Effects of an Individual Work System on the Independent Functioning of Students with Autism

This study examined the effects of a work system on the independent work and play skills of students with autism. Work systems, an element of structured teaching developed by Division TEACCH, are organized sets of visual information that inform a student about participation in work or play areas. A single subject withdrawal of treatment design, with replications across three participants, was used to assess the on-task behavior and work completion skills of the students in classroom and employment settings as a result of the intervention. Observational data indicated that all students showed increases in on-task behavior, increases in the number of tasks completed or play materials utilized, and reduction of teacher prompts. The results were maintained through the 1-month follow-up.     

Does tick-borne relapsing fever have an animal reservoir in East Africa?

Tick-borne relapsing fevers (TBRF) are caused by infection with Borrelia spirochetes and transmitted to humans by ticks. All except East African TBRF, caused by Borrelia duttonii, are known zoonoses. This widespread, endemic and pathogenic infection has only been found in humans and the Ornithodoros sp. soft tick vectors. We investigated the role of domestic animals as possible reservoirs of infection in a TBRF endemic region. Tick infestations in households and pigpens were investigated in the villages near Mvumi hospital in central Tanzania. Blood from chickens and pigs was examined by PCR and flagellin gene sequencing was performed on any Borrelia sp. infections detected. A mark-recapture experiment investigated tick movement between pigpens and houses. The acceptability of chickens as tick hosts was also investigated. Tick infestation of the 122 houses investigated was high (47%). Pigpens also were tick infested (16%) and were more likely to be so if they were located close to tick infested households (p<0.001). PCR screening of peripheral blood found Borrelia infections in both chickens and pigs (11% and 8.9% respectively). Sequencing of a subset of positive samples revealed that the amplified Borrelia sp. flagellin gene fragments shared greatest homology with B. duttonii. In a mark-recapture experiment, ticks released in pigpens were recaptured inside human bedrooms. When offered chickens as hosts, over 20% of ticks fed. For the first time in East Africa, we record natural infections of Borrelia in domestic animals and show that tick populations may act as bridging vectors between animals and humans. These results, from villages where B. duttonii is already known to be prevalent and a major cause of illness in humans, and where it has been found at high levels in ticks, strongly support the case that it is a zoonosis. This increases understanding of the epidemiology and control of this important but neglected human disease.     

Erythroplastidcytosis in a Major Mitchell’s cockatoo (Lophochroa leadbeateri)

Avian erythrocytes are typically nucleated. However, a small proportion of anucleated erythrocytes, termed erythroplastids, may be encountered in the peripheral blood of birds. We document the presence of a large proportion (up to 47.6 %) of erythroplastids in the blood of a Major Mitchell’s cockatoo (Lophochroa leadbeateri) and consider the pathophysiology of this finding.     

Socio-demographic characteristics of children experiencing socioeconomic disadvantage who meet physical activity and screen-time recommendations: the READI study

Objective

To identify socio-demographic characteristics of children from socioeconomically disadvantaged neighbourhoods who meet physical activity and screen recommendations.

Method

Children aged 5-12 years (n = 373; 45% boys) were recruited in 2007 from socioeconomically disadvantaged urban and rural areas of Victoria, Australia. Children's physical activity, height and weight were objectively measured. Mothers reported their highest level of education, and proxy-reported their child's usual screen-time. Odds ratios (OR) and 95% confidence intervals (95% CI) examined odds of meeting physical activity (> 60 minutes/day) and screen (≤ 120 minutes/day) recommendations according to socio-demographic characteristics.

Results

Approximately 84% of children met physical activity and 43% met screen recommendations. Age was inversely associated with odds of meeting physical activity and screen recommendations, and overweight/obese status was associated with lower odds of meeting screen recommendations (boys: OR = 0.39, 95%CI = 0.16-0.95; girls: OR = 0.47, 95%CI = 0.26-0.83). Among boys, living in a rural area was positively associated with meeting screen recommendations (OR = 3.08, 95%CI = 1.42-6.64). Among girls, high levels of maternal education were positively associated with meeting screen recommendations (OR = 2.76, 95%CI = 1.33-5.75).

Conclusion

Specific socio-demographic characteristics were associated with odds of meeting physical activity and screen recommendations. Identifying factors associated with such ‘resilience’ among this group may provide important learnings to inform future physical activity promotion initiatives.     

Platelet transfusion for patients with cancer: clinical practice guidelines of the American Society of Clinical Oncology.

OBJECTIVE: To determine the most effective, evidence-based approach to the use of platelet transfusions in patients with cancer. OUTCOMES: Outcomes of interest included prevention of morbidity and mortality from hemorrhage, effects on survival, quality of life, toxicity reduction, and cost-effectiveness. EVIDENCE: A complete MedLine search was performed of the past 20 years of the medical literature. Keywords included platelet transfusion, alloimmunization, hemorrhage, threshold and thrombocytopenia. The search was broadened by articles from the bibliographies of selected articles. VALUES: Levels of evidence and guideline grades were rated by a standard process. More weight was given to studies that tested a hypothesis directly related to one of the primary outcomes in a randomized design. BENEFITS/HARMS/COST: The possible consequences of different approaches to the use of platelet transfusion were considered in evaluating a preference for one or another technique producing similar outcomes. Cost alone was not a determining factor. RECOMMENDATIONS: Appendix A summarizes the recommendations concerning the choice of particular platelet preparations, the use of prophylactic platelet transfusions, indications for transfusion in selected clinical situations, and the diagnosis, prevention, and management of refractoriness to platelet transfusion. VALIDATION: Five outside reviewers, the ASCO Health Services Research Committee, and the ASCO Board reviewed this document. SPONSOR: American Society of Clinical Oncology