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Biomedical subjects

R Bingham

Publications and source records attributed to R Bingham.

At least 19 recordsLinked to original sources

The adaptive nature of the human neurocognitive architecture: an alternative model.

The model of the human neurocognitive architecture proposed by evolutionary psychologists is based on the presumption that the demands of hunter-gatherer life generated a vast array of cognitive adaptations. Here we present an alternative model. We argue that the problems inherent in the biological markets of ancestral hominids and their mammalian predecessors would have required an adaptively flexible, on-line information-processing system, and would have driven the evolution of a functionally plastic neural substrate, the neocortex, rather than a confederation of evolutionarily prespecified social cognitive adaptations. In alignment with recent neuroscientific evidence, we suggest that human cognitive processes result from the activation of constructed cortical representational networks, which reflect probabilistic relationships between sensory inputs, behavioral responses, and adaptive outcomes. The developmental construction and experiential modification of these networks are mediated by subcortical circuitries that are responsive to the life history regulatory system. As a consequence, these networks are intrinsically adaptively constrained. The theoretical and research implications of this alternative evolutionary model are discussed.

Adaptation, Biological

Generation of X-rays from Comet C/Hyakutake 1996 B2

The instability resulting from the relative motion of newly picked-up cometary photoions and the solar wind generates lower hybrid waves that are capable of accelerating electrons to the keV range of energies. These electrons may be responsible for the x-rays from comet C/Hyakutake 1996 B2 seen by the Rontgen X-ray Satellite. The inferred x-ray photon power depends on the electron energy, with keV electrons providing values of photon power two orders of magnitude greater than 100 eV electrons. These observations and in particular, spectral resolution of the x-rays, should provide more insight into the composition of the comet.

Journal Article

Paediatric life support. An advisory statement by the Paediatric Life Support Working Group of the International Liaison Committee on Resuscitation.

This document reflects the deliberations of ILCOR. The epidemiology and outcome of paediatric cardiopulmonary arrest and the priorities, techniques and sequence of paediatric resuscitation assessments and interventions differ from those of adults. The working group identified areas of conflict and controversy in current paediatric basic and advanced life support guidelines, outlined solutions considered and made recommendations by consensus. The working group was surprised by the degree of conformity already existing in current guidelines advocated by the American Heart Association (AHA), the Heart and Stroke Foundation of Canada (HSFC), the European Resuscitation Council (ERC), the Australian Resuscitation Council (ARC), and the Resuscitation Council of Southern Africa (RCSA). Differences are currently based upon local and regional preferences, training networks and customs, rather than scientific controversy. Unresolved issues with potential for future universal application are highlighted. This document does not include a complete list of guidelines for which there is no perceived controversy and the algorithm/decision tree figures presented attempt to follow a common flow of assessments and interventions, in coordination with their adult counterparts. Survival following paediatric prehospital cardiopulmonary arrest occurs in only approximately 3-17% and survivors are often neurologically devastated. Most paediatric resuscitation reports have been retrospective in design and plagued with inconsistent resuscitation definitions and patient inclusion criteria. Careful and thoughtful application of uniform guidelines for reporting outcomes of advanced life support interventions using large, randomized, multicenter and multinational clinical trials are clearly needed. Paediatric advisory statements from ILCOR will, by necessity, be vibrant and evolving guidelines fostered by national and international organizations intent on improving the outcome of resuscitation for infants and children worldwide.

Adolescent

Neonatal cleft lip repair: a retrospective review of anaesthetic complications.

A retrospective analysis of the first 50 cases of neonatal cleft lip repair performed at the Hospital for Sick Children is presented. The patient population included 11 expremature infants of less than 45 weeks postconceptual age. There was no mortality at the time of follow-up. There was one case of peroperative hypoxaemia. There was one case of postoperative laryngospasm requiring reintubation. Postoperatively there were four cases of mild hypoxaemia and one patient with transient apnoea. No patients required blood transfusion. Seventy-six percent of patients did not require opioid analgesia. The remainder received a single dose of intramuscular codeine phosphate. The advantages and risks of anaesthesia for cleft lip in the neonatal period are reviewed. Recommendations for safe practice include the selection of gestationally mature infants with no intercurrent illness, avoidance of opioid analgesia, adequate staffing ratios of experienced postoperative nursing care, appropriate monitoring including oximetry and apnoea detectors.

Anesthesia, General

Convention novice.

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Congresses as Topic

Postal survey of paediatric practice and training among consultant anaesthetists in the UK.

A postal survey of previous paediatric anaesthetic training, current paediatric experience and management of an infant pyloromyotomy was undertaken among consultant anaesthetists in the UK. A total of 851 questionnaires were returned, giving a response rate of 31%; 352 (41%) consultants had at least one paediatric list each week, 180 (21%) anaesthetized more than one infant less than 6 months old each month and 373 (44%) had obtained more than 6 months' specialist training. Consultants trained most recently had received significantly longer (P < 0.001) specialist training than their senior colleagues: 558 (66%) consultants dealt with infants requiring a pyloromyotomy, 348 with one or two cases annually. Two-thirds preferred to use an i.v. induction technique and less than half used cricoid pressure. Choice of technique was related to the duration of specialist paediatric training and when it was received, but not to current paediatric anaesthetic experience. The results are discussed in relation to recently published recommendations on paediatric anaesthetic services.

Anesthesia

An audit of induction of anaesthesia in neonates and small infants using pulse oximetry.

The frequency and severity of hypoxaemia during induction of anaesthesia in neonates and small infants at the Norfolk and Norwich Hospital, a district general hospital, was compared, using pulse oximetry, with that of the nearest specialist hospital, the Queen Elizabeth Hospital for Sick Children in London. There were differences in staffing and the choice of anaesthetic techniques between the hospitals. One third of the patients in both hospitals experienced desaturation of more than 5% (moderate or severe hypoxaemia) at one or more recordings during induction. The highest incidence of hypoxaemia was associated with awake intubation. There was no statistical difference in the incidence or severity of hypoxaemia between the hospitals. In the district general hospital, moderate or severe hypoxaemia of greater than 30 s duration was more likely if an anaesthetist with a regular paediatric operating list was not present at induction (p < 0.01).

Anesthesia, Inhalation

Venous cannulation in infants and small children.

Establishing venous access in infants and young children can be difficult and distressing for both operator and subject. Full competence in this procedure can only be achieved with experience. Nevertheless, a background knowledge of the basic principles involved and the differences from adult practice will considerably reduce the learning time.

Catheterization, Peripheral