Notes

Causal connection between education and learning about long-term elimination illness: any Mendelian randomization examine.
Positive signs are essential for the diagnosis of functional neurological disorders (FND). The author described a new positive sign to diagnose functional weakness (FW), "paradoxical wrist flexion", and tested its validity.

The test comprised Medical Research Council (MRC) examinations of wrist flexion in two different limb positions, one with the wrist maximally flexed (wrist flexion in the flexed position; WFfl) and the other with the wrist in the neutral position (wrist flexion in the extended position; WFex). PF-2545920 datasheet In "organic" weakness (OW), WFfl should be stronger than WFex according to the dynamic theory. Paradoxical wrist flexion was judged positive when the MRC score for WFfl was lower than that for WFex. A higher MRC score for WFfl than WFex was considered an "organic sign" for wrist flexion. We retrospectively enrolled patients with FND or other "organic" neurological disorders, who presented with wrist flexor weakness with an MRC score of 4.

Twenty-four patients with FW and 40 patients with OW were enrolled. Paradoxical wrist flexion was positive in 16 patients with FW and in no patients with OW, i.e. 67% sensitivity and 100% specificity. The "organic sign" for wrist flexion was positive in no patients with FW and in 35 patients with OW, i.e. 88% sensitivity and 100% specificity.

Paradoxical wrist flexion is useful for the detection of nonorganic paresis. The background theory is that an active movement is more severely affected in FW than a passive movement when maintaining a limb position.
Paradoxical wrist flexion is useful for the detection of nonorganic paresis. The background theory is that an active movement is more severely affected in FW than a passive movement when maintaining a limb position.
The early years are critical. Early nurturing care can lay the foundation for human capital accumulation with lifelong benefits. Conversely, early adversity undermines brain development, learning and future earning.Slums are among the most challenging places to spend those early years and are difficult places to care for a child. Shifting family and work structures mean that paid, largely informal, childcare seems to be becoming the 'new normal' for many preschool children growing up in rapidly urbanising Africa. However, little is known about the quality of this childcare.

To build a rigorous understanding what childcare strategies are used and why in a typical Nairobi slum, with a particular focus on provision and quality of paid childcare. Through this, to inform evaluation of quality and design and implementation of interventions with the potential to reach some of the most vulnerable children at the most critical time in the life course.

Mixed methods will be employed. Qualitative research (in-deptorkshops, policy briefs and social media content.
Ethical approval has been granted in the UK and Kenya. Findings will be disseminated through journal publications, community and government stakeholder workshops, policy briefs and social media content.We explore how and why the Liverpool Care Pathway (LCP) for the dying patient was transferred to 20 countries beyond the UK, and with what consequences for policy and practice. Our paper synthesises findings from 95 publications contained in a historical narrative literature review on the implementation of the LCP outside the United Kingdom, alongside data from 18 qualitative interviews with 19 key actors involved with the LCP in 14 countries. We use the review to explore the timelines and patterns of development and implementation in the specific countries, to consider what forms of research and evaluation about the LCP were undertaken to establish its effectiveness, and to summarise the resulting findings and their consequences. We use the interviews to gain insights into the elements, processes and dynamics that shaped the transfer and translation of the LCP from one location to another, across national boundaries. Using six questions from the policy transfer literature we then explain who were the key actors involved; what was transferred; from where lessons were drawn; the different degrees of transfer that took place; what restricted or facilitated transfer; and how transfer was related to 'success' or 'failure'. We conclude that the spread of the LCP took place mostly in prosperous countries, and was sustained over around 15 years. It took in differing geographies and cultures, and a variety of linguistic, policy and practice contexts. If it did not succeed in a wider transformational goal, it appears to have been well received and perceived as beneficial in many contexts, largely avoiding accusations of mis-use and harm that had occurred in the UK, and in some cases fostering a sustained international collaboration and ongoing use of local variants, even after withdrawal in its country of origin in 2014.This data note describes the linked antenatal and delivery records of the mothers and index children of the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort study. These records were extracted from the computerised maternity record system 'STORK' used by the two largest NHS trusts in the study catchment area. The STORK database was designed to be populated by midwives and other health professionals during a woman's pregnancy and shortly after the baby's birth. These early computer records were initiated in the early 1990s, shortly before the start of enrolment to ALSPAC. At this time the use of electronic medical record systems such as 'STORK' was very new, the accuracy of the records has been questioned and little contemporary detailed documentation is available. Small sample spot checks on the accuracy of the information in 'STORK' suggests extensive missingness and differences against gold-standard fieldworker abstracted information in some variables; yet high levels of completeness and agreement with gold-standard data in others. Software code was created using STATA (StataCorp LLC) to transform the original CSV (comma-separated values) files into a cohesive and consistent format which was reviewed for data-completeness for its potential use in future research. The cleaned 'STORK' records provide health, social and maternity data from the very earliest period of the ALSPAC study in an easily accessible format, which is particularly useful when other sources of data are missing.
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