The Traditional Lecture: A case of Academic Chuunibyou?

Chuunibyou: a Japanese slang term where people with chuunibyou act out by looking down on others resulting in a subculture-type preference for minor trends thereby seeking a "cool" factor. To this author, an apt description of how the lecture has been unfairly viewed in recent years as a poor pedagogic tool, in essence, an academic chuunibyou! My central belief here is that the lecture is a useful, relevant pedagogically focused application of the professional teacher working their craft and can be viewed in essence as facilitating a powerful “pedagogy of gesture

The Effectiveness of Alcohol Screening and Brief Intervention in Emergency Departments: A Multicentre Pragmatic Cluster Randomized Controlled Trial

BACKGROUND: Alcohol misuse is common in people attending emergency departments (EDs) and there is some evidence of efficacy of alcohol screening and brief interventions (SBI). This study investigated the effectiveness of SBI approaches of different intensities delivered by ED staff in nine typical EDs in England: the SIPS ED trial. METHODS AND FINDINGS: Pragmatic multicentre cluster randomized controlled trial of SBI for hazardous and harmful drinkers presenting to ED. Nine EDs were randomized to three conditions: a patient information leaflet (PIL), 5 minutes of brief advice (BA), and referral to an alcohol health worker who provided 20 minutes of brief lifestyle counseling (BLC). The primary outcome measure was the Alcohol Use Disorders Identification Test (AUDIT) status at 6 months. Of 5899 patients aged 18 or more presenting to EDs, 3737 (63·3%) were eligible to participate and 1497 (40·1%) screened positive for hazardous or harmful drinking, of whom 1204 (80·4%) gave consent to participate in the trial. Follow up rates were 72% (n?=?863) at six, and 67% (n?=?810) at 12 months. There was no evidence of any differences between intervention conditions for AUDIT status or any other outcome measures at months 6 or 12 in an intention to treat analysis. At month 6, compared to the PIL group, the odds ratio of being AUDIT negative for brief advice was 1·103 (95% CI 0·328 to 3·715). The odds ratio comparing BLC to PIL was 1·247 (95% CI 0·315 to 4·939). A per protocol analysis confirmed these findings. CONCLUSIONS: SBI is difficult to implement in typical EDs. The results do not support widespread implementation of alcohol SBI in ED beyond screening followed by simple clinical feedback and alcohol information, which is likely to be easier and less expensive to implement than more complex interventions

Arthroscopic Treatment of Acetabular Retroversion With Acetabuloplasty and Subspine Decompression: A Matched Comparison With Patients Undergoing Arthroscopic Treatment for Focal Pincer-Type Femoroacetabular Impingement.

BackgroundGlobal acetabular retroversion is classically treated with open reverse periacetabular osteotomy. Given the low morbidity and recent success associated with the arthroscopic treatment of femoroacetabular impingement (FAI), there may also be a role for arthroscopic treatment of acetabular retroversion. However, the safety and outcomes after hip arthroscopic surgery for retroversion need further study, and the effect of impingement from the anterior inferior iliac spine (subspine) in patients with retroversion is currently unknown.HypothesisArthroscopic treatment for global acetabular retroversion will be safe, and patients will have similar outcomes compared with a matched group undergoing arthroscopic treatment for focal pincer-type FAI.Study designCohort study; Level of evidence, 2.MethodsPatients undergoing hip arthroscopic surgery for symptomatic global acetabular retroversion were prospectively enrolled and compared with a matched group of patients undergoing arthroscopic surgery for focal pincer-type FAI. Both groups underwent the same arthroscopic treatment protocol. All patients were administered patient-reported outcome (PRO) measures, including the 12-item Short-Form Health Survey (SF-12) Physical Component Summary (PCS) and a Mental Component Summary (MCS), modified Harris Hip Score (mHHS), Hip disability and Osteoarthritis Outcome Score (HOOS), and visual analog scale (VAS) for pain preoperatively and at 1 year postoperatively.ResultsThere were no differences in age, sex, or body mass index between 39 hips treated for global acetabular retroversion and 39 hips treated for focal pincer-type FAI. There were no major or minor complications in either group. Patients who underwent arthroscopic treatment for global acetabular retroversion demonstrated similar significant improvements in postoperative PRO scores (scores increased by 17 to 43 points) as patients who underwent arthroscopic treatment for focal pincer-type FAI. Patients treated for retroversion who also underwent subspine decompression had greater improvement than patients who did not undergo subspine decompression for the HOOS-Pain (33.7 ± 15.3 vs 22.5 ± 17.6, respectively; P = .046) and HOOS-Quality of Life (49.7 ± 18.8 vs 34.6 ± 22.0, respectively; P = .030) scores.ConclusionArthroscopic treatment for acetabular retroversion is safe and provides significant clinical improvement similar to arthroscopic treatment for pincer-type FAI. Patients with acetabular retroversion who also underwent arthroscopic subspine decompression demonstrated greater improvements in pain and quality of life outcomes than those who underwent arthroscopic treatment without subspine decompression

Prospective memory functioning among ecstasy/polydrug users: evidence from the Cambridge Prospective Memory Test (CAMPROMPT)

Rationale: Prospective memory (PM) deficits in recreational drug users have been documented in recent years. However, the assessment of PM has largely been restricted to self-reported measures that fail to capture the distinction between event-based and time-based PM. The aim of the present study is to address this limitation. Objectives: Extending our previous research, we augmented the range laboratory measures of PM by employing the CAMPROMPT test battery to investigate the impact of illicit drug use on prospective remembering in a sample of cannabis only, ecstasy/polydrug and non-users of illicit drugs, separating event and time-based PM performance. We also administered measures of executive function and retrospective memory in order to establish whether ecstasy/polydrug deficits in PM were mediated by group differences in these processes. Results: Ecstasy/polydrug users performed significantly worse on both event and time-based prospective memory tasks in comparison to both cannabis only and non-user groups. Furthermore, it was found that across the whole sample, better retrospective memory and executive functioning was associated with superior PM performance. Nevertheless, this association did not mediate the drug-related effects that were observed. Consistent with our previous study, recreational use of cocaine was linked to PM deficits. Conclusions: PM deficits have again been found among ecstasy/polydrug users, which appear to be unrelated to group differences in executive function and retrospective memory. However, the possibility that these are attributable to cocaine use cannot be excluded

Emotional communication between nurses and parents of a child in hospital

University of Technology, Sydney. Faculty of Health.In contemporary child healthcare, there is an expectation that parents will be involved in the child’s care and work collaboratively with nurses. Collaboration such as this requires that nurses relate to and communicate with both the child and parents. The central concern of this study is emotional communication between the nurse and parent, focusing on parent’s feelings and affective responses as they are related to their child’s hospitalisation. The aims of the study were to investigate nurses’ and parents’ experiences of this aspect of communication within the environmental and cultural context of the parent-nurse interaction. A focused ethnography was conducted, given the importance of understanding the cultural context of nurse-parent interaction. Data collection occurred in a children’s ward of a New Zealand hospital, and involved 280 hours of participant observation field work over 22 weeks, 228 informal interviews with parents and nurses, followed by 20 formal interviews with nurses and parents. Data analysis occurred simultaneously as data were interpreted inductively throughout collection. The findings support the impact of ward and nursing culture as an influence that shapes nurses’ behaviour and affect. Parents of a child in hospital were in a vulnerable position, required support and looked to nurses for an interpersonal connection. Parents wanted nurses to provide support and guide them through the hospitalisation journey, acting as cultural brokers. Nurses recognised and responded to parents’ need for informational and instrumental support, however there was little acknowledgement that parents also needed emotional support. Nurses responded to parents’ overt displays of emotion, but did not elicit emotional expression. The emotional labour that is required by nurses to manage both parents and their own emotions led nurses to engage in self-protection actions. The cultural context of the ward impacts emotional communication between parents and nurses, inhibiting and governing parents’ actions and nurses’ responses. This work contributes to further understanding of the concept of cultural brokerage in nursing practice. Eliciting, acknowledging and confirming parents’ emotional concerns are core elements of nurses’ emotional communication. Organisations must value the labour required to emotionally support others, and recognise the vulnerability of parents and nurses as they work together on their mutual goal of improving the well-being of the child-patient

Translation invariant extensions of finite volume measures

We investigate the following questions: Given a measure μΛ on configurations on a subset Λ of a lattice L, where a configuration is an element of ΩΛ for some fixed set Ω, does there exist a measure μ on configurations on all of L, invariant under some specified symme- try group of L, such that μΛ is its marginal on configurations on Λ? When the answer is yes, what are the properties, e.g., the entropies, of such measures? Our primary focus is the case in which L = Zd and the symmetries are the translations. For the case in which Λ is an interval in Z we give a simple necessary and sufficient condition, local translation invariance (LTI), for extendibility. For LTI measures we construct extensions having maximal entropy, which we show are Gibbs measures; this construction extends to the case in which L is the Bethe lattice. On Z we also consider extensions supported on periodic configurations, which are analyzed using de Bruijn graphs and which include the extensions with minimal entropy. When Λ ⊂ Z is not an interval, or when Λ ⊂ Zd with d > 1, the LTI condition is necessary but not sufficient for extendibility. For Zd with d > 1, extendibility is in some sense undecidable

What factors are associated with adolescents\u27 school break time physical activity and sedentary time?

Purpose Adolescents\u27 physical activity levels during school break time are low and understanding correlates of physical activity and sedentary time in this context is important. This study investigated cross-sectional and longitudinal associations between a range of individual, behavioural, social and policy/organisational correlates and objectively measured school break time physical activity and sedentary time.Methods In 2006, 146 adolescents (50% males; mean age = 14.1&plusmn;0.6 years) completed a questionnaire and wore an accelerometer for &ge;3 school days. Time spent engaged in sedentary, light (LPA) and moderate-to-vigorous physical activity (MVPA) during school break times (recess and lunchtime) were calculated using existing cut-points. Measures were repeated in 2008 among 111 adolescents. Multilevel models examined cross-sectional and longitudinal associations.Results Bringing in equipment was cross-sectionally associated with 3.2% more MVPA during break times. Females engaged in 5.1% more sedentary time than males, whilst older adolescents engaged in less MVPA than younger adolescents. Few longitudinal associations were observed. Adolescents who brought sports equipment to school engaged in 7.2% less LPA during break times two years later compared to those who did not bring equipment to school.Conclusion These data suggest that providing equipment and reducing restrictions on bringing in sports equipment to school may promote physical activity during school recess. Strategies targeting females\u27 and older adolescents\u27, in particular, are warranted.<br /

The SNAPSHOT study protocol : SNAcking, Physical activity, Self-regulation, and Heart rate Over Time

Peer reviewedPublisher PD