What do adolescents want from their ED? An evaluation on the preferences and opinions of adolescents attending local EDs

IntroductionThe adolescent population comprises a significant proportion of attendances to the ED. Despite adolescent patients reporting lower levels of healthcare satisfaction compared with other age groups, their opinions are under-represented in existing literature. This prospective study investigated adolescents’ expectations and preferences regarding the ED service.MethodsA questionnaire designed by the investigators was distributed to children aged 12–16 years over a 6-month period in 2015 at two EDs in the UK. The questionnaire explored themes such as same-sex and similar-age areas, staff communication and environment. Interviews based on the questionnaire template were also conducted and guardians were permitted to accompany the participant. Verbal informed consent was obtained from both the young person and their guardian to participate in the study.ResultsThere were 254 respondents, which represented 8.8% of adolescent attendances in the study period. ‘Cleanliness’ was rated the most important factor within the ED setting with 94.8% of respondents selecting 4 or 5 on a 5-point Likert scale. This was followed by ‘feeling comfortable’, ‘clear explanation’ and ‘staff communication’ (91.2%, 90.8% and 90.4% rating these 4 or 5, respectively). However, when participants were asked to select a single most important factor, being ‘seen quickly’ was selected most frequently (95/206, 46.1%). ‘Entertainment’ was regarded the least important with only 17.0% selecting 4 or 5 on the Likert scale. Preference for being treated in an adult ED compared with a child ED increased with age.ConclusionsBeing ‘seen quickly’ was considered the single most important factor by adolescent patients in the ED. Notably, ‘cleanliness’ and aspects of communication also rated highly, with ‘entertainment’ regarded as least important. The additional insight into the healthcare preferences of the adolescent population provides a platform on which the future ED services can be tailored to the needs of young people.

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Genetic Contributions to Multivariate Data-Driven Brain Networks Constructed via Source-Based Morphometry

Cerebral Cortex ◽

10.1093/cercor/bhaa082 ◽

2020 ◽

Vol 30 (9) ◽

pp. 4899-4913

Author(s):

Amanda L Rodrigue ◽

Aaron F Alexander-Bloch ◽

Emma E M Knowles ◽

Samuel R Mathias ◽

Josephine Mollon ◽

...

Keyword(s):

Brain Function ◽

Complex Traits ◽

Brain Regions ◽

Data Driven ◽

Additional Insight ◽

Genetic Overlap ◽

Data Driven Approach ◽

The Uk ◽

Genetic Contributions ◽

Insight Into

Abstract Identifying genetic factors underlying neuroanatomical variation has been difficult. Traditional methods have used brain regions from predetermined parcellation schemes as phenotypes for genetic analyses, although these parcellations often do not reflect brain function and/or do not account for covariance between regions. We proposed that network-based phenotypes derived via source-based morphometry (SBM) may provide additional insight into the genetic architecture of neuroanatomy given its data-driven approach and consideration of covariance between voxels. We found that anatomical SBM networks constructed on ~ 20 000 individuals from the UK Biobank were heritable and shared functionally meaningful genetic overlap with each other. We additionally identified 27 unique genetic loci that contributed to one or more SBM networks. Both GWA and genetic correlation results indicated complex patterns of pleiotropy and polygenicity similar to other complex traits. Lastly, we found genetic overlap between a network related to the default mode and schizophrenia, a disorder commonly associated with neuroanatomic alterations.

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Effect of Age on the Outcome of Hospital Treated Depression

The British Journal of Psychiatry ◽

10.1192/bjp.168.1.76 ◽

1996 ◽

Vol 168 (1) ◽

pp. 76-81 ◽

Cited By ~ 19

Author(s):

T. A. Tuma

Keyword(s):

Age Groups ◽

Significant Proportion ◽

The Elderly ◽

Adult Patients ◽

Hospital Treatment ◽

Melancholic Depression ◽

Residual Symptoms ◽

Duration Of Illness ◽

One Year ◽

The Uk

BackgroundDepression affects a significant proportion of the expanding elderly population in the UK. Reports of a poorer prognosis for older than for younger adult patients have been challenged by recent papers.MethodThe casenotes of 56 adults (mean age 47.8 years) and 54 elderly (mean age 72.9 years) patients with primary depression were assessed one year after receiving hospital treatment. Outcome measures were compared with earlier reported findings and factors possibly influencing outcome were explored.ResultsThe pattern of outcome in both age groups was broadly similar, thus: adults v. elderly: recovered 44.6% v. 44.4%; relapsed and recovered 23.2% v. 24%; residual symptoms 19.6% v. 13% and chronic depression 7.1% v. 5.5%. In the adults there were two natural deaths and one suicide. In the elderly there were two cases of dementia and five natural deaths, which was double the expected death rate. Predictors of poor outcome were melancholic depression in adults and longer duration of illness at intake and an increasing number of previous episodes of affective disorder in the elderly.ConclusionThe outcome of treated depressive illnesses appears similar in elderly and adult patients. Associated physical ill health did not adversely affect outcome in the elderly group.

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Classification of Infant Vocalizations by Untrained Listeners

Journal of Speech Language and Hearing Research ◽

10.1044/2019_jslhr-s-18-0494 ◽

2019 ◽

Vol 62 (9) ◽

pp. 3265-3275

Author(s):

Heather L. Ramsdell-Hudock ◽

Anne S. Warlaumont ◽

Lindsey E. Foss ◽

Candice Perry

Keyword(s):

Formal Education ◽

Additional Insight ◽

Listener Responses ◽

Infant Vocalization ◽

Early Infant ◽

Infant Vocalizations ◽

Audio Recordings ◽

Speech And Language Development ◽

Insight Into

Purpose To better enable communication among researchers, clinicians, and caregivers, we aimed to assess how untrained listeners classify early infant vocalization types in comparison to terms currently used by researchers and clinicians. Method Listeners were caregivers with no prior formal education in speech and language development. A 1st group of listeners reported on clinician/researcher-classified vowel, squeal, growl, raspberry, whisper, laugh, and cry vocalizations obtained from archived video/audio recordings of 10 infants from 4 through 12 months of age. A list of commonly used terms was generated based on listener responses and the standard research terminology. A 2nd group of listeners was presented with the same vocalizations and asked to select terms from the list that they thought best described the sounds. Results Classifications of the vocalizations by listeners largely overlapped with published categorical descriptors and yielded additional insight into alternate terms commonly used. The biggest discrepancies were found for the vowel category. Conclusion Prior research has shown that caregivers are accurate in identifying canonical babbling, a major prelinguistic vocalization milestone occurring at about 6–7 months of age. This indicates that caregivers are also well attuned to even earlier emerging vocalization types. This supports the value of continuing basic and clinical research on the vocal types infants produce in the 1st months of life and on their potential diagnostic utility, and may also help improve communication between speech-language pathologists and families.

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Facial Perceptions: Age's Influence on People's Perceptions of Facial Modifications

Vanderbilt Undergraduate Research Journal ◽

10.15695/vurj.v6i0.2889 ◽

2010 ◽

Vol 6 ◽

Author(s):

Nascine Howell ◽

Lindsey Erin Overhalser ◽

Abigail Eliza Randall ◽

Rachael Dillon

Keyword(s):

Age Groups ◽

Likert Scale ◽

Online Surveys ◽

People’S Perception ◽

The Face ◽

Subject Experiment ◽

People’S Perceptions

A 2x7 between-subject experiment examined the affect of age on people’s perceptions of facial modifications. Researchers instructed participants aged 18-60 to complete two online surveys. One survey contained 10 modified faces (facial piercings and neck tattoos) and the second survey contained 10 non-modified faces. Participants were instructed to look at each face and rate the face using a 5 point Likert scale on five traits: Trustworthiness, Attractiveness, Confidence, Intelligence and Friendliness. Modified faces were rated higher and perceived more positively than the non-modified faces by participants in all age groups. There was an effect of modification on age groups one (18-23 years old), two (24-29 years), five (30-35 years) and six (36-41 years) for the traits Attractiveness and Confidence. These findings suggest people’s perception of strangers’ is influenced by their own age at the time of the encounter and the age of the faces.

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Diversity, Rationality, and the Division of Cognitive Labor

10.1093/oso/9780190680534.003.0004 ◽

2017 ◽

Cited By ~ 1

Author(s):

Ryan Muldoon

Keyword(s):

Social Structure ◽

Division Of Labor ◽

Additional Insight ◽

Division Of Cognitive Labor ◽

Social Structure Of Science ◽

The Social ◽

Insight Into

Existing models of the division of cognitive labor in science assume that scientists have a particular problem they want to solve and can choose between different approaches to solving the problem. In this essay I invert the approach, supposing that scientists have fixed skills and seek problems to solve. This allows for a better explanation of increasing rates of cooperation in science, as well as flows of scientists between fields of inquiry. By increasing the realism of the model, we gain additional insight into the social structure of science and gain the ability to ask new questions about the optimal division of labor.

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Implementation Strategies for Improving Vitamin D Status and Increasing Vitamin D Intake in the UK: Current Controversies and Future Perspectives. Proceedings of the 2nd Rank Prize Funds Forum on Vitamin D

British Journal Of Nutrition ◽

10.1017/s0007114521002555 ◽

2021 ◽

pp. 1-60

Author(s):

J.L. Buttriss ◽

S.A. Lanham-New ◽

S. Steenson ◽

L. Levy ◽

G.E. Swan ◽

...

Keyword(s):

Vitamin D ◽

Age Groups ◽

Implementation Strategies ◽

Vitamin D Status ◽

Cost Information ◽

Hydroxyvitamin D ◽

Minority Ethnic Groups ◽

Modelling Studies ◽

Clinical Consequences ◽

The Uk

Abstract A multi-disciplinary expert group met to discuss vitamin D deficiency in the UK, and strategies for improving population intakes and status. Changes to UK Government advice since the 1st Rank Forum on Vitamin D (2009) were discussed, including rationale for setting a RNI (10µg/day;400IU/day) for adults and children (4+ years). Current UK data show inadequate intakes among all age groups, and high prevalence of low vitamin D status among specific groups (e.g. pregnant women and adolescent males/females). Evidence of widespread deficiency within some minority ethnic groups, resulting in nutritional rickets (particularly among Black and South Asian infants), raised particular concern. It is too early to establish whether population vitamin D status has altered since Government recommendations changed in 2016. Vitamin D food fortification was discussed as a potential strategy to increase population intakes. Data from dose-response and dietary modelling studies indicate dairy products, bread, hens’ eggs and some meats as potential fortification vehicles. Vitamin D3 appears more effective than vitamin D2 for raising serum 25-hydroxyvitamin D concentration, which has implications for choice of fortificant. Other considerations for successful fortification strategies include: i) need for ‘real-world’ cost information for use in modelling work; ii) supportive food legislation; iii) improved consumer and health professional understanding of vitamin D’s importance; iv) clinical consequences of inadequate vitamin D status; v) consistent communication of Government advice across health/social care professions, and via the food industry. These areas urgently require further research to enable universal improvement in vitamin D intakes and status in the UK population.

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Using syndromic measures of mortality to capture the dynamics of COVID-19 in Java, Indonesia, in the context of vaccination rollout

BMC Medicine ◽

10.1186/s12916-021-02016-2 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Bimandra A. Djaafara ◽

Charles Whittaker ◽

Oliver J. Watson ◽

Robert Verity ◽

Nicholas F. Brazeau ◽

...

Keyword(s):

Rural Areas ◽

Vaccination Campaign ◽

Control Measures ◽

Additional Insight ◽

Short Term ◽

If Current ◽

Vaccine Impact ◽

Potential Impact ◽

The Impact ◽

Insight Into

Abstract Background As in many countries, quantifying COVID-19 spread in Indonesia remains challenging due to testing limitations. In Java, non-pharmaceutical interventions (NPIs) were implemented throughout 2020. However, as a vaccination campaign launches, cases and deaths are rising across the island. Methods We used modelling to explore the extent to which data on burials in Jakarta using strict COVID-19 protocols (C19P) provide additional insight into the transmissibility of the disease, epidemic trajectory, and the impact of NPIs. We assess how implementation of NPIs in early 2021 will shape the epidemic during the period of likely vaccine rollout. Results C19P burial data in Jakarta suggest a death toll approximately 3.3 times higher than reported. Transmission estimates using these data suggest earlier, larger, and more sustained impact of NPIs. Measures to reduce sub-national spread, particularly during Ramadan, substantially mitigated spread to more vulnerable rural areas. Given current trajectory, daily cases and deaths are likely to increase in most regions as the vaccine is rolled out. Transmission may peak in early 2021 in Jakarta if current levels of control are maintained. However, relaxation of control measures is likely to lead to a subsequent resurgence in the absence of an effective vaccination campaign. Conclusions Syndromic measures of mortality provide a more complete picture of COVID-19 severity upon which to base decision-making. The high potential impact of the vaccine in Java is attributable to reductions in transmission to date and dependent on these being maintained. Increases in control in the relatively short-term will likely yield large, synergistic increases in vaccine impact.

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Specialist infantry and defence engagement

BMJ Military Health ◽

10.1136/bmjmilitary-2020-001455 ◽

2020 ◽

pp. bmjmilitary-2020-001455 ◽

Cited By ~ 1

Author(s):

Jonathan Blair Thomas Herron ◽

K M Heil ◽

D Reid

Keyword(s):

Armed Forces ◽

Short Term ◽

The Future ◽

Uk Government ◽

The Uk ◽

Insight Into

In 2015, the UK government published the National Strategic Defence and Security Review (SDSR) 2015, which laid out their vision for the future roles and structure of the UK Armed Forces. SDSR 2015 envisaged making broader use of the Armed Forces to support missions other than warfighting. One element of this would be to increase the scale and scope of defence engagement (DE) activities that the UK conducts overseas. DE activities traditionally involve the use of personnel and assets to help prevent conflict, build stability and gain influence with partner nations as part of a short-term training teams. This paper aimed to give an overview of the Specialist Infantry Group and its role in UK DE. It will explore the reasons why the SDSR 2015 recommended their formation as well as an insight into future tasks.

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The RUMA Alliance targets: an overview

Livestock ◽

10.12968/live.2021.26.4.176 ◽

2021 ◽

Vol 26 (4) ◽

pp. 176-179

Author(s):

Chris Lloyd

Keyword(s):

Task Force ◽

Animal Health ◽

Antibiotic Use ◽

Codes Of Practice ◽

The Government ◽

The Uk ◽

Ongoing Support ◽

The Impact ◽

Insight Into ◽

Roll Out

The Responsible Use of Medicines in Agriculture Alliance (RUMA) was established to promote the highest standards of food safety, animal health and animal welfare in the British livestock industry. It has a current focus to deliver on the Government objective of identifying sector-specific targets for the reduction, refinement or replacement of antibiotics in animal agriculture. The creation and roll out of sector specific targets in 2017 through the RUMA Targets Task Force, has helped focus activity across the UK livestock sectors to achieve a 50% reduction in antibiotic use since 2014. This has been realised principally through voluntary multi-sector collaboration, cross sector initiatives, codes of practice, industry body support and farm assurance schemes. This article provides an overview of RUMA's work to date providing insight into the methods used to create the targets, why they are so important, the impact they are having and how ongoing support and robust data are vital components in achieving the latest set of targets.

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A Case Study of a Negotiated Tender within a Small-to-Medium Construction Contractor: Modelling Project Cost Variance

Buildings ◽

10.3390/buildings11060260 ◽

2021 ◽

Vol 11 (6) ◽

pp. 260

Author(s):

James Ellis ◽

David John Edwards ◽

Wellington Didibhuku Thwala ◽

Obuks Ejohwomu ◽

Ernest Effah Ameyaw ◽

...

Keyword(s):

Construction Industry ◽

Study Data ◽

Review Literature ◽

Third Party ◽

Open Book ◽

Competitive Tendering ◽

Construction Contractor ◽

The Uk ◽

Insight Into

This research explores the failure of competitively tendered projects in the UK construction industry to procure the most suited contractor(s) to conduct the works. Such work may have equal relevance for other developed nations globally. This research seeks to teach clients and their representatives that “lowest price” does not mean “best value”, by presenting a case study of a successfully negotiated tender undertaken by a small-to-medium enterprise (SME) contractor; SME studies are relatively scant in academic literature. By applying the “lessons learnt” principle, this study seeks to improve future practice through the development of a novel alternative procurement option (i.e., negotiation). A mixed philosophical stance combining interpretivism and pragmatism was used—interpretivism to critically review literature in order to form the basis of inductive research to discuss negotiation as a viable procurement route, and pragmatism to analyse perceptions of tendering and procurement. The methods used follow a three-stage waterfall process including: (1) literature review and pilot study; (2) quantitative analysis of case study data; and (3) qualitative data collection via a focus group. Our research underscores the need to advise clients and their representatives of the importance of understanding the scope of works allowed within a tender submission before discounting it based solely on price. In addition, we highlight the failings of competitive tendering, which results in increased costs and project duration once the works commence on site. These findings provide new contemporary insight into procurement and tendering in the construction industry, with emphasis on SME contractors, existing relationships, and open-book negotiation. This research illustrates the adverse effects of early cost estimates produced without first securing a true understanding of project buildability and programming. Our work concludes with a novel insight into an alternative procurement option that involves early SME contractor involvement in an open-book environment, without the need for a third-party cost control.

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