Effectiveness of αagonists for sedation in paediatric critical care: study protocol for a retrospective cohort observational study.

Introduction: Mechanically ventilated children in paediatric intensive care units are commonly administered analgesics and sedative agents to minimise pain and distress and facilitate cooperation with medical interventions. Opioids and benzodiazepines are the most common analgesic and sedative agents but have safety concerns. The α agonists clonidine and dexmedetomidine are alternative sedatives in use despite neither having robust evidence to support their use.

Speech prosody perception in cochlear implant users with and without residual hearing.

Objectives: The detection of fundamental frequency (F0) variations plays a prominent role in the perception of intonation. Cochlear implant (CI) users with residual hearing might have access to these F0 cues. The objective was to study if and how residual hearing facilitates speech prosody perception in CI users.

Brain prediction of auditory emphasis by facial expressions during audiovisual continuous speech.

The visual cues involved in auditory speech processing are not restricted to information from lip movements but also include head or chin gestures and facial expressions such as eyebrow movements. The fact that visual gestures precede the auditory signal implicates that visual information may influence the auditory activity. As visual stimuli are very close in time to the auditory information for audiovisual syllables, the cortical response to them usually overlaps with that for the auditory stimulation; the neural dynamics underlying the visual facilitation for continuous speech therefore remain unclear.

Global and local pitch perception in children with developmental dyslexia.

This study investigated global versus local pitch pattern perception in children with dyslexia aged between 8 and 11 years. Children listened to two consecutive 4-tone pitch sequences while performing a same/different task. On the different trials, sequences either preserved the contour (local condition) or they violated the contour (global condition).

Cross-modal facilitation in speech prosody.

Speech prosody has traditionally been considered solely in terms of its auditory features, yet correlated visual features exist, such as head and eyebrow movements. This study investigated the extent to which visual prosodic features are able to affect the perception of the auditory features. Participants were presented with videos of a speaker pronouncing two words, with visual features of emphasis on one of these words.

Congenital amusia: a short-term memory deficit for non-verbal, but not verbal sounds.

Congenital amusia refers to a lifelong disorder of music processing and is linked to pitch-processing deficits. The present study investigated congenital amusics' short-term memory for tones, musical timbres and words. Sequences of five events (tones, timbres or words) were presented in pairs and participants had to indicate whether the sequences were the same or different.

The neural bases underlying pitch processing difficulties.

Normal listeners are often surprisingly poor at processing pitch changes. The neural bases of this difficulty were explored using magnetoencephalography (MEG) by comparing participants who obtained poor thresholds on a pitch-direction task with those who obtained good thresholds. Source-space projected data revealed that during an active listening task, the poor threshold group displayed greater activity in the left auditory cortical region when determining the direction of small pitch glides, whereas there was no difference in the good threshold group.

fMRI evidence for a cortical hierarchy of pitch pattern processing.

Pitch patterns, such as melodies, consist of two levels of structure: a global level, comprising the pattern of ups and downs, or contour; and a local level, comprising the precise intervals that make up this contour. An influential neuropsychological model suggests that these two levels of processing are hierarchically linked, with processing of the global structure occurring within the right hemisphere in advance of local processing within the left. However, the predictions of this model and its anatomical basis have not been tested in neurologically normal individuals.

Rhythm deficits in 'tone deafness'.

It is commonly observed that 'tone deaf' individuals are unable to hear the beat of a tune, yet deficits on simple timing tests have not been found. In this study, we investigated rhythm processing in nine individuals with congenital amusia ('tone deafness') and nine controls. Participants were presented with pairs of 5-note sequences, and were required to detect the presence of a lengthened interval.

The right measure.

Obesity has been calculated traditionally by body mass index, but measuring waist circumference might be a more accurate way of identifying people at risk of cardiovascular disease. Excess visceral fat predisposes to several diseases, including diabetes and cardiovascular disease. The total cost to the NHS of obesity in 2001 was pounds sterling 2.

Musically tone-deaf individuals have difficulty discriminating intonation contours extracted from speech.

Musically tone-deaf individuals have psychophysical deficits in detecting pitch changes, yet their discrimination of intonation contours in speech appears to be normal. One hypothesis for this dissociation is that intonation contours use coarse pitch contrasts which exceed the pitch-change detection thresholds of tone-deaf individuals (). We test this idea by presenting intonation contours for discrimination, both in the context of the original sentences in which they occur and in a "pure" form dissociated from any phonetic context.

Coronary heart disease: risk factor management.

Coronary heart disease is the leading cause of mortality and morbidity in the UK. Nurses have a pivotal role in the management of high-risk patients and the modification of risk factors.

Actions to identify and reduce the risk of atherothrombosis in susceptible patients.

The recognition that coronary heart disease, stroke and peripheral vascular disease have a common origin in atherothrombosis is helping at-risk patients to be identified and helped. This paper looks at primary and secondary prevention strategies and describes an initiative to document the health status and treatment of all those at risk.

Characterization of deficits in pitch perception underlying 'tone deafness'.

Congenital amusia is a disorder characterized by life-long, selective deficits in the perception of music. This study examined pitch-perception abilities in a group of 10 adults with this disorder. Tests were administered that assessed fine-grained pitch perception by determining thresholds both for the detection of continuous and segmented pitch changes, and for the recognition of pitch direction.

Training improves acoustic pattern perception.

Pitch changes that occur in speech and melodies can be described in terms of contour patterns of rises and falls in pitch and the actual pitches at each point in time. This study investigates whether training can improve the perception of these different features. One group of ten adults trained on a pitch-contour discrimination task, a second group trained on an actual-pitch discrimination task, and a third group trained on a contour comparison task between pitch sequences and their visual analogs.

CHD prevention: the importance of identifying dyslipidaemia.

Coronary heart disease (CHD) is the major cause of death worldwide (Murray and Lopez, 1997) and confers a significant socio-economic burden on all populations. The careful identification and optimal treatment of all individuals at risk of CHD is necessary for significant reductions in morbidity and mortality to be realized. This strategy demands an integrated approach by healthcare teams, with nurses playing a significant role at all stages of patient care.

Absence of auditory 'global interference' in autism.

There has been considerable recent interest in the cognitive style of individuals with Autism Spectrum Disorder (ASD). One theory, that of weak central coherence, concerns an inability to combine stimulus details into a coherent whole. Here we test this theory in the case of sound patterns, using a new definition of the details (local structure) and the coherent whole (global structure).

Effects of attention and unilateral neglect on auditory stream segregation.

Two pairs of experiments studied the effects of attention and of unilateral neglect on auditory streaming. The first pair showed that the build up of auditory streaming in normal participants is greatly reduced or absent when they attend to a competing task in the contralateral ear. It was concluded that the effective build up of streaming depends on attention.

Atherogenic lipoprotein phenotype in type 2 diabetes: reversal with micronised fenofibrate.

Background: To assess the short-term effects of a micronised formulation of fenofibrate on lipids, lipoproteins and their composition, reflecting an atherogenic lipoprotein phenotype (ALP), in patients with stable Type 2 diabetes.

Methods: Thirty-two (18 male, 14 female) patients with Type 2 diabetes were randomised to a double-blind, placebo-controlled parallel group study after a 4-week diet run-in phase to a 12-week treatment period with either daily micronised fenofibrate 200 mg (Lipantil Micro((R))) or placebo.

Results: Baseline mean lipid and lipoproteins were similar in both groups: total cholesterol (TC) 7.

Hyperlipidaemia.

This article discusses the etiology of hyperlipidemia and methods of diagnosis and treatment, associating this with the risk of coronary heart disease, so that nurses will develop their understanding and advise patients appropriately.

Fat arms, obesity and choice of blood pressure cuff size in diabetic patients.

Four hundred consecutive diabetic patients had their mid-arm circumference (AC) measured and body mass index (BMI) calculated to determine the proportion of an unselected clinic group who would require a larger than standard adult blood pressure (BP) cuff and whether or not BMI could be used to predict AC and hence choice of appropriate BP cuff size. More than 75% of both men and women had an AC > or = 29cm, justifying a larger than standard adult cuff for their BP measurement. When patients were classified according to their BMI, at least 80% with a BMI > or = 30 and more than 70% with a BMI of 25-29 had a measured AC > or = 29cm, while less than a third of patients with a BMI > or = 25 had an AC > or = 29cm.

Association of angiotensin converting enzyme DD genotype with hypertension in diabetes.

Angiotensin converting enzyme (ACE) genotypes have been associated with hypertension in the general population. However, the relation of ACE genotype to the prevalence of hypertension in diabetic populations is less clear. This study investigated ACE genotypes in 100 patients with diabetes mellitus, of whom 41 were on anti-hypertensive medication.