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Challenging behaviour

Parker Magin, Rebecca Stewart, Allison Turnock, Amanda Tapley, Elizabeth Holliday, Nick Cooling
Underperforming trainees requiring remediation may threaten patient safety and are challenging for vocational training programs. Decisions to institute remediation are high-stakes-remediation being resource-intensive and emotionally demanding on trainees. Detection of underperformance requiring remediation is particularly problematic in general (family) practice. We sought to establish early-training assessment instruments predictive of general practice (GP) trainees' subsequently requiring formal remediation...
October 21, 2016: Advances in Health Sciences Education: Theory and Practice
Zsofia Orosz, Amy Porteous, Melissa Donskov, Tracy Luciani, Peter Walker
Ontario has eight designated Specialized Units (SUs) located in Long-Term Care (LTC) homes. Each unit serves a well-defined group of residents whose needs go beyond what regular LTC homes can offer but do not require the complexity and range of care provided in hospitals. An applied qualitative research project looked at the realities of designated SUs, explored their role in health system capacity planning, and created a tool kit to help stakeholders navigate the designation process. Results outline the benefits and challenges experienced by the existing SUs that provide care to clients with severe responsive behaviours or dialysis needs and the units' potential to address current and future healthcare system gaps...
October 20, 2016: Healthcare Management Forum
Elizabeth A Ellins, D Aled Rees, John E Deanfield, Andrew Steptoe, Julian P Halcox
Stress influences the risk of cardiovascular disease. Acute mental stress can induce both low-grade inflammation and endothelial dysfunction. The relationship between inflammatory responses to stress and future endothelial function is unexplored. Knowledge on the impact of other cardiovascular risk factors, such as dyslipidaemia, on such relationships is also limited We investigated the relationship between inflammatory responses to an acute mental stress challenge and endothelial function plus the influence of dyslipidaemia on the associations...
October 18, 2016: Brain, Behavior, and Immunity
Franziska Richter, Julia Gerstenberger, Anne Bauer, Chun-Chi Liang, Angelika Richter
Hereditary generalized dystonia is often caused by a GAG deletion in TOR1A (DYT1) that encodes for the protein torsinA. Although mutation carriers show alterations in neuronal connectivity and sensorimotor deficits, only 30% develop dystonia. Uncovering the factors triggering the dystonic symptoms and underlying pathophysiology would greatly benefit the development of more effective therapies. In DYT1 knock-in (KI) mice, the expression of torsinA mutant alters the connectivity of neurons and the function of striatal cholinergic interneurons...
October 18, 2016: Behavioural Brain Research
David W Putwain, Wendy Symes, Hannah M Wilkinson
BACKGROUND: Fear appeals are persuasive messages that draw attention to the negative consequences (e.g., academic failure) that follow a particular course of action (e.g., not engaging in lessons) and how negative consequences can be avoided with an alternate course of action. Previous studies have shown that when fear appeals are appraised as threatening, they are related to lower examination performance. AIM: In this study, we examined how challenge, as well as threat, appraisals are indirectly related to performance on a mathematics examination through behavioural engagement...
October 20, 2016: British Journal of Educational Psychology
James Gavin, Madeleine McBrearty, Kit Malo, Michael Abravanel, Tatiana Moudrakovski
The purpose of this study was to explore adolescents' perceptions of psychosocial influences - personal characteristics, environmental factors and behavioural undertakings - influencing their prolonged involvement in sports and physical activity (PA). A qualitative approach was adopted wherein 16 adolescents (8 boys, 8 girls; mean age 15.9 years), who had been physically active for at least the last 8 years, and sixteen adults identified as their 'parents' or 'guardians' participated in semi-structured interviews...
2016: International Journal of Exercise Science
Grete Mehus, Alf Gunnar Mehus, Sidsel Germeten, Nils Henriksen
INTRODUCTION: Snowmobiling among young people in Scandinavia frequently leads to accidents and injuries. Systematic studies of accidents exist, but few studies have addressed young drivers' experiences. The aim of this article is to reveal how young people experience and interpret accidents, and to outline a prevention strategy. METHODS: Thirty-one girls and 50 boys aged 16-23 years from secondary schools in Northern Norway and on Svalbard, a Norwegian archipelago in the Arctic Ocean, participated in 17 focus groups segregated by gender...
October 2016: Rural and Remote Health
Paul C Knox, Ian J C MacCormick, Emme Mbale, Macpherson Malewa, Gabriela Czanner, Simon P Harding
Paediatric cerebral malaria is the most serious complication of Plasmodium falciparum infection. While the majority recover, long-term cognitive impairment has been highlighted as a significant and neglected problem. Persistent or serious deficits in processes such as attention or behavioural inhibition should be manifest in changes to performance on oculomotor tasks. Therefore we investigated the impact of cerebral malaria on the development of reflexive pro-saccades and antisaccades. In a longitudinal study, 47 children previously admitted with retinopathy-confirmed cerebral malaria (mean age at admission 54 months), were compared with 37 local healthy controls (mean ages at first study visit 117 and 110 months respectively)...
2016: PloS One
Maria Carla de Francesco, Anna Loy
Feeding adaptation, social behaviour, and interspecific interactions related to sexual dimorphism and allometric growth are particularly challenging to be investigated in the high sexual monomorphic Delphinidae. We used geometric morphometrics to extensively explore sexual dimorphism and ontogenetic allometry of different projections of the skull and the mandible of the bottlenose dolphin Tursiops truncatus. Two-dimensional landmarks were recorded on the dorsal, ventral, lateral, and occipital views of the skull, and on the lateral view of the left and the right mandible of 104 specimens from the Mediterranean and the North Seas, differing environmental condition and degree of interspecific associations...
2016: PloS One
M A Cardoso, A Poças, M S Silva, R Ribeiro, M C Almeida, R S Brito, S T Coelho, H Alegre
The requirement to provide urban water services continuously while infrastructures are ageing, imposes the need for increasingly sustainable infrastructure asset management (IAM). To achieve and maintain adequate levels of service, the AWARE-P IAM methodology has been applied in collaborative projects launched by the National Civil Engineering Laboratory, in partnership with IST (Technical University of Lisbon), Addition (software company) and several water utilities. The objective of these projects is to support urban water utilities in the development, implementation and maintenance of IAM plans...
October 2016: Water Science and Technology: a Journal of the International Association on Water Pollution Research
Alex J Elliot, Helen E Hughes, John Astbury, Grainne Nixon, Kate Brierley, Roberto Vivancos, Thomas Inns, Valerie Decraene, Katherine Platt, Iain Lake, Sarah J O'Brien, Gillian E Smith
During August 2015, a boil water notice (BWN) was issued across parts of North West England following the detection of Cryptosporidium oocysts in the public water supply. Using prospective syndromic surveillance, we detected statistically significant increases in the presentation of cases of gastroenteritis and diarrhoea to general practitioner services and related calls to the national health telephone advice service in those areas affected by the BWN. In the affected areas, average in-hours general practitioner consultations for gastroenteritis increased by 24...
October 13, 2016: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
Xiaohu Zheng, Lei Gao, Quanzhou Yao, Qunyang Li, Miao Zhang, Xiaoming Xie, Shan Qiao, Gang Wang, Tianbao Ma, Zengfeng Di, Jianbin Luo, Xi Wang
Two-dimensional (2D) materials possess outstanding lubrication property with their thicknesses down to a few atomic layers, but they are easily susceptible to sliding induced degradation or ubiquitous chemical modification. Maintaining the superior lubricating performance of 2D materials in a harsh working environment is highly desirable yet grandly challenging. Here we show that by proper alignment of graphene on a Ge(111) substrate, friction of graphene could be well preserved at an ultra-low level even after fluorination or oxidation...
October 19, 2016: Nature Communications
Deborah S Bower, David M Scheltinga, Simon Clulow, John Clulow, Craig E Franklin, Arthur Georges
Freshwater biota experience physiological challenges in regions affected by salinization, but often the effects on particular species are poorly understood. Freshwater turtles are of particular concern as they appear to have limited ability to cope with environmental conditions that are hyperosmotic to their body fluids. Here, we determined the physiological responses of two Australian freshwater chelid turtles, Emydura macquarii and Chelodina expansa, exposed to freshwater (0‰) and brackish water (15‰, representing a hyperosmotic environment)...
2016: Conservation Physiology
Julian N Trollor, Carmela Salomon, Catherine Franklin
Mental illness is common in people with intellectual disability. They may also have physical health problems which can affect their mental state. Difficulties in communication can contribute to mental health problems being overlooked. These may present with changes in behaviour. Psychological management is usually preferable to prescribing psychotropic drugs. Behavioural approaches are the most appropriate way to manage challenging behaviour. If a drug is considered, prescribers should complete a thorough diagnostic assessment, exclude physical and environmental contributions to symptoms, and consider medical comorbidities before prescribing...
August 2016: Australian Prescriber
Bettina K Steiger, Hennric Jokeit
Social bonds are at the center of our daily living and are an essential determinant of our quality of life. In people with epilepsy, numerous factors can impede cognitive and affective functions necessary for smooth social interactions. Psychological and psychiatric complications are common in epilepsy and may hinder the processing of social information. In addition, neuropsychological deficits such as slowed processing speed, memory loss or attentional difficulties may interfere with enjoyable reciprocity of social interactions...
October 11, 2016: Seizure: the Journal of the British Epilepsy Association
Xiao-Juan Wang, Yin-Ping Gao, Nan-Nan Lu, Wei-Shuo Li, Ji-Fang Xu, Xiao-Ying Ying, Gang Wu, Mei-Hua Liao, Chao Tan, Ling-Xiao Shao, Ying-Mei Lu, Chen Zhang, Kohji Fukunaga, Feng Han, Yong-Zhong Du
Clinical treatment for vascular dementia still remains a challenge mainly due to Blood-Brain Barrier (BBB). Here, a micelle based on polysialic acid (PSA) which is a hydrophilic and endogenous carbohydrate polymer, was designed to deliver calmodulin antagonist for therapy of vascular dementia. PSA was firstly chemically conjugated with octadecylamine (ODA), and the obtained PSA-ODA copolymer could self-assemble into micelle in aqueous solution with a 120.0 μg/mL critical micelle concentration. The calmodulin antagonist loaded PSA-ODA micelle, featuring sustained drug release behaviour over a period of 72 h with 3...
October 17, 2016: ACS Applied Materials & Interfaces
Bianca Hemmingsen, David Peick Sonne, Maria-Inti Metzendorf, Bernd Richter
BACKGROUND: The projected rise in the incidence of type 2 diabetes mellitus (T2DM) could develop into a substantial health problem worldwide. Whether insulin secretagogues (sulphonylureas and meglitinide analogues) are able to prevent or delay T2DM and its associated complications in people at risk for the development of T2DM is unknown. OBJECTIVES: To assess the effects of insulin secretagogues on the prevention or delay of T2DM and its associated complications in people with impaired glucose tolerance, impaired fasting blood glucose, moderately elevated glycosylated haemoglobin A1c (HbA1c) or any combination of these...
October 17, 2016: Cochrane Database of Systematic Reviews
A Rosén, J Yi, I Kirsch, T J Kaptchuk, M Ingvar, K B Jensen
BACKGROUND: Expectancy is widely accepted as a key contributor to placebo effects. However, it is not known whether non-conscious expectancies achieved through semantic priming may contribute to placebo analgesia. In this study, we investigated if an implicit priming procedure, where participants were unaware of the intended priming influence, affected placebo analgesia. METHODS: In a double-blind experiment, healthy participants (n = 36) were randomized to different implicit priming types; one aimed at increasing positive expectations and one neutral control condition...
October 17, 2016: European Journal of Pain: EJP
K W Miskowiak, C V Ott, J Z Petersen, L V Kessing
Cognitive impairment is a core feature of Major Depressive Disorder (MDD) but treatments targeting cognition are lacking. Numerous pre-clinical and clinical studies have investigated potential cognition treatments, but overall the evidence is conflicting. We conducted a systematic search following the PRISMA guidelines on PubMed and PsychInfo to evaluate the extant evidence and methodological challenges in randomized controlled trials (RCTs) of biological, psychological and behavioural candidate treatments targeting cognition in MDD...
October 13, 2016: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
Christine H Oedegaard, Lesley Berk, Michael Berk, Eric A Youngstrom, Steven C Dilsaver, Robert H Belmaker, Ketil J Oedegaard, Ole B Fasmer, Ingunn M Engebretsen
OBJECTIVE: Clinical management of bipolar disorder patients might be affected by culture and is further dependent on the context of healthcare delivery. There is a need to understand how healthcare best can be delivered in various systems and cultures. The objective of this qualitative study was to gain knowledge about culture-specific values, beliefs and practices in the medical care provided to patients with bipolar disorders from a provider perspective in various areas of the world...
October 14, 2016: Australian and New Zealand Journal of Psychiatry
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