Probing the nature of deficits in the ‘Approximate Number System’ in children with persistent Developmental Dyscalculia

In the present study we examined whether children with Developmental Dyscalculia (DD) exhibit a deficit in the so-called \u27Approximate Number System\u27 (ANS). To do so, we examined a group of elementary school children who demonstrated persistent low math achievement over 4 years and compared them to typically developing (TD), aged-matched controls. The integrity of the ANS was measured using the Panamath (www.panamath.org) non-symbolic numerical discrimination test. Children with DD demonstrated imprecise ANS acuity indexed by larger Weber fraction (w) compared to TD controls. Given recent findings showing that non-symbolic numerical discrimination is affected by visual parameters, we went further and investigated whether children performed differently on trials on which number of dots and their overall area were either congruent or incongruent with each other. This analysis revealed that differences in w were only found between DD and TD children on the incongruent trials. In addition, visuo-spatial working memory strongly predicts individual differences in ANS acuity (w) during the incongruent trials. Thus the purported ANS deficit in DD can be explained by a difficulty in extracting number from an array of dots when area is anti-correlated with number. These data highlight the role of visuo-spatial working memory during the extraction process, and demonstrate that close attention needs to be paid to perceptual processes invoked by tasks thought to represent measures of the ANS

A predictive model of users’ behavior and values of smart energy meters using PLS-SEM

© Springer Nature Switzerland AG 2020. A smart energy metering system is an IoT device that connects several electrical household devices and record, monitor, estimate, control in-house energy consumption in a real-time basis. Although smart energy meters have great capabilities, this technology is still in infancy stages in many developing countries, and little is known about what perceived values are associated with smart meters from residents’ perspectives. Therefore, this research aimed to fill this gap by examining the impact of six different types of perceived values on residents’ intentions to use smart meters in UAE. The study followed a quantitative approach by gathering 266 survey responses which were tested by using Partial Least Squares-Structural Equation Modeling (PLS-SEM). The statistical results genuinely indicated that perceived epistemic values, environmental values, emotional values, and convenience values can significantly impact residents’ intention to use smart meter, whereas social values and monetary values found to have no significant impact on their intentions to use this technology. Theoretical and practical implications are indicated, and directions of future research are specified afterwards

Youth representations of environmental protest

A necessary condition for a functioning democracy is the participation of its citizens, including its youth. This is particularly true for political participation in environmental decisions because these decisions can have intergenerational consequences. In this article we examine young people’s beliefs about one form of political participation - protest - in the context of communities affected by fracking and associated anti-fracking protest, and discuss the implications of these representations for education. Drawing on focus groups with 121 young people (age 15-19) in 5 schools and colleges near sites which have experienced anti-fracking protest in England and Northern Ireland, we find young people well-informed about avenues for formal and non-formal political participation against a background of disillusionment with formal political processes and varying levels of support for protest. We find representations of protest as disruptive, divisive, extreme, less desirable than other forms of participation, and ineffective in bringing about change but effective in awareness-raising. These representations are challenging, not least because the way protest is interpreted is critical to the way people think and act in the world. These representations of environmental protest must be challenged through formal education in order to safeguard the UN Convention on the Rights of the Child and ensure that the spirit of Article 11 of the UK Human Rights Act is protected

An evaluation of early medication use for COPD: a population-based cohort study

Jamie Falk,1 Natalia Dik,2 Shawn Bugden1 1College of Pharmacy, Rady Faculty of Health Sciences, 2Manitoba Centre for Health Policy, Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada Purpose: The aim of this study was to evaluate the first initiation, sequence of addition, and appropriate prescribing of COPD medications in Manitoba, Canada.Patients and methods: A population-based cohort study of COPD medication use was conducted using administrative health care data (1997–2012). Those aged ≥35 years with COPD based on three or more COPD-related outpatient visits over a rolling 24-month window or at least one COPD-related hospitalization were included. The first medication(s) dispensed on or after the date of COPD diagnosis were determined based on pharmacy claims. The next medication(s) in sequence were determined to be additions or switches to the previous regimen. Evaluation of guideline-based appropriateness to receive inhaled corticosteroids (ICS) was based on exacerbation history and past medication use.Results: Of 13,369 patients dispensed COPD medications after diagnosis, 66.0% were dispensed short-acting bronchodilators as first medications. Although long-acting bronchodilators alone were uncommonly used as first or subsequent medications, ICS were dispensed as first medications in 28.2% of patients. Over the study period, use of short-acting bronchodilators as first medications declined from 70.6% to 59.4% (P<0.0001), whereas the use of ICS as a first medication increased from 23.5% to 34.4% (P<0.0001). Dispensation of an ICS plus a long-acting β-agonist increased dramatically from 1.2% to 27.3% (P<0.0001). By the end of the study period, the majority of patients (53.3%) were being initiated on two or more medications. Of 5,823 patients dispensed an ICS, 52.4% met Canadian guideline criteria for initiating an ICS, whereas 0.3% met Global Initiative for Chronic Obstructive Lung Disease guideline criteria.Conclusion: The use of first-line medications has declined over time, replaced primarily by combination inhalers prescribed early without prior trials of appropriate next step medications. This, along with an increasingly predominant use of multiple first medications, indicates a significant degree of medication burden in this already complex patient population. Keywords: COPD, medication, inhaled steroids, Canada, guideline, appropriat

Voluntary warnings and the limits of good prescribing behavior: the case for de-adoption of meperidine

Kevin J Friesen, Jamie Falk, Shawn BugdenCollege of Pharmacy, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, CanadaBackground: Meperidine (pethidine) offers little to no therapeutic advantage over other opioids, may be more prone to abuse, and produces a neurotoxic metabolite with a long half-life. The Institute for Safe Medication Practices (ISMP) issued warnings in 2004 and 2005 suggesting that meperidine be avoided, and when used, it should be in limited doses (<600 mg/24 h) and for a limited duration (<48 hours). Hospitals have responded to these warnings, but much less is known about meperidine prescribing in the community setting. This study examined the potential impact of ISMP warnings on the prescribing of meperidine using time series analysis.Methods: A population-based longitudinal cross-sectional study was conducted to examine oral meperidine utilization among persons 16 years of age and older in Manitoba, Canada, between April 1, 2001 and March 31, 2014. Amounts of meperidine were expressed using defined daily doses (DDDs), the equivalent of 400 mg of meperidine per day. The number of meperidine prescriptions and users per quarter were determined and analyzed using regression analysis.Results: There were 49,063 prescriptions for 442,641 DDDs of meperidine dispensed to 9,374 distinct users. The number of DDDs of meperidine per 1,000 persons peaked in the second quarter of 2003 at 11.75, and then dropped to a low of 5.36 by 2014. This represented a marked decline in the numbers of users and prescriptions over the study period. The piecewise regression model revealed a significant breakpoint in the last quarter of 2004 (F(3, 48)=337.00, P<0.0001). In contrast to these findings, among the remaining users, there was an increase in the amount of meperidine per prescription (increase of 0.34 DDDs/prescription/year; F(1, 50)=434, P<0.0001, R2=0.89) and the amount of meperidine per user (increase of 1.17 DDDs/user/year; F(1, 50)=653.5, P<0.0001, R2=0.93).Conclusion: Following the ISMP warnings, meperidine use dramatically declined. Unfortunately, the remaining users of meperidine are using more meperidine and receiving more meperidine in each prescription. This pattern of results suggests that there may be limits to voluntary safety warnings. Policy action such as removal of medication insurance coverage may represent a logical next step to reverse or de-adopt meperidine and further enhance patient safety.Keywords: meperidine, pethidine, safety, neurotoxic, utilizatio