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Waterfall Bluff is a rock shelter in eastern Pondoland, South Africa, adjacent to a narrow continental shelf that limited coastline movements across glacial/interglacial cycles. The archaeological deposits are characterized by well-preserved stratigraphy, faunal, and botanical remains alongside abundant stone artifacts and other materials. A comprehensive dating protocol consisting of 5 optically stimulated luminescence ages and 51 accelerator mass spectrometry 14C ages shows that the record of hunter-gatherer occupations at Waterfall Bluff persisted from the late Pleistocene to the Holocene, spanning the last glacial maximum and the transition from the Pleistocene to the Holocene. Here, we provide detailed descriptions about the sedimentary sequence, chronology, and characteristics of the archaeological deposits at Waterfall Bluff. Remains of marine mollusks and marine fish also show, for the first time, that coastal foraging was a component of some hunter-gatherer groups’ subsistence practices during glacial phases in the late Pleistocene. The presence of marine fish and shellfish further demonstrates that hunter-gatherers selectively targeted coastal resources from intertidal and estuarine habitats. Our results therefore underscore the idea that Pondoland's coastline remained a stable and predictable point on the landscape over the last glacial/interglacial transition being well positioned for hunter-gatherers to access resources from the nearby coastline, narrow continental shelf, and inland areas.
Aim of the study was assessing motivation to change in a clinical sample of adolescents with anorexia nervosa and its relation to specific cognitions and behaviours.
N= 77 patients with anorexia nervosa (75 female, 2 males, mean age = 15.8, SD = 1.3) were evaluated with Anorexia Nervosa Stage of Change Questionnaire (ANSOCQ) measuring motivation to recover and further questionnaires evaluating treatment and course of the disorder. The latter included Eating Disorder Inventory (EDI-2), the Eating Attitude Test (EAT), the Pros and Cons of Anorexia nervosa questionnaire (PCAN), and the Body Image Questionnaire (FKAN). Data were collected at treatment onset (T1), follow-up was after 12 months (T2).
At T1 motivation to change was significantly related to the EDI subscale measuring drive for thinness (p < .001) and body dissatisfaction (p< .01), to the PCAN pros scales measuring appearance (p< .01) and safe/structure (p< .01), to the EAT scale measuring dieting (p< .001) and the FKAN subscale measuring the feeling of body massivity (p< .001).The stage of motivation to change at treatment onset was very low in the sample (67% in stage 1 = precontemplation or 2 = contemplation). There was no relation between motivation at T1 and BMI at T2 but the increase of motivation between T1 and T2 predicted a better outcome (BMI at T2).
Motivation to change is related to specific cognitions and behaviours in adolescent patients with anorexia nervosa. Increase of treatment motivation during the first months of treatment seems to be predictive for outcome.
The main objective was to examine agreement between the internet based Development and Well-Being Assessment (DAWBA) generated diagnoses and clinical diagnoses. Second, we aimed to explore how disclosure of the DAWBA-diagnosis before clinical decision making influenced the clinicians diagnosis. Third, whether there were differences of influence for different categories of disorders. Last, we examined how the use of DAWBA information affected identification of co-morbidities.
315 patients from outpatient clinics were randomised into two groups. In 177 cases the clinician was informed about DAWBA diagnosis, in 155 cases the clinican was blind to DAWBA information. DAWBA is an internet based package of questionnaires and rating techniques designed to generate psychiatric ICD10 or DSM IV diagnoses for 5- 17 year old children and adolescents. Information from parents, teachers and self-reports are brought together by a computer programme that predicts likely diagnoses. An expert rater decides on the diagnosis by synopsis of these different inputs.
DAWBA diagnoses and clinical diagnosis without information from DAWBA showed acceptable agreement with Cohens kappa 0,26 for emotional disorders, kappa of 0,29 for hyperactive disorders and kappa of 0.31 for disruptive disorders.
There was a significant effect on clinical diagnoses for emotional disorders for disclosure of DAWBA (kappa of 0.26 without DAWBA information versus kappa of 0,52 with information, Fishers z of p< 0,05)
There was no significant effect of information about DAWBA-diagnosis considering comorbidities.
DAWBA showed the most pronounced effect on clinical diagnoses for emotional disorders in children and adolescents.
The aim of the study was assessing differences in selected psychosocial and behavioural variables between a referred sample of patients with an eating disorder, a non-referred risk sample with eating problems, and a healthy control group.
There were N=100 patients (95 females and 5 males, Mean age = 15.8, SD = 1.3) in the referred sample. The two matched non-referred groups of each N=215 participants (95% females, 5% males; Mean age =16.1, SD = 1.5) stem from the Zurich Adolescent Psychology- and Psychopathology-Study (ZAPPS). Emotional and behavioural problems were assessed using the Youth Self Report (YSR) and a depression scale. In addition, the participants responded to questionnaires covering life events, self-related cognitions, coping capacities, perceived parental behaviour, and family climate.
Compared to both non-referred groups, the referred sample had significantly higher scores on the social withdrawn, anxious/depressed and thought problems scale of the YSR, on the depression and the life events scales, and significantly lower scores on the self esteem scale. Compared to the referred sample, the non-referred risk sample had significantly higher scores on the YSR-scale measuring externalizing problems and the perceived parental rejection scale, but lower scores on the family climate scales measuring cohesion and adaptability.
The three groups were differentiated by various psychosocial and behavioural variables. Externalizing problems and indicators of a poor family climate were more common in a non-referred high-risk group with eating problems than in a referred sample with clinical eating disorders.
Background: External ventricular drain (EVD) insertion is a common neurosurgical procedure performed in patients with life-threatening conditions, but can be associated with complications. The objectives of this study are to evaluate data on national practice patterns and complications rates in order to optimize clinical care Methods: The Canadian Neurosurgery Research Collaborative conducted a prospective multi-centre registry of patients undergoing EVD insertions at Canadian residency programs Results: In this interim analysis, 4 sites had recruited 46 patients (mean age: 53.9 years, male:female 2:1). Most EVD insertions occurred outside of the operating theatre, using free-hand technique, and performed by junior neurosurgery residents (R1-R3). The catheter tip was in the ipsilateral frontal horn or body of the lateral ventricle in 76% of cases. Suboptimally placed catheters did not have higher rates of short-term occlusion. EVD-related hemorrhage occurred in 6.5% (3/45) with only 1 symptomatic patient. EVD-related infection occurred in 13% (6/46) at a mean of 6 days and was associated with longer duration of CSF drainage (P=0.039; OR: 1.13) Conclusions: Interim results indicate rates of EVD-related complications may be higher than previously thought. This study will continue to recruit patients to confirm these findings and determine specific risk factors associated with them
A recent theoretical literature highlights the role of endogenous firm entry as an internal amplification mechanism of business cycle fluctuations. The amplification mechanism works through the competition effect (CE) and the variety effect (VE). This paper tests the significance of this amplification mechanism, quantifies its importance, and disentangles the CE and VE. To this end, we estimate a medium-scale real business cycle model with firm entry for the U.S. economy. The CE and VE are estimated to be statistically significant. Together, they amplify the volatility of output by 8.5% relative to a model in which both effects are switched off. The CE accounts for most amplification, whereas the VE only plays a minor role.
Background: No standardized method of resident operative-case logging exists. Our study sought to develop a standardized form used by residents to log operative-cases. Methods: Members of the Canadian Neurosurgery Research Collaborative (CNRC), a national resident-led research organization have created a standardized document based on the current Royal College objectives for operative procedures (section 5). Modifications to structure and content will be guided via consensus from Canadian neurosurgery program-directors. Results: Program directors in each CNRC collaborative institution will be asked to modify the standardized form. The CNRC currently involves thirteen of the fourteen Canadian neurosurgery residency programs. Additional consensus, if necessary, can be reached at the Royal College meeting for program directors of neurosurgery March 20th 2017. Conclusions: A standardized operative-case log represents the first step in a prospective study towards compiling operative volume of all Canadian neurosurgical residents over one academic year. Such data will be essential to guide informed decisions with regard to Royal College requirements as Canadian neurosurgical programs transition to a competency based framework.
Background: Communicating with senior neurosurgical colleagues during residency necessitates a reliable and versatile smartphone. Smartphones and their apps are commonplace. They enhance communication with colleagues, provide the ability to access patient information and results, and allow access to medical reference applications. Patient data safety and compliance with the Personal Health Information Protection Act (PHIPA, 2004) in Canada remain a public concern that can significantly impact the way in which mobile smartphones are utilized by resident physicians Methods: Through the Canadian Neurosurgery Research Collaborative (CNRC), an online survey characterizing smartphone ownership and utilization of apps among Canadian neurosurgery residents and fellows was completed in April 2016. Results: Our study had a 47% response rate (80 surveys completed out of 171 eligible residents and fellows). Smartphone ownership was almost universal with a high rate of app utilization for learning and facilitating the care of patients. Utilization of smartphones to communicate and transfer urgent imaging with senior colleagues was common. Conclusions: Smartphone and app utilization is an essential part of neurosurgery resident workflow. In this study we characterize the smartphone and app usage within a specialized cohort of residents and suggest potential solutions to facilitate greater PHIPA adherence
Background: The Canadian Neurosurgery Research Collaborative (CNRC) was founded in November 2015 as a resident-led national network for multicentre research. We present an annual report of our activities. Methods: CNRC meetings and publications were reviewed and summarized. The status of ongoing and future studies was collected from project leaders. Results: In its first year, the CNRC produced two papers accepted for publication in the Canadian Journal of Neurological Sciences: A CNRC launch letter and a study of operative volume at Canadian neurosurgery residency programs. Three manuscripts are in preparation: 1) a study of the demographics of Canadian neurosurgery residents, 2) an assessment of mobile devices usage patterns and 3) a validation study of the most utilized neurosurgery mobile apps. In addition, protocols for two multi-centre studies are currently undergoing national Research Ethics Board review: A retrospective study of the incidence and predictors of cerebellar mutism and a prospective registry of external ventricular drain procedures and complications. The network is now a registered not-for-profit organization endorsed by the Canadian Neurosurgical Society. Conclusions: The CNRC is a feasibile, relevant and productive resident-led national research network. As the CNRC matures, we look forward to expanding the scope and impact of its projects.
Hulless oats are of interest as an alternative to corn and wheat in organic poultry diets because they offer potential to enhance agrobiodiversity and produce locally grown feeds both within and outside of corn-growing regions. Hulless oats are easily certified GM-free and have demonstrated nutritional value for poultry. A feeding study was carried out to examine: (i) the effects of substituting corn, wheat or a fraction of each with hulless oats in organic layer diets, and (ii) the importance of oat variety in feed performance. Productivity and economic implications in the context of current organic markets were explored. Experimental diets included an oat-free control, Oat + corn, Oat + wheat and Oat + corn + wheat, each of which was formulated with three hulless oat varieties, AC Gwen, Paul and Streaker. All but the control diet included oats at 200 g kg−1. Three hundred Hy-Line Brown hens were individually caged and allocated to diets in groups of 10 in a completely randomized design with three replicates per diet. Experimental diets were fed between 24 and 32 weeks of age during which time hen health, egg production and egg quality indicators were monitored. Results indicated that hulless oats had no negative effects on hen health and productivity. On the basis of current organic feed ingredient prices and an estimated cost of USD 533 mt−1 for production of oats in the study region, oat containing diets were more expensive than the oat-free control. In an evaluation of revenue based on current market prices for organic eggs, the additional cost was completely offset by larger egg sizes of hens on oat containing diets. There were no major differences associated with oat variety.
Background: The Canadian Neurosurgery Research Collaborative (CNRC) is a new consortium of neurosurgery residency programs set-up to facilitate the planning and implementation of multi-center studies. As a trainee-led organization, it will focus on resident-initiated, resident-driven projects. The goal of this study is to assess the demographics of Canadian neurosurgery residents, with particular focus on their academic and subspecialty interests. Methods: After approval by the CNRC, an online survey will be sent to all Canadian neurosurgery residents and fellows with reminders at 2, 4 and 6 weeks. Anonymous, basic demographic data will be collected. Specific interest towards the various subspecialties, research and academic vs community practice will be measured. The data will be crossed with the ongoing Canadian Neurosurgery Operative Landscape study to assess the impact of case volume on academic and subspecialty interests. Results: This is the first study providing a snapshot of Canadian neurosurgery residents at all levels of training. The study is ongoing and the official results will be presented at the meeting. As one of the first CNRC studies, it will also demonstrate the effectiveness of the collaborative. Conclusions: Understanding the demographics and interests of Canadian neurosurgery residents will allow the CNRC to better fulfill its mission.
Background: The Canadian Neurosurgery Research Collaborative (CNRC) is a trainee-led multi-centre collaboration made up of representatives from 12 of 14 neurosurgical centres with residency programs. To demonstrate the potential of this collaborative network, we gathered administrative operative data from each centre in order to provide a snapshot of the operative landscape in Canadian neurosurgery. Methods: Residents from each training program provided adult neurosurgical operative data for the 2014 calendar year, including the number of surgeries in the subcategories cranial, spinal, and peripheral nerve. Because some residency programs have surgeries distributed among more than one hospital, we calculated mean case load per residency program and per hospital. Results: Interim results from 6 neurosurgery residency programs are presented (with data from other programs forthcoming). Overall, there were on average 2,352 operative cases per residency program (n=6) and 1,176 operative cases per adult hospital (n=12). Among 5 programs with more detailed operative data, the mean numbers of cranial, spinal, peripheral nerve, and miscellaneous surgeries per residency program were 757 (47%), 487 (30%), 47 (3%), and 319 (20%) respectively. Conclusions: We show as a proof-of-concept that a trainee-led nation-wide research collaborative can generate meaningful data in a Canadian context.
Background: The goals of evidence-based neurosurgery are to improve surgical outcomes, reduce complications, and provide an objective basis for altering practice. The need for higher quality studies, typically prospective and multicentre, has been growing especially in light of the evolving complexity of neurosurgical interventions and heterogeneity of patient populations. In the United Kingdom (UK), trainee-led research collaboratives have been established to tackle this problem. Therefore, we sought to evaluate the potential role for a resident-led research collaborative in neurosurgery in Canada based on the UK experience. Methods: A literature review of trainee-led collaboratives was conducted utilizing PubMed and Medline. Identified articles were reviewed for study quality and clinical relevance to explore the potential benefits of collaboratives. Results: In the UK, 27 collaboratives have been established in various specialties by trainees. Some published high quality trials with implications on their clinical fields. Evidence suggests that such endeavors improves trainees’ research skills and may help cultivate a research culture tailored towards clinical trials. Conclusions: Given the growing evidence for research collaboratives in the UK, we propose launching the Canadian Neurosurgery Research Collaborative (CNRC) which currently represents 12 out of 14 neurosurgery programs in Canada, and planning its first multicenter prospective study.