Motivation and learning in medieval writings.

Quotations from writings during medieval times (the span in the Western World from 400 to 1400 A.D.) provide discussions and examples of conditioning or substitute stimulation, compensation, rationalization, projection, learning problems, individual differences, and "the importance of the formative years and of the significance of childhood impressions in the formation of attitudes and resultant behavior." However, "there does not seem to be much that is cumulative, no temporal development or drift, in behavioral knowledge." But "one can grant to many medieval persons rich insights into the behavior of their fellows." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Variations in the screening history and appropriateness of management of cervical cancer in South East England

In seven health districts in southern England, an audit of the management of cervical cancer compared with regionally developed guidelines was undertaken between 1988 and 1991. Four hundred and sixty-nine regional residents were treated in the study district hospitals. 73 (15.6%) women were appropriately staged, with increasing likelihood of appropriate staging investigations observed with higher stages (P < 0.0001) and type of hospital [Teaching 23 (21%), Non-Teaching with oncology support 11 (11.5%), Non-teaching 4 (7%), P < 0.0001] but with no change over the study period. There was no significant trend in the proportion of women treated appropriately over time, with 270 (59%) being appropriately treated, 91 (20%) under-treated and 98 (21%) over-treated overall. Appropriateness of treatment increased with higher stages (P < 0.0001) and hospital workload for cancer of the cervix (P = 0.038). Multivariable analysis indicated that survival independently and significantly decreased with age and stage, under-treatment and in cases where lymph nodes were involved or not examined. There was no change in the appropriateness of management over the 4 years, with high levels of inappropriate care. Survival was not only influenced by biological and demographic factors, but by inappropriate care.     

Paracetamol poisoning in the north east of England: presentation, early management and outcome

1. Paracetamol is increasingly involved in self-poisoning in the United Kingdom and remains a common cause of fatal poisoning. 2. To document the epidemiology and early management of paracetamol poisoning data were collected on consecutive patients with suspected paracetamol poisoning presenting to 6 hospitals in the North East of England over 12 weeks in 1994. 3. There were 400 presentations (attendance rate 1.14/10(3) population/yr) involving 343 persons (45% male). Paracetamol concentrations at 4 h correlated weakly with reported paracetamol dose (R = 0.49, P < 0.0001) and were similar comparing those treated and not treated by gastric decontamination. 4. In 38 (9%) cases paracetamol concentrations were above the appropriate nomogram treatment line, including 3% and 20% of patients who reported ingesting less than and more than 12 g respectively. In 21 patients acetylcysteine treatment was deferred until admission to the ward, the mean delay involved was 2.8 h. 5. One patient died, from arrhythmias caused by co-ingested dothiepin. 6. Paracetamol poisoning is common. Most cases do not have potentially toxic plasma paracetamol concentrations, but those who do often present late and antidotal treatment may be delayed inappropriately.     

Tooth diseases in the medieval population of Gracanica near Valjevo

The analyses of the pattern of dental disease in the Late Medieval Serbian population from cemetery excavations in the archaeological site Grachanica were based on the study of tooth wear, ante-mortem tooth loss, caries, hypoplasia, alveolar resorption, abscesses and calculus. The total sample of all available skeletons with almost complete permanent dentition numbers 45 individuals. Dental sample comprises 178 maxillary teeth and 337 mandibular teeth. The presence of dental caries was scored taking into consideration the size of the lesion (four degrees) and its position on the tooth. The degree of tooth wear was graded into one of four categories: atrition of enamel only; atrition involving dentin; atrition up to the level of fissure at the occlusal surface of the molar teeth, and exposure of the pulp chamber. The cystic defects within the alveolar bone were recorded according to their aetiology, size and position. Radiographic study had not been done in order to detect periapical destruction, so the presence of such destruction was recognizable in advanced stages associated with the appearance of fistula penetrating the compact alveolar bone usually at the buccal side. The condition of the alveolar crest resorption, as the evidence of periodontal disease, was graded into three categories, and the distance from the cemento-enamel junction to the alveolar crest was measured. The analysis of dental pathology profile consisted of the two reporting methods: individual count method (prevalence of disease based on the number of individuals affected) and tooth count method (distribution of lesions frequency on tooth type and class). The Grachanica dentition exhibits a dental pathology profile typical of agricultural medieval populations in this region. Tooth wear was the most frequent, affecting 95% of individuals. Dental caries and ante-mortem teeth loss exhibit also high frequency (51% and 69%). Dental pains of low prevalence include abscesses (13%) and enamel hypoplasia (20%). In the material examined, the carious process was responsible for pulp exposure to infection in all cases of abscess formation. The results obtained suggest that food processing technology and nature of diet allowed use of abrasive in the food and that oral hygiene was at the low level. On the other hand, there were not a lot of people who were subjected to stress-induced growth disruptures. The findings reported here contribute to understand how dietary change and life conditions are related to the changing patterns of dental diseases in medieval populations.     

Relationships between the presence of Johne's disease and farm and management factors in dairy cattle in England

The data collected by a postal questionnaire sent to 3772 randomly selected dairy farmers in England and the border regions in Wales were used to estimate the relationships between the presence of clinical Johne's disease and farm and management factors associated with that disease. Two binary outcomes (case reported in 1993, case reported in 1994) and 27 predictor variables were considered. Only two variables were consistently and significantly associated with clinical disease in multivariable analysis. Farms on which Channel Island breeds were predominant were associated with an increased risk of reporting disease (odds ratios (ORs) ranged from 10.9 to 12.9). The presence of farmed deer on the farm also increased the risk of reporting disease (ORs ranged from 15.2 to 209.3). There were other significant but inconsistent associations involving the source of replacements, age of first-offering hay, type of concentrate feed to calves, and calving in individual pens when the cows were at grass. Since Johne's disease is predominantly subclinical, these contributing factors may play important roles in switching subclinical infection to overt disease.     

Achievement testing in England.

Describes testing and grading practices in English schools. Objective tests have seldom been used, but consideration is now being given to the use of objective O-level tests for 16-yr-old students because of the unreliability of subjective examinations and the economy and efficiency of machine-scored tests. (0 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Four different ways of philanthropic aid to the blind in medieval eastern Christendom

The care of the blind, either as medical treatment or as divine therapy, has probably been the most ancient form of help for ill people. However, it was during the Byzantine Empire (325-1453 AD) that the state organized a 'blindness relief' plan as part of a widespread public health system. Our sources for the subject include medical writings, state decrees, Saint's 'vitae' and representations of relevant works of art. Based on the above data we classify the health care for the blind in Byzantium as: (a) support of ophthalmological education as evidenced by an abundance of medical writings on the subject; (b) establishment of charitable institutions exclusively or partially for the blind, where there was not only medical care but also provision for a wide range of social aid - the most advanced being specially trained escorts for each blind person; and (c) support by the state of an extended chain of religious institutions where miraculous help for the blind was promised. We conclude that the public health policy in Byzantium made adequate and very early provision for the blind.     

BRCA1 mutations in southern England

If genetic testing for breast and ovarian cancer predisposition is to become available within a public health care system there needs to be a rational and cost-effective approach to mutation analysis. We have screened for BRCA1 mutations in 230 women with breast cancer, all from the Wessex region of southern England, in order to establish the parameters on which to base a cost-effective regional mutation analysis strategy. Truncating mutations were detected in 10/155 (6.5%) consecutive cases selected only for diagnosis under the age of 40 (nine of these ten women had a strong family history of breast or ovarian cancer), 3/61 (4.9%) bilateral-breast cancer cases (all three mutations occurring among women for whom the first cancer was diagnosed under 40 years) and 8/30 (26.6%) breast cancer cases presenting to the genetics clinic (for whom a strong family history of breast and/or ovarian cancer was present). Ten different mutations were detected in 17 families, but three of these accounted for 10/17 (59%) of the families. The cost of screening the population for mutations in the entire BRCA1 gene is unacceptably high. However, the cost of screening a carefully selected patient cohort is low, the risk of misinterpretation much less and the potential clinical benefits clearer.     

Multivariate analyses of elemental hair concentrations from a medieval Nubian population

We review the etiologic agents, epidemiology, pathogenesis, pathology, clinical manifestations, and imaging features of several unusual intracranial infections that have not been discussed elsewhere in this issue. The central nervous system (CNS) infections discussed are Creutzfeldt-Jakob disease (CrJaD), neurosyphilis, primary amebic meningoencephalitis (PAM), granulomatous amebic encephalitis (GAE), cerebral amebiasis, and cerebral hydatid disease.     

Respiratory syncytial virus infection in north-east England

During a period covering four winter epidemics 987 respiratory syncytial (RS) virus infections were identified in the children's wards that served a total population of about 875 000 in north-east England. The incidence of admission to hospital with RS virus infection tended to be twice as high among children in Tyneside as that among children from the rest of the catchment area. The risk of hospital admission with RS virus infection in the first year of life for city children was about 1 in 50. The risk tended to be increased when there was a high proportion of children in the population, overcrowded housing, and unemployment. There was no clear relation between climatic changes and the onset or progress of epidemics. Thirteen deaths associated with RS virus infection were identified, four of them sudden and unexpected at home, and nine of them in children with congenital or acquired abnormalities. Twelve children were admitted twice with distinct RS virus infections; the relative severity of their two illnesses depended on age. Hospital cross-infection accounted for 60 of the 987 illnesses. Large families and overcrowding among poorer families seem to lead to a higher incidence of RS virus infection, and measures to reduce overcrowding and improve housing should help to reduce the spread of infection. Breast-feeding also protects infants from infection, but further information is needed to pinpoint the infants at greater risk and how they may best be protected.