A comparison of three methods of repairing the hard palate.

OBJECTIVE: To compare growth, speech, and nasal symmetry outcomes of three methods of hard palate repair. PATIENTS: Consecutive available records of children born with unilateral bony complete cleft lip and palate over the period 1972 to 1992. INTERVENTIONS: Identical management of lip, nose, alveolus, and soft palate. Hard palate repair by Cuthbert Veau (CV) from 1972 to 1981, von Langenbeck (vL) from 1982 to 1989, or medial Langenbeck (ML) from 1989 to 1991. OUTCOME MEASURES: For growth: GOSLON yardstick or 5-year model index. For speech: articulation test. Nasal anemometry. For nasal symmetry: Coghlan computer-based assessment. All these measures were developed during the period of data collection but not for this project. RESULTS: There was a strong trend toward more favorable anteroposterior maxillary growth with the change from CV to vL to ML techniques. This fell short of statistical significance because of the small sample size. There was a significant reduction in cleft-related articulation faults (p =.01) considered to be related to improved arch form. In the absence of improved rates of velopharyngeal insufficiency or nasal symmetry, increased surgical experience was discounted as a significant contribution to improved growth and articulation outcomes. CONCLUSIONS: Reduced periosteal undermining and residual exposed palatal shelf from CV to vL to ML improved incisor relationships and articulation.     

The compartment model for chronically implanted voltammetric electrodes in the rat brain

Diazepam (0.4-0.8 mg/kg i.p.) reduced the spontaneous activity in the electromyogram (EMG) recorded from the gastrocnemius-soleus muscle of spastic mutant Han--Wistar rats in a dose-dependent manner. The depressant effect of diazepam (0.8 mg/kg) on the EMG activity was antagonized by Ro 15-1788 (5 mg/kg i.p.) and by picrotoxin (2 mg/kg i.p.), but not by bicuculline (2 mg/kg i.p.). These results suggest that diazepam depresses EMG activity of mutant rats by mechanisms related to the interaction of the drug with GABA-independent benzodiazepine receptors.     

Universal Mindfulness Training in Schools for Adolescents: a Scoping Review and Conceptual Model of Moderators,Mediators, and Implementation Factors

Prevention Science - There is evidence that universal school-based mindfulness training (SBMT) can have positive effects for young people. However, it is unknown who benefits most from such...     

Food effects on tablet disintegration.

The aims of the present study was to investigate if food components, as represented by a multi-component nutritional drink for tube feeding, could affect tablet disintegration of standard tablets in vitro as well as in vivo and propose a mechanism for potential food effects on tablet disintegration. The tablet disintegration was delayed between 5 min and more than 1h in the simulated gastric fed medium compared to a simple buffer. This effect was dependent on the tablet composition. A similar delay in tablet disintegration was also found in vivo after administration of the nutritional drink to three Labradors as observed by removing the tablet from the stomach at different times through a gastric fistula. The delay in tablet disintegration appeared to be caused by precipitation of a film, mainly consisting of protein, on the tablet surface as indicated by disintegration studies with pure nutrients, identification by IR spectroscopy of contents of precipitates obtained in a model study were the nutrients were incubated with different tablet excipients and visual observations of tablets exposed to the simulated fed medium. The drug dissolution of a soluble compound, metoprolol tartrate, from a standard tablet was also strongly delayed in the simulated fed medium. In conclusion, food, could significantly delay tablet disintegration and drug dissolution in the stomach by formation of a film around the tablets. This effect could be monitored by a simple in vitro disintegration test using a test medium based on a nutritional drink. More studies are needed to investigate the significance of the slow tablet disintegrations on bioavailability and for which types of food the present effect occurs.     

Severe isolated Crohn's-like disease of the gastroduodenal tract

We report four cases of isolated GCD of the stomach and proximal small intestine that were refractory to conventional management. Gastric ulcers were present in patients 1-3 for 4, 13, and 22 years and erosive gastritis in patient 4 was present for at least 2 years. High-dose proton pump inhibition and H. pylori eradication failed to induce healing. Neither ileocolonic lesions nor typical CD pathology with granulomas were detected in any of the patients, but all behaved clinically like CD. The three patients with gastric ulcers failed initial partial gastrectomy and required multiple reoperations because of duodenojejunal ulceration and anastomotic stricture formation. Patient 1 did not improve with infliximab. Patient 2 healed on steroids and infliximab. Patient 3 did not tolerate sulfasalazine and steroids and is currently being treated with 6-mercaptopurine (6-MP). Patient 4 healed on prednisone and 6-MP. We conclude that GCD should be considered in isolated refractory gastroduodenal inflammation and ulceration. Immunomodulators and surgery may play a role in the treatment of this difficult-to-manage condition.     

The COVID-19 anxiety syndrome and selective attentional bias towards COVID-19-related stimuli in UK residents during the 2020–2021 pandemic

The psychological and social effects of the COVID-19 pandemic are pervasive, and there is potential for a long-lasting impact on mental health. In the current study, we sought to provide, in a representative sample of UK residents during the third COVID-19 lockdown in February 2021, further evidence for the validation of the COVID-19 anxiety syndrome construct. We did this by evaluating the COVID-19 anxiety syndrome against measures of personality, health anxiety and COVID-19 anxiety in predicting levels of generalized anxiety and depression and by examining whether increased health anxiety and COVID-19 psychological distress (COVID-19 anxiety and COVID-19 anxiety syndrome) scores were associated with increased attentional bias to COVID-19-related stimuli. A series of correlation analyses revealed that neuroticism, health anxiety, COVID-19 anxiety and COVID-19 anxiety syndrome scores were positively and significantly correlated with generalized anxiety and depression scores and that the perseveration component of the COVID-19 anxiety syndrome predicted generalized anxiety and depression scores independently of age, gender, conscientiousness, openness, health anxiety and COVID-19 anxiety. Furthermore, results indicated that only the total COVID-19 anxiety syndrome score and the scores on the avoidance and perseveration components were positively and significantly correlated with attentional bias indices. More specifically, the general attentional bias index was only shown to be positively and significantly correlated with the total COVID-19 anxiety syndrome score and its perseveration component, while slowed disengagement was only shown to be negatively and significantly correlated with the total COVID-19 anxiety syndrome score and its avoidance component. The implications of these findings are discussed.     

Longer-term effects of school-based counselling in UK primary schools

Children’s mental health is deteriorating while access to child and adolescent mental health services is decreasing. Recent UK policy has focused on schools as a setting for the provision of mental health services, and counselling is the most common type of school-based mental health provision. This study examined the longer-term effectiveness of one-to-one school-based counselling delivered to children in UK primary schools. Data were drawn from a sample of children who received school-based counselling in the UK in the 2015/16 academic year, delivered by a national charitable organisation. Mental health was assessed at baseline, immediately post-intervention, and approximately 1 year post-intervention, using the Strengths and Difficulties Questionnaire (SDQ) completed by teachers and parents. Paired t tests compared post-intervention and follow-up SDQ total difficulties scores with baseline values. Propensity score matching was then used to identify a comparator group of children from a national population survey, and linear mixed effects models compared trajectories of SDQ scores in the two groups. In the intervention group, teacher and parent SDQ total difficulties scores were lower at post-intervention and longer-term follow-up compared to baseline (teacher: baseline 14.42 (SD 7.18); post-intervention 11.09 (6.93), t(739) = 13.78, p < 0.001; follow-up 11.27 (7.27), t(739) = 11.92, p < 0.001; parent: baseline 15.64 (6.49); post-intervention 11.90 (6.78), t(361 = 11.29, p < 0.001); follow-up 11.32 (7.19), t(361) = 11.29, p < 0.001). The reduction in SDQ scores was greater in the intervention compared to the comparator group (likelihood ratio test comparing models with time only versus time plus group-by-time interaction: χ² (3) = 24.09, p < 0.001), and model-predicted SDQ scores were lower in the intervention than comparator group for 2 years post-baseline. A one-to-one counselling intervention delivered to children in UK primary schools predicted improvements in mental health that were maintained over a 2 year follow-up period.