Literacy-related skills among children after left or right hemispherectomy.

OBJECTIVE: Following hemispherectomy surgery, children's educational outcomes are of great importance but are understudied. The study goal was to investigate reading, language, and nonverbal cognitive skills in children obligatorily relying on a left versus right hemisphere using a cross-sectional design. METHODS: Participants (ages 6-18) who had undergone left hemispherectomy (LH; n = 10) or right hemispherectomy (RH; n = 14) completed standardized measures of reading, language, and nonverbal cognition. RESULTS: LH and RH groups were balanced for socioeconomic status, sex, and age. Both groups scored below the population mean across standardized measures (RH: -0.79 to -1.95 SDs; LH: -0.97 to -2.32 SDs). Compared to the LH group, the group retaining a functional left hemisphere (RH group) learned to read sooner (p = .011) despite no significant differences for surgery age, and scored higher on untimed real word and pseudoword reading measures (p < .05). Effect sizes were medium (r = 0.34-0.46) for the LH and RH comparison on measures of phonological awareness and both untimed and timed word and pseudoword reading. In examining the association between clinical variables and reading-related outcomes, younger age of post-hemispherectomy reading acquisition and shorter duration between seizure onset and hemispherectomy surgery were associated with higher standardized reading and language test scores (p < .05). SIGNIFICANCE: Investigations of psychoeducational skills in reading, language, and nonverbal cognition among children who have undergone hemispherectomy can offer important insights into compensatory potential for left and right hemispheres as well as inform educational programming for children following medical stabilization.

Referral of patients with emotionally unstable personality disorder for specialist psychological therapy: why, when and how?

Although we commonly work with patients with emotionally unstable personality disorder (EUPD) in community mental health teams (CMHTs), only some enter evidence-based psychological therapies. Many patients are not considered ready to engage in specialist treatments and remain in CMHTs without any clear focus or structure to their treatment, which is unsatisfactory for patients, clinicians and services. We present a fictional case and synthesise available literature and lived experience to explore readiness and ways to promote it. We highlight relevant issues for trainees to consider in practice. Patients with EUPD who have not received specialist treatment can be considered in terms of the transtheoretical model's stages of change. Identifying a patient's stage can help guide how to increase readiness for referral and decide when to refer. Interventions available to all healthcare professionals which may promote readiness include: psychoeducation, personal formulations, crisis planning, goal-setting, peer support, distress tolerance skills, motivational interviewing and mindfulness.

Validation of the English Language Version of the Violent Ideations Scale.

This study used a within-participant design to evaluate the concurrent validity and test-retest reliability of the Violent Ideations Scale in a general population, English-speaking opportunistic sample. Data from 116 adult participants (M age = 33.7, SD = 11.9, male = 30 [25.9%]) were used to compare scores on the Violent Ideations Scale and Aggression Questionnaire and responses to the Schedule of Imagined Violence. A subgroup of 27 participants (M age = 37.2, SD = 13.6, male = 8 [29.6%]) completed the Violent Ideations Scale on a second occasion, 2 weeks later. The Violent Ideations Scale was found to correlate significantly with the Aggression Questionnaire subscale and total scores, with the strongest correlations being with physical aggression and total scores. Participants were more likely to be categorized as having experienced a violent ideation based on responses to the Violent Ideation Scale, compared with the Schedule of Imagined Violence, most likely due to the Schedule of Imagined Violence underestimating the prevalence of violent ideation. A significant, strong correlation was found between total Violent Ideations Scale scores at Time 1 and Time 2. Overall, the Violent Ideations Scale was found to have concurrent validity when compared with the Aggression Questionnaire and good test-retest reliability, suggesting that it would be suitable for use with a nonclinical, English-speaking sample.

Highly chemoselective, sterically sensitive NHC-catalysed amine acylation with pyridil.

A new strategy for the protection of amines has been developed involving reaction with pyridil under the influence of N-heterocyclic carbene catalysis. The methodology is capable of distinguishing between two amines characterised by small differences in steric bulk and the resulting pyridoyl amides can be cleaved without requiring either strongly acidic or basic hydrolysis.

All that wheezes is not asthma: a 6-year-old with foreign body aspiration and no suggestive history.

The authors report the case of a 6-year-old girl, presenting with a 4-month history of wheeze associated with barking cough which frequently became wet requiring antibiotics. Her care was transferred to a paediatrician with specialist interest in paediatric respiratory medicine when she had continued symptoms despite bronchodilators and oral steroids for suspected asthma. Spirometry showed a forced expiratory volume 1 of 79% with no evidence of reversibility. The child was investigated for chronic wet cough. Immunoglobulins, sweat test and chest x-ray were all normal. There was no history suggestive of foreign body aspiration (FBA). Tracheomalacia was considered in view of the nature of the cough. The recurrence of an unusual inspiratory noise prompted referral for bronchoscopy. A small piece of plastic tube was removed from the bronchus intermedius. All symptoms resolved. The importance of clinical assessment to ascertain 'wheeze' when acutely unwell is emphasised. Current literature concerning FBA is reviewed.