée par un examen clinique. Les variables indépendantes étaient le sens de cohérence et le type de prosthèse, ainsi que des variables socio-démographiques. En utilisant des analyses statistiques bi et multi-factorielles, des comparaisons à l’intérieur d’un même groupe et entre deux groupes ont été effectuées. Résultats : Les différences pré et post traitement pour les cotes OHIP étaient significativement plus grandes pour le groupe IOD que le groupe CD (p<0.05). Le type de traitement et la cote pré-traitement étaient des facteurs significatifs à OHRQoL (p < 0.0001). Dans le groupe CD, il y avait une diminution significative par rapport aux cotes de «Physical Component Scores (PCS)», le fonctionnement physique, le rôle physique et la douleur physique entre les données pré-traitement et un an après le traitement, ce qui indique une diminution au niveau de la santé générale subjective. Dans le groupe IOD, une diminution statistiquement non significative a été remarquée par rapport à toutes les cotes des sous-échelles de SF-36, sauf pour la douleur physique. Le modèle final de régression a démontré qu’après ajustement pour les variables âge, sexe, statut marital et type de traitement, la cote totale finale d’OHIP et les données de bases de PCS prédisaient la cote finale de PCS (p < 0.0001). Aucune corrélation significative entre sens de cohérence et OHRQoL n'a été détectée (r =-0.1; p > 0.05). Les aînés porteurs des prothèses conventionnelles avaient presque 5 fois plus de chance d’avoir une stomatite prothétique que ceux portant des prothèses mandibulaires hybrides retenues par 2 implants (p < 0.0001). Les aînés ayant subjectivement une mauvaise santé générale avaient une qualité de sommeil moins bonne que ceux avec une meilleure santé générale subjective (p < 0.05). Les personnes qui avaient une OHRQoL moins bonne étaient presque 4 fois plus somnolentes pendant le jour que celles avec une meilleure OHRQoL (p=0.003, χ2; OR =3.8 CI 1.5 to 9.8). L'analyse de régression a montré que la santé générale subjective et OHRQoL prévoient la qualité du sommeil (p=0.022 et p=0.001, respectivement) et la somnolence diurne (p=0.017 et p=0.005, respectivement). Conclusions: Les résultats de cette étude suggèrent que, chez les aînés édentés, des prothèses mandibulaires hybrides retenues par deux implants amènent une amélioration significative de la qualité de vie reliée à la santé bucco-dentaire et maintiennent la sensation d’une meilleure santé physique. Des prothèses hybrides implanto-portées peuvent contribuer à la santé orale en réduisant les traumatismes infligés à la muqueuse orale et en contrôlant la stomatite prothétique. Les aînés édentés dont le niveau de qualité de vie reliée à la santé bucco-dentaire est bas, peuvent aussi avoir des troubles de qualité du sommeil.

A randomized controlled trial evaluating the quality of life and the sense of coherence in seniors wearing complete conventional dentures or mandibular two-implant overdentures

La supériorité des prothèses mandibulaires retenues par deux implants (IODs) sur les prothèses conventionnelles (CDs) nécessitent d’être éclaircies notamment en rapport à leur influence sur la qualité de vie reliée à la santé bucco-dentaire (OHRQoL) ainsi que sur la stabilité de cet effet de traitement. De plus, l’influence des facteurs psychologiques, tel que le sens de cohérence (SOC), sur l’effet de traitement reste encore inconnue. Le but de cette étude est de déterminer l’amplitude de l’influence du port des IODs et des CDs sur l’OHRQoL et d’évaluer la stabilité de l’effet de traitement dans le temps, tout en prenant en considération le niveau du SOC. MÉTHODOLOGIE: Des participants édentés (n=172, âge moyen 71, SD = 4.5) ayant reçu des CDs ou des IODs ont été suivis sur une période de deux ans. L’OHRQoL a été évaluée à l’aide du questionnaire « Oral Health Impact Profile (OHIP -20) » et ce avant le traitement et à chacun des deux suivis. Le SOC a été évalué à l’aide du questionnaire « The Orientation to Life (SOC -13) » à chacun des deux suivis. Des analyses statistiques ont été effectuées pour évaluer les différences intra et entre groupes (analyses statistiques descriptives, bivariées et multivariées). RÉSULTATS: Une amélioration statistiquement significative de l’OHRQoL entre les statuts avant et après traitement a été notée dans les deux groupes (Wilks’s Lambda = 0.473, F (1,151) = 157.31, p < 0.0001). L’amplitude de l’effet du traitement IOD est 1.5 fois plus grande que celle du traitement CD. Ces résultats ont été stables pendant les deux années d’étude et ils n’ont pas été influencés par le SOC. CONCLUSION: Le traitement IOD amène une meilleure OHRQoL à long terme en comparaison avec le traitement CD et ce sans influence du niveau du SOC. Ces résultats sont cliniquement significatifs et confirment la supériorité des IODs sur les CDs.

"Racism in a Melting Pot...?" Trinidadian mid-life transnational migrants' views on race and colour-class on return to their homes of descent

This paper deals with second-generation, one-and-a-half generation and ‘‘prolonged sojourner” Trinidadian transnational migrants, who have decided to ‘return’ to the birthplace of their parents. Based on 40 in-depth interviews, the paper considers both the positive and critical things that these youthful transnational migrants report about returning to, and living in, this multi-ethnic plural society and the salience of racial and colour-class stratification as part of their return migration experiences. Our qualitative analysis is based on the narratives provided by these youthful returnees, as relayed ‘‘in their own words”, presenting critical reflections on racism, racial identities and experiences as transnational Trinidadians. It is clear that it is contexts such as contemporary working environments, family and community that act as the reference points for the adaptation ‘‘back home” of this strongly middle-class cohort. We accordingly encounter a diverse, sometimes contesting set of racial issues that emerge as salient concerns for these returnees. The consensus is that matters racial remain as formidable legacies in the hierarchical stratification of Trinidadian society for a sizeable number. Many of our respondents reported the positive aspects of racial affirmation on return. But for another sub-set, the fact that multi-ethnic and multi-cultural mixing are proudly embraced in Trinidad meant that it was felt that return experiences were not overly hindered, or blighted by obstacles of race and colour-class. For these returnees, Trinidad and Tobago is seen as representing a 21st century ‘‘Melting Pot”. But for others the continued existence of racial divisions within society – between ethnic groups and among those of different skin shades – was lamented. In the views of these respondents, too much racial power is still ascribed to ‘near-whiteness’. But for the most part, the returnees felt that where race played a part in their new lives, this generally served to advantage them. However, although the situation in Trinidad appears to have been moderated by assumptions that it remains a racial ‘Melting Pot’, the analysis strongly suggests that the colour-class system of stratification is still playing an essential role, along with racial stereotyping in society at large.

Chronic toxicity of ibuprofen to Daphnia magna: Effects on life history traits and population dynamics

The non-steroidal anti-inflammatory drug (NSAID) ibuprofen (IB) is a widely used pharmaceutical that can be found in several freshwater ecosystems. Acute toxicity studies with Daphnia magna suggest that the 48 h EC50 (immobilisation) is 10-100 mg IB l(-1). However, there are currently no chronic IB toxicity dataon arthropod populations, and the aquatic life impacts of such analgesic drugs are still undefined. We performed a 14-day exposure of D. magna to IB as a model compound (concentration range: 0, 20, 40 and 80 mg IB l(-1)) measuring chronic effects on life history traits and population performance. Population growth rate was significantly reduced at all IB concentrations, although survival was only affected at 80 mg IB l(-1). Reproduction, however, was affected at lower concentrations of IB (14-day EC50 of 13.4 mg IB l(-1)), and was completely inhibited at the highest test concentration. The results from this study indicate that the long-term crustacean population consequences of a chronic IB exposure at environmentally realistic concentrations (ng l(-1) to mu g l(-1)) would most likely be of minor importance. We discuss our results in relation to recent genomic studies, which suggest that the potential mechanism of toxicity in Daphnia is similar to the mode of action in mammals, where IB inhibits eicosanoid biosynthesis. (C) 2007 Elsevier Ireland Ltd. All rights reserved.