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The aim was to create and deliver support sessions with the psychiatry consultant's dog, Rupert, to improve the emotional health of both patients and staff. It was hypothesised that having time with a calm and affectionate dog would reduce both young person and adult anxiety, improve their mood, and help them communicate. Since the start of the COVID-19 outbreak, there has been a gradual increase in demand from children and adolescent mental health services (CAMHS), and consequent pressure on NHS staff. On June 2021, Rupert was registered as an emotional support dog with the Trust and began weekly visits to the Darwin Hospital, Stoke-On-Trent. This is a 12 bedded CAMHS hospital, which has seen an increase in patient illness and increasing staff absence due to COVID-19. Informal reports from staff and patients suggested multiple mental health benefits from spending time with Rupert. To quantify the impact of an emotional support dog on the unit, it was agreed to perform a service evaluation on mood, communication and anxiety of both patients and staff.
A questionnaire, using a Likert-type rating scale, was given to staff and patients before and after spending time with Rupert. Questions asked for ratings of mood, anxiety, and comfort in communicating on a scale from ‘very low’ to ‘very high’. The data collection took place in the last 3 months of 2021. In all, 19 people completed the questionnaire. Because of the small sample size, non-parametric bootstrap resampling methods were used to test before-and-after paired differences for individual participants.
Because the rating scale is ordinal, care needs to be exercised in interpreting differences, but in broad terms a unit increase is equivalent to an improvement, for example, from ‘low’ to ‘neutral’. On average, patients reported statistically significant improvements in mood (mean diff: 1.14, 95% CI: [0.43, 1.71]), anxiety (mean diff: 2.00, 95% CI: [1.43, 2.57]), and communication (mean diff: 1.00, 95% CI: [0.43, 1.86]). Results for staff were similar with improvements in mood (mean diff: 1.08, 95% CI: [0.83, 1.58]) and anxiety (mean diff: 0.83, 95% CI: [0.50, 1.25]) but smaller in communication (mean diff: 0.33, 95% CI: [0.08, 0.67]).
Taking an emotional support dog into a CAMHS Hospital produced clear benefits, with consistently positive feedback from sessions and no negative effects. Such was the improvement in both patient and staff well-being, staff have since been encouraged to register their dogs too.
Little is known about the early history of the chicken (Gallus gallus domesticus), including the timing and circumstances of its introduction into new cultural environments. To evaluate its spatio-temporal spread across Eurasia and north-west Africa, the authors radiocarbon dated 23 chicken bones from presumed early contexts. Three-quarters returned dates later than those suggested by stratigraphy, indicating the importance of direct dating. The results indicate that chickens did not arrive in Europe until the first millennium BC. Moreover, a consistent time-lag between the introduction of chickens and their consumption by humans suggests that these animals were initially regarded as exotica and only several centuries later recognised as a source of ‘food’.
Acellular cementum (AC) is critical for dental attachment and periodontal function. This chapter emphasizes how insights into cementum's nature have increased through human disease and experimental animal models. X-linked hypophosphatemia (XLH) is the most common form of hereditary rickets, in which low circulating phosphate and altered vitamin D metabolism are associated with skeletal and dental mineralization defects. AC thickness is reduced in XLH, and periodontal function may be affected. Inorganic pyrophosphate is a circulating inhibitor of mineralization. The inherited disorder, hypophosphatasia (HPP), is characterized by increased pyrophosphate levels, leading to skeletal and dental hypomineralization. AC is mainly affected by HPP, and premature loss of deciduous and permanent teeth is a common result. Conversely, a decrease in pyrophosphate results in increased cementum thickness. Extracellular matrix proteins also regulate cementum formation. Bone sialoprotein (BSP) is a component of cementum. Deletion of BSP in genetically edited mice results in reduced or absent AC, leading to periodontal destruction.
International relations scholarship concerns dyads, yet standard modeling approaches fail to adequately capture the data generating process behind dyadic events and processes. As a result, they suffer from biased coefficients and poorly calibrated standard errors. We show how a regression-based approach, the Additive and Multiplicative Effects (AME) model, can be used to account for the inherent dependencies in dyadic data and glean substantive insights in the interrelations between actors. First, we conduct a simulation to highlight how the model captures dependencies and show that accounting for these processes improves our ability to conduct inference on dyadic data. Second, we compare the AME model to approaches used in three prominent studies from recent international relations scholarship. For each study, we find that compared to AME, the modeling approach used performs notably worse at capturing the data generating process. Further, conventional methods misstate the effect of key variables and the uncertainty in these effects. Finally, AME outperforms standard approaches in terms of out-of-sample fit. In sum, our work shows the consequences of failing to take the dependencies inherent to dyadic data seriously. Most importantly, by better modeling the data generating process underlying political phenomena, the AME framework improves scholars’ ability to conduct inferential analyses on dyadic data.
Expert guidance from scientific societies and regulatory agencies recommend a framework of principles for frequency of in-person evaluations and remote monitoring for patients with cardiac implantable electronic devices. However, there are limited data regarding adherence to recommendations among paediatric electrophysiologists, and there are no data regarding cardiac implantable electronic device-related ancillary testing.
To assess current clinical practices for cardiac implantable electronic device in-person evaluation, remote monitoring, and cardiac implantable electronic device-related ancillary testing, the Paediatric and Congenital Electrophysiology Society members were surveyed. The main outcome measures were variations in frequency of in person evaluation, frequency of remote monitoring, and cardiac implantable electronic device-related ancillary testing.
All respondents performed in-person evaluation at least once a year, but <50% of respondents performed an in-person evaluation within 2 weeks of cardiac implantable electronic device implantation. Remote monitoring was performed every 3 months for pacemakers and implantable cardioverter defibrillators by 71 and 75% respondents, respectively. Follow-up echocardiography was performed every 2–3 years by 53% respondents for patients with >50% ventricular pacing. Majority of respondents (75%) did not perform either an exercise stress test or ambulatory Holter monitoring or chest X-ray (65%) after cardiac implantable electronic device implantation.
This survey identified significant practice variations in cardiac implantable electronic device in- person evaluation, remote monitoring, and ancillary testing practices among paediatric electrophysiologists. Cardiac implantable electronic device management may be optimised by development of a paediatric-specific guidelines for follow-up and ancillary testing.