Media commentators have suggested that recent school shootings were precipitated by social rejection, but no empirical research has examined this claim. Case studies were conducted of 15 school shootings between 1995 and 2001 to examine the possible role of social rejection in school violence. Acute or chronic rejection-in the form of ostracism, bullying, and/or romantic rejection-was present in all but two of the incidents. In addition, the shooters tended to be characterized by one or more of three other risk factors-an interest in firearms or bombs, a fascination with death or Satanism, or psychological problems involving depression, impulse control, or sadistic tendencies. Implications for understanding and preventing school violence are discussed.

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Interest in vascular causes for cognitive impairment is increasing, in recognition that such causes are common, and possibly preventable. This has led to attempts to better define vascular dementia and its natural history. Several sets of criteria for the diagnosis of vascular dementia have been proposed. We provide a brief overview of the background to the initiation of a Canadian consensus conference, established by the Consortium of Canadian Centres for Clinical Cognitive Research (C5R) and report the conclusions reached at that conference. To date, no one set of criteria is demonstrably superior to another; we have therefore not endorsed any of the competing sets, nor have we recommended our own. Instead we suggest that empiric studies are required to establish valid criteria. A diagnostic checklist, which combines existing criteria and additional data, is attached for clinicians wishing to participate in such studies.Resume: Diagnostic de la demence vasculaire: consensus du consortium des centres canadiens pour recherche clinique sur la cognition. L'interet pour les causes vasculaires des deficits cognitifs a augmente depi que I'on sait que ces causes sont frequentes et qu'on peut possiblement les prevenir. De la les efforts pour miei definir la demence vasculaire et decrire son evolution naturelle. Plusieurs series de criteres pour le diagnostic de . demence vasculaire ont ete proposees. Nous faisons un bref rappel du contexte dans lequel la conference pour u consensus canadien, etablie par le Consortium des centres canadiens pour la recherche clinique sur la cognition, ; ete amorcee et nous en rapportons les conclusions. Aucun ensemble de criteres ne s'est av6re superieur aux autre; jusqu'a maintenant; nous n'en avons done recommande aucun, meme pas le notre. Nous croyons que des etudes empiriques sont necessaires pour etablir des criteres valides. Nous presentons une grille diagnostique incluant des criteres actuels et des donnees additionelles a I'intention des cliniciens qui desirent participer a ces etudes.

Tel: 07747654280Key points:1. Type 2 diabetes can be preventable.2. Diagnosis of pre-diabetes or at risk status may enable behaviour change.3. Increased provision of education and support is required to motivate lifestyle change in the person with pre-diabetes.Key words: Type 2 diabetes; pre-diabetes; motivation; lifestyle; education; support Abstract Type 2 diabetes is a growing global problem that not only affects individuals but has an impact upon the economic health of countries 1 . The number of people developing type 2 diabetes can be reduced by up to by 80%; this can be achieved by targeting those who are "at risk" 2. This reduction can be achieved by appropriate lifestyle changes to diet and physical activity 3. It is not known what the impact of being informed that you have prediabetes has on a patients motivation to make appropriate lifestyle changes.The aim of this study was to assess whether having the diagnosis of pre-diabetes encourages or empowers people to make appropriate lifestyle changes to prevent progression to a diagnosis of type 2 diabetes.Using a systematic approach, an integrative literature review was undertaken, using a standard retrieval and appraisal method. The studies demonstrated that pre-diabetes was found to be a challenging concept by patients and nurse alike. Lack of knowledge and support, along with patient's perceived barriers had an impact upon the various motivation and self-efficacy behaviours towards lifestyle changes.

The sheer volume of decisions taken within the public sector procurement process prevents perfect and complete information being obtained and applied to every best value tender analysis that is carried out. As such, uncertainty must be accepted as a feature of the best value decision-making process. • This paper reports research which is developing a methodology for utilising the uncertainty component in best value tender analysis in order to create a more transparent decision making process.• The main output of the research is the production of a robust support tool which aids the multi objective decision making process within the public sector of the UK construction industry by provoking rational discussion with respect to; the industry's key performance indicators (KPIs), the client's attitude to risk and provides a transparent audit trail of the decisions taken.• The underlying rationale for the support tool is based on a combination of the Analytic Hierarchy Process (AHP), Multi-Attribute Utility Theory (MAUT) and Whole Life Costing (WLC). The paper demonstrates the practical utility of the methodology of the tool through a tender decision process.