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Purpose: The study improves our understanding of the reading comprehension difficulties seen in people with aphasia. It investigates the influence of reader characteristics, including personal demographic variables, and linguistic and wider cognitive skills, on text comprehension. Method: Seventy-five people with aphasia and 87 neurologically typical readers completed a test of paragraph comprehension. People with aphasia also completed background tests of language, attention, recognition memory, and executive functions. The influence of demographic variables (age, gender, and level of education) was analyzed separately in the group of people with aphasia and the typical readers using analyses of variance. In the people with aphasia, the relationship between paragraph comprehension and the language and cognitive tests was explored using correlational analyses. Results: In the typical readers, there was a significant effect of gender and level of education and a significant three-way interaction. For the people with aphasia, there were no significant effects of demographic variables. Significant positive correlations were found between performance on paragraph comprehension and each of the language tests and with tests of auditory attention, executive functions, and recognition memory for words. Conclusions: In people with aphasia, the effects of demographic variables were overshadowed by the effect of their language difficulties. The association seen across language measures reflects the shared semantic representations across single-word, sentence, and text levels, across modalities. The study emphasizes the importance of attention, executive functions, and short-term memory in the comprehension of and memory for what we read. The contribution of both language difficulties and wider cognitive skills needs to be considered when planning intervention. [ABSTRACT FROM AUTHOR]

Reading is an important everyday activity. Extensive individual variability exists in both typical readers and readers with aphasia in their reading ability, preferences, and practice. Although reading comprehension difficulties in people with aphasia are typically assessed at single word, sentence, and text level, there is limited information about how performance at these levels corresponds to their enjoyment and practice of reading. This study aimed to improve our understanding of reading in people with aphasia by examining: 1) the relationship between performance on assessments of word, sentence, and paragraph comprehension; 2) the relationship between reported reading difficulty, feelings about reading, and reading activity; and 3) the relationship between reading comprehension scores and personal perception of reading. Participants included 74 adults with a single symptomatic stroke resulting in aphasia; they did not have to report or present with reading difficulties. Participants completed the Comprehensive Assessment of Reading in Aphasia (CARA). Statistical analysis used Spearman correlations to investigate the relationship between measures. Illustrative case studies provided evidence of individual variability. Significant positive correlations were found between comprehension accuracy in single word and sentence, single word and paragraph, and sentence and paragraph assessments. There were also significant positive correlations among reported reading difficulty, feelings about reading, and reading activity. There were no significant correlations between reading comprehension scores and personal perception of reading. There is no straightforward relationship between reading comprehension difficulties and individual perception of reading. This emphasises the importance of considering both when discussing and agreeing goals, selecting a treatment approach, and evaluating the outcome of intervention. [ABSTRACT FROM AUTHOR]

Both reading speed and comprehension at the text level are often impaired in people with aphasia, potentially impacting their daily life. Provision of advance context (e.g., pictures provided to the reader prior to reading) is found to facilitate text processing and comprehension in typical readers. However, there has been no investigation of whether advance context influences reading in people with aphasia, although some studies have found no benefit on people with aphasia's comprehension accuracy from contextual supports presented simultaneously with text. It also remains unclear whether context may impact people with aphasia's understanding of any particular type of textual information (main ideas vs details, stated ideas vs implied ideas). This study aimed to investigate the effect of advance picture context on reading speed, overall comprehension accuracy and comprehension of different types of ideas for naturalistic everyday texts in people with aphasia. Twenty-nine adult typical readers and 10 people with aphasia with varying reading ability took part in the study. Participants read three matched sets of short news articles which were either preceded by a related picture, no picture, or (as fillers) an unrelated picture and were followed by multiple-choice comprehension questions. For each text, the questions assessed the understanding of a stated main idea, an implied main idea, a stated detail, and an implied detail. Mixed-effects regression analyses were performed to examine the effect of advance (related) picture context on participants' reading time and comprehension accuracy. The results showed a significant effect of advance picture context on reading speed, with both typical readers and readers with aphasia showing significantly shorter reading times when a picture was available. Advance context did not affect overall comprehension accuracy or accuracy for any subtype of textual information for either group of participants. Advance context facilitates text processing in people with aphasia, resulting in increased reading speed for everyday texts, although it does not influence their comprehension accuracy for these types of texts. This suggests that therapeutic approaches could develop more effective use of advance contextual organisers in order to increase people with aphasia's reading efficiency and ultimately, their confidence and pleasure in reading. [ABSTRACT FROM AUTHOR]

Background: Whilst reading difficulties are a common feature of aphasia, there has been limited consideration of the impact of these difficulties on how people with aphasia experience reading in their everyday lives. Previous studies, using semi-structured interviews, have highlighted the need to consider reading from the perspective of the individual due to the complexity of factors influencing reading and individual variation in practices and preferences. These studies have contributed to our understanding of the individual's perspective but have been restricted to people with less severe aphasia and some expressive ability. We need tools to facilitate understanding the personal perspective of people across the severity range that are feasible within a clinical setting. Aims: The aim of this study was to investigate people with aphasia's perception of their current reading ability and activities and feelings about reading using a questionnaire. The validity, reliability, and clinical usefulness and acceptability of the questionnaire were considered. Methods & Procedures: The questionnaire was developed through an iterative process, involving a review of literature, integration of findings from an interview study, direct consultation with people with aphasia, pilot testing, and review. The questionnaire comprised four sections: A) Current reading, B) Thoughts and feelings about reading, C) Reading activities, and D) Reading strategies. Eighty-one participants completed the questionnaire during a study of reading in people with aphasia. Following completion of data collection, tester feedback was considered and the psychometric properties of the questionnaire in relation to aspects of validity and reliability were analysed. Outcomes & Results: Perception of reading ability, feelings about reading and reading activity varied considerably across participants, with not all individuals reporting difficulties. There was increased perceived difficulty as the length of text increased. Participants highlighted that they were unhappy with their speed of reading. The most common strategies used to support reading were re-reading, slowing down, and reducing distractions. The iterative process resulted in a 29 item questionnaire which had appropriate face validity, construct validity and test re-test reliability and was clinically appropriate and feasible. Conclusions: The study provides additional evidence about the individual variability in reading in people with aphasia, emphasising the importance of considering personal perception alongside formal assessments of reading comprehension. The questionnaire provides a practical and reliable measure of a person's perception of reading post-stroke and has potential as a patient-centred tool, contributing to goal setting and outcome measurement. [ABSTRACT FROM AUTHOR]

The paper uses data from the American Community Survey to explore the impact of pre-departure characteristics and class of entry on the integration of Nigerian- and Somali-born immigrants into US society. It argues for scholars to reconsider the treatment of African immigrants as a collective group as this obscures differences between immigrants from different African countries and the ways they adjust to life in the US. Understanding the ways in which disadvantaged immigrant groups navigate their day-to-day lives and the social structures which they draw upon for support is flagged as a possible area of future research inquiry. [ABSTRACT FROM AUTHOR]

Purpose: This study compared Internet use post-stroke in people with aphasia (n = 25) and without aphasia (n = 17). The purpose was to understand how people with aphasia were using the Internet and to investigate the impact of aphasia on their use. Materials and methods: A face-to-face supported questionnaire explored the use of technologies, types of Internet use, traditional and Internet communication, the perception of abilities, and possible barriers to acquiring or improving Internet skills. Descriptive and inferential statistics were used to analyze the data. Results: Internet use ranged from fully independent to by proxy across both groups. Most participants perceived their aphasia as a barrier, but for the majority, it was not the sole reason for failing to acquire or improve skills. Aphasia was related to difficulties with technology-based written communication. Educational attainment was related to participant's feelings about their own skills. Whilst aphasia was important, analysis revealed that age was a stronger predictor of Internet use per se. Conclusions: It is clear that aphasia often negatively affects Internet use and proficiency. However, this research clearly demonstrates that it is important to consider the influence of factors such as age, proxy use, education, and previous technology use and experience. Post-stroke aphasia contributes negatively to Internet use, particularly in the use of online communication tools such as email and messaging services. Sub-groups of people with aphasia are likely to be more vulnerable to exclusion from the benefits of the Internet; specifically, older people and those with lower levels of educational attainment. It is common for both older adults with and without aphasia to use the Internet via a proxy. Independent use may not always be the desired goal within rehabilitation. People with aphasia may perceive their age and disability as barriers to using the Internet and may lack confidence in their own ability or potential. [ABSTRACT FROM AUTHOR]

Pivoting to all-remote teaching in response to the COVID-19 pandemic of 2020 has been a challenge for faculty and students accustomed to personalized face-to-face relationshipbuilding. Successfully designing remote courses that are supportive, positive, purposeful, and enriching via Zoom platforms can seem daunting. This article offers suggestions for purposeful and unique remote course-design strategies that build class community and student belonging through class interactions, individual student engagement, and faculty feedback. Examples shared directly reflect those in which the authors have engaged with their students in remote learning settings. [ABSTRACT FROM AUTHOR]

Background: It remains controversial whether the reduction in associative learning ability previously reported among people with aphasia is specific to linguistic learning or whether the difficulty lies in the formation of new associative learning. Furthermore, an effective associative learning approach that benefits people with aphasia with different profiles of language impairment and levels of severity is yet to be identified. Aims: This study investigates associative learning within linguistic and non-linguistic domains, contrasting the performance of people with aphasia (n = 11) and two groups of control participants [young (n = 18) and old (n = 18)] to identify if, for people with aphasia, reduced associative learning occurs across domains or is specific to the linguistic domain. In addition, the effect of massed and spaced practice is examined to explore potential facilitative learning approaches for people with aphasia. Methods and procedures: Learning of linguistic (word-pairs) and non-linguistic (picture-pairs) material took place separately but follow the same procedures. The study involves pair-association learning, with a study phase (involving massed and spaced practice) followed by an immediate cued recall task to assess learning outcomes. Retention of learning was assessed 2 days post-study, with a delayed recognition task and a delayed cued recall task. Outcomes and results: The findings show that, in cued-recall tasks, despite an overall reduced performance among people with aphasia, patterns of learning largely mirrored the control participants. Word-pairs were better retained than picture-pairs with spaced practice producing better results than massed in both learning conditions. Conclusion: This study advances our understanding of how people with aphasia learn new associations and, regardless of language impairment, associative learning can be facilitated by spaced practice. The findings of the current study highlight the potential importance of adopting spaced practice in clinical settings to maximise outcomes of therapy sessions. [ABSTRACT FROM AUTHOR]

Background: In the context of therapy for word retrieval in aphasia, the person with aphasia is often required to attempt to name treated items on multiple occasions. However, there is limited information about the impact of these repeated attempts at naming in and of themselves. Aim: The aim of this study was to examine if repeated attempts at naming, with no treatment or feedback, improve naming accuracy in people with aphasia. Methods & Procedures: 23 participants with stroke aphasia named 50 pictures on seven occasions, approximately six weeks apart. No support, cues (written or spoken) or feedback on accuracy was provided at the time or between naming attempts. This was part of a larger study investigating two different types of therapy on different items. Outcomes & Results: After excluding any potential influence from treatment of other items, four participants showed significant improvements in accuracy and two participants showed a worsening of accuracy for the stimuli that received repeated naming attempts (but were untreated). We found evidence that significant change in accuracy was predicted by the variability of naming accuracy between sessions, executive functioning skills (as measured by the Wisconsin Card Sorting Task), and picture naming ability (Nickels' Naming Test). Conclusions: We hypothesised that in the context of variability in naming accuracy, intact executive functioning may help monitor responses, such that only correctly named items are reinforced. Critically, without the ability to monitor responses without feedback, incorrect responses may be reinforced, leading to a worsening of performance. The fact that four individuals with aphasia showed improved naming accuracy by naming items once every six weeks is striking and suggests that further investigation of effects of repeated naming at closer intervals is warranted, as for some participants any advantage from a naming attempt may have decayed by the time of repetition. [ABSTRACT FROM AUTHOR]

Purpose: Informativeness refers to how successfully a person is able to convey their intended message. This study explores the relationship between perceptual ratings of informativeness and selected linguistic measures of lexical and structural content. It considers which linguistic measures have ecological validity in terms of what listeners view as important. Method: Two complex picture description samples from 20 people with aphasia were analyzed. Linguistic measures included number of correct information units (NCIU), percentage of correct information units, number of propositions (NP), propositional idea density (PID), and mean length of utterance in words (MLU-w). Eleven naïve listeners produced direct magnitude estimation (DME) ratings of informativeness. A correlational design was used to investigate the relationship between mean DME informativeness ratings and each of the linguistic measures. Results: The 2 picture description samples elicited similar informativeness ratings. Positive significant correlations were identified between mean DME informativeness ratings and NCIU, percentage of correct information units, NP, and MLU-w; the strength of correlation differed across variables. No significant correlation was found between mean DME informativeness ratings and PID. Significant correlations were also seen between the linguistic variables, particularly between NP and PID as well as NP and MLU-w. Conclusions: Overall, the linguistic measures corresponded to rated informativeness, highlighting their ecological validity. The strongest relationship was between NCIU and rated informativeness, emphasizing the importance of complete and accurate production of lexical information, particularly nouns. Less strong, but still significant, relationships were seen with variables looking at the efficiency of information giving and the connection of ideas within sentences. The importance of different types of informative measures is considered in relation to the elicitation stimuli. [ABSTRACT FROM AUTHOR]

Foraging honey bees (Apis mellifera) seem to use the presence of conspecific foragers as cues for flower quality. However, there is disagreement regarding how a conspecific cue is perceived by other foragers (enhancement or inhibition). Most studies manipulate the total number of bees foraging in an arena or the presence or absence of a bee on a flower and then observe the behavior of one forager in response to a single conspecific, which does not reflect natural foraging. We tested how a range of conspecifics on flowers affected on which flowers foraging honey bees landed. We trained students from a biology class for non-STEM majors to collect data and tested whether the number of conspecifics on flowers influences on which flower foragers land. We found that foragers land more frequently on flowers occupied by more conspecifics, which supports the hypothesis that conspecifics are cues for local enhancement. Our results increase our understanding of how honey bees forage once at a flower patch. [ABSTRACT FROM AUTHOR]

Summary: Background: Gut‐directed hypnotherapy is effective for patients with irritable bowel syndrome (IBS). Despite its considerable evidence base, gut‐directed hypnotherapy is not widely available and remains a limited resource. This emphasises the need to select patients who are most likely to benefit. Aim: To determine whether baseline patient characteristics were predictive of response to gut‐directed hypnotherapy in patients with IBS Methods: We conducted a secondary analysis of outcomes of 448 patients with refractory Rome III IBS who participated in a randomised study confirming non‐inferiority of 6 compared to 12 sessions of gut‐directed hypnotherapy. We compared baseline patient characteristics, including age, sex, IBS subtype, quality of life and IBS‐Symptom Severity Scale (IBS‐SSS), non‐colonic symptom score and Hospital Anxiety and Depression (HAD) score between responders and non‐responders. We defined response as ≥50‐point decrease in IBS‐SSS or ≥30% reduction in pain severity scores. Results: Overall, 76.3% achieved ≥50‐point decrease in IBS‐SSS. Responders had a higher baseline non‐colonic symptom score (p = 0.005). Those who achieved ≥30% improvement in abdominal pain scores (59.8%) had higher baseline IBS‐SSS (p = 0.03), and lower baseline HAD‐depression score (p = 0.012). Fifty‐four patients (12%) dropped out of gut‐directed hypnotherapy. Compared to completers, dropouts had higher baseline HAD‐anxiety score (p = 0.034). Conclusions: These data suggest that patients with a higher burden of gastrointestinal and extraintestinal symptoms are most likely to benefit from gut‐specific behavioural intervention for refractory IBS. Clinical assessment of gastrointestinal, somatic and psychological symptom profiles may play a role in selecting patients for gut‐directed hypnotherapy. [ABSTRACT FROM AUTHOR]

Background: Anxiety and depression have been linked to repetitive negative self-regulation styles in the form of worry and rumination respectively. Following predictions of the metacognitive model [Wells, A., & Matthews, G. (1994). Attention and emotion: A clinical perspective. Hove: Erlbaum], the current study compared the effect on recovery from stress of three strategies: worry, rumination, and distraction using a stress exposure paradigm. It was predicted that worry and/or rumination would be associated with delayed recovery on physiological and/or self-report indices when compared to distraction.Method: Fifty-four participants were randomly assigned to one of the self-regulation conditions and then completed a modified version of the Trier Social Stress Test [TSST; Kirschbaum, C., Pirke, K. M., & Hellhammer, D. H. (1993). The "TSST" - A tool for investigating psychobiological stress responses in a laboratory setting. Neuropsychobiology, 28, 76-81. doi: 10.1159/000119004 ]. Skin conductance and negative affect (NA) measurements were obtained at six different time points.Results: Skin conductance indicated a prolonged recovery in the rumination condition when compared with the distraction condition. Individuals in the worry condition reported an immediate-delayed recovery from stress marked by higher NA scores in comparison to the distraction condition.Conclusions: These findings may provide important insights into the effects of different forms of repetitive negative thinking on physiological and psychological recovery from stress. The different response patterns observed are discussed within the context of the metacognitive model. [ABSTRACT FROM AUTHOR]

Purpose: The current study investigated the effect of text variables including length, readability, propositional content, and type of information on the reading comprehension of people with aphasia. Method: The performance of 75 people with aphasia was compared with 87 healthy, age-matched control participants. Reading comprehension was considered in terms of both accuracy in responding to questions tapping comprehension and reading time. Participants with aphasia (PWA) were divided into 2 groups (no reading impairment [PWA:NRI] and reading impairment [PWA:RI]) depending on whether their performance fell within the 5th percentile of control participants. Results: As groups, both PWA:NRI and PWA:RI differed significantly from control participants in terms of reading time and comprehension accuracy. PWA:NRI and PWA:RI differed from each other in terms of accuracy but not reading time. There was no significant effect of readability or propositional density on comprehension accuracy or reading time for any of the groups. There was a significant effect of length on reading time but not on comprehension accuracy. All groups found main ideas easier than details, stated information easier than inferred, and had particular difficulty with questions that required integration of information across paragraphs (gist). Conclusions: Both accuracy of comprehension and reading speed need to be considered when characterizing reading difficulties in people with aphasia. [ABSTRACT FROM AUTHOR]

Purpose: This article uses an illustrative case example to discuss a means of producing a holistic profile of Internet use for individuals with aphasia. Methods: The authors used the International Classification of Functioning, Disability, and Health as a framework to select novel and existing assessments to explore the Internet use and skills of a 74-year-old retired academic with severe aphasia. Results: Quantitative and qualitative assessment results revealed that language impairment, nonverbal impairment, nonverbal aspects of cognition, and hemiparesis had an impact on the individual's ability to use the Internet independently for many previous professional activities; however, relevant Personal Factors showed him to have strong goals and motivation to continue to use the Internet for email and gaining information about topics such as sports. Consideration of Environmental Factors provided insight into barriers and facilitators to Internet use and into the skills of people providing support. Discussion/conclusions: This approach to profiling Internet use in aphasia may be clinically useful in identifying key factors at work to guide information gathering and decision making with people with aphasia. Implications about SLP preparation and funding policies related to therapeutic priorities also are discussed. [ABSTRACT FROM AUTHOR]

Background: Aphasia is likely to impact adversely on the ability to use the Internet successfully, as linguistic skills are important for many aspects of Internet use. Despite this, there exists limited evidence on how best to support people with aphasia to benefit from the Internet. Whilst linguistic impairments in aphasia will have an impact on Internet use, there are other important factors such as other cognitive or physical impairments. There are also differences in digital skills between social groups in the UK, creating inequalities. People with aphasia and those who support them are likely to have varying levels of Internet use. These aspects are relevant in improving our understanding of factors relevant to supporting people with aphasia to use the Internet. Aims: The main aim is to discuss the key areas related to supporting people with aphasia to achieve equality of access to and use of the Internet. This paper focuses on three questions related to Internet use: (1) What do we know about access and use of the Internet by populations who share characteristics with people with aphasia and may experience similar disabilities?, (2) Based on that knowledge, what types of difficulties with Internet use might be predicted for people with aphasia? and (3) How has Internet use or support with Internet skills been studied in relation to people with aphasia. If not directly studied, what does relevant related work tell us? Main Contribution: This paper discusses factors that might act as barriers or facilitators to Internet use by people with aphasia, viewed from within the conceptual frameworks of the International Classification of Disability and Functioning and the Communications Consumer Panel Framework on Digital Participation. It considers the relevant literature on digital exclusion in the wider population and on aphasia and technology, in order to present a wide perspective on the range of issues involved in mitigating digital exclusion. Conclusions: The interrelationships between the complex demands imposed by aphasia and factors thought to contribute to digital exclusion are complex and multifactorial. The literature directly relating to aphasia and technology and from wider evidence on digital exclusion all contribute to understanding of key barriers and facilitators to Internet use. Consideration of these wider factors and of the contributions from a range of disciplines, historically not involved in aphasia rehabilitation, is helpful in understanding the needs of people with aphasia in a digital age and to develop future interventions. [ABSTRACT FROM PUBLISHER]

Objective: Pelvic vein incompetence (PVI) affects 15-20% of all women, yet we know little about how it affects sufferers. The aim of this prospective pilot study was to explore symptoms experienced by women with PVI, and determine its impact on quality of life and NHS costs.Study Design: Case-control study at a UK University teaching hospital conducted over an eight-month period. Cases were 40 premenopausal women aged 18-49 years with PVI and varicose veins (VV). There were two age-matched controls groups: (i) 40 healthy women with no PVI but with VV, and (ii) 40 healthy women with no PVI and no VV. Subjects were asked to complete a structured questionnaire on disease specific outcomes, health status and use of healthcare resources.Results: Mean age (range) was 39.8 (24-47) years for cases, 39.1 (24-49) for VV controls and 38 (25-49) for healthy controls. Pelvic pain was reported by 38 of 40 (95%) PVI cases, compared with 25 of 40 (62%) VV controls, and 26 of 40 (65%) healthy controls (p=0.001). The median (range) EQ-5D utility score for PVI cases was 0.80 (0.29-1.0) compared with 0.80 (0.09-1.0) for VV controls and 1.0 (0.62-1.0) for healthy controls (p=0.002). Of the 40 PVI cases, 35 (88%) visited a consultant in the previous 12 months compared with 12 of 40 (30%) VV controls, and 14 of 40 (35%) healthy controls (p<0.001).Conclusions: Women with PVI report a greater frequency of pelvic pain with reduced health status and increased use of healthcare resources compared with matched controls. [ABSTRACT FROM AUTHOR]

The article focuses on rehabilitation of people with aphasia. Topics discussed include treating challenges faced by people with aphasia in reading and reporting a preference for texts accompanied with pictures; improving patients quality of life; and use of cognitive screening for examining cognitive deficits.

The article focuses on rehabilitation of people with aphasia. Topics discussed include assessment of language as an integral part of aphasia management; improving patients quality of life; and use of screening measures to determine the nature, severity and personal consequences of the suspected communication deficit.

Background: The influence of skin substitutes upon angiogenesis during wound healing is unclear. Objectives: To compare the angiogenic response in acute cutaneous human wounds treated with autogenic, allogenic and xenogenic skin substitutes to those left to heal by secondary intention. Methods: On day 0, four 5mm full-thickness punch biopsies were harvested from fifty healthy volunteers (sites 1-4). In all cases, site 1 healed by secondary intention (control), site 2 was treated with collagen-GAG scaffold (CG), cadaveric decellularised dermis (DCD) was applied to site 3, whilst excised tissue was re-inserted into site 4 (autograft). Depending on study group allocation, healing tissue from sites 1-4 was excised on day 7, 14, 21 or 28. All specimens were bisected, with half used in histological and immunohistochemical evaluation whilst extracted RNA from the remainder enabled whole genome microarrays and qRT-PCR of highlighted angiogenesis-related genes. All wounds were serially imaged over 6 weeks using laser-doppler imaging and spectrophotometric intracutaneous analysis. Results: Inherent structural differences between skin substitutes influenced the distribution and organisation of capillary networks within regenerating dermis. Haemoglobin flux (p = 0.0035), oxyhaemoglobin concentration (p = 0.0005), and vessel number derived from CD31-based immunohistochemistry (p = 0.046) were significantly greater in DCD wounds at later time points. This correlated with time-matched increases in mRNA expression of membrane-type 6 matrix metalloproteinase (MT6-MMP) (p = 0.021) and prokineticin 2 (PROK2) (p = 0.004). Conclusion: Corroborating evidence from invasive and non-invasive modalities demonstrated that treatment with DCD resulted in increased angiogenesis after wounding. Significantly elevated mRNA expression of pro-angiogenic PROK2 and extracellular matrix protease MT6-MMP seen only in the DCD group may contribute to observed responses. [ABSTRACT FROM AUTHOR]

There is increasing interest of the worldwide kidney community in home hemodialysis (HHD). This is due to emerging evidence of its superiority over conventional hemodialysis (HD), largely attributed to improved outcomes on intensive schedule HD, best deployed in patient's own homes. Despite published work in this area, universal uptake remains limited and reasons are poorly understood. All those who provide HD care were invited to participate in a survey on HHD, initiated to understand the beliefs, attitudes, and practice patterns of providers offering this therapy. The survey was developed and posted on the Nephrology Dialysis Transplantation-Educational (NDT-E) website. Two hundred and seventy-two responses were deemed suitable for complete analysis. It is apparent from the survey that there is great variability in the prevalence of HHD. Physicians have a great deal of interest in this modality, with majority viewing home as being the ideal location for the offer of intensive HD schedules (55%). A significant number (21%) feel intensive HD may be offered even outside the home setting. Those who offer this therapy do not see a financial disadvantage in it. Many units identify lack of appropriately trained personnel (35%) and funding for home adaptation (50.4%) as key barriers to widespread adoption of this therapy. Despite the interest and belief in this therapy among practitioners, HHD therapy is still not within reach of a majority of patients. Modifiable organizational, physician, and patient factors exist, which could potentially redefine the landscape of HHD provision. Well-designed systematic research of national and local barriers is needed to design interventions to help centers facilitate change. [ABSTRACT FROM AUTHOR]

Objective To compare the incidence rates of malignancy among patients with psoriatic arthritis (PsA) and patients with rheumatoid arthritis (RA) in the Consortium of Rheumatology Researchers of North America (CORRONA) registry. Methods We analyzed 2,970 patients with PsA (7,133 patient-years of followup) and 19,260 patients with RA (53,864 patient-years of followup). Using a standardized adjudication process, we identified 40 confirmed malignancies in the patients with PsA and 307 confirmed malignancies in those with RA. Incidence rates were calculated per 100 patient-years. Incidence rate ratios were estimated, with adjustment for age, sex, disease duration, body mass index, disease activity, year of enrollment, and medication use. Results The overall malignancy incidence per 100 patient-years was similar between patients with PsA and patients with RA (0.56 [95% confidence interval (95% CI) 0.40−0.76] and 0.56 [95% CI 0.50−0.63], respectively). Nonmelanoma skin cancer was the most common type of cancer in the overall cohort, with an incidence rate of 0.21 (95% CI 0.12−0.35) in PsA, and 0.20 (95% CI 0.17−0.24) in RA, with a calculated incidence rate ratio of 1.05 (95% CI 0.61−1.80; P = 0.85). Lymphoma rates were similar in PsA and RA (0.04 [95% CI 0.01−0.12] and 0.04 [95% CI 0.02−0.06], respectively; incidence rate ratio 1.00 [95% CI 0.17−3.11]; P = 0.67). The adjusted incidence rate ratio of malignancy in PsA versus RA was 1.17 (95% CI 0.82−1.69; P = 0.37). Conclusion The incidence rates across malignancy subtypes were similar in the PsA and RA cohorts from a US registry. [ABSTRACT FROM AUTHOR]

Aspergillus spp. can lead to allergic bronchopulmonary aspergillosis (ABPA), Aspergillus sensitisation and Aspergillus bronchitis in CF. The relative frequencies of these entities have recently been ascertained in a large UK adult CF cohort. We have used this data to estimate the burden of aspergillosis and ABPA cases in adult CF patients in 30 countries reporting CF. National and international CF registry data was accessed and assessed for completeness and age distribution. Published proportions of ABPA (17.7%), Aspergillus sensitisation (14.6%) and Aspergillus bronchitis (30%) in CF were applied to those >18 years and compared with notified ABPA cases. Of the 76,201 estimated CF patients worldwide (not including India), 37,714 were >18 years. The proportion of adults to children varied from 63% in Norway to 20% in Brazil. ABPA caseload in adults is anticipated to be 6,675 cases of which only 2,221 cases (33%) are currently recorded, indicating substantial underdiagnosis. The ABPA diagnosis rate compared with estimated rates varies by country from 101% (France) to 14.5% (Greece), although genetic variation could account for genuine differences compared with the UK. Aspergillus bronchitis is not currently recognised or recorded in CF registries but there are an anticipated 10,988 adult cases. Aspergillus sensitisation, associated with increased bronchiectasis and reduced FEV1, affects an anticipated 5,506 patients without ABPA or Aspergillus bronchitis. Together ABPA and Aspergillus bronchitis are estimated to affect 17,989 adults, 47.7% of the adult CF population. ABPA also occurs in children and teenagers and 984 cases were documented in registries. Diagnosed ABPA rates by age were available for the ECFS registry, USA, UK, Ireland, Belgium and Netherlands. The rate was <1% under 4 years, and increased throughout childhood and adolescence, with marked variation between countries. Newly published diagnostic criteria and methods should facilitate better recognition of aspergillosis in CF, allowing better CF disease control. [ABSTRACT FROM AUTHOR]

Mainstream superhero comics, such asBatman, SupermanandSpider-Man, rarely ask their predominantly male readers the question: ‘What is our role as men in the everyday world?’ By overlooking this question, such typical superhero comics struggle with exploring the ‘normal, average’ roles of ordinary men: husband, father, son, worker, lover. Rather, superhero comics most often explore men in the public, political realm, creating narratives about the political climate of the times. Such superhero narratives build on literary traditions and exemplify political or world situations rather than personal ones. Stuck in their colourful uniform tights, mainstream male superheroes have little latitude to break from the one-dimensional personal expectations of the public world. This historical precedence and continuing characterization of superheroes is limiting for comic readers of all ages. Removing such essentialist gender criteria offers a liberating effect for superheroes stuck in their quick-change costumes. Social and cultural constructivist theory criteria allow examination of narratives revolving around possible applications of personal elements of these characters’ lives and explore the public centric roles normally associated with male superheroes. [ABSTRACT FROM PUBLISHER]

Background: Reading comprehension difficulties are a common feature of aphasia, affecting the understanding of single words, sentences, paragraphs and extended text. Whilst there have been studies investigating treatment for single word reading, there are a limited number of studies of treatment methods targeting the reading of paragraphs and connected text. Aims: This paper will describe a series of single case studies, each investigating the effectiveness of a different therapy approach for paragraph level reading comprehension. The studies raise a number of issues regarding the assessment of reading, choice of therapy and measurement of outcome; these will be discussed in relation to the studies and the wider evidence base. Methods & Procedures: Four people with aphasia were involved in the studies. Participants presented with reading difficulties alongside other language difficulties. Each study involved a single case study, multiple baseline with control task design. Detailed assessment of reading comprehension was completed pre-therapy, post-therapy and at follow-up, approximately 2–4 weeks post-therapy. Participants were also asked about their pre-morbid reading abilities and preferences, their reading difficulties and their views about therapy and its impact. Outcomes & Results: All participants showed some improvement in the accuracy of reading comprehension but there was extensive variability in the significance of gains, when gains were seen and on which assessments. Post-therapy, three of the four participants read the assessment passages and answered the questions more quickly. All participants reported some positive change in their reading, either in reading ability, reading behaviour or feelings about reading, but again individual variation was evident in the extent and type of change perceived. Conclusions: These studies raise a number of important issues regarding the assessment of reading, therapy choice and measuring the outcome of therapy. These issues are discussed in relation to current literature, with an aim of informing future research investigating the assessment of, and therapy for, reading comprehension difficulties in people with aphasia. Reading is fundamental to everyday activities and developing the evidence base is of crucial importance in supporting people with aphasia to maximise their reading ability. [ABSTRACT FROM AUTHOR]

Background: While evidence on the use of semantic therapy to improve word retrieval has increased (Whitworth, Webster, & Howard, 2005), the impact of semantic therapy on comprehension itself has not been studied in depth. This paper reports on a specific semantic therapy, which aims to improve access to semantic information. Data from two participants, JAC and AD, are presented. Aims: The study aimed to examine the effectiveness of a specific semantic therapy on comprehension of treated and untreated items, and on related tasks, thereby examining generalisation of any improvement to both items and tasks involving semantic processing. Methods & Procedures: The participants' comprehension was assessed in detail prior to therapy. Measures were repeated over time to ensure any improvement seen could not be due to more general recovery mechanisms. The two participants then took part in therapy which aimed to improve their comprehension, using a picture name verification task. Following therapy, relevant assessments were repeated to examine the effects of therapy. The study uses single case methodology with comparison across two similar cases. Outcomes & Results: JAC and AD responded differently to the semantic therapy; JAC's auditory comprehension performance improved and this was regardless of whether items had been treated or not. In contrast, despite having a broadly similar profile of language ability, AD's performance did not change. Potential reasons for this are explored within the paper. Conclusions: This paper provides a much needed demonstration of semantic therapy for comprehension problems. One specific therapy is tested, rather than the combined therapies used in the existing literature. It considers the extent to which therapy generalises to untreated words. It is clear that further research is needed regarding finer differential diagnosis, and ultimately, the impact of therapy on everyday comprehension for these individuals. [ABSTRACT FROM AUTHOR]

Systemic Lupus Erythematosus (SLE) typically affects females at far greater rates than males; however male SLE patients often have more severe disease than females. The gender disparities have been reported in clinical manifestations and in serological and hematological indices as well. In particular, SLE complicated with nephritis is more frequent in men than women, and several groups identified male gender as a risk factor for progression to renal failure. The specific differences in pathogenesis amongst genders have yet to be conclusively defined, though genetic, hormonal, and immune responses have been analyzed thus far. Further research is warranted to further elucidate these differences and permit the development of gender-tailored treatment regimens. [ABSTRACT FROM AUTHOR]

Background: For some people with aphasia, returning to work will be their eventual goal. While there are reports in the literature of incidence of return to work, and general discussion of success, there are few documented in depth studies of what this might entail for the individual with aphasia. Aims: This paper explores returning to work with aphasia, and examines the complex relationship between the person, the aphasia and the demands of employment. Methods & Procedures: This is a detailed case report, describing and reflecting on the experiences of GD, who returned to work following his stroke and aphasia. Therapy focused specifically on work requirements is described and the factors affecting GD's return to work explored. An interview was used to elicit GD's reflections on his experiences. Outcome & Results: GD's language skills improved over time and with therapy, and he developed several strategies that facilitated his communication. He was able to return to work (part-time) in a modified role and this was successful initially. After an extended period (∼19 months) his employment was terminated and GD explored other options. He moved on to a volunteering and charity trustee role. Conclusions: The success (or not) of returning to work with aphasia is multi-faceted and does not rest solely with the person with aphasia. The nature of the work may have a strong bearing on success, as will the ability and willingness of the employer to engage in the process. Partnership with the person and constant review of goals and management is of overwhelming importance. We need to consider what 'success' may mean in this context and the need to consider therapeutic and rehabilitation needs over a longer time frame. [ABSTRACT FROM AUTHOR]

Background: For the purposes of our research programme we needed a simple, reliable and validated method for allowing choice of a color in response to a series of questions. On reviewing the literature no such instrument was available and this study aimed to rectify this situation. This was achieved by developing a simple method of presenting a series of colors to people validating it in healthy volunteers and in individuals where color choice might be distorted, namely anxiety and depression. Methods: A series of different presentations of four shades of eight colors and grey, as well as black and white were evaluated. 'Mood', 'favourite' and 'drawn to' colors were assessed in 105 healthy, 108 anxious and 110 depressed participants. The positive neutral or negative attribution of these colors was recorded in a further 204 healthy volunteers. Results: The circular presentation of colors was most favoured (Color Wheel). Yellow was the most 'drawn to' color and blue the commonest 'favourite' color in all subjects. Yellow was most often associated with a normal mood and grey with an anxious or depressed mood. Different shades of the same color had completely different positive or negative connotations. Reproducibility was exceptionally high when color choice was recorded in positive, neutral or negative terms. Conclusions: The Color Wheel could be used to assess health status, mood or even treatment outcome in a variety of clinical situations. It may also have utility in circumstances where verbal communication may not be optimal, such as with children. [ABSTRACT FROM AUTHOR]

We report new geochemical data for marine sediments sampled in the frontal prism associated with the Costa Rica subduction zone during Leg 205 of the Ocean Drilling Program (ODP). We describe variation in sediment geochemistry with depth as the décollement zone, the interface between overriding and downgoing tectonic plates, is approached. This variation can be explained by three-component mixing of ash, lower plate sediments (LPS), and frontal prism or upper plate sediments (UPS). We detect in-mixing of LPS in localized sediment intervals, amounting to tens of vertical meters of LPS incorporation; no persuasive evidence of LPS transfer into the prism has been shown until this contribution. This inference of fi ne structure in the prism provides new insight into how tectonic kneading of sediments occurs in décollement zones. [ABSTRACT FROM AUTHOR]

Objectives To follow a population of preschool children with and without parent reported wheeze over a period of 6-11 years to determine prognosis and its important predictive factors. Design Longitudinal series of five postal surveys based on the international study of asthma and allergies in childhood questionnaire carried out between 1993 and 2004. Setting Two general practice populations, south Manchester. Participants 628 children aged less than 5 years at recruitment and those with at least six years' follow-up data. Main outcome measures Parent completed questionnaire data for respiratory symptoms and associated features. Results Of 628 children included in the study, 201 (32%) had parent reported wheeze at the first observation (baseline), of whom 27% also reported the symptom on the second occasion (persistent asthma). The only important baseline predictors of persistent asthma were exercise induced wheeze (odds ratio 3.94, 95% confidence interval 1.72 to 9.00) and a history of atopic disorders (4.44,1.94 to 10.13). The presence of both predictors indicated a likelihood of 53.2% of developing asthma; if only one feature was present this decreased to 17.2%, whereas if neither was present the likelihood was 10.9%. Family history of asthma was not predictive of persistent asthma among children with preschool wheeze. Conclusion Using two simple predictive factors (baseline parent reported exercise induced wheeze and a history of atopic disorders), it is possible to estimate the likelihood of future asthma in children presenting with preschool wheeze. The absence of baseline exercise induced wheeze and a history of atopic disorders reduces the likelihood of subsequent asthma by a factor of five. [ABSTRACT FROM AUTHOR]

Background & objectives: Though number of studies have examined the prevalence of depression at different phases of the schizophrenic illness, the precise nature of depressive symptoms present in different phases of the schizophrenic illness remains unclear. We therefore undertook this study to characterize and compare the profile of depressive symptoms in acute and chronic schizophrenia with those in major depression. Methods: Three groups of patients with (i)an acute schizophrenic episode, (ii) stable schizophrenia and (iii) primary major depression, were compared on demographic variables and on clinical rating scales for depression and the positive and negative syndrome scale (PANSS). Results: The clinical depression seen in acute schizophrenia and primary depression differed significantly from that seen in chronic schizophrenia. This was confirmed by factor analysis which showed that selective subsets of symptoms were more likely to differentiate the three groups clinically. Further, the depression in chronic schizophrenia was less likely to be associated with life events and was best detected by using the Beck depression inventory (BDI). Interpretation & conclusions: Careful analysis of depressive symptoms can differentiate between the three groups - this would also imply that the underlying pathogenetic mechanism for depression in the groups may be different. Our findings support the use of the BDI to identify depressive symptoms in chronic schizophrenia so that appropriate early intervention can be targeted. [ABSTRACT FROM AUTHOR]

The Florida Fish and Wildlife Conservation Commission manages over 650,000 ha, including 26 wildlife management and environmental areas. To improve management, they developed an objective-based vegetation management (OBVM) process that focuses on desired conditions of plant communities through an adaptive management framework. Our goals were to understand potential barriers to implementing OBVM and to recommend strategies to overcome barriers. A literature review identified 47 potential barriers in six categories to implementation of adaptive and ecosystem management: logistical, communication, attitudinal, institutional, conceptual, and educational. We explored these barriers through a bureau-wide survey of 90 staff involved in OBVM and personal interviews with area managers, scientists, and administrators. The survey incorporated an organizational culture assessment instrument to gauge how institutional factors might influence OBVM implementation. The survey response rate was 69%. Logistics and communications were the greatest barriers to implementing OBVM. Respondents perceived that the agency had inadequate resources for implementing OBVM and provided inadequate information. About one-third of the respondents believed OBVM would decrease their job flexibility and perceived greater institutional barriers to the approach. The 43% of respondents who believed they would have more responsibility under OBVM also had greater attitudinal barriers. A similar percentage of respondents reported OBVM would not give enough priority to wildlife. Staff believed that current agency culture was hierarchical but preferred a culture that would provide more flexibility for adaptive management and would foster learning from land management activities. In light of the barriers to OBVM, we recommend the following: (1) mitigation of logistical barriers by addressing real and perceived constraints of staff, funds, and other resources in a participatory manner; (2) mitigation of communication barriers through interpersonal and electronic communication channels; (3) development of an OBVM external advisory committee; and (4) adoption of characteristics of an organizational culture that promotes flexibility and learning. [ABSTRACT FROM AUTHOR]

Abstract: Analyses of individuals classically treated as Juniperus oxycedrus L. var. oxycedrus from Morocco, Portugal, Spain, France, Italy, Greece and Turkey, using DNA sequencing of nrDNA (ITS 1, 5.8S, ITS 2) plus RAPDs, leaf terpenoids and morphology revealed that two cryptic, genetically distinct but morphologically almost identical species are present. These species, J. oxycedrus L. var. oxycedrus and Juniperus deltoides R.P. Adams, are about as different from each other as Juniperus navicularis and Juniperus macrocarpa are from J. oxycedrus var. oxycedrus. Examination of herbarium specimens revealed that the two species are largely allopatric with J. deltoides occurring from Italy eastward through Turkey into the Caucasus Mts. and Iran. J. oxycedrus var. oxycedrus appears to be largely concentrated west of Italy (France, Spain, Portugal, Morocco). Cryptic speciation is discussed. [Copyright &y& Elsevier]

Background: Verb retrieval and sentence production difficulties are both common features of aphasia. Previous treatment studies have focused predominantly on verb retrieval and the mapping of semantic and syntactic structure. There have been more limited investigations of the production of the predicate argument structure (PAS). Aims: This study aimed to evaluate the outcome of intensive therapy for a client with aphasia. NS had multiple and interacting difficulties that resulted in problems in producing sentences. Therapy aimed to improve his sentence production by: (a) improving the retrieval of verbs, (b) increasing his awareness of the relationship between nouns and verbs, and (c) improving his production of one-, two-, and three-argument structures. The therapy thus targeted access to PAS information and PAS production as well as verb retrieval. Methods & Procedures: A period of intensive therapy, based around a set of 48 self-selected verbs, was preceded and followed by detailed assessment of NS's single word and sentence production and comprehension. Outcomes & Results: Therapy resulted in a significant improvement in NS's retrieval of the verbs involved in treatment but no generalisation to other verbs. His production of sentences showed more widespread changes. He produced more nouns within sentences, omitted fewer obligatory arguments, and produced a greater variety of argument structures in connected speech. Conclusions: Therapy resulted in a greater awareness of the need for a verb within a sentence and a strategy for producing the argument structure frame around that verb. Improved sentence production was therefore seen, although verb retrieval difficulties were still evident. The study replicates previous research that verb and sentence production difficulties can be treated effectively in people with aphasia. The effects of therapy on sentence production in constrained tasks and narrative speech are discussed. [ABSTRACT FROM AUTHOR]

Human embryonic stem (ES) cells can be induced to differentiate into hematopoietic lineages either by stromal cell coculture or by formation of embryoid bodies (EBs). Here, we better characterize cell-bound and secreted factors that support this hematopoietic development.Human ES cells either cocultured on the mouse bone marrow cell line S17, or allowed to form EBs, were induced to differentiate in the presence of serum, serum-free conditions, and serum-free media supplemented with defined cytokines. To better characterize the requirement for stromal cell–bound or secreted proteins, S17 conditioned media and transwell cultures were also utilized.In both models, CD34+, CD45+, and hematopoietic colony-forming cells (CFCs) were routinely derived. While hematopoietic development was diminished without serum, here we demonstrate with the stromal cell coculture model that addition of the growth factors stem cell factor (SCF), thrombopoietin (TPO), and Flt-3 ligand (Flt3L) to serum-free media does allow isolation of hematopoietic progenitors. However, these same three growth factors added to serum-free media do not support significant hematopoiesis in the EB system. However, addition of the mesoderm-inducing factors bone morphogenic protein-4 and vascular endothelial growth factor to EBs grown in serum-free media plus SCF, TPO, and Flt-3L does improve hematopoietic development.These results demonstrate the utility of human ES cell to evaluate specific stimuli that regulate cell fate decisions and the survival of specific lineages. Moreover, the method used to promote differentiation of ES cells may alter the cytokines or growth factors required to isolate specific cell types. [Copyright &y& Elsevier]

The authors examined associations among parental and child adjustment, child syncope, somatic, and school problems. Participants were children (N = 56) ages 7-18 years with syncope. Measures included syncope severity, parental distress, and children's internalizing symptoms. For children diagnosed negative for neurocardiogenic syncope (NCS), their fathers' and their own psychological symptoms were positively associated with the severity of syncope, whereas their mothers' functioning was negatively associated with the severity of syncope. Also, for the negative NCS group, fathers' psychological functioning was associated with children's nonsyncope somatic complaints but not with their school problems. For the positive NCS group, few significant father-child associations were found, but several significant positive associations were revealed between mothers' psychological symptoms and their children's syncope as well as somatic and school problems. [ABSTRACT FROM AUTHOR]

Blk57/B6 mice were infected with LD90 dose of Sterne strain anthrax spores subcutaneously and then treated with doxycycline. Doxycycline at a dose of 1.5 mg/kg, by intra-peritoneal injection, protected mice from death when given at the same time as spores. When doxycycline administration was delayed 4 h survival is 90%. Delay of 24 h increased survival time but had no impact on eventual mortality. When doxycycline was delayed 48 h, mortality and time to death were comparable to sham injection. Peritoneal macrophages harvested from Blk57/B6 mice were examined for response to anthrax lethal toxin and are shown to be deficient in their ability to produce TNF-α and have increased expression of IL-6 compared to RAW 264.7 murine macrophage cell line. These findings suggest that antibiotic therapy has limited effects following lethal anthrax spore challenge, even when the host is of a phenotype that does not produce TNF-α in response to anthrax lethal toxin exposure. [Copyright &y& Elsevier]

Based on North American evidence that multi-component drugs prevention programmes have an impact on reducing young people's drug taking, the Integrated Programme (IP) was designed and delivered to adolescents in northern England during 1998-1999. The IP was evaluated by comparing the attitudes and drug-taking behaviour of nearly 2000 young people before and after programme delivery. Action sites (which received the IP) and comparison sites (which did not) were randomly allocated once baseline survey measurements had been taken. Controlling for key variables multiple logistic regression was used to measure the odds ratio of drug taking on 20 measures for young people in both action and comparison sites based on a follow-up survey. The results suggested that young people who received the IP were more likely to reduce harder drug use and maintain a softer drug-taking repertoire than those in the comparison sites. However, these 'gains' were small and inconsistent and the IP had no impact on reducing initiation/first trying rates. The results were thus only indicative that such programmes might be effective in the UK context. [ABSTRACT FROM AUTHOR]

Studies the association between parental variables and child syncope. Tilt-table testing for neurocardiogenic syncope; Definition of syncope; Psychological factors affecting syncope; Biobehavioral symptoms of physical disorders.

This study examined whether minority-status stresses and acculturative stresses increase the risk of psychological maladjustment of Latino students at a university where Latinos constitute the largest ethnic group. Participants were 338 Latino (228 Mexican American, 110 Central American) college students who responded to a mailed survey. The results of 2 separate hierarchical regression analyses of psychological distress and well-being, controlling for demographic (gender, socioeconomic status, and ethnicity), sociocultural (level of acculturation), college role (generic college stresses), and personal (academic self-confidence) influences provided partial support for our hypothesis and demonstrated the incremental predictive validity of acculturative stresses, but not of minority-status stresses. Results are discussed in terms of the variety of stresses that Latino college students are likely to experience. [ABSTRACT FROM AUTHOR]

Investigates the differences in child adjustment and family functioning in children with and without leukemia. Relationship between familial and adjustment factors; Comparison between the families of healthy children and children with leukemia; Implications of the findings for the family system approach in pediatric psychology.

Americans profess a great love for their companion animals, and, indeed, their expenditures on food and other products for their dogs and cats would seem to confirm this. However, each year, many millions of dogs and cats are brought to animal shelters, where the majority are euthanized. Our inability to provide reasonably valid statistics related to this concern makes it difficult to offer a credible presentation on the need for a concerted effort to deal with the issue, design initiatives to ameliorate the problem, or evaluate progress and performance of these efforts. In this article we review some of the past efforts to document the scale of the "pet overpopulation" problem. We reexamine long-term shelter statistics from a single shelter system and present new data that reflect a recent cooperative effort to understand the origins and disposition of dogs and cats received by animal shelters. [ABSTRACT FROM AUTHOR]

Describes the techniques of obtaining confidence intervals for estimates of relative risk in Great Britain. Effect of sampling variation on the precision of the estimated statistics; Construction of confidence intervals by a logarithmic transformation; Calculation of odd ratios and confidence intervals.