Computational Methods for Predicting and Understanding Food Judgment.

People make subjective judgments about the healthiness of different foods every day, and these judgments in turn influence their food choices and health outcomes. Despite the importance of such judgments, there are few quantitative theories about their psychological underpinnings. This article introduces a novel computational approach that can approximate people's knowledge representations for thousands of common foods. We used these representations to predict how both lay decision-makers (the general population) and experts judge the healthiness of individual foods. We also applied our method to predict the impact of behavioral interventions, such as the provision of front-of-pack nutrient and calorie information. Across multiple studies with data from 846 adults, our models achieved very high accuracy rates (r2 = .65-.77) and significantly outperformed competing models based on factual nutritional content. These results illustrate how new computational methods applied to established psychological theory can be used to better predict, understand, and influence health behavior.

Child violence experiences in institutionalised/orphanage care.

Institutions are not necessarily good environments for children. In the face of challenges such as HIV, Ebola, poverty, conflict and disaster the numbers have grown rather than reduced. Some countries have closed institutions down -driven by findings that cognitive developmental delay is associated with institutional care. Yet insight into abuse and violence within institutionalised settings is neglected. Maltreatment -violence and abuse -may be an issue. This systematic review series addresses violence and abuse experiences in institutionalised care, exploring firstly the frequency of abuse/violence in institutions, secondly any interventions to reduce such violence or abuse and thirdly the perpetrators of such violence or abuse. The final systematic review updates the findings on cognitive delay associated with institutionalised care. With a violence lens, cognitive delay may well be considered under the umbrella of neglect. Maltreatment and abuse may be a driver of cognitive delay. The keyword search covered several electronic databases and studies were included for data abstraction if they met adequacy criteria. Eight studies were identified on the prevalence of abuse in institutions and a further three studies reported on interventions. Only one study was identified documenting peer on peer violence in institutions. Sixty-six studies were identified examining cognitive development for institutionalised children. All but two of these record cognitive deficits associated with institutionalisation. Only two asked about violence or abuse which was found to be higher in institutionalised children. Overall the abuse experiences of children in institutions are poorly recorded, and in one study violence was associated with high suicidal attempts. The major intervention pathway for ameliorating cognitive challenge seems to be placement out of the institutions which shows benefits and redresses some cognitive outcomes - yet not a total panacea. The single study providing training and monitoring of harsh punishment and maltreatment showed immediate and decided reductions. This data suggest, despite the paucity of studies, violence and abuse, by commission or omission is prevalent in institutions, has an effect on child well-being and is amenable to intervention. Simple training or more complex structures to place children within conducive alternative environments (or to avoid institutionalised placements in the first place) seem to be the main pathway of intervention.

Gallstone pancreatitis secondary to a pathological cystic duct stump in a setting of chronic pain syndrome: a diagnostic dilemma.

A 32-year-old woman presented with epigastric pain. She was a patient with chronic pain syndrome and had visited the emergency department several times over the past year. She did not drink alcohol. She had a laparoscopic cholecystectomy for gallstone pancreatitis 4 years ago. Her lipase was 2020 with normal bilirubin. MR cholangiopancreatography revealed a cystic structure resembling a gallbladder in the gallbladder fossa. This was in connection with the biliary system. The structure also contained stones. A review of the histology did confirm the gallbladder had been removed. She proceeded to have a laparoscopic re-cholecystectomy and made an unremarkable recovery.

Abdominal wall abscess: more than meets the eye.

An 83-year-old, mildly demented rest home resident presented to the emergency department with a 2 day history of a right sided abdominal wall mass. He had a mechanical fall 2 days previously and landed on his right side and had attributed the mass to this. He had no symptoms apart from feeling bloated and not being able to pass wind for a day. He had passed a normal bowel motion the day before presentation. On abdominal examination there was an 11 × 4 cm mass in the right lower quadrant. It was firm in consistency, non-fluctuant and non-tender to touch. There was mild erythema over the area but no skin breaks. Chest radiograph was unremarkable. The abdominal film showed dilated small bowel and no large bowel could be seen. A computed tomography (CT) scan showed a thick walled gallbladder with multiple calculi and air present. There was also an extensive air and fluid collection in the layers of the abdominal wall and subcutaneous fat which arose from a perforation of the gallbladder. The patient was not a surgical candidate due to multiple comorbidities. The patient was treated with antibiotics and underwent a CT guided percutaneous cholecystostomy. Despite the radiological intervention and antibiotics the patient progressively deteriorated and died peacefully 5 days after admission.

Epiploic appendagitis.

A 25-year-old female presented to the emergency department (ED) with a 1-day history of crampy left iliac fossa (LIF) abdominal pain. It was associated with both nausea and vomiting. On examination she was tender in the LIF with some guarding. Her observations were satisfactory and she was apyrexial. Urine dipstick and pregnancy stick were negative. The case was a diagnostic quandary. On ultrasound scan (USS) no acute gynaecological problems were found. Computed tomography (CT) of the abdomen showed epiploic appendagitis. This was managed conservatively with analgesia and antibiotics and the patient was discharged home pain free. She was followed up in the general surgical clinic 1 week later where she continued to be symptom free. She was discharged from general surgical care.