Consistent Approach Research Articles

A drone-based approach to enhance spatial insight into surrounding air pollutant distributions for healthier indoor environments

Current investigations into the interplay between indoor and outdoor air quality in buildings often rely on limited measurements of a small subset of air pollutants taken outside the structure. Implicit in this methodology is the assumption of a homogeneous distribution of air pollutants around the building, a premise that may not accurately reflect real-world conditions. This study introduces a more accurate and consistent approach to comprehending air pollutant distributions around buildings through systematic measurements conducted using a drone platform equipped with essential air quality sensors. Employing a fully autonomous drone, the study adopts a parametric approach to collect numerous air pollutant measurements around buildings with unconventional shapes. The resulting air pollutant maps offer comprehensive insights into the spatial distribution of pollutants around the building. A detailed analysis, achieved by dividing the building surroundings into different zones, revealed that concentrations of NO2, CO, PM10, and PM2.5 on the inward facade of the ¾ torus-shaped building were 12.64%, 14.49%, 7.66%, and 15.77% higher, respectively, than in the other measured areas around the building. These findings highlight that air pollutants around the building are notably influenced by the building's geometry, challenging the assumption of homogeneity. Instead, pollutants tend to accumulate at specific points, underscoring the significance of considering these factors in air quality assessments. Furthermore, the noted uneven distribution of pollutants around the building has distinct effects on various sections within the structure, as revealed by indoor measurements. Bureaus on the inward facade, where higher levels of outdoor pollutants are measured, can exhibit up to 44% more indoor air pollutants than those on the other side. This study not only contributes to a nuanced understanding of air pollutant distributions but also showcases the superior potential of drone platforms in advancing such research.

‘A consistent approach across the home and nursery environment is key in supporting children's holistic development’

‘A consistent approach across the home and nursery environment is key in supporting children's holistic development’

An update on the global disparities in kidney disease burden and care across world countries and regions

Since 2015, the International Society of Nephrology (ISN) Global Kidney Health Atlas (ISN-GKHA) has spearheaded multinational efforts to understand the status and capacity of countries to provide optimal kidney care, particularly in low-resource settings. In this iteration of the ISN-GKHA, we sought to extend previous findings by assessing availability, accessibility, quality, and affordability of medicines, kidney replacement therapy (KRT), and conservative kidney management (CKM). A consistent approach was used to obtain country-level data on kidney care capacity during three phases of data collection in 2016, 2018, and 2022. The current report includes a detailed literature review of published reports, databases, and registries to obtain information on the burden of chronic kidney disease and estimate the incidence and prevalence of treated kidney failure. Findings were triangulated with data from a multinational survey of opinion leaders based on the WHO's building blocks for health systems (ie, health financing, service delivery, access to essential medicines and health technology, health information systems, workforce, and governance). Country-level data were stratified by the ISN geographical regions and World Bank income groups and reported as counts and percentages, with global, regional, and income level estimates presented as medians with interquartile ranges. The literature review used information on prevalence of chronic kidney disease from 161 countries. The global median prevalence of chronic kidney disease was 9·5% (IQR 5·9-11·7) with the highest prevalence in Eastern and Central Europe (12·8%, 11·9-14·1). For the survey analysis, responses received covered 167 (87%) of 191 countries, representing 97·4% (7·700 billion of 7·903 billion) of the world population. Chronic haemodialysis was available in 162 (98%) of 165 countries, chronic peritoneal dialysis in 130 (79%), and kidney transplantation in 116 (70%). However, 121 (74%) of 164 countries were able to provide KRT to more than 50% of people with kidney failure. Children did not have access to haemodialysis in 12 (19%) of 62 countries, peritoneal dialysis in three (6%) countries, or kidney transplantation in three (6%) countries. CKM (non-dialysis management of people with kidney failure chosen through shared decision making) was available in 87 (53%) of 165 countries. The annual median costs of KRT were: US$19 380 per person for haemodialysis, $18 959 for peritoneal dialysis, and $26 903 for the first year of kidney transplantation. Overall, 74 (45%) of 166 countries allocated public funding to provide free haemodialysis at the point of delivery; use of this funding scheme increased with country income level. The median global prevalence of nephrologists was 11·8 per million population (IQR 1·8-24·8) with an 80-fold difference between low-income and high-income countries. Differing degrees of health workforce shortages were reported across regions and country income levels. A quarter of countries had a national chronic kidney disease-specific strategy (41 [25%] of 162) and chronic kidney disease was recognised as a health priority in 78 (48%) of 162 countries. This study provides new information about the global burden of kidney disease and its treatment. Countries in low-resource settings have substantially diminished capacity for kidney care delivery. These findings have major policy implications for achieving equitable access to kidney care. International Society of Nephrology.

A thermodynamically consistent strain difference-based nonlocal damage mechanics approach for failure analysis of quasi-brittle materials

The nonlocal integral approaches are established methods known for their effectiveness in dealing with the challenges of ill-posed behaviour and mesh sensitivity during the strain softening process, especially within classical continuum theories. The present work extends the strain difference-based nonlocal approach to continuum damage mechanics (CDM) theories for predicting the failure behaviour of quasi-brittle materials. The strain difference approach is adopted for two reasons: (i) it maintains physical realism and indirectly incorporates nonlocal effects while computing both the damage variable and the damage energy release rate, and (ii) the constitutive model maintains a symmetry nature in constructing the nonlocal part of the stiffness matrix, reducing the computational cost in strain-softening problems. The state and damage evolution equations for the present nonlocal approach are formulated within the thermodynamic framework. Numerical examples involving 2D and 3D cases are solved: (i) to study the influence of nonlocal parameter ‘α’ on the damage distribution while capturing the post-peak behaviours, (ii) to demonstrate the effectiveness of the present methodology by obtaining mesh-independent results and accurately predicting damage propagation paths, and (iii) to compare the experimental results and numerical structural response for coarse mesh, highlighting both computational efficiency and reduction of mesh-bias dependency. The results obtained by the strain difference-based nonlocal damage model agree well with the experimental results in the literature.

Global impacts of aviation on air quality evaluated at high resolution

Abstract. Aviation emissions cause global changes in air quality which have been estimated to result in ∼ 58 000 premature mortalities per year, but this number varies by an order of magnitude between studies. The causes of this uncertainty include differences in the assessment of ozone exposure impacts and in how air quality changes are simulated, as well as the possibility that low-resolution (∼ 400 km) global models may overestimate impacts compared to finer-resolution (∼ 50 km) regional models. We use the GEOS-Chem High-Performance chemistry-transport model at a 50 km global resolution, an order of magnitude finer than recent assessments of the same scope, to quantify the air quality impacts of aviation with a single internally consistent global approach. We find that aviation emissions in 2015 resulted in 21 200 (95 % confidence interval due to health response uncertainty: 19 400–22 900) premature mortalities due to particulate matter exposure and 53 100 (36 000–69 900) due to ozone exposure. Compared to a prior estimate of 6800 ozone-related premature mortalities for 2006 our central estimate is increased by 5.6 times due to the use of updated epidemiological data, which includes the effects of ozone exposure during winter, and by 1.3 times due to increased aviation fuel burn. The use of fine (50 km) resolution increases the estimated impacts on both ozone and particulate-matter-related mortality by a further 20 % compared to coarse-resolution (400 km) global simulation, but an intermediate resolution (100 km) is sufficient to capture 98 % of impacts. This is in part due to the role of aviation-attributable ozone, which is long-lived enough to mix through the Northern Hemisphere and exposure to which causes 2.5 times as much health impact as aviation-attributable PM2.5. This work shows that the air quality impacts of civil aviation emissions are dominated by the hemisphere-scale response of tropospheric ozone to aviation NOx rather than local changes and that simulations at ∼ 100 km resolution provide similar results to those at a 2 times finer spatial scale. However, the overall quantification of health impacts is sensitive to assumptions regarding the response of human health to exposure, and additional research is needed to reduce uncertainty in the physical response of the atmosphere to aviation emissions.

Analysis of Current Rules and Regulations for Preclinical Studies of Radiopharmaceuticals

SCIENTIFIC RELEVANCE. Owing to specific aspects of their development and use, radiopharmaceuticals require separate rules and regulations for preclinical studies. However, current legislation and regulations on the organisation and conduct of preclinical studies of radiopharmaceuticals contain a number of contradictions and need improvement.AIM. This review aimed to analyse the rules and regulations governing preclinical studies of radiopharmaceuticals in the Russian Federation and abroad.DISCUSSION. The regulatory requirements for preclinical studies of radiopharmaceuticals that are conducted by specialised institutions in Russia and abroad have several shortcomings and inconsistencies. Laboratories working with animals and open sources of ionising radiation should prioritise regulations related to radiation safety. Radiation safety requirements should be in line with the sanitary standards and practical guidelines used in preclinical studies. This review covers the specific aspects of conducting preclinical studies of therapeutic and diagnostic radiopharmaceuticals. According to the review results, international guidelines for preclinical studies of radiopharmaceuticals focus on systematising the applicable requirements and aim at providing a consistent approach to preclinical studies to reduce the conduct of studies that are not informative for a specific radiopharmaceutical product.CONCLUSIONS. Radiation safety requirements should be harmonised with international guidelines. Methodological recommendations and local regulations should be developed and approved to facilitate the resolution of regulatory issues related to the organisation and conduct of preclinical studies of radiopharmaceuticals. Many medical, social, technical, and administrative issues need addressing at the inter-institutional and/or national level.

Potential energy surfaces and dynamic properties via ab initio composite and density functional approaches.

Vibrational spectroscopy enables critical insight into the structural and dynamic properties of molecules. Presently, the majority of theoretical approaches to spectroscopy employ wavefunction-based ab initio or density functional methods that rely on the harmonic approximation. This approximation breaks down for large molecules with strongly anharmonic bonds or for molecules with large internuclear separations. An alternative to these methods involves generating molecular anharmonic potential energy surfaces (potentials) and using them to extrapolate the vibrational frequencies. This study examines the efficacy of density functional theory (DFT) and the correlation consistent Composite Approach (ccCA) in generating anharmonic frequencies from potentials of small main group molecules. Vibrational self-consistent field Theory (VSCF) and post-VSCF methods were used to calculate the fundamental frequencies of these molecules from their potentials. Functional choice, basis set selection, and mode-coupling are also examined as factors in influencing accuracy. The absolute deviations for the calculated frequencies using potentials at the ccCA level of theory were lower than the potentials at the DFT level. With DFT resulting in bending modes that are better described than those of ccCA, a multilevel DFT:ccCA approach where DFT potentials are used for single vibrational mode potentials and ccCA is used for vibrational mode-mode couplings can be utilized for larger polyatomic systems. The frequencies obtained with this multilevel approach using VCIPSI-PT2 were closer to experimental frequencies than the scaled harmonic frequencies, indicating the success of utilizing post-VSCF methods to generate more accurate representations of computed infrared spectra.

From segmentalist to liberal skill formation system: A comparative analysis of labour market activation policies in Japan and South Korea

Abstract This study provides a comparative analysis of the evolution of skill formation systems in Japan and South Korea, considering the nuances in active labour market policies (ALMPs) and institutional transformations in the post-industrial landscape. Both nations initially adopted segmentalist skill formation systems; however, they now exhibit divergent paths. Korea, in particular, has undergone institutional changes from segmentalist to a liberal skill formation system, with firms reducing their involvement in skill formation, resulting in a pronounced skill formation gap. Firms have curtailed their role in skill formation in alignment with environmental changes, and ALMPs have primarily centred on job creation for the elderly and small- and medium-sized enterprise employment subsidies. Conversely, Japan has maintained consistent policy approaches despite similar environmental changes. This study highlights that these divergent trajectories are rooted in the different stages of institutional maturity established during industrialization.

Uniform upscaling techniques for eddy covariance FLUXes (UFLUX)

ABSTRACT Data-driven techniques that scale up eddy covariance (EC) fluxes from tower footprints with satellite observations and machine learning algorithms significantly advance our understanding of global carbon, water, and energy cycles. However, few upscaling approaches take a consistent approach to upscaling both carbon and energy fluxes. A lack of uniformity in the upscaling approach could lead to inconsistencies in global interannual variability of fluxes and between types of carbon and energy fluxes. Hence, this study aims to identify obstacles in flux upscaling and propose a uniform upscaling framework UFLUX for gross primary productivity (GPP), ecosystem respiration (Reco), net ecosystem exchange (NEE), sensible heat (H), and latent energy (LE). The key findings are as follows: 1) The upscaling performance exhibits a limited improvement from the use of more advanced machine learning approaches (e.g. <0.3 in R2 improvements while using deep neural networks). 2) The spatial density of EC towers is the primary factor determining the effectiveness of upscaling, explaining >50% of the upscaling uncertainty. 3) The UFLUX framework considered the interconnection between fluxes and achieved a competitive validation precision (daily R2 = 0.7 on average of five flux types) when compared with products that upscaled a subset of the fluxes. UFLUX effectively preserved the ecosystem light-use efficiency (0.83 of linear regression slope and the same after), Bowen ratio (0.8), and particularly, the water-use efficiency (0.81), when compared to the only other product (i.e. FLUXCOM) to upscale both carbon and water.

Veterinary students’ proximity to and interpretation of a simulated “aggressive” dog before and after training

Dog “aggression” in the veterinary practice is commonplace. Therefore, student knowledge and education about dog behaviour and the ability to interpret “aggressive” behaviour is important from a human injury prevention and dog welfare perspective. The study aimed to compare first-year veterinary students’ perceived safest proximity to both an “aggressive” and non-reactive simulated dog, both before and after a teaching intervention about canine behaviour and a handling practical. It also examined student confidence and their ability to identify “aggressive” behaviours. Forty first year veterinary students took part in two surveys. Each survey included two videos: one of a simulated dog displaying “aggressive” behaviour, based on the ‘Canine Ladder of Aggression’; and another displaying non-reactive (passive behaviours without reaction to the participants) behaviours. Each video depicted the slow and consistent approach towards the virtual dog within a virtual indoor environment, and participants were asked to press stop if or when they would stop approaching the dog. In the “aggressive” scenario, there was a reduction in the approach-stop time from survey 1 (median = 17.8 s) to survey 2 (median = 15.2 s) in the intervention group (p = 0.018) but not in the control group (p = 0.147). Regarding confidence, there was a significant increase in the self-reported confidence rating relating to a participant’s ability to interpret canine behaviour in both the control (p = 0.011) and intervention (p = 0.003). In conclusion, these results indicate that students using approach-stop videos stayed further away from an “aggressive” virtual dog model if they had undertaken a canine behaviour educational intervention. This novel approach has the potential for further use in teaching and assessment of student knowledge and behaviour which may otherwise be difficult to demonstrate.

SPeC: A soft prompt-based calibration on performance variability of large language model in clinical notes summarization

Electronic health records (EHRs) store an extensive array of patient information, encompassing medical histories, diagnoses, treatments, and test outcomes. These records are crucial for enabling healthcare providers to make well-informed decisions regarding patient care. Summarizing clinical notes further assists healthcare professionals in pinpointing potential health risks and making better-informed decisions. This process contributes to reducing errors and enhancing patient outcomes by ensuring providers have access to the most pertinent and current patient data. Recent research has shown that incorporating instruction prompts with large language models (LLMs) substantially boosts the efficacy of summarization tasks. However, we show that this approach also leads to increased performance variance, resulting in significantly distinct summaries even when instruction prompts share similar meanings. To tackle this challenge, we introduce a model-agnostic Soft Prompt-BasedCalibration (SPeC) pipeline that employs soft prompts to lower variance while preserving the advantages of prompt-based summarization. Experimental findings on multiple clinical note tasks and LLMs indicate that our method not only bolsters performance but also effectively regulates variance across different LLMs, providing a more consistent and reliable approach to summarizing critical medical information.

A framework for automated scalable designation of viral pathogen lineages from genomic data.

Pathogen lineage nomenclature systems are a key component of effective communication and collaboration for researchers and public health workers. Since February 2021, the Pango dynamic lineage nomenclature for SARS-CoV-2 has been sustained by crowdsourced lineage proposals as new isolates were sequenced. This approach is vulnerable to time-critical delays as well as regional and personal bias. Here we developed a simple heuristic approach for dividing phylogenetic trees into lineages, including the prioritization of key mutations or genes. Our implementation is efficient on extremely large phylogenetic trees consisting of millions of sequences and produces similar results to existing manually curated lineage designations when applied to SARS-CoV-2 and other viruses including chikungunya virus, Venezuelan equine encephalitis virus complex and Zika virus. This method offers a simple, automated and consistent approach to pathogen nomenclature that can assist researchers in developing and maintaining phylogeny-based classifications in the face of ever-increasing genomic datasets.

A combined experimental, numerical, and data consistency approach for the characterization of temperature distribution in a MILD combustion furnace

This work aimed to compare the non-intrusive Rayleigh scattering technique and intrusive suction pyrometry for temperature measurements in a semi-industrial MILD combustion furnace. The temperature trends obtained with the two measurement techniques were consistent. However, in the zone characterized by the jet development and the mixing process between the reactants and the recirculated burnt gases, laser-based measurements brought different temperature values, which compared favorably with model predictions. CFD simulations were used to shed light on the disturbances induced by the suction pyrometer and their impact on the fluid dynamics field. It was found that the suction pyrometer disrupts the flow inside the furnace, leading to an asymmetry of the system. In addition, the temperature measured using the suction probe is an average over the sucked volume which itself is variable in nature as, for a given suction volumetric flow rate, the sucked volume depends on the local mixture velocity and density. The present analysis can help reconcile inconsistencies found in CFD modeling in which probe sampling measurements were used for validation.

Petrophysical Considerations for CO2 Capture and Storage

Carbon capture, utilization, and storage (CCUS) is a process that involves capturing carbon dioxide (CO2) emissions and storing them in geological formations. While the challenge of CCUS is one of multiple disciplines, this paper will discuss the key petrophysical considerations worth noting for CCUS projects. As the storage capacity and effectiveness of the storage reservoir depend on the physical and chemical properties of the geological formations that are used for storage, petrophysicists working on CCUS projects must have a good understanding of the subsurface and its limitations. Any CCUS project can be better managed by application and adherence to the CO2 Storage Resources Management System (SRMS), which aims to develop a consistent approach to estimating storable quantities of CO2 in the subsurface and evaluating development projects. In this paper, we will also discuss a risk matrix that we have designed as a tool for project petrophysicists to document uncertainties and rank them to enhance communication with team members. We finally share a petrophysical checklist to highlight considerations as the evaluation of prospective, contingent, and (commercial storage) capacity-scale CCUS projects are matured and use a well in the North West Shelf, Australia, as a case study to show how reservoirs can be analyzed for suitability for CO2 storage.

A unified approach to demographic data collection for research with young children across diverse cultures.

Culture is a key determinant of children's development both in its own right and as a measure of generalizability of developmental phenomena. Studying the role of culture in development requires information about participants' demographic backgrounds. However, both reporting and treatment of demographic data are limited and inconsistent in child development research. A barrier to reporting demographic data in a consistent fashion is that no standardized tool currently exists to collect these data. Variation in cultural expectations, family structures, and life circumstances across communities make the creation of a unifying instrument challenging. Here, we present a framework to standardize demographic reporting for early child development (birth to 3 years of age), focusing on six core sociodemographic construct categories: biological information, gestational status, health status, community of descent, caregiving environment, and socioeconomic status. For each category, we discuss potential constructs and measurement items and provide guidance for their use and adaptation to diverse contexts. These items are stored in an open repository of context-adapted questionnaires that provide a consistent approach to obtaining and reporting demographic information so that these data can be archived and shared in a more standardized format. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Interbank Decisions and Margins of Stability: an Agent-Based Stock-Flow Consistent Approach

This study investigates the functioning of modern payment systems through the lens of banks' maturity mismatch practices, and it examines the effects of banks' refusal to roll over short-term interbank liabilities on financial stability. Within an agent-based stock-flow consistent framework, banks can engage in two segments of the interbank market that differ in maturity, overnight and term. We compare two interbank matching scenarios to assess how bank-specific maturity targets, dependent on the dictates of the Net Stable Funding Ratio, impact the dynamics of the interbank market and the effectiveness of conventional monetary policies. The findings reveal that maturity misalignment between deficit and surplus banks compromises the interbank market's efficiency and increases reliance on the central bank's standing facilities. Monetary policy interest-rate steering practices also become less effective. The study also uncovers a dual stability-based configuration in the banking sector, resembling the segmented European interbank structure. This paper suggests that heterogeneous maturity mismatches between surplus and deficit banks may result in asymmetric funding frictions that might precede credit- and sovereign-risk explanations of interbank tensions. Also, a combined examination of macroprudential tools and rollover-based interbank dynamics can enhance our understanding of how regulatory changes impact the stability of heterogeneous banking sectors.

A viscoplastic constitutive model for plastic silts and clays for static slope stability applications

A viscoplastic model for representing plastic silts and clays in geotechnical static slope stability applications is presented. The PM4SiltR model builds on the stress ratio-controlled, critical state-based, bounding surface plasticity model PM4Silt and is coded as a dynamic link library for use in the finite difference program FLAC 8.1. PM4SiltR incorporates strain rate-dependent shear strength, stress relaxation, and creep using a consistency approach combined with an internal strain rate and auto-decay process. The model does not include a cap, and as such cannot simulate strain rate-dependent consolidation under increasing overburden stress. Six parameters control the viscous response for PM4SiltR while the parameters controlling the nonviscous components of the response are the same as for PM4Silt. Single element simulations are presented to illustrate the influence of viscoplasticity on the constitutive response in direct simple shear loading and undrained creep. Single element responses are shown to be consistent with observed experimental results. Simulations of a hypothetical tailings dam constructed using the upstream method are performed to illustrate use of PM4SiltR at field scale. Results of field scale simulations show PM4SiltR can model undrained creep and progressive failure leading to delayed slope instability after relatively minor changes in loading conditions at field scale.&#x0D;

OP07 Consistent IBD treatment approaches across South Asian and White ethnicities despite phenotypic variations: a study of 33,157 patients using the IBD BioResource

Abstract Background The current evidence suggests ethnic distinctions in IBD phenotype, and differences in the provision of treatment have been reported. This multi-centre cohort study utilised the UK IBD BioResource dataset to evaluate phenotypic differences between South Asian (SA) and White (WH) IBD, and to explore if these were associated with differences in treatment. Methods Phenotypic and outcome data were extracted from the IBD BioResource. Chi2 (categorical data) and Mann-Whitney U (continuous data) tests were used. Propensity score matching (PSM) accounted for age at diagnosis, sex, smoking status, disease location and behaviour and perianal disease (CD). Differences in medication use (multivariable logistic regression) and surgical outcomes (Kaplan-Meier and Cox regression analysis) were assessed in propensity-matched (PM) cohorts. Results 33,157 (31,932 WH; 1225 SA) individuals were included (48.1% CD, 45.4% UC, 6.5% IBD-U). UC was the predominant disease subtype in SA (UC, SA 57.3% vs WH 44.9%, p&amp;lt;0.001). SA were younger at diagnosis [CD, SA 24 (IQR 17-36) vs WH 26 (IQR 19-39) years, p&amp;lt;0.001; UC, SA 29 (IQR 22-38) vs WH 35 (25-48) years, p&amp;lt;0.001]. SA CD had less ileal disease (SA 30.3% vs WH 38.4%, padj=0.008), and more perianal involvement (SA 38.5% vs WH 32.3%, p=0.009) than WH. SA CD had less stricturing disease (SA 16.9% vs WH 25.6%, padj&amp;lt;0.001). SA UC were more likely to have extensive disease (SA 41.7% vs WH 34.1%, padj&amp;lt;0.001). Initial analyses in non-PSM cohorts showed that fewer SA CD underwent surgery [SA (n=157,37.4%) vs WH (n=7532,50.4%), p&amp;lt;0.001], and that similar proportions of SA (n=33,5.1%) and WH (n=747,5.5%; p=0.15) UC underwent a colectomy. PSM was used to match 355 SA to 355 WH in CD, and 525 SA to 525 WH in UC. Variables were well-balanced. There were no differences in 5-ASA, corticosteroid, thiopurine, anti-TNF or Vedolizumab use (Table 1). In CD, 126 (36.5%) SA and 152 (44.7%) had surgery. Survival analysis in CD showed no difference in the time to surgery (Fig 1A, log-rank 0.28). SA ethnicity was not associated with increased risk of surgery in CD (HR 0.82, 95% CI 0.63-1.07, p=0.14). In UC, 25 (4.8%) and 37 (7.1%) WH had a colectomy. There was no significant difference in the time to colectomy (Fig 1B, log-rank 0.12) nor was SA ethnicity associated with an increased risk of having a colectomy (HR 0.65, 95% CI 0.39-1.11, p=0.12). Conclusion In the largest analysis of SA IBD to date, we have demonstrated phenotypic differences associated with ethnicity. Accounting for these variations, we have shown comparable provision of medical and surgical treatment in SA and WH. These findings indicate consistent care of IBD patients from different ethnic backgrounds in the UK.

Dissociative Identity Disorder in Schools Part I.

Dissociation is a normal life adaptation that can become pronounced and disruptive in the setting of repeated or extreme exposure to trauma. Children and adolescents may experience dissociation due to a trauma or stressor-related disorder, anxiety, or depressive disorders. Children and adolescents also may mimic behavior they see online as a way of expressing internally painful and intolerable experiences. Myth and misinformation surround the diagnosis of dissociative identity disorder (DID), formerly multiple personality disorder. The purpose of this article is to provide school nurses with evidence-based information on DID and resources for practice regarding how to provide a secure, consistent approach to students who are being traumatized, misunderstood, or excluded at home or at school. Part 1 of this two-part series describes DID foundations and DID in school-aged children, reviews controversy spurred by social media representation, and presents the Trauma-Informed Care (TIC) model. TIC offers useful perspectives regardless of a student's presentation or diagnostic status. Part 2 will discuss recommendations for managing dissociative presentations using a team-based approach, focusing on the school nurse's roles and responsibilities.

Autism Observation Scale for Infants: Systematic Review and Meta-Analysis in Samples at Increased Likelihood of Autism Spectrum Disorders

AbstractThe Autism Observation Scale for Infants (AOSI) is being applied to non infant sibling populations. Assessment of the tool’s utility across increased likelihood (IL) populations is therefore needed. A systematic review and meta-analysis was conducted on 17 studies identified from six databases. The AOSI has been used in four IL contexts: infant siblings, infants with Fragile X Syndrome, Tuberous Sclerosis Complex, and Down Syndrome. There were three main findings: (1) five studies report classification data though no consistent approach was used; (2) group differences between IL-ASD, IL non-ASD, and controls started at 12-months; and (3) large effect sizes between IL-ASD and control samples was identified. Utility of the AOSI to identify early signs of ASD in IL populations was demonstrated.