Excise tax differences at Oklahoma smoke shops: an opportunity for inter-tribal coordination.

PubMed

Laux, Fritz L; Chaloupka, Frank J; Beebe, Laura A

2015-01-01

Oklahoma's tribal tobacco shops are distributed throughout the state, including in urban areas. During the time frame of this study, state excise tax rates for cigarettes varied by tribe and region, and took five distinct levels, ranging from 5.75 cents to $1.03 per pack. To describe the pricing behavior of these smoke shops in a way that could support potential increases in the tribal taxation of cigarettes within the state. Two waves (2010 and 2011) of site visits were conducted, covering nearly all tribal smoke shops in the northeastern quarter of the state, an area containing the city of Tulsa and 60% of all tribal outlets. Researchers recorded representative prices and verified the tax rate paid (via tax stamp) for each shop. Data were analyzed in 2013. Lower-taxed tribal cigarettes tended to be priced at discounts that were even greater than the differential in tax rates. For example, across waves, the average pack of Marlboros from a shop with a 5.75-cent tax stamp sold for 52 cents less than the same pack from a 25.75-cent shop and 60 cents less than from a 51.5-cent shop. The minimal inter-tribal price response to the discontinuation of large quantities of contraband cigarette sales suggests that inter-tribal price competition in the Tulsa area is not as intense as expected. Ample scope exists for either unilateral or coordinated cross-tribal tax and price increases that will increase tribal cigarette tax revenue collections and improve public health. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Nursery nutrition in Liverpool: an exploration of practice and nutritional analysis of food provided.

PubMed

Parker, Mike; Lloyd-Williams, Ffion; Weston, Gemma; Macklin, Julie; McFadden, Kate

2011-10-01

To explore nutrition and food provision in pre-school nurseries in order to develop interventions to promote healthy eating in pre-school settings. Quantitative data were gathered using questionnaires and professional menu analysis. In the community, at pre-school nurseries. All 130 nurseries across Liverpool were a sent questionnaire (38 % response rate); thirty-four menus were returned for analysis (26 % response rate). Only 21 % of respondents stated they had adequate knowledge on nutrition for pre-school children. Sixty-one per cent of cooks reported having received only a 'little' advice on healthy eating and this was often not specific to under-5 s nutrition. Fifty-seven per cent of nurseries did not regularly assess their menus for nutritional quality. The menu analysis revealed that all menus were deficient in energy, carbohydrate, Fe and Zn. Eighty-five per cent of nurseries had Na/salt levels which exceed guidelines. Nurseries require support on healthy eating at policy, knowledge and training levels. This support should address concerns relating to both menu planning and ingredients used in food provision and meet current guidelines on food provision for the under-5 s.

Prevalence of wet litter and the associated risk factors in broiler flocks in the United Kingdom.

PubMed

Hermans, P G; Fradkin, D; Muchnik, I B; Organ, K L

2006-05-06

A postal questionnaire was sent to the managers of 857 broiler farms in the UK to determine the prevalence and risk factors for wet litter. The response rate was 75 per cent. Wet litter was reported by 75 per cent (95 per cent confidence interval [CI] 71.3 to 78.3) of the respondents in at least one flock during the year 2001 and 56.1 per cent (95 per cent CI 52.0 to 60.0) of them reported that they had an outbreak of wet litter in their most recently reared flock. Wet litter occurred more often during the winter months and farms using side ventilation systems were at an increased risk (odds ratio 1.74; 95 per cent CI 1.09 to 2.76). A multivariable analysis was carried out using two different definitions of wet litter as outcome variables - all cases of wet litter, and cases of wet litter associated with disease. Consistent risk factors for both outcomes were coccidiosis, feed equipment failures and the availability of separate farm clothing for each house. Cases of wet litter associated with disease were reported by 33.7 per cent (95 per cent CI 28.8 to 39.1) of the managers in their last flock and were associated with the use of hand sanitisers and broiler houses with walls made of concrete.

Initial hydrologic and geomorphic response following a wildfire in the Colorado front range

USGS Publications Warehouse

Moody, J.A.; Martin, D.A.

2001-01-01

A wildfire in May 1996 burned 4690 hectares in two watersheds forested by ponderosa pine and Douglas fir in a steep, mountainous landscape with a summer, convective thunderstorm precipitation regime. The wildfire lowered the erosion threshold in the watersheds, and consequently amplified the subsequent erosional response to shorter time interval episodic rainfall and created both erosional and depositional features in a complex pattern throughout the watersheds. The initial response during the first four years was an increase in runoff and erosion rates followed by decreases toward pre-fire rates. The maximum unit-area peak discharge was 24 m3 s-1 km-2 for a rainstorm in 1996 with a rain intensity of 90 mm h-1. Recovery to pre-fire conditions seems to have occured by 2000 because for a maximum 30-min rainfall intensity of 50 mm h-1, the unit-area peak discharge in 1997 was 6.6 m3 s-1 km-2, while in 2000 a similar intensity produced only 0.11 m3 s-1 km-2. Rill erosion accounted for 6 per cent, interrill erosion for 14 per cent, and drainage erosion for 80 per cent of the initial erosion in 1996. This represents about a 200-fold increase in erosion rates on hillslopes which had a recovery or relaxation time of about three years. About 67 per cent of the initially eroded sediment is still stored in the watersheds after four years with an estimated residence time greater than 300 years. This residence time is much greater than the fire recurrence interval so erosional and depositional features may become legacies from the wildfire and may affect landscape evolution by acting as a new set of initial conditions for subsequent wildfire and flood sequences. Published in 2001 by John Wiley and Sons, Ltd.

Declines in tobacco brand recognition and ever-smoking rates among young children following restrictions on tobacco advertisements in Hong Kong.

PubMed

Fielding, R; Chee, Y Y; Choi, K M; Chu, T K; Kato, K; Lam, S K; Sin, K L; Tang, K T; Wong, H M; Wong, K M

2004-03-01

We compared the recognition of tobacco brands and ever-smoking rates in young children before (1991) and after (2001) the implementation of cigarette advertising restrictions in Hong Kong and identified continuing sources of tobacco promotion exposure. A cross-sectional survey of 824 primary school children aged from 8 to 11 (Primary classes 3-4) living in two Hong Kong districts was carried out using self-completed questionnaires examining smoking behaviour and recognition of names and logos from 18 tobacco, food, drink and other brands common in Hong Kong. Ever-smoking prevalence in 2001 was 3.8 per cent (1991, 7.8 per cent). Tobacco brand recognition rates ranged from 5.3 per cent (Viceroy name) to 72.8 per cent (Viceroy logo). Compared with 1991, in 2001 never-smoker children recognized fewer tobacco brand names and logos: Marlboro logo recognition rate fell by 55.3 per cent. Similar declines were also seen in ever-smoker children, with recognition of the Marlboro logo decreasing 48 per cent. Recognition rates declined amongst both boys and girls. Children from non-smoking families constituted 51 per cent (426) of the sample, whereas 34.5 per cent (284), 8.5 per cent (70), 1.7 per cent (14) and 4.4 per cent (36) of the children had one, two, three or more than three smoking family members at home, respectively. Tobacco brand recognition rates and ever-smoking prevalence were significantly higher among children with smoking family members compared with those without. Among 12 possible sources of exposure to cigarette brand names and logos, retail stalls (75.5 per cent; 622), indirect advertisements (71.5 per cent; 589) and magazines (65.3 per cent; 538) were ranked the most common. Advertising restrictions in Hong Kong have effectively decreased primary-age children's recognition of tobacco branding. However, these children remain vulnerable to branding, mostly through exposure from family smokers, point-of-sale tobacco advertisement and occasional promotions. Action to curb these is now required.

The Arcminute Microkelvin Imager catalogue of gamma-ray burst afterglows at 15.7 GHz

NASA Astrophysics Data System (ADS)

Anderson, G. E.; Staley, T. D.; van der Horst, A. J.; Fender, R. P.; Rowlinson, A.; Mooley, K. P.; Broderick, J. W.; Wijers, R. A. M. J.; Rumsey, C.; Titterington, D. J.

2018-01-01

We present the Arcminute Microkelvin Imager (AMI) Large Array catalogue of 139 gamma-ray bursts (GRBs). AMI observes at a central frequency of 15.7 GHz and is equipped with a fully automated rapid-response mode, which enables the telescope to respond to high-energy transients detected by Swift. On receiving a transient alert, AMI can be on-target within 2 min, scheduling later start times if the source is below the horizon. Further AMI observations are manually scheduled for several days following the trigger. The AMI GRB programme probes the early-time (<1 d) radio properties of GRBs, and has obtained some of the earliest radio detections (GRB 130427A at 0.36 and GRB 130907A at 0.51 d post-burst). As all Swift GRBs visible to AMI are observed, this catalogue provides the first representative sample of GRB radio properties, unbiased by multiwavelength selection criteria. We report the detection of six GRB radio afterglows that were not previously detected by other radio telescopes, increasing the rate of radio detections by 50 per cent over an 18-month period. The AMI catalogue implies a Swift GRB radio detection rate of ≳ 15 per cent, down to ∼0.2 mJy beam-1. However, scaling this by the fraction of GRBs AMI would have detected in the Chandra & Frail sample (all radio-observed GRBs between 1997 and 2011), it is possible ∼ 44-56 per cent of Swift GRBs are radio bright, down to ∼0.1-0.15 mJy beam-1. This increase from the Chandra & Frail rate (∼30 per cent) is likely due to the AMI rapid-response mode, which allows observations to begin while the reverse-shock is contributing to the radio afterglow.

Exploring patient satisfaction predictors in relation to a theoretical model.

PubMed

Grøndahl, Vigdis Abrahamsen; Hall-Lord, Marie Louise; Karlsson, Ingela; Appelgren, Jari; Wilde-Larsson, Bodil

2013-01-01

The aim is to describe patients' care quality perceptions and satisfaction and to explore potential patient satisfaction predictors as person-related conditions, external objective care conditions and patients' perception of actual care received ("PR") in relation to a theoretical model. A cross-sectional design was used. Data were collected using one questionnaire combining questions from four instruments: Quality from patients' perspective; Sense of coherence; Big five personality trait; and Emotional stress reaction questionnaire (ESRQ), together with questions from previous research. In total, 528 patients (83.7 per cent response rate) from eight medical, three surgical and one medical/surgical ward in five Norwegian hospitals participated. Answers from 373 respondents with complete ESRQ questionnaires were analysed. Sequential multiple regression analysis with ESRQ as dependent variable was run in three steps: person-related conditions, external objective care conditions, and PR (p < 0.05). Step 1 (person-related conditions) explained 51.7 per cent of the ESRQ variance. Step 2 (external objective care conditions) explained an additional 2.4 per cent. Step 3 (PR) gave no significant additional explanation (0.05 per cent). Steps 1 and 2 contributed statistical significance to the model. Patients rated both quality-of-care and satisfaction highly. The paper shows that the theoretical model using an emotion-oriented approach to assess patient satisfaction can explain 54 per cent of patient satisfaction in a statistically significant manner.

Comparison of quality of life outcomes following different mastoid surgery techniques.

PubMed

Joseph, J; Miles, A; Ifeacho, S; Patel, N; Shaida, A; Gatland, D; Watters, G; Kiverniti, E

2015-09-01

Mastoid surgery carried out to treat chronic otitis media can lead to improvement in objective and subjective measures post-operatively. This study investigated the subjective change in quality of life using the Glasgow Benefit Inventory relative to the type of mastoid surgery undertaken. A retrospective multicentre postal survey of 157 patients who underwent mastoid surgery from 2008 to 2012 was conducted. Eighty-three questionnaire responses were received from patients who underwent surgery at one of three different hospitals (a response rate of 53 per cent). Fifty-seven per cent of patients had a Glasgow Benefit Inventory score of 0, indicating no change in quality of life post-operatively. Thirty-five per cent scored over 50, indicating significant improvement. The only significant difference found was that women fared worse after surgery than men. The choice of mastoid surgery technique should be determined by clinical need and surgeon preference. There is no improvement in quality of life for most patients following mastoid surgery.

Breast reconstruction in the United Kingdom and Ireland.

PubMed

Callaghan, C J; Couto, E; Kerin, M J; Rainsbury, R M; George, W D; Purushotham, A D

2002-03-01

Although it is becoming more common, previous surveys have identified concerns regarding the safety of immediate reconstruction following mastectomy. The aims of this study were to define current practice of breast reconstruction in the UK and Ireland, and to identify the characteristics of surgeons who use immediate breast reconstruction. : A postal questionnaire survey of 498 consultant breast surgeons in the UK and Ireland was performed in January 2000. There were 376 responses (response rate 76 per cent). Eighty-eight per cent of surgeons 'always' or 'usually' discuss reconstruction with patients due to undergo mastectomy; clinicians with a heavy caseload were significantly more likely to discuss it (odds ratio (OR) 18.45 (95 per cent confidence interval 1.99 to 171.07)). The majority of respondents (57 per cent) preferred delayed to immediate breast reconstruction; 70 per cent believed that immediate reconstruction has disadvantages, most commonly that it interferes with adjuvant therapy (56 per cent). Older surgeons were significantly less likely to perform immediate reconstruction (OR 5.18 (2.21 to 12.11)), and were significantly more likely to believe that immediate breast reconstruction has disadvantages (OR 2.02 (1.01 to 4.05)). Surgeons from Ireland were less likely to discuss and perform breast reconstruction (OR 0.20 (0.10 to 0.43) and 0.27 (0.12 to 0.60) respectively), or to have access to a plastic surgeon (OR 0.22 (0.11 to 0.44)). : Significant variation exists in the delivery of breast reconstruction after mastectomy in the UK and Ireland. The age, workload and personal characteristics of the surgeon are important in determining reconstructive practice.

Post-operative radiation therapy for advanced-stage oropharyngeal cancer.

PubMed

Hansen, Eric; Panwala, Kathryn; Holland, John

2002-11-01

Between 1985 and 1999, 43 patients with locally-advanced, resectable oropharyngeal cancer were treated with combined surgery and post-operative radiation therapy (RT) at Oregon Health and Science University. Five patients (12 per cent) had Stage III disease and 38 patients (88 per cent) had Stage IV disease. All patients had gross total resections of the primary tumour. Thirty-seven patients had neck dissections for regional disease. RT consisted of a mean tumour-bed dose of 63.0 Gy delivered in 1.8-2.0 Gy fractions over a mean of 49 days. At three- and five-years, the actuarial local control was 96 per cent and the actuarial local/regional control was 80 per cent. The three- and five-year actuarial rates of distant metastases were 41 per cent and 46 per cent, respectively. The actuarial overall survival at three- and five-years was 41 per cent and 34 per cent, respectively. The actuarial rates of progression-free survival were 49 per cent at three-years and 45 per cent at five years. Combined surgery and post-operative RT for advanced-stage oropharyngeal cancer results in excellent local/regional control. This particular group of patients experienced a high-rate of developing distant metastases.

An Evaluation of Parastomal Hernia Repair Using the Americas Hernia Society Quality Collaborative.

PubMed

Fox, Sarah S; Janczyk, Randy; Warren, Jeremy A; Carbonell, Alfredo M; Poulose, Benjamin K; Rosen, Michael J; Hope, William W

2017-08-01

The purpose of this review was to evaluate outcomes relating to parastomal hernia repair. Data from the Americas Hernia Society Quality Collaborative were used to identify patients undergoing parastomal hernia repair from 2013 to 2016. Parastomal hernia repairs were compared with other repairs using Pearson's test and Wilcoxon test with a P value <0.05 considered significant. Parastomal hernia repairs were performed in 311 patients. Techniques of repair include open in 85 per cent and laparoscopic in 15 per cent. Mesh was used in 92 per cent with keyhole in 34 per cent, flat mesh in 33 per cent, and Sugarbaker in 25 per cent. Mesh types were permanent synthetic in 79 per cent, biologic in 13 per cent, absorbable synthetic in 6 per cent, and hybrid synthetic/biologic in 2 per cent. Most common location for mesh was sublay in 84 per cent followed by onlay in 14 per cent and inlay in 2 per cent with 59 per cent of patients undergoing a myofascial release. Ostomy disposition included ostomy left in situ (47%), moved to a new site (18%), taken down (22%), and rematured in same location in (13%). Outcomes related to parastomal hernia repair included 10 per cent surgical site infection, 24 per cent surgical site occurrence, and 12 per cent surgical site occurrences requiring procedural interventions with a 13 per cent readmission rate and 6 per cent reoperation rate. When comparing parastomal hernias with other ventral hernia repairs, parastomal hernias had a significantly higher surgical site infection, surgical site occurrence, surgical site occurrences requiring procedural intervention, readmission, reoperation rate, and length of stay, and were less commonly performed laparoscopically (P < 0.05). Most parastomal hernias are being repaired open with synthetic mesh in the sublay position. Less favorable outcomes of parastomal hernia repair when compared with other ventral hernia repairs are likely related to the complexity of parastomal hernia repair.

Outcome evaluation of clarithromycin, metronidazole and lansoprazole regimens in Helicobacter pylori positive or negative children with resistant otitis media with effusion.

PubMed

Mel-Hennawi, D; Ahmed, M R

2015-11-01

To compare the efficacy of two treatment regimens among Helicobacter pylori stool antigen positive children suffering from resistant otitis media with effusion. The study comprised 258 children with bilateral otitis media with effusion; 134 were positive for H pylori stool antigen, and were equally and randomly allocated to the control group or study group. The control group received standard otitis media with effusion therapy (amoxicillin and clavulanate), while the study group received standard H pylori triple therapy (clarithromycin, metronidazole and lansoprazole). In the control group, there was a marked clinical response to treatment in 33 of the 67 children (49.3 per cent). In the study group, there was a marked response in a significantly higher number of children (46 out of 67, 68.7 per cent). The 124 H pylori stool antigen negative children not included in the 2 aforementioned groups received amoxicillin and clavulanate, and a marked response in symptoms was evident in 98 of these children (79 per cent). H pylori infection may lead to resistance to traditional otitis media with effusion treatment in some cases. H pylori eradication is associated with a high cure rate.

Prospective cohort study to assess rates of contagious disease in pre-weaned UK dairy heifers: management practices, passive transfer of immunity and associated calf health

PubMed Central

Johnson, Kate F; Chancellor, Natalie; Burn, Charlotte C; Wathes, D Claire

2017-01-01

Dairy calves are vulnerable to infectious diseases, particularly diarrhoea and bovine respiratory disease (BRD), causing mortality and reducing welfare and growth. A prospective cohort study was performed on 11 UK dairy farms to determine the underlying causes for calf disease. This first paper describes the incidence, timing and duration of infectious disease, mortality rates, passive transfer of immunity and key management practices that may contribute to disease incidence. Heifer calves were recruited in the first week of life (n=492) and a blood sample taken to measure IgG and total protein (TP). Each animal was examined weekly for nine weeks using a standardised health scoring system. Recruitment of calves occurred between August and February. Four farms provided supplementary colostrum to more than 75 per cent of calves born, whereas on the remainder only 0 to 19 per cent were supplemented. Mean serum IgG and TP were 19.0±10 and 56.7±10.3 mg/ml respectively, with 20.7 per cent (95CI: 17.2 to 24.7 per cent) of all calves classified as having failure of passive transfer (IgG <10 mg/ml). The overall preweaning mortality rate was 4.5 per cent. (95 per cent CI: 2.9 to 6.8 per cent). During this period,48.2 per cent of all calves (range 24.1 to 74.4 per cent between farms) were diagnosed with diarrhoea and 45.9 per cent (range 20.4 to 77.8 per cent) with BRD. The incidence rates were 7.8 cases of diarrhoea and 10.1 cases of BRD per 100 calf weeks at risk, respectively. Rates of infectious disease were therefore high despite relatively good passive transfer. PMID:29259784

Veterinarian's dilemma: a study of how Danish small animal practitioners handle financially limited clients.

PubMed

Kondrup, S V; Anhøj, K P; Rødsgaard-Rosenbeck, C; Lund, T B; Nissen, M H; Sandøe, P

2016-12-10

This study examined the extent to which Danish veterinary practices encounter financially limited clients and how different factors relating to the animal, the client and the veterinarian affect decisions to provide treatment for these clients. 300 small animal practices were invited to participate in an online survey. 195 participated, giving a response rate of 65 per cent. The results show that Danish small animal veterinary practices encounter clients with limited finances regularly: 33.8 per cent of them 3-4 times, 24.6 per cent 5-10 times and 19.5 per cent 1-2 times a month. Only around 9 per cent reported having a written practice policy on handling financially limited clients. Factors affecting decisions to treat include the severity and type of the animal's condition, the medical care needed and the client's expressed emotions. The propensity to treat is significantly higher in female veterinarians and in situations involving unborn animals. The overall conclusion is that small animal veterinary practices often provide treatment to clients who are not able to pay-far beyond what is legally required. This can be considered a major economic and psychological challenge for the practising veterinarians. British Veterinary Association.

Confirmation of linear system theory prediction: Changes in Herrnstein's k as a function of changes in reinforcer magnitude.

PubMed

McDowell, J J; Wood, H M

1984-03-01

Eight human subjects pressed a lever on a range of variable-interval schedules for 0.25 cent to 35.0 cent per reinforcement. Herrnstein's hyperbola described seven of the eight subjects' response-rate data well. For all subjects, the y-asymptote of the hyperbola increased with increasing reinforcer magnitude and its reciprocal was a linear function of the reciprocal of reinforcer magnitude. These results confirm predictions made by linear system theory; they contradict formal properties of Herrnstein's account and of six other mathematical accounts of single-alternative responding.

Self-reported optometric practise patterns in age-related macular degeneration.

PubMed

Ly, Angelica; Nivison-Smith, Lisa; Zangerl, Barbara; Assaad, Nagi; Kalloniatis, Michael

2017-11-01

The use of advanced imaging in clinical practice is emerging and the use of this technology by optometrists in assessing patients with age-related macular degeneration is of interest. Therefore, this study explored contemporary, self-reported patterns of practice regarding age-related macular degeneration diagnosis and management using a cross-sectional survey of optometrists in Australia and New Zealand. Practising optometrists were surveyed on four key areas, namely, demographics, clinical skills and experience, assessment and management of age-related macular degeneration. Questions pertaining to self-rated competency, knowledge and attitudes used a five-point Likert scale. Completed responses were received from 127 and 87 practising optometrists in Australia and New Zealand, respectively. Advanced imaging showed greater variation in service delivery than traditional techniques (such as slitlamp funduscopy) and trended toward optical coherence tomography, which was routinely performed in age-related macular degeneration by 49 per cent of respondents. Optical coherence tomography was also associated with higher self-rated competency, knowledge and perceived relevance to practice than other modalities. Most respondents (93 per cent) indicated that they regularly applied patient symptoms, case history, visual function results and signs from traditional testing, when queried about their management of patients with age-related macular degeneration. Over half (63 per cent) also considered advanced imaging, while 31 per cent additionally considered all of these as well as the disease stage and clinical guidelines. Contrary to the evidence base, 68 and 34 per cent rated nutritional supplements as highly relevant or relevant in early age-related macular degeneration and normal aging changes, respectively. These results highlight the emergence of multimodal and advanced imaging (especially optical coherence tomography) in the assessment of age-related macular degeneration by optometrists. Clinically significant variations in self-rated test competency and the understanding regarding nutritional supplements for different stages of age-related macular degeneration suggest that further work to up-skill optometrists may be required. © 2017 Optometry Australia.

National study of the impact of patient information and involvement in decision-making on immediate breast reconstruction rates.

PubMed

Frisell, A; Lagergren, J; de Boniface, J

2016-11-01

Reconstructive alternatives should be discussed with women facing mastectomy for breast cancer. These include immediate and delayed reconstruction, which both have inherent advantages and disadvantages. Immediate reconstruction rates vary considerably in Swedish healthcare regions, and the aim of the study was to analyse reasons for this disparity. All women who underwent mastectomy for primary breast cancer in Sweden in 2013 were included. Tumour data were retrieved from the Swedish National Breast Cancer Registry and from questionnaires regarding patient information and involvement in preoperative decision-making sent to women who were still alive in 2015. Of 2929 women who had undergone 2996 mastectomies, 2906 were still alive. The questionnaire response rate was 76·3 per cent. Immediate reconstruction rates varied regionally, between 3·0 and 26·4 per cent. Tumour characteristics impacted on reconstruction rates but did not explain regional differences. Patient participation in decision-making, availability of plastic surgery services and patient information, however, were independent predictors of immediate breast reconstruction, and varied significantly between regions. Even in younger patients with low-risk tumours, rates of patient information ranged between 34·3 and 83·3 per cent. Significant regional differences in immediate reconstruction rates were not explained by differences in tumour characteristics, but by disparities in patient information, availability of plastic surgery services and involvement in decision-making. © 2016 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.

Risk stratification by the Appendicitis Inflammatory Response score to guide decision-making in patients with suspected appendicitis.

PubMed

Scott, A J; Mason, S E; Arunakirinathan, M; Reissis, Y; Kinross, J M; Smith, J J

2015-04-01

Current management of suspected appendicitis is hampered by the overadmission of patients with non-specific abdominal pain and a significant negative exploration rate. The potential benefits of risk stratification by the Appendicitis Inflammatory Response (AIR) score to guide clinical decision-making were assessed. During this 50-week prospective observational study at one institution, the AIR score was calculated for all patients admitted with suspected appendicitis. Appendicitis was diagnosed by histological examination, and patients were classified as having non-appendicitis pain if histological findings were negative or surgery was not performed. The diagnostic performance of the AIR score and the potential for risk stratification to reduce admissions, optimize imaging and prevent unnecessary explorations were quantified. A total of 464 patients were included, of whom 210 (63·3 per cent) with non-appendicitis pain were correctly classified as low risk. However, 13 low-risk patients had appendicitis. Low-risk patients accounted for 48·1 per cent of admissions (223 of 464), 57 per cent of negative explorations (48 of 84) and 50·7 per cent of imaging requests (149 of 294). An AIR score of 5 or more (intermediate and high risk) had high sensitivity for all severities of appendicitis (90 per cent) and also for advanced appendicitis (98 per cent). An AIR score of 9 or more (high risk) was very specific (97 per cent) for appendicitis, and the majority of patients with appendicitis in the high-risk group (21 of 30, 70 per cent) had perforation or gangrene. Ultrasound imaging could not exclude appendicitis in low-risk patients (negative likelihood ratio (LR) 1·0) but could rule-in the diagnosis in intermediate-risk patients (positive LR 10·2). CT could exclude appendicitis in low-risk patients (negative LR 0·0) and rule-in appendicitis in the intermediate group (positive LR 10·9). Risk stratification of patients with suspected appendicitis by the AIR score could guide decision-making to reduce admissions, optimize utility of diagnostic imaging and prevent negative explorations. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

Self-help smoking cessation and maintenance programs: a comparative study with 12-month follow-up by the American Lung Association.

PubMed Central

Davis, A L; Faust, R; Ordentlich, M

1984-01-01

One thousand two hundred thirty seven smokers responding to lung association announcements in five geographic areas were randomly assigned to one of four groups and mailed American Lung Association materials: 1) leaflets (L); 2) leaflets plus maintenance manual (L + M); 3) cessation manual (C); and 4) cessation and maintenance manuals (C + M). Five telephone interviews over one year achieved a 95 per cent follow-up completion rate. Nonrespondents as well as exclusive cigar and pipe users were classified as smokers. Twenty per cent quit initially, with 5 per cent continually abstinent in (C + M) at 12 months vs 2 per cent in (L) (p less than .05). Nonsmoking prevalence rates (no tobacco smoking in the past month), on the other hand, gradually increased after six months; at 12 months those with the maintenance component, (L + M) and (C + M), had higher rates (18 per cent) than (L) (12 per cent) or (C) (15 per cent). Leaflets and manual alone were least cost effective. Rising nonsmoking prevalence rates observed in all groups suggest that successful attempts to quit increased over time and that a contributing factor might have been the follow-up method. Although achieving lower quit rates than methods requiring attendance at a course, the self-help intervention has the advantages of greater availability, flexibility, and in some instances lower cost. PMID:6437257

Provision of surgical voice restoration in England: questionnaire survey of speech and language therapists.

PubMed

Bradley, P J; Counter, P; Hurren, A; Cocks, H C

2013-08-01

To conduct a questionnaire survey of speech and language therapists providing and managing surgical voice restoration in England. National Health Service Trusts registering more than 10 new laryngeal cancer patients during any one year, from November 2009 to October 2010, were identified, and a list of speech and language therapists compiled. A questionnaire was developed, peer reviewed and revised. The final questionnaire was e-mailed with a covering letter to 82 units. Eighty-two questionnaires were distributed and 72 were returned and analysed, giving a response rate of 87.8 per cent. Forty-four per cent (38/59) of the units performed more than 10 laryngectomies per year. An in-hours surgical voice restoration service was provided by speech and language therapists in 45.8 per cent (33/72) and assisted by nurses in 34.7 per cent (25/72). An out of hours service was provided directly by ENT staff in 35.5 per cent (21/59). Eighty-eight per cent (63/72) of units reported less than 10 (emergency) out of hours calls per month. Surgical voice restoration service provision varies within and between cancer networks. There is a need for a national management and care protocol, an educational programme for out of hours service providers, and a review of current speech and language therapist staffing levels in England.

Emergency telephone consultations: a new course for medical students.

PubMed

Schaufelberger, Mireille; Harris, Michael; Frey, Peter

2012-12-01

Using the telephone for consultations is now common practice. Although there is a clear need for specific training for telephone consultations, it is uncommon for it to be taught in medical school. A practical course on emergency telephone consultations (ECTs) was designed for the medical degree course at the University of Bern Medical School. During the module, each of the volunteer fifth-year medical students had to perform two simulated telephone consultations. Medical students in their first year of medical school acted as simulated patients (SPs), and they gave immediate feedback to the participants. Nineteen per cent of fifth-year students voluntarily undertook the ETC course. The course was rated 'very informative' by 68 per cent of the participants, and 'informative' by 32 per cent. Ninety-four per cent of the attendees recorded a personal learning gain, and 68 per cent suggested that the course should be obligatory. All the participants thought that the SPs played their roles realistically. In their rating of the ETC, the fifth-year students gave it a mean mark of 5.5 (out of a maximum of 6), suggesting that they thought it had been very successful. Students became aware of their need for ETC training through the course itself, and they recommended that it should be obligatory. The ETC pilot received a highly positive response from lead clinicians who anticipated a rising number of telephone consultations, and who have to deal with trainees who have not been taught about how to deal with ETCs. As a result, the Faculty of Medicine decided to make the course obligatory. © Blackwell Publishing Ltd 2012.

Experience with the artificial urinary sphincter model AS800 in 148 patients.

PubMed

Fishman, I J; Shabsigh, R; Scott, F B

1989-02-01

The latest version of the artificial urinary sphincter, AS800, was used in 148 patients with urinary incontinence of different etiologies. Followup ranged from 3 to 37 months, with an average of 20.8 months. There were 112 (76 per cent) male and 36 (24 per cent) female patients. The cuff was implanted around the bladder neck in 78 patients (53 per cent) and around the bulbar urethra in 70 (47 per cent). Socially acceptable urinary control was achieved in 90 per cent of the 139 patients with active devices in place. It was necessary to remove the sphincter in 11 patients (7.4 per cent). The reasons for removal were infection and erosion in 8 patients (5.4 per cent), infection without erosion in 2 (1.3 per cent), and erosion due to excess pressure and poor tissues in 1 (0.7 per cent). Comparison of success and failure rates associated with incontinence of different etiologies revealed that patients with incontinence after failure of a conventional antistress incontinence operation and those with incontinence after transurethral resection or radical prostactectomy had the highest success rate, and that patients with incontinence secondary to pelvic fracture or exstrophy and epispadias had the highest failure rates. The deactivation feature (the lock) of the new artificial sphincter model was beneficial for primary deactivation, urethral catheterization or cystoscopy, or for elective nocturnal decompression of the bladder neck or urethral tissues.

The prevalence of refractive errors among adult rural populations in Iran.

PubMed

Hashemi, Hassan; Nabovati, Payam; Yekta, Abbasali; Shokrollahzadeh, Fereshteh; Khabazkhoob, Mehdi

2018-01-01

The aim was to determine the prevalence of myopia and hyperopia and related factors in underserved rural areas in Iran. Under random cluster sampling, two rural regions were randomly selected in the north and southwest of the country, and 3,061 persons over 15 years of age were invited into the study. After selecting samples, all participants had refraction, measurement of uncorrected vision and visual acuity and ocular health examination by slitlamp biomicroscopy. Of the 3,061 invitees, 2,575 participated in the study (response rate: 84.1 per cent). After excluding those who met the exclusion criteria or had missing refractive data, eventually there were 2,518 subjects available for this analysis. The mean age of the participants was 44.3 ± 17.5 years (range: 16 to 93 years) and 1,460 of them (58.0 per cent) were female. The overall prevalence of myopia and hyperopia in this study was 25.2 per cent (95 per cent CI: 23.2 to 27.2) and 22.5 per cent (95 per cent CI: 20.6 to 24.4), respectively. The prevalence of myopia increased from 20.9 per cent in participants 16 to 20 years to 32.9 per cent in the 21 to 30 years age group, declined up to the age of 60 years and increased again afterwards. The lowest prevalence was 6.8 per cent observed in the 16 to 20 years age group and the highest was 45.8 per cent in 61- to 70-year-olds. In the final logistic regression model, myopia significantly associated with age, higher education levels and cataracts, while hyperopia associated with age, lower education levels and male gender. In our study, the prevalence of myopia was lower and the prevalence of hyperopia was higher compared to most previous studies. The findings of this study imply that refractive errors vary by age. © 2017 Optometry Australia.

One year study of bacterial and fungal nosocomial infections among patients in pediatric intensive care unit (PICU) in Alexandria.

PubMed

El-Nawawy, Ahmed Ahmed; Abd El-Fattah, Mohamed Mohamed; Metwally, Hala Abd El-Raouf; Barakat, Shahira Salah El Din; Hassan, Ihab Abdel Rehim

2006-06-01

A 1-year prospective and observational study included all admissions (n=216) until 48 h after discharge to Alexandria PICU between first of May 2003 and end of April 2004. Cultures for bacteria and fungi and antibiotic sensitivity tests (19 antibiotic using Bauer-Kirby disc diffusion method) were obtained (blood, stool, urine and cerebrospinal fluid, if needed) and repeated on suspicion of NIs. All cannulae, endotracheal tube (ET) aspirates and tips, nasogastric tubes and different catheters were cultured. All PICU health care workers (HCWs) were subjected to throat and under-finger nails cultures as well as inanimate objects, both on bimonthly basis. The referral place (ward or emergency), PRISM III score, length of stay (LOS) and fate were recorded. Amongst those patients whose age ranged from 1 to 23 months, 23 per cent had NIs with infection rates of 40/1000 days. Significantly high rates of mortality, LOS and PRISM III score were encountered among patients with NIs (52 per cent vs 30 per cent; 9.4+/-4.8 vs 5.4+/-2.2 days; 14.4+/-7 vs 11.8+/-6 respectively). The descending order of frequency of NIs was blood stream infection (BSI) (47 per cent), urinary tract infection (UTI) (28 per cent), ventilator-associated pneumonia (VAP) (16 per cent) and meningitis (9 per cent). Gr-ve bacilli accounted for 76.7 per cent; Gr+ve cocci 13.3 per cent (with satisfactory sensitivity to cefepime, imipenem and meropenem) and Candida albicans 10 per cent of all NIs. The rate of NIs/1000 device days were: 18.7 per cent for BSI, 10.9 per cent for VAP and 25.5 per cent for UTI. Vulnerable age groups were >6 m for VAP and <6 m for meningitis. Multiple logistic regression analysis identified LOS, PRISM III score and referral from wards a predictors of NI acquisition (odd ratio and 95 per cent confidence interval: 1.537, 1.423-1.659; 1.073, 1.041-1.105 and 0.269, 0.178-0.406 respectively). Bimonthly cultures for HCWs isolated coagulase-ve Staphylococci, while inanimate objects isolated diphtheroids and Candida albicans. NIs rate was high (23 per cent) mainly due to severity of condition on admission as shown by high PRISM III score value, the high PRISM III score, LOS and referral from wards were predictors of acquisition of NIs and there is a high incidence of Candida albicans infection (10 per cent of NIs).

[Shortages in Swedish tuberculosis care. Good results only in 71 percent of cases after 12-month treatment as shown in a current study].

PubMed

Romanus, V; Julander, I; Blom-Bülow, B; Larsson, L O; Normann, B; Boman, G

2000-11-29

During the period August 1994-December 1995 783 cases of active tuberculos (TB) were notified to the health authorities in Sweden. By means of questionnaires sent to the consulting physicians (92 per cent response rate) the treatment outcome was studied twelve months after the diagnosis. Out of 676 patients only 71 per cent were reported to have completed the treatment and be cured of TB. This indicates that there is room for improvement as regards monitoring patients, if necessary by Directly Observed Therapy (DOT), in order to make sure that prescribed treatment is adhered to.

Whooping cough: are health-care workers putting children at risk?

PubMed

Peadon, Elizabeth; Cooper, Carolyn

2007-05-01

To explore the attitudes and knowledge of health-care workers (HCW) towards whooping cough and an adult whooping cough booster for HCW. HCW at Fairfield Health Service, who had clinical contact with infants or children, were sent a self-administered questionnaire. Questionnaires were completed by 135 staff, giving a response rate of 74%. Thirty-five per cent were not known to be immunised against whooping cough. Fifty-nine per cent of doctors were known to be immunised, 33% of allied health staff and 28% of nurses. The rates of immunisation between the professional groups were significantly different (chi2 = 8.2 with 2 degrees of freedom; P = 0.017). Thirty-nine per cent of HCW did not know that primary immunisation did not provide lifelong protection. Twenty-seven per cent did not agree that HCW should be offered an adult whooping cough booster. Staff who felt at risk of contracting whooping cough were more likely to recommend that a booster should be offered (OR 2.71; 95% CI 1.22-6.04; P = 0.019). Doctors were less likely to recommend that a booster should be offered (OR 0.36; 95% CI 0.15-0.87; P = 0.028). HCW have low rates of immunity to whooping cough and misconceptions about whooping cough infection and immunisation. Over a quarter of HCW did not agree that a booster should be offered. An ongoing education programme addressing the attitudes and misconceptions identified in this study is a crucial component of the campaign to increase the uptake of adult whooping cough booster immunisation by HCW.

The Effects of Rate of Deviation and Musical Context on Intonation Perception in Homophonic Four-Part Chorales.

NASA Astrophysics Data System (ADS)

Bell, Michael Stephen

Sixty-four trained musicians listened to four -bar excerpts of selected chorales by J. S. Bach, which were presented both in four-part texture (harmonic context) and as a single voice part (melodic context). These digitally synthesized examples were created by combining the first twelve partials, and all voice parts had the same generic timbre. A within-subjects design was used, so subjects heard each example in both contexts. Included in the thirty -two excerpts for each subject were four soprano, four alto, four tenor, and four bass parts as the target voices. The intonation of the target voice was varied such that the voice stayed in tune or changed by a half cent, two cents, or eight cents per second (a cent is 1/100 of a half step). Although direction of the deviation (sharp or flat) was not a significant factor in intonation perception, main effects for context (melodic vs. harmonic) and rate of deviation were highly significant, as was the interaction between rate of deviation and context. Specifically, selections that stayed in tune or changed only by half cents were not perceived differently; for larger deviations, the error was detected earlier and the intonation was judged to be worse in the harmonic contexts compared to the melodic contexts. Additionally, the direction of the error was correctly identified in the melodic context more often than the hamonic context only for the examples that mistuned at a rate of eight cents per second. Correct identification of the voice part that went out of tune in the four-part textures depended only on rate of deviation: the in tune excerpts (no voice going out of tune) and the eight cent deviations were correctly identified most often, the two cent deviations were next, and the half cent deviation excerpts were the least accurately identified.

Poverty nutrition linkages.

PubMed

Ramachandran, Prema

2007-10-01

At the time of independence majority of Indians were poor. In spite of spending over 80 per cent of their income on food, they could not get adequate food. Living in areas of poor environmental sanitation they had high morbidity due to infections; nutrition toll due to infections was high because of poor access to health care. As a result, majority of Indians especially children were undernourished. The country initiated programmes to improve economic growth, reduce poverty, improve household food security and nutritional status of its citizens, especially women and children. India defined poverty on the basis of calorie requirement and focused its attention on providing subsidized food and essential services to people below poverty line. After a period of slow but steady economic growth, the last decade witnessed acceleration of economic growth. India is now one of the fastest growing economies in the world with gross domestic product (GDP) growth over 8 per cent. There has been a steady but slow decline in poverty; but last decade's rapid economic growth did not translate in to rapid decline in poverty. In 1970s, country became self sufficient in food production; adequate buffer stocks have been built up. Poor had access to subsidized food through the public distribution system. As a result, famines have been eliminated, though pockets of food scarcity still existed. Over the years there has been a decline in household expenditure on food due to availability of food grains at low cost but energy intake has declined except among for the poor. In spite of unaltered/declining energy intake there has been some reduction in undernutrition and increase in overnutrition in adults. This is most probably due to reduction in physical activity. Under the Integrated Child Development Services (ICDS) programme food supplements are being provided to children, pregnant and lactating women in the entire country. In spite of these, low birth weight rates are still over 30 per cent and about half the children are undernourished. While poverty and mortality rates came down by 50 per cent, fertility rate by 40 per cent, the reduction in undernutrition in children is only 20 per cent. National surveys indicate that a third of the children from high income group who have not experienced any deprivations are undernourished. The high undernutrition rates among children appears to be mainly due to high low birthweight rates, poor infant and young child feeding and caring practices. At the other end of the spectrum, surveys in school children from high income groups indicate that between 10-20 per cent are overnourished; the major factor responsible appears to be reduction in physical activity. Some aspects of the rapidly changing, complex relationship between economic status, poverty, dietary intake, nutritional and health status are explored in this review.

Dealing with complaints--are we doing well?

PubMed

Miller, J A

1995-01-01

Investigates the views of complainants and how they felt that their complaints had been handled. Complainants from a three-month period were sent a nine-question questionnaire to which the response rate was 52.3 per cent. Shows that, on the whole, complaint-response times were being met; the complaints system was seen as user friendly; and overall, complaints were satisfied with the way in which their complaints were handled.

76 FR 4395 - Postal Service Price Adjustment

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-25

... the First-Class Mail, single- piece first-ounce letter price; however, the additional-ounce rate for single-piece letters and flats increases from 17 cents to 20 cents. Id. at 12. The price of a single-piece postcard increases from 28 cents to 29 cents. Id. However, to meet the cap average increase for...

Problems associated with restorative materials--dentists' views in Finland and Sweden.

PubMed

Widström, E; Sundberg, H

1991-01-01

During the past 10-15 years the possible side-effects of dental restorative materials, especially due to amalgam fillings, have caused a lively debate in Sweden. There is an extensive literature on the chemical and biological properties of dental materials but no investigations have dealt with the providers' attitudes. The purpose of this study was to find out the dentists' experiences of and attitudes to patients who state they have problems related to dental restorative materials and compare the dentists' subjective assessments of those side-effects in two neighboring countries, Finland and Sweden. Information was collected by postal questionnaires addressed to dentists chosen at random in Finland (n = 625) and in Sweden (n = 960). The response rate was 73 per cent and 72 per cent respectively. The results showed that 99 per cent of the respondents had patients questioning the safety of dental materials. The number of such patients was estimated to be three times higher in Sweden (124 patients per dentist in 1989) than in Finland (39 patients per dentist). More than 90 per cent of the questions from the patients regarded amalgam fillings. Statistically significant differences were found between the respondents' opinions of amalgam, 81 per cent of the Finnish contrary to 59 per cent of the Swedish respondents considered the risk of side-effects to be low when using this material. About 90 per cent of the respondents considered glass-ionomer, gold and ceramic restorations safe, but only half of them were convinced of the safety of composite. A great majority of the Swedish respondents (79 per cent) claimed that the patients should get their fillings changed without odontologic indications if they insisted on it and paid for the treatment in comparison to 22 per cent of the Finnish respondents (p less than 0.001). In case dental insurance was to pay for this kind of treatment it was accepted by 6 per cent of the Finns and 25 per cent of the Swedes. The attitude to amalgam was in general less favorable among the dentists in Sweden than in Finland.

PEACE: pulsar evaluation algorithm for candidate extraction - a software package for post-analysis processing of pulsar survey candidates

NASA Astrophysics Data System (ADS)

Lee, K. J.; Stovall, K.; Jenet, F. A.; Martinez, J.; Dartez, L. P.; Mata, A.; Lunsford, G.; Cohen, S.; Biwer, C. M.; Rohr, M.; Flanigan, J.; Walker, A.; Banaszak, S.; Allen, B.; Barr, E. D.; Bhat, N. D. R.; Bogdanov, S.; Brazier, A.; Camilo, F.; Champion, D. J.; Chatterjee, S.; Cordes, J.; Crawford, F.; Deneva, J.; Desvignes, G.; Ferdman, R. D.; Freire, P.; Hessels, J. W. T.; Karuppusamy, R.; Kaspi, V. M.; Knispel, B.; Kramer, M.; Lazarus, P.; Lynch, R.; Lyne, A.; McLaughlin, M.; Ransom, S.; Scholz, P.; Siemens, X.; Spitler, L.; Stairs, I.; Tan, M.; van Leeuwen, J.; Zhu, W. W.

2013-07-01

Modern radio pulsar surveys produce a large volume of prospective candidates, the majority of which are polluted by human-created radio frequency interference or other forms of noise. Typically, large numbers of candidates need to be visually inspected in order to determine if they are real pulsars. This process can be labour intensive. In this paper, we introduce an algorithm called Pulsar Evaluation Algorithm for Candidate Extraction (PEACE) which improves the efficiency of identifying pulsar signals. The algorithm ranks the candidates based on a score function. Unlike popular machine-learning-based algorithms, no prior training data sets are required. This algorithm has been applied to data from several large-scale radio pulsar surveys. Using the human-based ranking results generated by students in the Arecibo Remote Command Center programme, the statistical performance of PEACE was evaluated. It was found that PEACE ranked 68 per cent of the student-identified pulsars within the top 0.17 per cent of sorted candidates, 95 per cent within the top 0.34 per cent and 100 per cent within the top 3.7 per cent. This clearly demonstrates that PEACE significantly increases the pulsar identification rate by a factor of about 50 to 1000. To date, PEACE has been directly responsible for the discovery of 47 new pulsars, 5 of which are millisecond pulsars that may be useful for pulsar timing based gravitational-wave detection projects.

The predictability of frequency-altered auditory feedback changes the weighting of feedback and feedforward input for speech motor control.

PubMed

Scheerer, Nichole E; Jones, Jeffery A

2014-12-01

Speech production requires the combined effort of a feedback control system driven by sensory feedback, and a feedforward control system driven by internal models. However, the factors that dictate the relative weighting of these feedback and feedforward control systems are unclear. In this event-related potential (ERP) study, participants produced vocalisations while being exposed to blocks of frequency-altered feedback (FAF) perturbations that were either predictable in magnitude (consistently either 50 or 100 cents) or unpredictable in magnitude (50- and 100-cent perturbations varying randomly within each vocalisation). Vocal and P1-N1-P2 ERP responses revealed decreases in the magnitude and trial-to-trial variability of vocal responses, smaller N1 amplitudes, and shorter vocal, P1 and N1 response latencies following predictable FAF perturbation magnitudes. In addition, vocal response magnitudes correlated with N1 amplitudes, vocal response latencies, and P2 latencies. This pattern of results suggests that after repeated exposure to predictable FAF perturbations, the contribution of the feedforward control system increases. Examination of the presentation order of the FAF perturbations revealed smaller compensatory responses, smaller P1 and P2 amplitudes, and shorter N1 latencies when the block of predictable 100-cent perturbations occurred prior to the block of predictable 50-cent perturbations. These results suggest that exposure to large perturbations modulates responses to subsequent perturbations of equal or smaller size. Similarly, exposure to a 100-cent perturbation prior to a 50-cent perturbation within a vocalisation decreased the magnitude of vocal and N1 responses, but increased P1 and P2 latencies. Thus, exposure to a single perturbation can affect responses to subsequent perturbations. © 2014 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

Smoking and the eye: what Québec teenagers know and fear.

PubMed

Brûlé, Julie; Tousignant, Benoît; Marcotte, Stéphanie; Moreau, Marie-Christelle

2018-01-01

Although most people associate smoking with lung cancer and heart disease, few are aware of the impact of smoking on ocular health. Studies have suggested a better knowledge of this association might promote higher quit rates, particularly in teenagers. The purpose of our study was to determine the knowledge of teenagers about the effects of smoking on ocular health and the fear associated with several tobacco-related health conditions. A self-administered questionnaire was distributed to 180 high school students aged 14 to 17 years. Measured variables included socio-economic demographics, smoking status, knowledge of the effects of smoking on general and ocular health, and level of fear as well as level of motivation to quit smoking associated with the following tobacco-related conditions: lung cancer, cardiovascular disease, heart attack, blindness and deafness. Response rate was 100 per cent. Eleven per cent of responders were smokers. The proportion of smokers who thought smoking could cause blindness was 64.3 per cent while it was 13.5 per cent for non-smokers. The proportion of smokers fearing blindness was 30 per cent, as opposed to 69.8 per cent for non-smokers. The proportion of respondents who thought the presented conditions were 'extremely' or 'very good' reasons to quit were similarly high for all smoking-associated conditions. These findings suggest teenagers are unaware of the impact smoking can have on ocular health. Smokers did not seem more concerned about vision loss compared to other tobacco-related diseases, as opposed to non-smokers. Our findings suggest vision loss would be a strong motivator to prevent initiation, but not very effective regarding cessation in this group. However, optometrists should be aware teenagers seem receptive to the message that 'smoking can cause blindness' and use this strategy in order to prevent smoking initiation. © 2017 Optometry Australia.

Prescription compliance in ophthalmic lenses.

PubMed

Yuen, Gloria S-C; Chou, B Ralph; Ngo, Thao Pt; Cheng, Brian B; Dain, Stephen J

2011-07-01

Tolerances required for ophthalmic lenses are set down in national and international standards. It appears that the compliance of manufactured lenses has not been reported previously. Assembling a statistical quantity of lenses of a single prescription is usually an expensive process. It was, secondary to a lens impact study, possible to assemble a large number of plano lenses. In the assessment of the fracture velocity of lenses approximately 20 plano lenses of each material and thickness are required. Prior to using lenses for the impact study, they were checked for prescription. The results of the prescription measurements are reported here and the results of the impact study are reported in a separate paper. Using an automated focimeter, 679 plano lenses in stock thickness, typical occupational eye protector thickness and up to 3.5 mm thick were measured. There were 21 combinations of material/thickness/coating from seven suppliers. The power was evaluated against Australian Standard 2228.1-1992, as the lenses were supplied in Australia. The permitted tolerances are ±0.09 D sphere and ±0.06 D cylinder. When assessed for material/thickness/coating combination, failure rates varied from <0.0001 per cent to 77.5 per cent (with a further 17.3 per cent classified as borderline, because they were within the uncertainty of measurement of the required limit). Grouped by supplier, the failure rates ranged from <0.0001 per cent to 7.6 per cent (with a further 12.3 per cent borderline). To improve understanding of the result, it may be easier to quote the figures without considering uncertainties. When assessed by supplier, the failure rate varies from <0.0001 per cent to 12.6 per cent. Compliance of plano lenses should be among the easiest of tasks for a laboratory. While we know of no defined or required acceptance rates for prescription lenses, a failure rate for a laboratory of 12.6 per cent, which includes a failure rate of 88 per cent in 2.8 mm thick refractive index = 1.53 hard coated lenses (n = 20) cannot be considered satisfactory and is a strong indication of a failure to check lenses before they leave the laboratory. © 2011 The Authors. Clinical and Experimental Optometry © 2011 Optometrists Association Australia.

Impotence evaluated by the use of prostaglandin E1

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hwang, T.I.; Yang, C.R.; Wang, S.J.

1989-06-01

We screened 80 patients at our hospital for the differential diagnosis of impotence using intracavernous injection of prostaglandin E1 (20 micrograms). The rate of positive response was 78.8 per cent (63 patients). Neither systemic reactions nor priapism occurred. However, a considerable incidence (23.8 per cent, 19 of 80 patients) of tolerable injection pain was encountered. The 133-xenon penile washout study was conducted routinely in impotent men for hemodynamic evaluation of penile vascularity. In 80 patients a positive correlation between the response of intracavernous prostaglandin E1 injection and the result of the washout study was found (r equals 0.381, p lessmore » than 0.0002). We selected 14 subjects randomly to receive additional intravenous infusions of prostaglandin E1 (6 ampules, 120 micrograms total) for 3 days, after which another 133-xenon washout study was done. The washout studies before and after intravenous prostaglandin E1 infusion were compared, and 10 patients (71.4 per cent) appeared to obtain improvement in half-time clearance and penile blood flow. However, only 3 patients noticed improvement subjectively. We suggest that prostaglandin E1 could be a desirable alternative for the diagnosis and treatment of impotence.« less

Nuptiality pattern in Saudi Arabia.

PubMed

Farag, M K; al-Mazrou, Y Y; Baldo, M H; Aziz, K M; al-Shehri, S N

1995-01-01

The data of this work are based on the 'Saudi Maternal and Child Health Survey' conducted in 1991. This was a nationwide house to house field survey. The study included 6294 ever-married Saudi female in the childbearing age who represent the target population. They were randomly selected from both urban and rural settings of the five geographical areas of Saudi Arabia. The mean current age of the sample of ever-married women was 31 years and the mean age at first marriage was 17 and 16 years for urban and rural females, respectively. Education was associated with upward shift of the age at first marriage. About 20 per cent of the sampled ever-married Saudi females got married before their 15th birthday and 83 per cent before reaching 20 years of age. These percentages are even higher in rural than urban settings. The overall percentage of women who were currently married at the time of the survey was 96 per cent. The divorced and widowed women of childbearing age were 2 and 3 per cent, respectively, of the total. Husband's educational level had positive impact on the frequency of divorce. The latter was highest among women married to illiterate husbands with a dose response pattern. Comparison has been made with the situation 4 years ago. An increase in literacy rates among Saudi ever-married women and their husbands was observed, however, a significant (P < 0.05) difference still exists between female and male literacy rates (38 and 71 per cent, respectively). The events of early marriage, before the age of 15 years, became less frequent. There is an overall decline in teenage marriages which explains a large part of the recent changes observed in nuptiality and pattern of birth in Saudi Arabia.

Continuing education: the 1998 Survey of the Royal Australasian College of Dental Surgeons.

PubMed

Sambrook, P; Thomson, D; Bastiaan, R; Goss, A

2001-06-01

Continuing education (CE) is an essential professional activity. In the last decade, CE has been actively pursued by the medical profession in Australia and abroad. However, the uptake of CE in dentistry has been much slower and there is minimal Australian data on dental CE. To determine the level of CE activity, in 1998, postal questionnaires were sent to all fellows of the Royal Australasian College of Dental Surgeons. The responses were analysed. There was a high response rate (90 per cent) but a moderate usable rate (54 per cent). The results show a biphasic distribution between high and low CE activity. The average amount of activity of those involved in CE was 116 hours per year, above the usually accepted minimum of 100 hours/year. Some groups, particularly members of the specialist divisions of oral and maxillofacial surgeons (215 hours) and periodontists (205 hours), have high levels of CE. However, approximately 25 per cent of college fellows reported little or no CE activity. The survey revealed that inactive fellows are more likely to be older and in general practice. Inactive fellows were also tardy in replying to the questionnaire. The high activity CE group needs to be recognised and encouraged to continue. Specific plans to help the low CE activity group should be developed. Although these findings relate directly to the Royal Australasian College of Dental Surgeons, they are presented as they have implications for the dental profession at large.

Acid reflux management: ENT perspective.

PubMed

Ahmad, Ijaz; Batch, A J G

2004-01-01

Otolaryngological manifestations of acid reflux include a wide range of pharyngeal and laryngeal symptoms; and the constellation of symptoms has been called laryngopharyngeal reflux. This is a prospective study in a cohort of patients with various throat symptoms suggestive of laryngopharyngeal reflux (LPR) who underwent flexible oesophago-gastroscopy, as a principal investigation. The aims were to look at the most reliable symptom(s) and sign(s), the diagnostic role of flexible oesophago-gastroscopy and the treatment response in these patients. The endoscopy score of 0 to 3 was based on endoscopic findings and the treatment response was measured from 0 to 100 per cent improvement of symptoms, as described by the patients. There were a total of 303 patients, 174 females and 129 males with ages ranging from 19 to 88 years. Seventy-five per cent had had symptoms for more than a year. Fifteen per cent were smokers. Globus, voice change, sore throat, dysphagia and cough were the predominant symptoms. Most patients, however, presented with a complex of various other secondary symptoms. The endoscopic findings were abnormal in 98 per cent of patients. Apart from the finding of non-specific hyperaemia, usually of the posterior larynx (13 per cent), lesions of the larynx and vocal folds were surprisingly uncommon. Proton pump inhibitors (PPI) were prescribed in 90 per cent of patients. A total of 233 (76.8 per cent) responded to treatment. The improvement of symptoms ranged from 25 per cent in 36 (23 per cent), 50 per cent in 60 (20 per cent), 75 per cent in 59 (19 per cent) and 100 per cent in 78 (26 per cent) patients. Accumulative analysis of variance showed a significant difference between treatment responders and non-responders (p <0.04). In a logistic regression model patients with globus, voice change and gastric prolapse were more likely to respond to treatment (p <0.04). It can be concluded that voice change, sore throat, globus and cough choking are the most reliable symptoms of laryngopharyngeal reflux. Voice change and globus symptoms can be of predictive value in terms of successful treatment response. Flexible oesophago-gastroscopy (FOG) is a simple, safe and reliable way of assessment in these cases and treatment with PPI can be effective in the majority of patients.

Prevalence of rheumatoid arthritis in Dublin, Ireland: a population based survey.

PubMed

Power, D; Codd, M; Ivers, L; Sant, S; Barry, M

1999-01-01

The prevalence of Rheumatoid Arthritis (RA) in Ireland has never been established. Studies from different countries show varying rates, being almost 100 per cent greater in the highlands of Scotland (10/1,000) than in rural Lesotho (6/1,000). A recent study also suggests a fall in the prevalence of RA among women in the London urban area. Given these variations the validity of extrapolating prevalence rates established for other countries to Ireland is questionable. This study aimed to establish a prevalence rate for RA in a defined Dublin population. A self-administered questionnaire was sent to 2,500 people chosen at random from the electoral register. The questionnaire was designed to select out both undiagnosed patients and those with definite arthritis. Respondents whose replies indicated an arthritic process, but in whom no diagnosis had been made, were asked to attend for further assessment and investigations as appropriate. Those who responded that they had been diagnosed with arthritis were asked for consent to inspect their hospital or general practitioner records. A diagnosis of RA was based on American Rheumatism Association (ARA) criteria. Valid responses were received from 1,227 people surveyed (response rate = 49 per cent). Six cases of RA were identified including 2 previously undiagnosed cases. A prevalence rate of 5/1,000 has been estimated based on these findings.

Twins: causes of perinatal death in 12 United States cities and one African city.

PubMed

Naeye, R L; Tafari, N; Judge, D; Marboe, C C

1978-06-01

The perinatal mortality rate in a large U. S. study was 139 per 1,000 births for twins and 33 per 1,000 for singletons. Sixteen per cent of the twin deaths were due to amniotic fluid infections, 11 per cent to premature rupture of the membranes, 8 per cent to the monovular twin transfusion syndrome, 8 per cent to large placental infarcts, 7 per cent to congenital anomalies, and the rest to over 20 other disorders. The perinatal mortality rate for monozygotic twins was 2.7 times that for dizygotic twins, mainly due to more amniotic fluid infections, congenital anomalies, and the twin transfusion syndrome in the monozygotic pairs. To study the role of poor maternal nutrition on twins, a similar study of perinatal mortality rates was undertaken in Addis Ababa, Ethiopia. Addis Ababa twins had 2.5 times the mortality rate of U. S. twins, mainly due to a higher frequency of amniotic fluid infections, abruptio placentae, cord accidents, obstructed labors, congenital syphillis, and the twin transfusion syndrome in the Ethiopians.

Effect of a blood transfusion protocol and low dose steroid regime on renal transplant survival.

PubMed

Notghi, A; Anderton, J L; Chisholm, G D; Hamer-Hodges, D; Wilkinson, S; Smith, G; Galloway, N T; Yap, P L; Winney, R J

1986-04-01

The effects of introduction of a low steroid regime and pre-transplant blood transfusion were evaluated. The kidney and patient survival rates for the period before such a policy was adopted were compared with the period after this policy. There has been a highly significant rise in patient survival rates to the present level of 95 per cent at three years. There was a similar rise in three year graft survival rates from less than 40 per cent to 66 per cent.

The use of digital imaging, video conferencing, and telepathology in histopathology: a national survey.

PubMed

Dennis, T; Start, R D; Cross, S S

2005-03-01

To undertake a large scale survey of histopathologists in the UK to determine the current infrastructure, training, and attitudes to digital pathology. A postal questionnaire was sent to 500 consultant histopathologists randomly selected from the membership of the Royal College of Pathologists in the UK. There was a response rate of 47%. Sixty four per cent of respondents had a digital camera mounted on their microscope, but only 12% had any sort of telepathology equipment. Thirty per cent used digital images in electronic presentations at meetings at least once a year and only 24% had ever used telepathology in a diagnostic situation. Fifty nine per cent had received no training in digital imaging. Fifty eight per cent felt that the medicolegal implications of duty of care were a barrier to its use. A large proportion of pathologists (69%) were interested in using video conferencing for remote attendance at multidisciplinary team meetings. There is a reasonable level of equipment and communications infrastructure among histopathologists in the UK but a very low level of training. There is resistance to the use of telepathology in the diagnostic context but enthusiasm for the use of video conferencing in multidisciplinary team meetings.

Occupational musculoskeletal pain amongst ENT surgeons - are we looking at the tip of an iceberg?

PubMed

Vijendren, A; Yung, M; Sanchez, J; Duffield, K

2016-05-01

Surgeons are exposed to a variety of occupational risks, including work-related musculoskeletal disorders. This study investigated the prevalence of these latter disorders amongst UK ENT surgeons and compared this with the existing literature. A survey containing questions on work-related musculoskeletal disorders was distributed to the entire membership of ENT-UK electronically, with the assistance of its Survey Guardian. A literature review on the subject was then performed. A total of 323 completed questionnaires were received (a 24 per cent response rate). Work-related musculoskeletal disorders had been experienced by 47.4 per cent of respondents. There were no statistical differences between the occurrence of work-related musculoskeletal disorders and: grade, length of time spent in the specialty or the subspecialty of respondents. Eighty-five per cent of affected surgeons sought treatment, with 22.9 per cent taking time off work and six surgeons retiring early. The literature review only identified five related studies. Despite the scarcity of studies, work-related musculoskeletal disorders are common amongst ENT surgeons in the UK. Such disparity highlights the need for more research and appropriate ergonomic intervention within the specialty.

Can cell kinetic parameters predict the response of tumours to radiotherapy?

PubMed

McNally, N J

1989-11-01

Three potential predictive assays of the repopulation component in tumour response to therapy are considered. (1) The DNA index can easily be measured. It is of prognostic value for cancers of certain sites, aneuploidy being a bad prognostic indicator. It is not strictly an indicator of cell proliferation. (2) The in vitro labelling index is of predictive value in early stage operable breast cancer and in head and neck cancer. In the former a high pretreatment labelling index can identify patients who could benefit from adjuvant chemotherapy. (3) The tumour potential doubling time (Tpot) can be measured rapidly following in vivo labelling with bromodeoxyuridine or iododeoxyuridine. We have measured Tpot in over 100 solid tumours with a success rate of about 75 per cent. Nearly 50 per cent of the tumours have a pre-treatment potential doubling time of 5 days or less. These would be suitable candidates for accelerated fractionation.

The prevalence and causes of visual impairment in seven-year-old children.

PubMed

Ghaderi, Soraya; Hashemi, Hassan; Jafarzadehpur, Ebrahim; Yekta, Abbasali; Ostadimoghaddam, Hadi; Mirzajani, Ali; Khabazkhoob, Mehdi

2018-05-01

To report the prevalence and causes of visual impairment in seven-year-old children in Iran and its relationship with socio-economic conditions. In a cross-sectional population-based study, first-grade students in the primary schools of eight cities in the country were randomly selected from different geographic locations using multistage cluster sampling. The examinations included visual acuity measurement, ocular motility evaluation, and cycloplegic and non-cycloplegic refraction. Using the definitions of the World Health Organization (presenting visual acuity less than or equal to 6/18 in the better eye) to estimate the prevalence of vision impairment, the present study reported presenting visual impairment in seven-year-old children. Of 4,614 selected students, 4,106 students participated in the study (response rate 89 per cent), of whom 2,127 (51.8 per cent) were male. The prevalence of visual impairment according to a visual acuity of 6/18 was 0.341 per cent (95 per cent confidence interval 0.187-0.571); 1.34 per cent (95 per cent confidence interval 1.011-1.74) of children had visual impairment according to a visual acuity of 6/18 in at least one eye. Sixty-six (1.6 per cent) and 23 (0.24 per cent) children had visual impairment according to a visual acuity of 6/12 in the worse and better eye, respectively. The most common causes of visual impairment were refractive errors (81.8 per cent) and amblyopia (14.5 per cent). Among different types of refractive errors, astigmatism was the main refractive error leading to visual impairment. According to the concentration index, the distribution of visual impairment in children from low-income families was higher. This study revealed a high prevalence of visual impairment in a representative sample of seven-year-old Iranian children. Astigmatism and amblyopia were the most common causes of visual impairment. The distribution of visual impairment was higher in children from low-income families. Cost-effective strategies are needed to address these easily treatable causes of visual impairment. © 2017 Optometry Australia.

Developing an analytical tool for evaluating EMS system design changes and their impact on cardiac arrest outcomes: combining geographic information systems with register data on survival rates

PubMed Central

2013-01-01

Background Out-of-hospital cardiac arrest (OHCA) is a frequent and acute medical condition that requires immediate care. We estimate survival rates from OHCA in the area of Stockholm, through developing an analytical tool for evaluating Emergency Medical Services (EMS) system design changes. The study also is an attempt to validate the proposed model used to generate the outcome measures for the study. Methods and results This was done by combining a geographic information systems (GIS) simulation of driving times with register data on survival rates. The emergency resources comprised ambulance alone and ambulance plus fire services. The simulation model predicted a baseline survival rate of 3.9 per cent, and reducing the ambulance response time by one minute increased survival to 4.6 per cent. Adding the fire services as first responders (dual dispatch) increased survival to 6.2 per cent from the baseline level. The model predictions were validated using empirical data. Conclusion We have presented an analytical tool that easily can be generalized to other regions or countries. The model can be used to predict outcomes of cardiac arrest prior to investment in EMS design changes that affect the alarm process, e.g. (1) static changes such as trimming the emergency call handling time or (2) dynamic changes such as location of emergency resources or which resources should carry a defibrillator. PMID:23415045

ACTION OF SERUM ON FIBROBLASTS IN VITRO

PubMed Central

Carrel, Alexis; Ebeling, Albert H.

1923-01-01

It may be concluded that, under the conditions of the experiments: 1. The duration of life of fibroblasts is not altered by the presence of 7 per cent serum in a medium composed of fibrin and Tyrode solution, but is slightly decreased when the concentration of the serum reaches 25 per cent. 2. Fibroblasts cultivated in serum or in Tyrode solution are only in a condition of survival; they do not build up new protoplasm from the serum proteins and their mass does not increase. 3. When embryonic tissue juice is added to the medium, the tissues increase in mass. But the rate of growth is the same in media containing 0 per cent and 10 per cent serum. In 25 per cent serum, however, the rate of growth slightly decreases. Even in the presence of embryonic tissue juice, serum does not increase the rate of growth of connective tissue. 4. The nitrogenous compounds contained in serum are not used as food material by fibroblasts growing in vitro. PMID:19868757

Results of surgical palliation for cancer of the head of the pancreas and periampullary region.

PubMed

Prêtre, R; Huber, O; Robert, J; Soravia, C; Egeli, R A; Rohner, A

1992-08-01

Between 1977 and 1986, 101 patients underwent surgical bypass for periampullary carcinoma. The hospital mortality rate was 18 per cent and the morbidity rate 43 per cent. Mortality was not influenced by the extent of the tumour. Survival rates at 1,2 and 3 years were 28, 9 and 4 per cent, respectively. The median survival time was 17 months for localized tumours, 10 months for those that had invaded surrounding tissues, 6 months in the presence of lymph node involvement and 3 months with distant metastasis. The quality of survival was good for most patients with localized tumours but poor for those with parenchymal metastasis, in whom palliation was transient for 85 per cent and effective for less than half of their survival time for 60 per cent. These results suggest that patients with distant metastasis but without impending duodenal obstruction should undergo palliation by endoscopic or percutaneous routes while those with less advanced disease or with duodenal involvement remain candidates for surgical bypass.

Effectiveness of 3 per cent boric acid in 70 per cent alcohol versus 1 per cent clotrimazole solution in otomycosis patients: a randomised, controlled trial.

PubMed

Romsaithong, S; Tomanakan, K; Tangsawad, W; Thanaviratananich, S

2016-09-01

To compare the clinical effectiveness and adverse events for 3 per cent boric acid in 70 per cent alcohol versus 1 per cent clotrimazole solution in the treatment of otomycosis. A total of 120 otomycosis patients were randomly assigned to receive either 1 per cent clotrimazole solution (intervention group) or 3 per cent boric acid in 70 per cent alcohol (control group) at the Khon Kaen Hospital ENT out-patient department. Treatment effectiveness was determined based on the otomicroscopic absence of fungus one week after therapy, following a single application of treatment. After 1 week of treatment, there were data for 109 participants, 54 in the clotrimazole group and 55 in the boric acid group. The absolute difference in cure rates between 1 per cent clotrimazole solution and 3 per cent boric acid in 70 per cent alcohol was 17.9 per cent (95 per cent confidence interval, 2.3 to 33.5; p = 0.028) and the number needed to treat was 6 (95 per cent confidence interval, 3.0 to 43.4). Adverse events for the two agents were comparable. One per cent clotrimazole solution is more effective than 3 per cent boric acid in 70 per cent alcohol for otomycosis treatment.

Study on the management of diarrhea in young children at community level in Thailand.

PubMed

Wongsaroj, T; Thavornnunth, J; Charanasri, U

1997-03-01

An evaluating study was carried out among 15,466 children from households randomized from 30 clusters from twelve provinces of twelve regions of Thailand. Results of this study revealed 5.13 per cent of incidence-rate of diarrhea among young children aged under five years with an average of annual prevalence of 1.3 per child. The overall mortality-rate and diarrhea associated death were 51.7 per 100,000 and 6.5 per 100,000 respectively. The utilization of ORS was 25.6 per cent while the using-rate of sugar salt solution (SSS) and the use of recommended home fluids were 2.8 and 33.8 per cent respectively. As for treatment, the intravenous therapy was 6.2 per cent and the use of different types of drugs varied from 18.0 to 21.3 per cent. Only 23.7 per cent of parents could correctly prepare the ORS. The authors have made recommendations for the strengthening of community health education aiming at better promotion of ORS and other home care practices for diarrhea as important measures for lowering mortality together with relating preventive interventions.

Re-Visit to the School Nurse and Adolescents' Medicine Use

ERIC Educational Resources Information Center

Borup, Ina K.; Andersen, Anette; Holstein, Bjorn E.

2011-01-01

Objective: To examine if students who re-visit the school nurse use medicines differently than other students when exposed to aches and psychological problems. Methods: The study includes all 11-, 13- and 15-year-old students from a random sample of schools in Denmark, response rate 87 per cent, n = 5,205. The data collection followed the…

Population‐based incidence rate of inpatient and outpatient surgical procedures in a high‐income country

PubMed Central

Jarnheimer, A.; Rose, J.; Björk, J.; Meara, J. G.; Hagander, L.

2017-01-01

Background The WHO and the World Bank ask countries to report the national volume of surgery. This report describes these data for Sweden, a high‐income country. Methods In an 8‐year population‐based observational cohort study, all inpatient and outpatient care in the public and private sectors was detected in the Swedish National Patient Register and screened for the occurrence of surgery. The entire Swedish population was eligible for inclusion. All patients attending healthcare for any disease were included. Incidence rates of surgery and likelihood of surgery were calculated, with trends over time, and correlation with sex, age and disease category. Results Almost one in three hospitalizations involved a surgical procedure (30·6 per cent). The incidence rate of surgery exceeded 17 480 operations per 100 000 person‐years, and at least 58·5 per cent of all surgery was performed in an outpatient setting (range 58·5 to 71·6 per cent). Incidence rates of surgery increased every year by 5·2 (95 per cent c.i. 4·2 to 6·1) per cent (P < 0·001), predominantly owing to more outpatient surgery. Women had a 9·8 (95 per cent c.i. 5·6 to 14·0) per cent higher adjusted incidence rate of surgery than men (P < 0·001), mainly explained by more surgery during their fertile years. Incidence rates peaked in the elderly for both women and men, and varied between disease categories. Conclusion Population requirements for surgery are greater than previously reported, and more than half of all surgery is performed in outpatient settings. Distributions of age, sex and disease influence estimates of population surgical demand, and should be accounted for in future global and national projections of surgical public health needs. PMID:29131303

Facial burns in children: a series analysis with implications for resuscitation and forensic odontology.

PubMed

Acton, C; Nixon, J; Pearn, J; Williams, D; Leditschke, F

1999-03-01

This study comprises a continuous (1981-1995) unselected series of all children who died from thermal injuries in the State of Queensland, Australia. One hundred and six children, so identified, died from incineration (35 per cent), respiratory burns with smoke or carbon monoxide inhalation (33 per cent), body surface area burns comprising greater than 60 per cent (9 per cent) and electrocution (20 per cent). The burn fatality rate was 0.98 per hundred thousand children (0-14 years) per year, with no secular trend and, specifically, no reduction in the annual rate of such fatalities. Eighty-two children (49 males) had concomitant facial injuries, both thermal and nonthermal; of whom 55 per cent were under the age of five years. Sixty (73 per cent) child burn victims died in house fires. Forensic odontology is important in confirming the age of such victims in single incinerations but is of limited value when larger numbers of children are incinerated, because of the relative lack of dental restorations in the infant and pre-school age group. Of the 82 children with facial and airway injuries, 12 per cent had only mild or superficial facial damage and only seven (8 per cent) were alive or resuscitable at the time of rescue from the conflagration or burning injury. child deaths from burns contributed an annual loss rate of 506 years of potential life lost (YPLL) in a population of 3 million of whom 21.5 per cent were children under the age of 15 years. Airway management and resuscitation, in the context of managing surviving burn victims of any age with facial injuries, pose special difficulties. Inhalational burns (smoke and the gases of conflagration) result in a mortality greater than 60 per cent. Although 81 per cent of children showed evidence of airway obstruction, analysis of current data indicates that a maximum of 8 per cent could have survived with airway maintenance and protection. Inhalational burns (to both upper and lower airways) grossly reduce survivability. Primary prevention would seem vital and thus remains a major challenge to reduce the incidence of such deaths. Some strategies include advocacy to promote the compulsory installation of smoke alarms, family drills to practise escape and the teaching of 'first aid for all'

The anthelmintic efficacy of fenbendazole in the control of Moniezia expansa and Trichuris ovis in sheep.

PubMed

Townsend, R B; Kelly, J D; James, R; Weston, I

1977-11-01

The anthelmintic efficacy of fenbendazole (methyl 5-(phenyl-thio)-2-benzimidazole-carbamate) against Moniezia expansa and Trichuris ovis was tested. At dose rates of 5 mg per kg and above, efficacies were found to be greater than 91 percent against M expansa and greater than 92 per cent against T ovis. At these dose rates efficacy on egg suppression was 100 per cent for Moniezia and greater than 97 per cent for Trichuris.

Teen Birth Rate. Facts at a Glance

ERIC Educational Resources Information Center

Franzetta, Kerry; Ikramullah, Erum; Manlove, Jennifer; Moore, Kristin Anderson; Terry-Humen, Elizabeth

2005-01-01

Preliminary data for 2003 from the National Center for Health Statistics show the teen birth rate continues to decline, reaching historic lows for teens in each age group. The 2003 rate of 41.7 births per 1,000 females 15-19 was 33 per cent lower than the 1991 peak rate of 61.8. The 2003 birth rate for teens aged 15-17 (22.4) was 42 per cent lower…

Mortality, crime and access to basic needs before and after the Haiti earthquake: a random survey of Port-au-Prince households.

PubMed

Kolbe, Athena R; Hutson, Royce A; Shannon, Harry; Trzcinski, Eileen; Miles, Bart; Levitz, Naomi; Puccio, Marie; James, Leah; Noel, Jean Roger; Muggah, Robert

2010-01-01

On 12 January 2010 an earthquake measuring 7.0 on the Richter Scale struck Haiti, causing unprecedented death, injury and destruction for an event of this magnitude. Our aim was to generate a rapid assessment of the primary consequences for the population of the metropolitan area of Port-au-Prince, the national capital. During the summer of 2009 we conducted a survey of 1,800 households in metropolitan Port-au-Prince. Six weeks after the earthquake, we attempted to trace these households in order to re-interview them. The questionnaire examined mortality and injuries generated by the natural disaster, as well as the character of victimization, food security and living arrangements following the quake. Data analysis incorporated sampling weights and adjusted for clustering within households. The original 2009 survey featured a 90 per cent response rate; in 2010 we re-interviewed 93 per cent of these households. We estimate that 158,679 people in Port-au-Prince (95 per cent CI 136,813-180,545) died during the quake or in the six-week period afterwards owing to injuries or illness. Children were at particular risk for death. In the six weeks after the earthquake, 10,813 people (95 per cent CI 6,726-14,900) were sexually assaulted, the vast majority of whom were female. In the same period 4,645 individuals (95 per cent CI 1,943-7,347) were physically assaulted. Of all households, 18.6 per cent (95 per cent CI 16.6-20.8) were experiencing severe food insecurity six weeks after the earthquake. 24.4 per cent (95 per cent CI 22.1-26.9) of respondents' homes were completely destroyed. Many residents of Port-au-Prince died during or as a result of the earthquake, albeit fewer than were widely reported. More than half of the capital's population experienced moderate to severe food insecurity, though remittances are a major protective factor in promoting food security. Survivors continue to experience high levels of sexual assault and limited access to durable shelter.

37 CFR 255.3 - Adjustment of royalty rate.

Code of Federal Regulations, 2010 CFR

2010-07-01

... fraction thereof, whichever amount is larger, subject to further adjustment pursuant to paragraphs (b....85 cent per minute of playing time or fraction thereof, whichever amount is larger, subject to... embodied in the phonorecord shall be either 5.0 cents, or 0.95 cent per minute of playing time or fraction...

Discharge planning in a cardiology out-patient clinic: a clinical audit.

PubMed

Ingram, Shirley; Khan, Barkat

2014-01-01

The purpose of this paper is to audit the active discharge (DC) planning process in a general cardiology clinic, by pre-assessing patients' medical notes and highlighting those suitable for potential DC to the clinic physician. The cardiology clinical nurse specialist (CNS) identified patients' for nine- to 12-month return visits one week prior to attendance. The previous consultation letter was accessed and information was documented by the CNS in the medical record. The key performance indicator (KPI) used was patient DCs for each clinic visit. The process was audited at three separate times to reflect recommended action carried out. The CNS pre-assessment and presence at the clinics significantly increased total DCs during the first period compared to usual care, 11 vs 34 per cent (p < 0.0001). During the third audit period, DCs fell (9 per cent) with a reduction in CNS pre-assessed DCs (10 per cent). Recommendations were implemented. The process was continued by clinic administration staff, colour coding all nine- to 12-month returns, resulted in a 19 per cent DC rate in 2012. CNS pre-assessment and highlighting DC suitability increased the number of patient DCs. As the CNS presence at the clinic reduced so did the rate of DC. Specific personnel need to be responsible for monitoring and reminding staff of the process; this does not always have to be medical or nursing. Implementing positive discharging procedures is aimed at improving quality, increasing efficiency and accessibility of services for patients. This audit describes a process to promote DC planning from cardiology outpatients.

Phytate destruction by yeast fermentation in whole wheat meals. Study of high-extraction rate meals.

PubMed

Reinhold, J G

1975-01-01

Destruction of phytate by yeast fermentation is compared in sponges prepared from Iranian whole wheat meals of different extraction rates. Phytate was destroyed rapidly in whole meals of 75 to 85 and 85 to 90 per cent extraction, but destruction was retarded in those of 95 to 100 per cent extraction. Production of acid-soluble phosphorus kept pace with phytate destruction in the two whole meals of lower extraction rates but was delayed with less-than-expected yield in those of 95 to 100 per cent rate. Unleavened whole meal bread contains little acid-soluble phosphorus. Leavened breads made from whole meals of slightly lower extraction rate average five times as much. Since phytate phosphorus appears to remain unavailable in the small intestine in many circumstances, dependece on unleavened whole meal bread may result in critically low intakes of available phosphorus when other sources are lacking in the diet. It is concluded that replacement of the whole meals of 95 to 100 per cent extraction rate, presently the main staple of the diet of rural Iran, by those of somewhat lower rate is an important preliminary to the introduction of leaven and fermentation into village bread-making methods.

Impact of pre-operative body mass index in head and neck cancer patients undergoing microvascular reconstruction.

PubMed

Hyun, D-J; Joo, Y-H; Kim, M-S

2017-11-01

To analyse the relationship of pre-operative body mass index with surgical complications and oncological outcomes in patients undergoing microvascular reconstruction for head and neck squamous cell cancer. A retrospective review was conducted of 259 patients who underwent microvascular free flap reconstruction after head and neck ablative surgery. Mean body mass index was 22.48 kg/m2. There were no correlations between body mass index and: flap failure (p = 0.739), flap ischaemia (p = 0.644), pharyngocutaneous fistula (p = 0.141) or wound infection (p = 0.224). The five-year disease-specific survival rate was 63 per cent. On univariate analysis, the five-year disease-specific survival rate was significantly correlated with pre-operative body mass index, based on Kaplan-Meier survival curves (p = 0.028). The five-year disease-specific survival rates in underweight, normal weight, overweight and obese groups were 47 per cent, 55 per cent, 65 per cent and 80 per cent, respectively. Pre-operative body mass index was a useful predictor for recurrence and survival in patients who underwent microvascular reconstruction for head and neck squamous cell cancer.

Injury rates during the 1988 US Olympic Team Trials for taekwondo.

PubMed Central

Zemper, E D; Pieter, W

1989-01-01

Injury rates were recorded during the 1988 US Olympic Team Trials for taekwondo involving 48 men and 48 women. The injury rate for men (12.74/100 athlete-exposures) was about 40 per cent higher than the rate for women (9.01/100 athlete-exposures). The foot and the head were the most frequently injured body parts. Contusions were the predominant type of injury, and concussions were recorded for both men and women. A large proportion (41 per cent) of the men's injuries were the result of receiving a blow from an unblocked attack. For the women the most common injury situation (40 per cent) was while attacking with a kick. For both men and women, 15 per cent of the reported injuries were time-loss injuries. The head injuries found in this study are discussed with reference to the high impact velocities and momentum levels generated during taekwondo kicking. Recommendations are made with regard to protective equipment testing and rule changes to reduce the possibility of cerebral injury. PMID:2620229

Effect of Ambient Temperature on Australian Northern Territory Public Hospital Admissions for Cardiovascular Disease among Indigenous and Non-Indigenous Populations

PubMed Central

Webb, Leanne; Bambrick, Hilary; Tait, Peter; Green, Donna; Alexander, Lisa

2014-01-01

Hospitalisations are associated with ambient temperature, but little is known about responses in population sub-groups. In this study, heat responses for Indigenous and non-Indigenous people in two age groups were examined for two categories of cardiac diseases using daily hospital admissions from five Northern Territory hospitals (1992–2011). Admission rates during the hottest five per cent of days and the coolest five per cent of days were compared with rates at other times. Among 25–64 year olds, the Indigenous female population was more adversely affected by very hot days than the non-Indigenous female population, with admission rates for ischaemic heart disease (IHD) increasing by 32%. People older than 65 were more sensitive to cold, with non-Indigenous male admissions for heart failure increasing by 64%, and for IHD by 29%. For older Indigenous males, IHD admissions increased by 52% during cold conditions. For older non-Indigenous females, increases in admissions for heart failure were around 50% on these cold days, and 64% for older Indigenous females. We conclude that under projected climate change conditions, admissions for IHD amongst younger Indigenous people would increase in hot conditions, while admissions among elderly people during cold weather may be reduced. The responses to temperature, while showing significant relationships across the Northern Territory, may vary by region. These variations were not explored in this assessment. PMID:24531121

Meta-analysis of aberrant lymphatic drainage in recurrent breast cancer.

PubMed

Ahmed, M; Baker, R; Rubio, I T

2016-11-01

Sentinel node biopsy (SNB) in recurrent breast cancer offers targeted axillary staging compared with axillary lymph node dissection (ALND) or no treatment. The evidence for lymphatic mapping in recurrent breast cancer is reviewed, focusing on aberrant drainage and its implications for patient management. A meta-analysis of studies evaluating lymphatic mapping in recurrent breast cancer was performed. Outcomes included sentinel node identification, aberrant lymphatic pathways and metastatic node rates in aberrant drainage and ipsilateral axilla. Pooled odds ratios (ORs) and 95 per cent confidence intervals (c.i.) were estimated using fixed-effect analyses, or random-effects analyses in the event of statistically significant heterogeneity. Seven studies reported data on lymphatic mapping in 1053 patients with recurrent breast cancer. The intraoperative sentinel node identification rate was 59·6 (95 per cent c.i. 56·7 to 62·6) per cent, and significantly greater when the original axillary surgery was SNB compared with ALND (OR 2·97, 95 per cent c.i. 1·66 to 5·32). The rate of aberrant lymphatic drainage identification was 25·7 (23·0 to 28·3) per cent, and significantly greater when the original axillary surgery was ALND (OR 0·27, 0·19 to 0·38). The metastatic sentinel node rate was 10·4 (8·6 to 12·3) per cent, and a significantly greater metastatic nodal burden was identified in the ipsilateral axilla (OR 6·31, 1·03 to 38·79). Lymphatic mapping is feasible in recurrent breast cancer. It avoids ALND in over 50 per cent of patients who have undergone SNB, and allows the 4 per cent of patients with metastatically involved aberrant nodes to receive targeted surgical and adjuvant therapies. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

The accuracy of age—sex registers, practice medical records and family practitioner committee registers

PubMed Central

Fraser, Robin C.; Clayton, David G.

1981-01-01

This paper presents the results of a point prevalent evaluation of the comparative reliability and validity of age-sex registers, practice medical records and family practitioner committee (FPC) registers from five teaching practices. They all exhibited similar levels of acceptable accuracy for patient names, sex and age, but the distribution of wrong addresses varied greatly: practice medical records 3·9 per cent, age-sex registers 8·2 per cent and FPC registers 17·1 per cent. The presence of a patient entry in all three registers was associated with a high degree of probability (95·3 per cent) that this individual would be a bona fide practice patient. The register population inflation rates were FPC records 5·5 per cent, practice records 9·8 per cent and age-sex registers 10·6 per cent, but there were large variations between individual practices. A statistically significant contribution to inflation rates came from the age groups 0 to 1 and 21 to 40 (p<0·0005). The register population deflation rates were minimal. The significance of these findings is discussed and the need for practices to determine the accuracy of their individual age-sex registers is stressed. A convenient and economic method for so doing is suggested. We also suggest ways of making it easier to construct and use age-sex registers, since they can be a most versatile and useful aid to research in general practice. ImagesFigure 1. PMID:7320986

Iodine 125 source in interstitial tumor therapy. Clinical and biological considerations.

PubMed

Kim, J H; Hilaris, B

1975-01-01

Our clinical experience with interstitial tumor therapy is presented in 2 groups of patients: 98 patients with metastatic carcinoma in neck lymph nodes implanted with iodine 125, iridium 192 or radon 222 encapsulated sources, and 105 patients with primary unresectable lung tumors, which were implanted either with radon 222 or iodine 125 seeds. The local tumor control rates with iodine 125, radon 222 and iridium 192 were 78 per cent (38/49), 65 per cent (15/23) and 58 per cent (7/12), while the local complication rates were 17 per cent, 35 per cent and 43 per cent, respectively. An analysis of the tumor control rate as a function of the implanted tumor dose shows that the iodine 125 implants with a delivery of the minimal effective tumor dose of 16,000 rads have a higher therapeutic effect than either radon 222 or iridium 192. The results of the patients with unresectable lung tumors similarly show that the implants with iodine 125 sources are superior to those with radon 222. The advantages could stem from the better spatial dose distribution, and from radiobiologic considerations associated with low dose rates, continous irradiation, and possibly gains in RBE. There present clinical data clearly demonstrate that iodine 125 seeds have a higher therapeutic ratio than radon 222 seeds. There are, in addition, distinct physical advantages making iodine 125 an attractive substitute for radon 222 for the interstitial implantation of malignant tumors.

The use of digital imaging, video conferencing, and telepathology in histopathology: a national survey

PubMed Central

Dennis, T; Start, R D; Cross, S S

2005-01-01

Aims: To undertake a large scale survey of histopathologists in the UK to determine the current infrastructure, training, and attitudes to digital pathology. Methods: A postal questionnaire was sent to 500 consultant histopathologists randomly selected from the membership of the Royal College of Pathologists in the UK. Results: There was a response rate of 47%. Sixty four per cent of respondents had a digital camera mounted on their microscope, but only 12% had any sort of telepathology equipment. Thirty per cent used digital images in electronic presentations at meetings at least once a year and only 24% had ever used telepathology in a diagnostic situation. Fifty nine per cent had received no training in digital imaging. Fifty eight per cent felt that the medicolegal implications of duty of care were a barrier to its use. A large proportion of pathologists (69%) were interested in using video conferencing for remote attendance at multidisciplinary team meetings. Conclusions: There is a reasonable level of equipment and communications infrastructure among histopathologists in the UK but a very low level of training. There is resistance to the use of telepathology in the diagnostic context but enthusiasm for the use of video conferencing in multidisciplinary team meetings. PMID:15735155

Retrospective study of bacterial infective arthritis in 31 dogs.

PubMed

Clements, D N; Owen, M R; Mosley, J R; Carmichael, S; Taylor, D J; Bennett, D

2005-04-01

To characterise the presenting signs and pathological changes of canine bacterial infective arthritis in 31 dogs, and to document the response to different treatment regimens. Risk factors that may predispose joints to bacterial infective arthritis and influence the success of treatment were also investigated. A retrospective review of cases of bacterial infective arthritis that were presented to three university veterinary referral hospitals over a five-year period (January 1997 to January 2002) was performed. The elbow joint (38 per cent) and stifle joint (44 per cent) were most commonly affected. Radiographic changes consistent with pre-existing osteoarthritis were identified in 14 joints, which had no history of previous surgery (articular or periarticular) or penetrating wound. No significant difference (P = 0.78) was identified between the outcome of combined surgical and medical management, and medical management alone. There were trends for poorer outcomes with increased bodyweight of the dog, longer duration of lameness and a higher nucleated cell count of the affected joint fluid at presentation. The overall infection rate for articular surgical procedures at one institution was 1-3 per cent. Medical and/or surgical management were usually successful in resolving infection (94 per cent). However, they were frequently unsuccessful in restoring full joint function; this may in part have been due to the nature of the underlying joint

Breastfeeding at 6 weeks and predictive factors.

PubMed

Chye, J K; Zain, Z; Lim, W L; Lim, C T

1997-10-01

Despite the numerous changes made in accordance with the Baby Friendly Hospital Initiative at the University Hospital, Kuala Lumpur, the low rates of breastfeeding have persisted. This study aims to examine the current trend in infant feeding, and the influences of some perinatal and sociodemographic factors on breastfeeding. Five-hundred mothers with singleton pregnancies and healthy infants were interviewed at 6 weeks post-partum. Only 124 (25 per cent) mothers were practising exclusive breastfeeding (EBF), and 132 (26 per cent) mothers were using exclusive infant formula feeding (EIF). On logistic regression analyses, mothers who followed EBF were more likely to have had antenatal plans to breastfeed (Odds ratio 2.44, 95 per cent confidence interval 1.75-3.45), not in paid employment post-natally (OR 1.76, 95 per cent CI 1.31-2.36), of older age group (> 27 years) (OR 1.48, 95 per cent CI 1.13-1.93), had female infants (OR 1.38, 95 per cent CI 1.05-1.80) and of Indian ethnicity (compared to Chinese) (OR 3.87, 95 per cent CI 2.16-6.89). Breastfeeding difficulties were associated with decreased odds of EBF (OR 0.21, 95 per cent CI 0.13-0.34). Parental education, fathers' ages and incomes, primigravida status, Caesarean section, present of episiotomy, late first breastfeed, phototherapy, and length of hospital stay were not significant predictors of failure of EBF. In comparison, predictive factors for increased use of EIF were mothers who have had breastfeeding difficulties, < or = 9 years of schooling, and of Chinese descent. In conclusions, the overall rate of EBF by 6 weeks of age in infants born in this urban hospital had remained poor. The adverse factors for EBF identified in this study warrant further in-depth studies to determine effective ways of improving EBF rates.

General practitioners' knowledge and management of viral hepatitis in the migrant population.

PubMed

Guirgis, M; Yan, K; Bu, Y M; Zekry, A

2012-05-01

Escalating morbidity and mortality associated with hepatitis B virus (HBV) and hepatitis C virus (HCV) infections represent a major health burden in Australia, particularly among migrants from endemic areas who may present late. We evaluated the knowledge and educational needs of general practitioners (GPs) in the St George Division, Sydney which serves a large migrant population. The aims of the study were to identify gaps in knowledge about viral hepatitis that may affect management and referral patterns. GPs completed a survey comprised of 15 questions. They were also invited to comment on barriers to managing viral hepatitis in migrant patients. A 44% response rate was achieved from 280 eligible GPs. Forty-two per cent of GPs lacked confidence in interpreting HCV serology and 20% for HBV serology. Twenty-two per cent of GPs did not recognise HCC as a complication of HBV and 18% for HCV. Twenty per cent of GPs were unaware of treatment for HBV. Forty-seven per cent of GPs were uncertain whether pregnant women could receive HCV treatment. Twenty-three per cent and 21% of respondents believed that all HCV- or HBV-infected mothers, respectively, should not breast-feed. Eighty-nine per cent of GPs identified language difficulties as the main barrier to treatment among the migrant population. There were gaps in the knowledge of GPs particularly concerning natural history, diagnosis, treatment availability and management of pregnant or lactating women with viral hepatitis. Specific educational initiatives targeting these deficits are required as well as increased availability of language resources for managing patients from a non-English-speaking background. © 2011 The Authors. Internal Medicine Journal © 2011 Royal Australasian College of Physicians.

Potential value of routine contralateral patent processus vaginalis repair in children with unilateral inguinal hernia.

PubMed

Zhao, J; Chen, Y; Lin, J; Jin, Y; Yang, H; Wang, F; Zhong, H; Zhu, J

2017-01-01

The development of laparoscopy as a means of evaluation and treatment of inguinal hernia in children has raised the question of whether simultaneous closure of a contralateral patent processus vaginalis (CPPV) is justified. The present study aimed to determine the rate of metachronous inguinal hernia (MIH) in children with CPPV. Children with unilateral inguinal hernia from two hospitals underwent either open or laparoscopic repair, and were followed up for MIH. The presence of CPPV was evaluated during laparoscopy and, if detected, the CPPV was closed. The relationship between CPPV and subsequent MIH was studied. The study included children who had complete follow-up (90·0 per cent of those having open repair and 92·2 per cent of those undergoing laparoscopic repair). Of 2538 children who had open hernia repair, 62 (2·4 per cent) developed MIH (30 on the right side and 32 on the left; P = 0·015). Among 2855 children who underwent laparoscopic repair, a CPPV was identified and closed in 1469 (51·5 per cent). The rate of MIH after negative laparoscopic evaluation for CPPV was three of 2855 (0·1 per cent). There were no significant differences in the rate of CPPV between sexes and either the right or left side (P = 0·072 and P = 0·099 respectively). Ipsilateral recurrence was less frequent after laparoscopic repair: seven (0·2 per cent) versus 26 (1·0 per cent) for open repair (P < 0·001). Laparoscopic inguinal hernia repair was associated with a lower recurrence rate than open repair. Routine repair of CPPV reduced the rate of subsequent MIH, but 21 CPPVs needed to be closed to prevent one MIH. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

Portal vein embolization improves rate of resection of extensive colorectal liver metastases without worsening survival.

PubMed

Shindoh, J; Tzeng, C-W D; Aloia, T A; Curley, S A; Zimmitti, G; Wei, S H; Huang, S Y; Gupta, S; Wallace, M J; Vauthey, J-N

2013-12-01

Most patients requiring an extended right hepatectomy (ERH) have an inadequate standardized future liver remnant (sFLR) and need preoperative portal vein embolization (PVE). However, the clinical and oncological impact of PVE in such patients remains unclear. All consecutive patients presenting at the M. D. Anderson Cancer Center with colorectal liver metastases (CLM) requiring ERH at presentation from 1995 to 2012 were studied. Surgical and oncological outcomes were compared between patients with adequate and inadequate sFLRs at presentation. Of the 265 patients requiring ERH, 126 (47·5 per cent) had an adequate sFLR at presentation, of whom 123 underwent a curative resection. Of the 139 patients (52·5 per cent) who had an inadequate sFLR and underwent PVE, 87 (62·6 per cent) had a curative resection. Thus, the curative resection rate was increased from 46·4 per cent (123 of 265) at baseline to 79·2 per cent (210 of 265) following PVE. Among patients who underwent ERH, major complication and 90-day mortality rates were similar in the no-PVE and PVE groups (22·0 and 4·1 per cent versus 31 and 7 per cent respectively); overall and disease-free survival rates were also similar in these two groups. Of patients with an inadequate sFLR at presentation, those who underwent ERH had a significantly better median overall survival (50·2 months) than patients who had non-curative surgery (21·3 months) or did not undergo surgery (24·7 months) (P = 0·002). PVE enabled curative resection in two-thirds of patients with CLM who had an inadequate sFLR and were unable to tolerate ERH at presentation. Patients who underwent curative resection after PVE had overall and disease-free survival rates equivalent to those of patients who did not need PVE. © 2013 British Journal of Surgery Society Ltd. Published by John Wiley & Sons Ltd.

External rhinoplasty: a critical analysis of 500 cases.

PubMed

Foda, Hossam M T

2003-06-01

The study presents a comprehensive statistical analysis of a series of 500 consecutive rhinoplasties of which 380 (76 per cent) were primary and 120 (24 per cent) were secondary cases. All cases were operated upon using the external rhinoplasty technique; simultaneous septal surgery was performed in 350 (70 per cent) of the cases. Deformities of the upper two-thirds of the nose that occurred significantly more in the secondary cases included; dorsal saddling, dorsal irregularities, valve collapse, open roof and pollybeak deformities. In the lower third of the nose; secondary cases showed significantly higher incidences of depressed tip, tip over-rotation, tip asymmetry, retracted columella, and alar notching. Suturing techniques were used significantly more in primary cases, while in secondary cases grafting techniques were used significantly more. The complications encountered intra-operatively included; septal flap tears (2.8 per cent) and alar cartilage injury (1.8 per cent), while post-operative complications included; nasal trauma (one per cent), epistaxis (two per cent), infection (2.4 per cent), prolonged oedema (17 per cent), and nasal obstruction (0.8 per cent). The overall patient satisfaction rate was 95.6 per cent and the transcolumellar scar was found to be unacceptable in only 0.8 per cent of the patients.

Epidemiological, clinical, haematological and biochemical characteristics of canine hypothyroidism.

PubMed

Dixon, R M; Reid, S W; Mooney, C T

1999-10-23

Hypothyroidism was diagnosed in 50 dogs and excluded in 86 dogs suspected of hypothyroidism, on the basis of the results of bovine thyrotropin response tests. Breed, pedigree, sex or neutering status did not significantly influence the likelihood of the dogs being hypothyroid. The hypothyroid dogs were significantly older than the non-hypothyroid dogs referred to the University of Glasgow during the same period. However, when dogs under two years of age were excluded from the statistical analyses there was no significant difference in age between the two groups. The most common clinical characteristics associated with hypothyroidism were metabolic signs (84 per cent of cases), particularly lethargy (76 per cent), obesity or weight gain (44 per cent), and exercise intolerance (24 per cent); and dermatological abnormalities (80 per cent), including alopecia (56 per cent), poor coat quality (30 per cent) and hyperpigmentation (20 per cent). When compared with the laboratory reference limits the most common biochemical and haematological abnormalities were increased concentrations of triglycerides (88 per cent), cholesterol (78 per cent), glucose (49 per cent), and fructosamine (43 per cent), and increased activities of creatine kinase (35 per cent), and decreased concentrations of inorganic phosphate (63 per cent), and a low red blood cell count (40 per cent). When compared with reference limits derived from the euthyroid dogs the most common abnormalities were increased concentrations of gamma-glutamyltransferase (21 per cent), cholesterol (18 per cent), and aspartate aminotransferase (15 per cent) and a decreased red blood cell count (29 per cent), and decreased neutrophils (18 per cent) and decreased activity of creatine kinase (15 per cent). Assessment of cholesterol, creatine kinase, aspartate aminotransferase, gamma-glutamyltransferase, and red blood cell and neutrophil counts may be particularly useful in distinguishing hypothyroid dogs from euthyroid animals with similar clinical signs.

75 FR 55292 - Amendment to Egg Research and Promotion Order and Regulations To Increase the Rate of Assessment...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-10

...] Amendment to Egg Research and Promotion Order and Regulations To Increase the Rate of Assessment and.... SUMMARY: This proposed rule would amend the Egg Research and Promotion Order (Order) to increase the assessment rate on egg producers paying assessments to the American Egg Board (AEB) from 10 cents to 15 cents...

Government regulation of occupational safety: underground coal mine accidents 1973-75.

PubMed Central

Boden, L I

1985-01-01

The purpose of this paper is to determine the influence of federal mine safety inspections on underground coal mine accidents. An economic incentives model is developed to relate federal enforcement activities to accident rates. The determinants of accident rates are analyzed for 535 coal mines during the period 1973-75. Estimates based on these data when applied to the model indicate that increasing inspections by 25 per cent would have produced a 13 per cent decline in fatal accidents and an 18 per cent decline in disabling accidents. PMID:3985237

Government regulation of occupational safety: underground coal mine accidents 1973-75.

PubMed

Boden, L I

1985-05-01

The purpose of this paper is to determine the influence of federal mine safety inspections on underground coal mine accidents. An economic incentives model is developed to relate federal enforcement activities to accident rates. The determinants of accident rates are analyzed for 535 coal mines during the period 1973-75. Estimates based on these data when applied to the model indicate that increasing inspections by 25 per cent would have produced a 13 per cent decline in fatal accidents and an 18 per cent decline in disabling accidents.

Error-dependent modulation of speech-induced auditory suppression for pitch-shifted voice feedback.

PubMed

Behroozmand, Roozbeh; Larson, Charles R

2011-06-06

The motor-driven predictions about expected sensory feedback (efference copies) have been proposed to play an important role in recognition of sensory consequences of self-produced motor actions. In the auditory system, this effect was suggested to result in suppression of sensory neural responses to self-produced voices that are predicted by the efference copies during vocal production in comparison with passive listening to the playback of the identical self-vocalizations. In the present study, event-related potentials (ERPs) were recorded in response to upward pitch shift stimuli (PSS) with five different magnitudes (0, +50, +100, +200 and +400 cents) at voice onset during active vocal production and passive listening to the playback. Results indicated that the suppression of the N1 component during vocal production was largest for unaltered voice feedback (PSS: 0 cents), became smaller as the magnitude of PSS increased to 200 cents, and was almost completely eliminated in response to 400 cents stimuli. Findings of the present study suggest that the brain utilizes the motor predictions (efference copies) to determine the source of incoming stimuli and maximally suppresses the auditory responses to unaltered feedback of self-vocalizations. The reduction of suppression for 50, 100 and 200 cents and its elimination for 400 cents pitch-shifted voice auditory feedback support the idea that motor-driven suppression of voice feedback leads to distinctly different sensory neural processing of self vs. non-self vocalizations. This characteristic may enable the audio-vocal system to more effectively detect and correct for unexpected errors in the feedback of self-produced voice pitch compared with externally-generated sounds.

Sexual and marital relationships after radiotherapy for seminoma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schover, L.R.; Gonzales, M.; von Eschenbach, A.C.

Questionnaires on sexual function, marital status, and fertility were returned by 84 men who received radiotherapy for seminoma (Stage I, II, or III). The mean length of follow-up was ten years. Although 93 per cent were married, 19 per cent had low rates of sexual activity, 12 per cent reported low sexual desire, 15 per cent had erectile dysfunction, 10 per cent had difficulty reaching orgasm, and 14 per cent had premature ejaculation. The most common problems were reduced intensity of orgasm (33%) and reduced semen volume (49%). Twenty-one men remained childless, and 30 per cent of men worried atmore » least occasionally about infertility. Thirteen children were conceived after cancer therapy. The data suggest that sexual dysfunction and infertility are important concerns for a subgroup of men treated for seminoma.« less

Attitudes towards and personal use of complementary and alternative medicine amongst clinicians working in audiovestibular disciplines.

PubMed

Crundwell, G; Baguley, D M

2016-08-01

Literature indicates that complementary and alternative medicine is used by patients with auditory and vestibular symptoms. This study sought to determine the prevalence of complementary and alternative medicine uptake, and examine attitudes towards complementary and alternative medicine in clinicians working with audiovestibular disorder patients. The Holistic Complementary and Alternative Medicine Questionnaire and a devised questionnaire about recent and lifetime use of complementary and alternative medicine were used. Fifty-four individuals, including audiologists, ENT surgeons, nurses and rehabilitationists, completed the questionnaires (67 per cent response rate). Lifetime prevalence of complementary and alternative medicine uptake was 44 per cent, and 12-month prevalence was 22 per cent. Uptake was more common in females, but there was no significant difference in use when comparing age, seniority or profession. Attitudes towards complementary and alternative medicine were mildly adverse, but sizeable standard deviation indicates wide-ranging attitudes. Clinicians working with patients with audiovestibular disorders have a range of attitudes towards complementary and alternative medicine. Personal uptake of complementary and alternative medicine was lower than that of the general UK population, but remains sizeable.

Professionals' and laypersons' appreciation of various options for Class III surgical correction.

PubMed

Fabré, M; Mossaz, C; Christou, P; Kiliaridis, S

2010-08-01

The objectives of this study were to evaluate the assessments of maxillofacial surgeons, orthodontists, and laypersons on the predicted aesthetic outcome of various surgical options in Class III correction and the associations between certain initial cephalometric values and the judges' preferred option. Pre-surgical lateral headfilms and coloured profile photographs of 18 skeletal Class III Caucasian adult patients (10 males and 8 females) with a mean age of 24.5 years were used. The headfilms were hand traced and digitized. Conventional cephalometric analysis was performed. Computerized predictions of three surgical options, mandibular setback, Le Fort I advancement, and bimaxillary surgery, were made. For each case, the pre-surgical profile photograph with the three predictions was presented on a printed page. The questionnaire was sent to 51 maxillofacial surgeons (response rate 45.1 per cent), 78 orthodontists (response rate 71.8 per cent), and 61 laypersons (response rate 100 per cent) to aesthetically evaluate the pre-surgical photographs and the surgical predictions by placing a mark along a 10-graded visual analogue scale (VAS) using a standard profile for calibration. Confidence interval was calculated for each patient. An independent samples t-test was used to detect initial cephalometric values associated with the judges' preferred option and analysis of variance/Tukey's honestly significant differences to evaluate differences between judges. Intra-observer reliability was assessed with a paired t-test. All treatment predictions led to improved scoring of facial aesthetics with the exception of the setback option for three patients. For 14 patients, general agreement for the preferred option existed between the three groups of judges. Laypersons tended to give lower improvement scores than professionals. Overjet, nasofacial, and nasomental angles were important in decision making between the mandibular setback and Le Fort I options (the more negative the overjet, the larger the nasofacial angle, the smaller the nasomental angle, the greater the preference for the Le Fort I option). Wits appraisal seemed to be important in decision making between the mandibular setback and bimaxillary options (the more negative the Wits appraisal, the greater the preference for the latter option).

Compliance and hygiene behaviour among soft contact lens wearers in the Maldives.

PubMed

Gyawali, Rajendra; Nestha Mohamed, Fathimath; Bist, Jeewanand; Kandel, Himal; Marasini, Sanjay; Khadka, Jyoti

2014-01-01

Significant levels of non-compliance and poor hygiene among contact lens wearers have been reported previously from different parts of the world. This survey aimed at identifying the scope of hygiene and non-compliant behaviour of soft contact lens wearers in the Maldives. Established soft lens wearers attending two eye clinics in Male' city, were interviewed in office or via telephone. A set of interviewer-administered questions was used to access the subjective response on compliance and hygiene behaviour (hand and lens case hygiene, water exposure, adherence to lens replacement schedule, dozing and overnight wear, awareness of aftercare visits and reuse of disinfecting solution). Participants were also asked to rate themselves as a contact lens user based on their perceived compliance and hygiene practices. Out of 107 participants, 79 (74.8 per cent) were interviewed in the office and the rest via telephone. The majority of lens wearers were female, office workers and students, with a mean age of 20.64 ± 4.4 years. Mean duration of lens wear was 28.04 ± 8.36 months. Most of them were using spherical lenses (86.9 per cent) on a daily wear basis (96.3 per cent). Major reported forms of non-compliance were poor hand hygiene (60.7 per cent), lack of aftercare awareness (39.3 per cent), water exposure (35.5 per cent) and over-use of lenses (24.3 per cent). While females were more likely to overuse their lenses than males (p < 0.005), other socio-demographic factors were not associated with reported non-compliance. Although around 90 per cent of the participants considered themselves average or good contact lens wearers, most exhibited some form of non-compliant and poor hygienic behaviour. A significant number of Maldivian contact lens wearers exhibited poor levels of hygiene and compliance with contact lenses and lens care systems. An effective educational reinforcement strategy needs to be developed to modify lens wearers' non-compliance. © 2013 The Authors. Clinical and Experimental Optometry © 2013 Optometrists Association Australia.

Factors influencing Saudi Arabian optometry candidates' career choices and institution of learning. Why do Saudi students choose to study optometry?

PubMed

Osuagwu, Uchechukwu L; Briggs, Stella T; Chijuka, John C; Alanazi, Saud A; Ogbuehi, Kelechi C

2014-09-01

Optometry is a primary health-care profession (PHCP) and this study aimed to elucidate the factors influencing the choice of optometry as a career for Saudi students, the students' perceptions of optometry and the effect of gender. Two hundred and forty-seven students whose average age was 21.7 ± 1.5 (SD) years and who are currently enrolled in two colleges of optometry in Saudi Arabia--King Saud University (KSU) and Qassim University (QU)--completed self-administered questionnaires. The survey included questions concerning demography, career first choice, career perception and factors influencing career choices. The response rate was 87.6 per cent and there were 161 male (64.9 per cent) students. Seventy-nine per cent of the participants were from KSU (males and females) and 20.6 per cent were from QU (only males). Seventy-three per cent come from Riyadh and 19 per cent are from Qassim province. Regarding the first choice for their careers, the females (92 per cent) were 0.4 times more likely (p = 0.012) to choose optometry than males (78.3 per cent). The males were significantly more likely to be influenced by the following factors: the Doctor of Optometry (OD) programs run at both universities, good salary and prospects (p < 0.05, for all). The women were significantly less likely to be influenced by another individual (p = 0.0004). Generally, more than two-thirds of the respondents viewed the desire to help others, professional prestige and the new OD programs as the three most influential factors in opting for a career in optometry. Females were more likely to opt for a career in optometry and males were more likely to be influenced by the new OD programs, good salary and job prospects. Service provision to others in the community was a primary motivation to opt for a career in optometry among young Saudis. © 2014 The Authors. Clinical and Experimental Optometry © 2014 Optometrists Association Australia.

Therapeutic use of compression stockings for orthostatic hypotension: an assessment of patient and physician perspectives and practices.

PubMed

Quinn, Colin; Deegan, Brian; Cooke, John; Carew, Sheila; Hannigan, Ailish; Dunne, Colum; Lyons, Declan

2015-03-01

Elastic compression stockings (ECS) can be used as a non-pharmacological therapeutic option for older patients with orthostatic hypotension (OH). We aimed to investigate the practices and views of patients and physicians regarding the use of ECS for OH. Two surveys were designed. The first was sent to 90 patients known to have been prescribed ECS for OH. This questionnaire included items related to the frequency of use and issues related to non-compliance. The second was sent to 69 consultant physicians in geriatric medicine. This included items related to prescribing practices and perceived patient compliance. Sixty-seven patients responded (response rate, 74%) and of those 64% were female. Mean age (SD) was 75.1 years (10.5), range 45-91 years. Thirty-three per cent wore ECS daily, whereas 43% never used them. Over half (51%) of the patients reported difficulty in application and 31% reported discomfort. Those aged 75 or older were more likely to report difficulty in application (P=0.003). Forty-eight physicians responded (response rate, 70%). Eighty-nine per cent prescribe ECS for OH. There were significant differences between the frequency of use reported by patients and predicted by physicians (P<0.001), with physicians less likely to predict daily or non-use. Eighty-nine per cent of physicians predicted that difficulty in application was the main reason for non-compliance. Although prescribed frequently, the use of ECS in patients with OH is often limited by issues related to practicality. Physicians correctly predicted the main reasons for non-compliance although underestimated the scale of patient compliance with ECS. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The survival benefit of bystander cardiopulmonary resuscitation in a paramedic served metropolitan area.

PubMed Central

Guzy, P M; Pearce, M L; Greenfield, S

1983-01-01

We investigated the survival benefit bystander cardiopulmonary resuscitation (CPR) for out-of-hospital emergencies in a paramedic served area of metropolitan Los Angeles. Clinical information for all events occurring between January 1 and December 31, 1978 was obtained from paramedic report forms and hospital medical records. Bystander CPR was performed for 93 cases and, of these, 20 (22 per cent) survived to hospital discharge, as compared to 7 (5 per cent) of the 150 patients not receiving bystander CPR (p less than 0.001). Twelve (27 per cent) of the 45 patients in ventricular fibrillation (VF) who had bystander CPR survived, as compared to 4 (6 per cent) of 70 VF patients without bystander CPR (p less than 0.01). We conclude that bystander CPR, initiated prior to arrival of paramedics, produced a fourfold improvement in survival. Overall there was a 10 per cent survival rate at hospital discharge. Survival rates reported from Seattle may not necessarily be generalized to larger cities. PMID:6859360

Periodontal disease among 45-54 year olds in Adelaide, South Australia.

PubMed

Brennan, D S; Spencer, A J; Roberts-Thomson, K F

2007-03-01

The aims of this study were to describe the prevalence, extent and severity of periodontal disease among middle-aged adults, and to examine periodontitis by dental visit pattern, dental and health behaviour, socio-demographics and socioeconomic status. A random sample of 45-54 year olds from metropolitan Adelaide, South Australia was surveyed by mailed self-complete questionnaire during 2004-2005 with up to four follow-up mailings of the questionnaire to non-respondents (n=879 responded, response rate = 43.8 per cent). Oral examinations were performed on 709 people who responded to the questionnaire (completion rate=80.7 per cent), providing an assessment of periodontal status. Prevalence of loss of attachment (LOA) of 6+ mm was 19.2 per cent, extent of sites with LOA of 6+ mm was 1.3 per cent, and severity of LOA of sites with LOA of 2+ mm was 2.4mm. Using a case definition for periodontitis of two or more sites with LOA of 5+ mm and one or more sites with PD of 4+ mm in a multivariate logistic regression showed higher odds of periodontitis for people who last visited for relief of pain (OR = 1.93) and who smoked daily/occasionally (OR = 3.84), while lower odds were observed for people who were born in Australia (OR = 0.51) and spoke English as the main language at home (OR = 0.34). While periodontal disease was related to visit pattern and health-related behaviours, the relationship with place of birth and main language spoken at home indicated socio-cultural variation in disease not explained by behaviour among this cohort of 45-54 year olds.

The expediency of peritoneal lavage for blunt trauma in children.

PubMed

Drew, R; Perry, J F; Fischer, R P

1977-12-01

Two hundred and thirty children, ten years of age or younger, suspected of having blunt abdominal injuries underwent diagnostic peritoneal lavage. Peritoneal lavage was 99.1 per cent accurate in determining the presence or absence of abdominal injuries. One patient had a false-positive peritoneal lavage. Sixty-nine of the 70 patients with blunt abdominal injuries, who underwent peritoneal lavage, had a positive peritoneal lavage; one patient had a false-negative peritoneal levage. Ninety-one per cent of the positive peritoneal lavages were grossly positive for hemoperitoneum. All 11 children with extraperitoneal abdominal injuries had positive peritoneal lavages from associated intraperitoneal injeries. The mortality for children with blunt abdominal injuries was 19.4 per cent. Intra-abdominal injuries were solely responsible for 29 per cent of the deaths and were a major contributing factor in an additional 21 per cent of the deaths. The routine use of diagnostic peritoneal lavage during the initial evaluation of blunt abdominal trauma was, in large part, responsible for the rapid, definitive treatment which -he children with abdominal injuries received. Sixty-five per cent of the children underwent exploratory laparotomy within one hour of admission to the hospital.

Food insecurity and low income in an English inner city.

PubMed

Tingay, Richard S; Tan, Chuan Jin; Tan, Neil C W; Tang, Stephen; Teoh, Pei Fen; Wong, Rebecca; Gulliford, Martin C

2003-06-01

Low incomes may not provide the minimum requirements for healthy living. We evaluated experiences of food insecurity in relation to income in inner London. Subjects attending 10 general medical practices completed a short self-administered questionnaire, including the short form Household Food Security Scale and a short food frequency questionnaire. Responses were obtained from 431/495 (87 per cent) subjects. Overall 87 (20 per cent) of subjects were classified as food insecure. Food insecurity was negatively associated with household income (p = 0.004). University-educated subjects (8 per cent) were less often food insecure than all others (26 per cent). Subjects who were food insecure were less likely to report eating fruit daily (food secure 48 per cent, food insecure 33 per cent, p = 0.017) or vegetables or salads daily (food secure 56 per cent, food insecure 34 per cent, p = 0.002). Experiences of food insecurity may be common in households with incomes at the level of the UK national minimum wage or lower.

Compensation for pitch-shifted auditory feedback during the production of Mandarin tone sequences

NASA Astrophysics Data System (ADS)

Xu, Yi; Larson, Charles R.; Bauer, Jay J.; Hain, Timothy C.

2004-08-01

Recent research has found that while speaking, subjects react to perturbations in pitch of voice auditory feedback by changing their voice fundamental frequency (F0) to compensate for the perceived pitch-shift. The long response latencies (150-200 ms) suggest they may be too slow to assist in on-line control of the local pitch contour patterns associated with lexical tones on a syllable-to-syllable basis. In the present study, we introduced pitch-shifted auditory feedback to native speakers of Mandarin Chinese while they produced disyllabic sequences /ma ma/ with different tonal combinations at a natural speaking rate. Voice F0 response latencies (100-150 ms) to the pitch perturbations were shorter than syllable durations reported elsewhere. Response magnitudes increased from 50 cents during static tone to 85 cents during dynamic tone productions. Response latencies and peak times decreased in phrases involving a dynamic change in F0. The larger response magnitudes and shorter latency and peak times in tasks requiring accurate, dynamic control of F0, indicate this automatic system for regulation of voice F0 may be task-dependent. These findings suggest that auditory feedback may be used to help regulate voice F0 during production of bi-tonal Mandarin phrases.

Impact of lambdacyhalothrin capsule suspension treated bed nets on malaria in tribal villages of Malkangiri district, Orissa, India.

PubMed

Sahu, S S; Vijayakumar, T; Kalyanasundaram, M; Subramanian, S; Jambulingam, P

2008-09-01

Insecticide treated mosquito nets are increasingly being used in malaria control programmes. One of the problems with the treatment of bed nets with conventional formulations of insecticides was that regular washing of treated nets diminish insecticidal effect. Lambdacyhalothrin 2.5 capsule suspension (CS) (2.5% a.i., w/v), a new water-based microencapsulated formulation is reported to have wash-resistant property and longer persistence on the netting material than other formulations. We evaluated the impact of the use of nylon bed nets treated with lambdacyhalothrin 2.5 CS at 10 mg (a.i.)/m(2) in comparison to untreated nets and no nets on malaria in tribal villages in Orissa. Nine foothill villages, highly endemic for falciparum malaria, from the Primary Health Centre (PHC) areas of Khairput and Kudumulugumma of Malkangiri district, Orissa, were divided into three groups, each with a population of about 500 and allocated randomly for treated (TN) and untreated nets (UN) and no nets (NN). Bed nets were distributed in September 2001 and retreatment was done in June 2002. The impact was assessed based on the changes in vector density, parous rate, malaria incidence and parasite rates. Indoor-resting collections of Anopheles fluviatilis and An. culicifacies were made at fortnightly intervals from fixed human dwellings. Mass blood surveys before and after distribution of nets and fortnightly active surveillance were carried out to assess the change in parasite rates and malaria incidence. Bioassays were conducted at fortnightly intervals on the bed nets supplied to the villagers. The reductions in indoor resting catches of An. fluviatilis and An. culicifacies were 96 and 38 per cent in villages with treated nets and 2.6 and 23 per cent in villages with untreated nets respectively compared to no net villages. For six months following treatment, 100 per cent mortality of An. fluviatilis was observed on the unwashed nets and on the nets washed once or twice. After re-treatment, 100 per cent mortality of An. fluviatilis or An. culicifacies was observed for nine months even after two washes. Usage rates of treated and untreated nets varied seasonally; 58.9 and 46.3 per cent in rainy season, 48.6 and 37.1 per cent in winter season and 38.1 and 31.6 per cent in summer season respectively. Reductions in malaria parasite rates were about 65 per cent in the treated net villages and 39 per cent in the untreated net villages compared to no net villages. About 75 per cent of treated nets and 60 per cent of untreated nets were in usable condition 19 months after distribution. The estimated protection factor based on malaria incidence was 86 per cent for the treated nets during both post-treatment and post-retreatment periods and 34 and 51 per cent for untreated nets for the corresponding periods compared to no nets. The results of the study showed that the use of bed nets treated nets with CS formulation of lambdacyhalothrin at 10 mg (a.i.)/m(2) was acceptable to the community and re-treatment of nets at nine-monthly intervals can significantly reduce density and survival of An. fluviatilis and incidence of falciparum malaria.

Public perception of cross-infection control in dentistry.

PubMed

Thomson, W M; Stewart, J F; Carter, K D; Spencer, A J

1997-10-01

Since the advent of HIV/AIDS at the beginning of the 1980s, concern has generated considerable impetus for change in cross-infection control procedures in dentistry. This process has been hastened partly by media coverage which, in tending to favour sensation over rational discourse, has played a not inconsiderable role in shaping public understanding and expectations. This study aimed to investigate public perceptions of cross-infection control in dentistry in Australia using a postal follow-up to the 1995 National Dental Telephone Interview Survey. The postal survey response rate was 85.2 per cent. Concerns about the procedures used by their dentist to sterilize instruments were reported by 13.3 per cent of respondents overall, and this was greater among non-health-card-holders, individuals who mainly spoke a language other than English in the home, and those who reported a non-routine dental visiting pattern. Avoidance or delaying of dental visits due to the perceived cross-infection risk was reported by an overall 3.6 per cent of people, and this was higher among females and those who expressed concern about cross-infection control. The profession has a responsibility to ensure that information on the measures which have been taken to reduce the risk of cross-infection in dentistry is disseminated as widely and as clearly as possible so that undue public concern and avoidance of dental care are minimized.

Reconciliation of the carbon budget in the ocean's twilight zone.

PubMed

Giering, Sarah L C; Sanders, Richard; Lampitt, Richard S; Anderson, Thomas R; Tamburini, Christian; Boutrif, Mehdi; Zubkov, Mikhail V; Marsay, Chris M; Henson, Stephanie A; Saw, Kevin; Cook, Kathryn; Mayor, Daniel J

2014-03-27

Photosynthesis in the surface ocean produces approximately 100 gigatonnes of organic carbon per year, of which 5 to 15 per cent is exported to the deep ocean. The rate at which the sinking carbon is converted into carbon dioxide by heterotrophic organisms at depth is important in controlling oceanic carbon storage. It remains uncertain, however, to what extent surface ocean carbon supply meets the demand of water-column biota; the discrepancy between known carbon sources and sinks is as much as two orders of magnitude. Here we present field measurements, respiration rate estimates and a steady-state model that allow us to balance carbon sources and sinks to within observational uncertainties at the Porcupine Abyssal Plain site in the eastern North Atlantic Ocean. We find that prokaryotes are responsible for 70 to 92 per cent of the estimated remineralization in the twilight zone (depths of 50 to 1,000 metres) despite the fact that much of the organic carbon is exported in the form of large, fast-sinking particles accessible to larger zooplankton. We suggest that this occurs because zooplankton fragment and ingest half of the fast-sinking particles, of which more than 30 per cent may be released as suspended and slowly sinking matter, stimulating the deep-ocean microbial loop. The synergy between microbes and zooplankton in the twilight zone is important to our understanding of the processes controlling the oceanic carbon sink.

The Cleveland Clinic experience with adrenal cortical carcinoma.

PubMed

Bodie, B; Novick, A C; Pontes, J E; Straffon, R A; Montie, J E; Babiak, T; Sheeler, L; Schumacher, P

1989-02-01

Between 1936 and 1987, 82 patients with adrenal cortical carcinoma were seen at our clinic. Of these patients 49 (72 per cent) have been seen during the last 25 years. A total of 40 patients (48.8 per cent) presented with a hormonally functional tumor and 42 (51.2 per cent) had a nonfunctional tumor. Forty patients (48.8 per cent) presented with localized disease, 12 (14.6 per cent) with regional disease and 30 (36.6 per cent) with distant metastases. Complete surgical removal of all gross tumor was achieved in 49 patients. Over-all 3 and 5-year patient survival rates in this series were 37.5 and 25.1 per cent, respectively. Survival was significantly improved (43.9 per cent at 5 years, p equals 0.0001) in patients with localized disease that was completely removed surgically; postoperative adjuvant therapy with op'-DDD was of no benefit in these patients. Survival in patients with metastatic disease was poor and was not improved by treatment with op'-DDD, cytotoxic chemotherapy or radiation therapy.

Employment and hospital support among pediatric surgeons.

PubMed

Stehr, Wolfgang; Nakayama, Don K

2014-12-01

Employment, either by an academic entity or a hospital, is increasingly becoming a feature of surgical practice. Independent practices receive indirect subsidies to support their revenue. A survey of the extent of employment and the forms of indirect subsidies by which hospitals support independent practices, not previously done, would be of interest to all clinicians. A 2012 Internet survey of pediatric surgeons, asking practice description, hospital support, governance and management, conditions of compensation, selected contractual obligations, and arrangements for part-time coverage was conducted. Response rate was 21.8 per cent (253 of 1,163). Employed surgeons comprised 80 per cent: 60 per cent academic (152 of 253) and 20 per cent nonacademic (51). Only eight per cent (19) were in private practice. Half (47% [106 of 226]) had administrative tasks. One-fifth (20% [45 of 223]) was in a system without physician input in governance. The rest were in practices with physicians involved in management: on boards of directors (35% [78]), in management positions (31% [69]), and entirely physician-run (14% [31]). Most salaries were independent of external benchmarks. Productivity measures, when applied to compensation (54% [117 of 218]), used relative value units (71% [83 of 117]) more often than revenue production (29% [34]). Patient contact minimums (4% [nine of 217]) and penalties were less common (20% [43 of 218]) than bonus provisions (53% [116 of 218]). Most surgeons in private practice (75% [14 of 19]) received nonsalary hospital support. Pediatric surgery reflects the current trend of physician employment and hospital subsidies. Surgeon participation in governance and strategic system decisions will be necessary as healthcare systems evolve.

Human resources for refraction services in Central Nepal.

PubMed

Kandel, Himal; Murthy, G V S; Bascaran, Covadonga

2015-07-01

Uncorrected refractive error is a public health problem globally and in Nepal. Planning of refraction services is hampered by a paucity of data. This study was conducted to determine availability and distribution of human resources for refraction, their efficiency, the type and extent of their training; the current service provision of refraction services and the unmet need in human resources for refraction in Central Nepal. This was a descriptive cross-sectional study. All refraction facilities in the Central Region were identified through an Internet search and interviews of key informants from the professional bodies and parent organisations of primary eye centres. A stratified simple random sampling technique was used to select 50 per cent of refraction facilities. The selected facilities were visited for primary data collection. Face-to-face interviews were conducted with the managers and the refractionists available in the facilities using a semi-structured questionnaire. Data was collected in 29 centres. All the managers (n=29; response rate 100 per cent) and 50 refractionists (Response rate 65.8 per cent) were interviewed. Optometrists and ophthalmic assistants were the main providers of refraction services (n=70, 92.11 per cent). They were unevenly distributed across the region, highly concentrated around urban areas. The median number of refractions per refractionist per year was 3,600 (IQR: 2,400 - 6,000). Interviewed refractionists stated that clients' knowledge, attitude and practice related factors such as lack of awareness of the need for refraction services and/or availability of existing services were the major barriers to the output of refraction services. The total number of refractions carried out in the Central Region per year was 653,176. An additional 170 refractionists would be needed to meet the unmet need of 1,323,234 refractions. The study findings demand a major effort to develop appropriately trained personnel when planning refraction services in the Central Region and in Nepal as a whole. The equitable distribution of the refractionists, their community-outreach services and awareness raising activities should be emphasised. © 2015 The Authors. Clinical and Experimental Optometry © 2015 Optometry Australia.

Predictors for people's response to a tornado warning: Arkansas, 1 March 1997.

PubMed

Balluz, L; Schieve, L; Holmes, T; Kiezak, S; Malilay, J

2000-03-01

On 1 March 1997, powerful tornadoes touched down in Arkansas (USA) on a Saturday afternoon. Twenty-six fatalities and 400 non-fatal injuries were reported. We performed a population-based cross-sectional study to determine factors associated with appropriate responses to tornado warnings. Of 146 survey participants, 140 (96 per cent) knew the difference between 'tornado watch' and 'tornado warning' and were aware of when the warning was announced. Of those 140 participants, 64 (45.7 per cent) responded to the warning by seeking shelter, and 58 (90.6 per cent) of those 64 acted within five minutes of hearing the warning. Four factors were positively associated with those seeking shelter: having graduated from high school (OR = 4.2, 95 per cent CI = 1.1-15.5); having a basement in one's house (OR = 3.8, 95 per cent exact CI = 1.1-17.1); hearing a siren (OR = 4.4, 95 per cent CI = 1.3-18.9); and having prepared a household plan of response when tornadoes occur (OR = 2.6, 95 per cent CI = 1.1-6.3). On the basis of these findings, we recommend: first, that people who live in tornadoprone areas have a personal plan of action to help them respond immediately to warnings; second, public-health education officials in areas with frequent tornadic activity should do more to educate the public about what they can do to protect themselves from a tornado; and third, that emergency-management officials planning protection measures for vulnerable communities should consider that most people have limited time (our study documented five minutes) in which to respond to a tornado warning. Thus, shelters in tornado-prone areas should be quickly accessible by residents.

Multicentre propensity score-matched analysis of conventional versus extended abdominoperineal excision for low rectal cancer.

PubMed

Ortiz, H; Ciga, M A; Armendariz, P; Kreisler, E; Codina-Cazador, A; Gomez-Barbadillo, J; Garcia-Granero, E; Roig, J V; Biondo, S

2014-06-01

Abdominal perineal excision (APE) was originally described with levator ani removal for rectal cancer. An even wider, more aggressive extralevator resection for APE has been proposed. Although some surgeons are performing a very wide 'extralevator APE (ELAPE)', there are few data to recommend it routinely. This multicentre study aimed to compare outcomes of APE and ELAPE. A multicentre propensity case-matched analysis comparing two surgical approaches (APE and ELAPE) was performed. All patients who underwent abdominoperineal resection of a rectal tumour were considered for the analysis. Tumour height was defined by magnetic resonance imaging measurement and patients with stage II-III tumours had neoadjuvant radiochemotherapy. Involvement of the circumferential resection margin (CRM) and intraoperative tumour perforation were the main outcome measures. A logistic regression model was used to study the relationship between the surgical approaches and outcomes. From January 2008 to March 2013 a total of 1909 consecutive patients underwent APE or ELAPE, of whom 914 matched patients (457 in each group) formed the cohort for analysis. Intraoperative tumour perforation occurred in 7.9 and 7.7 per cent of patients during APE and ELAPE respectively (P = 0.902), and there was CRM involvement in 13.1 and 13.6 per cent (P = 0.846). There were no differences between APE and ELAPE in terms of postoperative complication rates (52.3 versus 48.1 per cent; P = 0.209), need for reoperation (7.7 versus 7.0 per cent; P = 0.703), perineal wound problems (26.0 versus 21.9 per cent; P = 0.141), mortality rate (2.0 versus 2.0 per cent; P = 1.000) and local recurrence rate at 2 years (2.7 versus 5.6 per cent; P = 0.664). ELAPE does not improve rates of CRM involvement, intraoperative tumour perforation, local recurrence or mortality. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

Error-dependent modulation of speech-induced auditory suppression for pitch-shifted voice feedback

PubMed Central

2011-01-01

Background The motor-driven predictions about expected sensory feedback (efference copies) have been proposed to play an important role in recognition of sensory consequences of self-produced motor actions. In the auditory system, this effect was suggested to result in suppression of sensory neural responses to self-produced voices that are predicted by the efference copies during vocal production in comparison with passive listening to the playback of the identical self-vocalizations. In the present study, event-related potentials (ERPs) were recorded in response to upward pitch shift stimuli (PSS) with five different magnitudes (0, +50, +100, +200 and +400 cents) at voice onset during active vocal production and passive listening to the playback. Results Results indicated that the suppression of the N1 component during vocal production was largest for unaltered voice feedback (PSS: 0 cents), became smaller as the magnitude of PSS increased to 200 cents, and was almost completely eliminated in response to 400 cents stimuli. Conclusions Findings of the present study suggest that the brain utilizes the motor predictions (efference copies) to determine the source of incoming stimuli and maximally suppresses the auditory responses to unaltered feedback of self-vocalizations. The reduction of suppression for 50, 100 and 200 cents and its elimination for 400 cents pitch-shifted voice auditory feedback support the idea that motor-driven suppression of voice feedback leads to distinctly different sensory neural processing of self vs. non-self vocalizations. This characteristic may enable the audio-vocal system to more effectively detect and correct for unexpected errors in the feedback of self-produced voice pitch compared with externally-generated sounds. PMID:21645406

The impact of generic substitution on the turnover and gross margin of pharmaceutical companies a survey 1 year and 5 years after the introduction of generic substitution in Finland.

PubMed

Timonen, Johanna; Karttunen, Pekka; Bengtström, Marina; Ahonen, Riitta

2009-10-01

To explore and compare the impact of generic substitution (GS) on the turnover and gross margin per cent of pharmaceutical companies representing mainly original or generic products in Finland. A mail survey to pharmaceutical companies with an office in Finland and substitutable medicines in the Finnish pharmaceutical market 1 year (2004) and nearly 5 years (2008) after GS. The questionnaire were answered by 16 original and 7 generic product companies in 2004 (response rate 56%, n=41) and by 16 original and 6 generic product companies in 2008 (response rate 56%, n=39). Turnover had decreased in the original product companies and increased in the generic product companies. The gross margin per cent had decreased in the original and generic product companies, and the companies had also compensated for it in many ways. The study suggests that GS has promoted the sales of generic product companies in Finland. However, price competition caused by GS has generally decreased the proportion of profit from turnover in the original and generic product companies. The companies have also compensated for their decreased gross margin, which suggests that the profit in euros has not been sufficient to cover fixed costs in the companies.

[Perception of common symptomatology during pregnancy, puerperium and lactation].

PubMed

Salinas Martínez, A M; Martínez Sánchez, C; Pérez Segura, J

1991-01-01

The objective of this investigation was to identify women's perception on normal and abnormal symptoms of pregnancy, puerperium and breastfeeding; its purpose was to assess the varying educational needs in the geographical area where a reproductive health education program will be implemented. 405 fertile females living in non-residential areas were interviewed in their homes. A predominantly pre-coded questionnaire was used; items related to reproductive health, preventable and susceptible to education were included. Symptomatology perceived incorrectly as normal: a) In pregnancy: Dysuria: 24 percent, genital hemorrhage: 15 per cent, absence of fetal movement: 23 per cent, did not know how to recognize preterm birth symptoms: 70 per cent. b) In puerperium: Increased quantity in lochia rubra: 17 per cent, fever: 22 per cent, fetid lochia: 28 per cent, and c) In breastfeeding: Breasts red and warm: 48 per cent, fever: 30 per cent, nipple fissures: 70 per cent. Symptomatology perceived incorrectly as abnormal: a) In pregnancy: Frequent urination: 17 per cent, morning nausea in the 1st trimester: 9 per cent, emotional instability: 21 per cent, Braxton Hicks contractions: 41 per cent, and b) Postpartum period: Decreased quantity in lochia rubra: 9 per cent, non-fetid lochia alba: 43 per cent, calostrum: 20 per cent. The assessment educational needs showed an inaccurate identification of abnormal and normal obstetric events; its frequency varied. It is essential that a pregnant woman be well informed and educated in order to preserve her own health as well as that of her unborn child. She must be able to recognize warning signs, take action and demand appropriate medical care. Health care personnel and health educators must be responsible for the promoting of maternal and child health during pregnancy.

Health literacy on tuberculosis amongst vulnerable segment of population: special reference to Saharia tribe in central India.

PubMed

Muniyandi, M; Rao, V G; Bhat, J; Yadav, R; Sharma, R K; Bhondeley, M K

2015-05-01

Health literacy on tuberculosis (TB) is an understanding about TB to perform activities with regard to prevention, diagnosis and treatment. We undertook a study to assess the health literacy on TB among one of the vulnerable tribal groups (Saharia) in central India. In this cross-sectional study, 2721 individuals aged >15 yr from two districts of Madhya Pradesh State of India were interviewed at their residence during December 2012-July 2013. By using a short-form questionnaire, health literacy on cause, symptoms, mode of transmission, diagnosis, treatment and prevention of TB was assessed. Of the 2721 (Gwalior 1381; Shivpuri 1340) individuals interviewed; 76 per cent were aged <45 yr. Living condition was very poor (62% living in huts/katcha houses, 84 per cent with single room, 89 per cent no separate kitchen, 97 per cent used wood/crop as a fuel). Overall literacy rate was 19 per cent, and 22 per cent had >7 members in a house. Of the 2721 respondents participated, 52 per cent had never heard of TB; among them 8 per cent mentioned cough as a symptom, 64 per cent mentioned coughing up blood, and 91 per cent knew that TB diagnosis, and treatment facilities were available in both government and private hospitals. Health literacy score among participants who had heard of TB was <40 per cent among 36 per cent of respondents, 41-60 per cent among 54 per cent and >60 per cent among 8 per cent of respondents. The finding that nearly half of the respondents had not heard of TB indicated an important gap in education regarding TB in this vulnerable population. There is an urgent need to implement targeted interventions to educate this group for better TB control.

IONIZING RADIATION AND PACKAGING EFFECTS ON RESPIRATORY BEHAVIOR, FUNGAL GROWTH, AND STORAGE-LIFE OF PEACHES, PRUNUS PERSICA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dhaliwal, A.S.; Salunkhe, D.K.

1963-01-01

Investigations were conducted in 1960 to study effects of fast electron and gamma radiations and packaging films on respiratory rate, control of fungal deterioration, and subsequent refrigeration life of peaches. The fungi responsible for deterioration of peaches were also studied in vitro to determine if they were susceptible or resistant to ionizing (fast electron and gamma) radiations. Respiratory behavior of the fruits under normal as well as modified conditions was assessed with a Claypool and Keefer-type respirometer and Orsat- type gas analyzer. Two kinds of polyethylene films were used for packaging fruits. The fruits after treatments and packaging were storedmore » at 40 un. Concent 85% F and 85 per cent relative humidity and at 75 un. Concent 85% F and 35 per cent relative humidity. (auth)« less

Randomized multicentre trial comparing external and internal pancreatic stenting during pancreaticoduodenectomy.

PubMed

Jang, J-Y; Chang, Y R; Kim, S-W; Choi, S H; Park, S J; Lee, S E; Lim, C-S; Kang, M J; Lee, H; Heo, J S

2016-05-01

There is no consensus on the best method of preventing postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD). This multicentre, parallel group, randomized equivalence trial investigated the effect of two ways of pancreatic stenting after PD on the rate of POPF. Patients undergoing elective PD or pylorus-preserving PD with duct-to-mucosa pancreaticojejunostomy were enrolled from four tertiary referral hospitals. Randomization was stratified according to surgeon with a 1 : 1 allocation ratio to avoid any related technical factors. The primary endpoint was clinically relevant POPF rate. Secondary endpoints were nutritional index, remnant pancreatic volume, long-term complications and quality of life 2 years after PD. A total of 328 patients were randomized to the external (164 patients) or internal (164) stent group between August 2010 and January 2014. The rates of clinically relevant POPF were 24·4 per cent in the external and 18·9 per cent in the internal stent group (risk difference 5·5 per cent). As the 90 per cent confidence interval (-2·0 to 13·0 per cent) did not fall within the predefined equivalence limits (-10 to 10 per cent), the clinically relevant POPF rates in the two groups were not equivalent. Similar results were observed for patients with soft pancreatic texture and high fistula risk score. Other postoperative outcomes were comparable between the two groups. Five stent-related complications occurred in the external stent group. Multivariable analysis revealed that soft pancreatic texture, non-pancreatic disease and high body mass index (23·3 kg/m 2 or above) predicted clinically relevant POPF. External stenting after PD was associated with a higher rate of clinically relevant POPF than internal stenting. Registration number: NCT01023594 (https://www.clinicaltrials.gov). © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

Wilms' tumor in New York State: epidemiology and survivorship.

PubMed

Griffel, M

1977-12-01

The outcomes during the period 1950--1972 were compared for Wilms' tumor patients in Erie County, New York (Buffalo and environs) and in a random selection of 23 counties having much smaller populations. For the Erie cohorts of 1967 to 1972 an 87 per cent 7-year survival rate was found as compared with a 50 per cent survival for the corresponding cohorts of the less populous couties. For the years 1960--1966 the 5-year survival rates were respectively 67 and 25 per cent and for the decade 1950--1959, 26 and 23 per cent. The principal conclusion is that within the last 15 years the Erie residents have fared better than residents of the smaller counties. The difference is attributed to the better treatment and care available at some of the hospitals in Buffalo. Data on incidence, age at diagnosis, male/female ratio, and laterality are presented.

Efficacy of recombinant bovine epidermal growth factor in the treatment of experimental subclinical Staphylococcus aureus mastitis in a ewe model.

PubMed

Gabadage, Kamal; Chirino-Trejo, Manuel; Campbell, John; Luby, Christopher

2017-01-01

Staphylococcus aureus is the most common contagious mastitis pathogen of dairy cattle. Antimicrobial treatment of infected cattle results in variable cure rates. Epidermal growth factor (EGF) plays an important role in the modulation of host innate immune responses and the regulation of mammary epithelial regeneration, indicating that EGF may be useful as a treatment for mastitis. A pilot study was conducted to evaluate the efficacy of recombinant bovine EGF (rbEGF) for the treatment of S aureus intramammary infection (IMI) using an ovine model. Each ewe was experimentally infected with S aureus in both udder halves. One udder half of each ewe received one of two treatments: EGF (n=13) or pirlimycin (n=13). The contralateral udder half of each ewe received sterile saline as a control. The bacteriological cure rate following rbEGF was significantly lower (15 per cent) than that attained with pirlimycin hydrochloride (61 per cent) and did not differ from that following treatment with sterile saline. Cure rates following treatment with rbEGF were not significantly different to those following sterile saline. Given that EGF is associated with modulation of host immunity and wound healing, future studies into EGF should not focus on whether EGF increases cure rates of S aureus IMI.

Human factors paradigm and customer care perceptions.

PubMed

Clarke, Colin; Eales-Reynolds, Lesley-Jane

2015-01-01

The purpose of this paper is to examine if customer care (CC) can be directly linked to patient safety through a human factors (HF) framework. Data from an online questionnaire, completed by a convenience healthcare worker sample (n=373), was interrogated using thematic analysis within Vincent et al.'s (1998) HF theoretical framework. This proposes seven areas affecting patient safety: institutional context, organisation and management, work environment, team factors, individual, task and patient. Analysis identified responses addressing all framework areas. Responses (597) principally focused on work environment 40.7 per cent (n=243), organisation and management 28.8 per cent (n=172). Nevertheless, reference to other framework areas were clearly visible within the data: teams 10.2 per cent (n=61), individual 6.7 per cent (n=40), patients 6.0 per cent (n=36), tasks 4.2 per cent (n=24) and institution 3.5 per cent (n=21). Findings demonstrate congruence between CC perceptions and patient safety within a HF framework. The questionnaire requested participants to identify barriers to rather than CC enablers. Although this was at a single site complex organisation, it was similar to those throughout the NHS and other international health systems. CC can be viewed as consonant with patient safety rather than the potentially dangerous consumerisation stance, which could ultimately compromise patient safety. This work provides an original perspective on the link between CC and patient safety and has the potential to re-focus healthcare perceptions.

Evaluation of serum free thyroxine and thyrotropin concentrations in the diagnosis of canine hypothyroidism.

PubMed

Dixon, R M; Mooney, C T

1999-02-01

Canine thyroid-stimulating hormone (cTSH), total thyroxine (T4) and free T4 by equilibrium dialysis (fT4d) were measured in serum samples from 107 dogs with clinical signs suggestive of hypothyroidism in which the diagnosis was either confirmed (n = 30) or excluded (n = 77) by exogenous TSH response testing. Median serum total T4 and fT4d concentrations were significantly lower and cTSH significantly higher (P < 0.001) in hypothyroid compared with euthyroid dogs. Differential positive rate analysis determined optimal cut-off values of less than 14.9 nmol/litre (total T4), less than 5.42 pmol/litre (fT4d), greater than 0.68 ng/ml (cTSH), less than 17.3 (T4 to cTSH ratio), and less than 7.5 (fT4d to cTSH ratio) for hypothyroidism. These had a sensitivity and specificity of 100 and 75.3 per cent, 80 and 93.5 per cent, 86.7 and 81.8 per cent, 86.7 and 92.2 per cent, and 80 and 97.4 per cent, respectively, for diagnosing hypothyroidism. Corresponding areas under the receiver operating characteristic curves were 0.92, 0.93, 0.87, 0.93 and 0.93. Unexpectedly low cTSH values in hypothyroid dogs may have resulted from concurrent non-thyroidal illness. Unexpectedly high serum cTSH values in the euthyroid dogs might have resulted from recovery from illness or concurrent potentiated sulphonamide therapy. Measurement of endogenous cTSH concentration is a valuable diagnostic tool for canine hypothyroidism if used in association with assessment of T4. Estimation of fT4d added only limited additional information over total T4 measurement.

Precipitation Impacts of a Shrinking Arctic Sea Ice Cover

NASA Astrophysics Data System (ADS)

Stroeve, J. C.; Frei, A.; Gong, G.; Ghatak, D.; Robinson, D. A.; Kindig, D.

2009-12-01

Since the beginning of the modern satellite record in October 1978, the extent of Arctic sea ice has declined in all months, with the strongest downward trend at the end of the melt season in September. Recently the September trends have accelerated. Through 2001, the extent of September sea ice was decreasing at a rate of -7 per cent per decade. By 2006, the rate of decrease had risen to -8.9 per cent per decade. In September 2007, Arctic sea ice extent fell to its lowest level recorded, 23 per cent below the previous record set in 2005, boosting the downward trend to -10.7 per cent per decade. Ice extent in September 2008 was the second lowest in the satellite record. Including 2008, the trend in September sea ice extent stands at -11.8 percent per decade. Compared to the 1970s, September ice extent has retreated by 40 per cent. Summer 2009 looks to repeat the anomalously low ice conditions that characterized the last couple of years. Scientists have long expected that a shrinking Arctic sea ice cover will lead to strong warming of the overlying atmosphere, and as a result, affect atmospheric circulation and precipitation patterns. Recent results show clear evidence of Arctic warming linked to declining ice extent, yet observational evidence for responses of atmospheric circulation and precipitation patterns is just beginning to emerge. Rising air temperatures should lead to an increase in the moisture holding capacity of the atmosphere, with the potential to impact autumn precipitation. Although climate models predict a hemispheric wide decrease in snow cover as atmospheric concentrations of GHGs increase, increased precipitation, particular in autumn and winter may result as the Arctic transitions towards a seasonally ice free state. In this study we use atmospheric reanalysis data and a cyclone tracking algorithm to investigate the influence of recent extreme ice loss years on precipitation patterns in the Arctic and the Northern Hemisphere. Results show enhanced cyclone associated precipitation in autumn over Siberia for anomalously low ice years compared with anomalously high ice years along with a strengthening of the North Atlantic Storm track.

Topical nonsteroidal anti-inflammatory drugs versus oil of evening primrose in the treatment of mastalgia.

PubMed

Qureshi, S; Sultan, N

2005-02-01

To compare oil of evening primrose (OEP) and topical nonsteroidal anti-inflammatory (NSAIDs) with respect to safety, effectiveness, rapidity of response, cost effectiveness and acceptability in the treatment of breast pain. An open, non-randomised, comparative study of topical (NSAI) gel versus OEP was carried out, over a period of one year. Fifty female patients attending the outpatient department with moderate to severe breast pain were given one of the two agents alternatively, after selection. Results showed that out of 25 patients treated with OEP, 64% had a clinically significant response after three months of treatment, compared with 92% with topical NSAIDs. Only one patient (4%) had side effects with OEP, while no patient had side effects with topical NSAIDs. Twenty per cent and seventy per cent showed acceptability as far as costs were concerned and mode of administration respectively, with OEP. The acceptability rate was 68% and 96% respectively, with topical NSAIDs. This study has shown topical NSAIDs to be safe, effective, rapid and acceptable mode of treatment for cyclical and non-cyclical mastalgia.

Audit of an inpatient liaison psychiatry consultation service.

PubMed

Lyne, John; Hill, Michelle; Burke, Patricia; Ryan, Martina

2009-01-01

The purpose of this paper is to examine an audit that was performed of all patients referred to a liaison psychiatry inpatient consultation service which sought to establish a baseline for demographics, type of referral, and management of referrals, with a view to introducing improved evidence-based treatments. It also aims to examine timeliness of response to referrals benchmarked against published standards. All inpatient referrals to a liaison psychiatry service were recorded over a six-month period, including demographics, diagnosis, management and timeliness of response to referrals. The data were retrospectively analysed and compared against international standards. A total of 172 referrals were received in the six months. Commonest referral reasons included assessments regarding depressive disorders (23.8 per cent), delirium/other cognitive disorders (19.2 per cent), alcohol-related disorders (18.6 per cent), anxiety disorders (14.5 per cent), and risk management (12.2 per cent). Evidence-based practices were not utilised effectively for a number of different types of presentations. A total of 40.1 per cent of referrals were seen on the same day, 75.4 per cent by the end of the next day, and 93.4 per cent by the end of the following day. Use of a hospital protocol for management of delirium may improve outcomes for these patients. Evidence-based techniques, such as brief intervention therapies, may be beneficial for referrals involving alcohol dependence. Referrals were seen reasonably quickly, but there is room for improvement when compared with published standards. This paper provides valuable information for those involved in management of liaison psychiatry consultation services, providing ideas for development and implementation of evidence based practices.

Nursing home care quality: a cluster analysis.

PubMed

Grøndahl, Vigdis Abrahamsen; Fagerli, Liv Berit

2017-02-13

Purpose The purpose of this paper is to explore potential differences in how nursing home residents rate care quality and to explore cluster characteristics. Design/methodology/approach A cross-sectional design was used, with one questionnaire including questions from quality from patients' perspective and Big Five personality traits, together with questions related to socio-demographic aspects and health condition. Residents ( n=103) from four Norwegian nursing homes participated (74.1 per cent response rate). Hierarchical cluster analysis identified clusters with respect to care quality perceptions. χ 2 tests and one-way between-groups ANOVA were performed to characterise the clusters ( p<0.05). Findings Two clusters were identified; Cluster 1 residents (28.2 per cent) had the best care quality perceptions and Cluster 2 (67.0 per cent) had the worst perceptions. The clusters were statistically significant and characterised by personal-related conditions: gender, psychological well-being, preferences, admission, satisfaction with staying in the nursing home, emotional stability and agreeableness, and by external objective care conditions: healthcare personnel and registered nurses. Research limitations/implications Residents assessed as having no cognitive impairments were included, thus excluding the largest group. By choosing questionnaire design and structured interviews, the number able to participate may increase. Practical implications Findings may provide healthcare personnel and managers with increased knowledge on which to develop strategies to improve specific care quality perceptions. Originality/value Cluster analysis can be an effective tool for differentiating between nursing homes residents' care quality perceptions.

Clinical evaluation of glass ionomer-silver cermet restorations in primary molars: one year results.

PubMed

Hung, T W; Richardson, A S

1990-03-01

Using the half mouth technique, 33 silver amalgam (Dispersalloy) and 40 glass ionomer (Ketec silver) restorations were placed in the primary molars of children aged five to seven years. After one year, 73 restorations were evaluated. The amalgam restorations rated 90-100 per cent alpha for anatomic form and margins with no recurrent caries or fractures. The glass ionomer restorations rated 35 to 55 per cent alpha for anatomic form and margins with 40 per cent being replaced due to fracture of the material. Within the guidelines of this study, glass ionomer silver cermet was not a suitable material for the restoration of interproximal cavities in primary molars.

Health literacy on tuberculosis amongst vulnerable segment of population: special reference to Saharia tribe in central India

PubMed Central

Muniyandi, M.; Rao, V.G.; Bhat, J.; Yadav, R.; Sharma, R.K.; Bhondeley, M.K.

2015-01-01

Background & objectives: Health literacy on tuberculosis (TB) is an understanding about TB to perform activities with regard to prevention, diagnosis and treatment. We undertook a study to assess the health literacy on TB among one of the vulnerable tribal groups (Saharia) in central India. Methods: In this cross-sectional study, 2721 individuals aged >15 yr from two districts of Madhya Pradesh State of India were interviewed at their residence during December 2012-July 2013. By using a short-form questionnaire, health literacy on cause, symptoms, mode of transmission, diagnosis, treatment and prevention of TB was assessed. Results: Of the 2721 (Gwalior 1381; Shivpuri 1340) individuals interviewed; 76 per cent were aged <45 yr. Living condition was very poor (62% living in huts/katcha houses, 84 per cent with single room, 89 per cent no separate kitchen, 97 per cent used wood/crop as a fuel). Overall literacy rate was 19 per cent, and 22 per cent had >7 members in a house. Of the 2721 respondents participated, 52 per cent had never heard of TB; among them 8 per cent mentioned cough as a symptom, 64 per cent mentioned coughing up blood, and 91 per cent knew that TB diagnosis, and treatment facilities were available in both government and private hospitals. Health literacy score among participants who had heard of TB was <40 per cent among 36 per cent of respondents, 41-60 per cent among 54 per cent and >60 per cent among 8 per cent of respondents. Interpretation & conclusions: The finding that nearly half of the respondents had not heard of TB indicated an important gap in education regarding TB in this vulnerable population. There is an urgent need to implement targeted interventions to educate this group for better TB control. PMID:26139783

Survival in 76 cats with epilepsy of unknown cause: a retrospective study.

PubMed

Szelecsenyi, Arlette Cornelia; Giger, Urs; Golini, Lorenzo; Mothersill, Ian; Torgerson, Paul R; Steffen, Frank

2017-11-01

Survival of cats with epilepsy of unknown cause (EUC) has not been reported. Seizure semiology and its relationship to treatment outcome and survival was studied in a population of 76 cats. A questionnaire for seizure semiology was developed based on experimental data. Seizure semiology was characterised by owner interviews at least one year after discharge. Seizures were classified as (1) primary generalised and (2) focal without and (3) with secondary generalisation. Median age at seizure onset was four (range 0.3-18) years. One-third of cats with EUC presented with primary generalised seizures and 78 per cent of those with initially focal seizures progressed to secondary generalised seizures. Clinical signs of generalised seizures included sudden onset of loss of consciousness and tonic-clonic seizures, while cats with focal seizures had unilateral signs. Antiepileptic drug (AED) therapy was initiated in 62 cats. Complete remission rate was 42 per cent and the median survival time was 3.2 (range 1-11) years with or without AED, and 91 per cent were still alive at the time of interview. Neither semiology nor seizure type predicted survival, response to treatment and outcome in cats with EUC. A seizure-free status of more than 12 months was observed in 79 per cent of cats without AED. © British Veterinary Association (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Annual planning meetings: views and perceptions.

PubMed

Bindal, Taruna; Wall, David; Goodyear, Helen

2014-12-01

In 2009, annual face to face planning meetings (APMs) were introduced as an optional meeting for all paediatric trainees. APMs are a formative assessment process whereby the trainee meets with a panel of consultants and sets the agenda for discussion. A questionnaire about APMs was given to all participating trainees and trainers in 2011. The response rate was 93 per cent (139/150) and 67 per cent (12/18) for trainees and trainers, respectively. All trainers had received panel member training. Ninety-one per cent of trainees (126/139) felt adequately prepared for the meeting. Issues discussed included career plans (93%), future training placements (73%), ePortfolio (61%) and previous training posts (61%). Trainees felt that the APM was a helpful formative assessment process (with a mean score of five on a six-point Likert scale: 1, strongly disagree; 6, strongly agree), and that panels were fair, supportive, communicated clearly, listened to concerns and focused on individual learning needs. Sixty-seven per cent (8/12) of trainers would have liked more information about the process beforehand. The main benefits of APMs were trainees feeling supported in their training and better informed regarding career options. APMs would be of value to all specialties to enable annual formative assessment to be undertaken at a different time to the summative assessment process. APMs facilitate reflection on learning needs, and the formulation of personal development plans and career goals for trainees. Trainees felt that the APM was a helpful formative assessment process. © 2014 John Wiley & Sons Ltd.

Core information set for oesophageal cancer surgery.

PubMed

Blazeby, J M; Macefield, R; Blencowe, N S; Jacobs, M; McNair, A G K; Sprangers, M; Brookes, S T

2015-07-01

Surgeons provide patients with information before surgery, although standards of information are lacking and practice varies. The development and use of a 'core information set' as baseline information before surgery may improve understanding. A core set is a minimum set of information to use in all consultations before a specific procedure. This study developed a core information set for oesophageal cancer surgery. Information was identified from the literature, observations of clinical consultations and patient interviews. This was integrated to create a questionnaire survey. Stakeholders (patients and professionals) were surveyed twice to assess views on importance of information from 'not essential' to 'absolutely essential' using Delphi methods. Items not meeting predefined criteria were discarded after each survey and the final retained items were voted on, in separate patient and professional stakeholder meetings, to agree the core set. Some 67 information items were identified initially from multiple sources. Survey response rates were 76·5 per cent (185 of 242) and 54·8 per cent (126 of 230) for patients and professionals respectively (first round), and over 83 per cent in both groups thereafter. Health professionals rated short-term clinical outcomes most highly (technical complications), whereas patients prioritized information related to long-term benefits. The consensus meetings agreed the final set, which consisted of: in-hospital milestones to recovery, rates of open-and-close surgery, in-hospital mortality, major complications (reoperation), milestones in recovery after discharge, longer-term eating and drinking and overall quality of life, and chances of survival. This study has established a core information set for surgery for oesophageal cancer. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

Thirteen-week dose-intensifying simultaneous combination chemotherapy protocol for malignant lymphoma in dogs.

PubMed

Zenker, I; Meichner, K; Steinle, K; Kessler, M; Hirschberger, J

2010-11-06

This prospective study aimed to record the toxicity profile of a dose-intensifying simultaneous chemotherapy (DISC) protocol for lymphoma in dogs. Remission rates and the duration of the protocol were also evaluated. Twenty-one dogs were studied. Diagnosis was based on cytological or histological assessments. The DISC protocol is a 13-week maintenance-free protocol. L-Asparaginase (400 iu/kg) was administered subcutaneously on day 1, followed by weekly simultaneous intravenous administration of vincristine (0.7 mg/m(2) = 100 per cent), cyclophosphamide (200 mg/m(2) = 100 per cent) and doxorubicin (30 mg/m(2) = 100 per cent) at a starting dose level of 33 per cent. Dose levels were given twice and then increased by 5 to 7 per cent if grade 0 or I toxicities were seen, to a maximum dose level of 60 per cent. Two dogs experienced a grade IV toxicity (asymptomatic neutropenia in one dog and sepsis in the other). Two episodes of asymptomatic grade III thrombocytopenia and one episode of neutropenia were recorded. Other toxic events were infrequent and mild. Only one dog required hospitalisation for less than 72 hours. Seventeen dogs (80.9 per cent) achieved complete remission, one (4.8 per cent) achieved partial remission, two (9.5 per cent) had stable disease and in one (4.8 per cent) disease progressed.

A survey of patients' receipt of prescription drug information

DOE Office of Scientific and Technical Information (OSTI.GOV)

Morris, L.A.

1982-06-01

A nationwide telephone survey of 1,223 individuals investigated the nature and source of information provided to patients regarding prescription drugs. About half of the respondents said that they had received information from their doctor about the purpose and directions for use for their most recent prescription. Only a few people (11 per cent) said that they had been informed about the drug's side effects and 19 per cent said that they had been told nothing by their doctor. Most (72 per cent) related that nothing had been said to them at the pharmacy. Written information (stickers on the medicine container,more » leaflets or brochures) were said to be infrequently provided at the pharmacy. About 12 per cent of the respondents said they had expected they might get a drug side effect, but only 9 per cent said that they had experienced one. The most frequently cited action in response to side effects was to consult the physician (40 per cent); however, a sizeable percentage of people stopped the medicine completely or temporarily (36 per cent) or kept on taking the drug as prescribed (32 per cent).« less

Attitudes of healthcare professionals and the public towards the sale of kidneys for transplantation.

PubMed Central

Guttmann, A; Guttmann, R D

1993-01-01

We conducted a survey of attitudes towards the sale of kidneys for transplantation within and without the medical community. Half of those polled received a case of a young man in India whose only chance for survival was to purchase a kidney, the other half a case of a Canadian man who was suffering side-effects from dialysis and had been on the transplant waiting list for three years. We found the percentage of responses allowing the patients to purchase a kidney was similar for the two cases (40 per cent in the Canadian case and 49 per cent in the Indian case). The medical groups had much lower rates of approval of this practice than the public. In all groups those allowing the practice showed similar concerns about regulation. This survey indicates public opinion to be contrary to public policy. PMID:8230146

[Seasonal variations in Aedes Aegypti populations in Monterrey, Mexico].

PubMed

Salas-Luévano, M A; Reyes-Villanueva, F

1994-01-01

Seasonal variation of the populations of the dengue vector mosquito Aedes aegypti, in the city of Monterrey, N.L., Mexico, showed a bimodal pattern. The first peak is lower and appeared at early June, while the second and higher one was observed in the second week of October. 1,419 female mosquitoes were caught in this study. Females with fresh red blood in the stomach were present in all the catches, gravid females (mature eggs in the ovaries) being more abundant than the non-gravid ones. The gravid females with red blood are the oldest of the vector population. Nevertheless, in October, 40 per cent of females had red blood and of these, 37 per cent were gravid. In relation to the biting rate, a 10 females/hour-man rate was recorded for the first peak and a 13.3 females/hour-man rate for the second one. There were 32 per cent of females involved in multiple feedings during the weekly catches. This incidence increases to 40 per cent in October. These rates were calculated on the basis of females with fresh blood in the stomach; from these the gravids and non-gravids have at least three and two multiple feedings, respectively. Finally the epidemiological importance of these multiple feedings on dengue transmission is discussed.

Systematic review of high-intensity focused ultrasound ablation in the treatment of breast cancer.

PubMed

Peek, M C L; Ahmed, M; Napoli, A; ten Haken, B; McWilliams, S; Usiskin, S I; Pinder, S E; van Hemelrijck, M; Douek, M

2015-07-01

A systematic review was undertaken to assess the clinical efficacy of non-invasive high-intensity focused ultrasound (HIFU) ablation in the treatment of breast cancer. MEDLINE/PubMed library databases were used to identify all studies published up to December 2013 that evaluated the role of HIFU ablation in the treatment of breast cancer. Studies were eligible if they were performed on patients with breast cancer and objectively recorded at least one clinical outcome measure of response (imaging, histopathological or cosmetic) to HIFU treatment. Nine studies fulfilled the inclusion criteria. The absence of tumour or residual tumour after treatment was reported for 95·8 per cent of patients (160 of 167). No residual tumour was found in 46·2 per cent (55 of 119; range 17-100 per cent), less than 10 per cent residual tumour in 29·4 per cent (35 of 119; range 0-53 per cent), and between 10 and 90 per cent residual tumour in 22·7 per cent (27 of 119; range 0-60 per cent). The most common complication associated with HIFU ablation was pain (40·1 per cent) and less frequently oedema (16·8 per cent), skin burn (4·2 per cent) and pectoralis major injury (3·6 per cent). MRI showed an absence of contrast enhancement after treatment in 82 per cent of patients (31 of 38; range 50-100 per cent), indicative of coagulative necrosis. Correlation of contrast enhancement on pretreatment and post-treatment MRI successfully predicted the presence of residual disease. HIFU treatment can induce coagulative necrosis in breast cancers. Complete ablation has not been reported consistently on histopathology and no imaging modality has been able confidently to predict the percentage of complete ablation. Consistent tumour and margin necrosis with reliable follow-up imaging are required before HIFU ablation can be evaluated within large, prospective clinical trials. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

Influenza B virus infections in the community and the family. The epidemics of 1976-1977 and 1979-1980 in Houston, Texas.

PubMed

Frank, A L; Taber, L H; Glezen, W P; Geyer, E A; McIlwain, S; Paredes, A

1983-09-01

Influenza B virus epidemics occurred in Houston, Texas, in 1976-1977 and 1979-1980. Among families with young children followed longitudinally in the Houston Family Study, 112 infections were detected during 511 person-years of observation. The infection rates for the two epidemics were similar--24 per cent and 20 per cent--although the two epidemics differed greatly in the community. The first epidemic was much more intense with a mid-winter peak that produced school absentee rates above 12 per cent for four consecutive weeks. The indolent epidemic of 1979-1980 smoldered from late September to mid-April with a peak during the second week of March for which school absenteeism did not exceed 8 per cent. In the Houston Family Study population, the combined infection rate for the two outbreaks was highest at 35 per 100 person-years for school children aged 6-19 years. Preschool children aged 7 months-5 years and adults had infection rates of 31 and 16 per 100 person-years, respectively. Preexisting neutralizing antibody titers greater than or equal to 3.5 log2 protected against influenza B infection and illness. Preschool children above 6 months of age, school age children, and parents introduced infection into the family at rates of 15, 15, and 9 per 100 person-years, respectively. Three second introductions were observed. The secondary infection rate was highest among school aged children at 61 per 100 persons at risk.

Occurrence of otitis media in children and assessment of treatment options.

PubMed

Nwokoye, N N; Egwari, L O; Olubi, O O

2015-08-01

Otitis media is a more frequent occurrence in children, and the disease may progress from an acute to chronic state if appropriate and timely intervention is not initiated. A total of 212 children aged 6 months to 10 years were examined and treated for otitis media, in a 13-month hospital-based study. Acute otitis media was diagnosed in 130 (61.3 per cent) of the patients. There were 82 (38.7 per cent) chronic suppurative otitis media cases. The incidence of acute otitis media and chronic suppurative otitis media in the first year of life was 54.6 per cent and 45.1 per cent respectively. Chronic suppurative otitis media patients were assigned to one of three treatment groups. Recovery occurred in 70.4 per cent of amoxicillin-treated patients, in 88.9 per cent of amoxicillin-clavulanic acid treated patients and in 96.4 per cent of culture and antibiotic sensitivity test patients. Relapses were seen only in the amoxicillin (five cases) and amoxicillin-clavulanic acid (two cases) groups. The success rate in patients treated with antibiotics makes this option mandatory for an established diagnosis.

[An epidemiologic study of anti-ATLA (antibody to adult T-cell leukemia-associated antigen) by category of disease in the Karatsu and Higashimatsuura districts of northern Kyusyu by enzymeimmunoassay].

PubMed

Morofuji, M; Kajiyama, W; Nakashima, K; Noguchi, A; Hayashi, J; Kashiwagi, S; Sumida, I; Hanada, M

1990-08-01

The Kyusyu district is known as an endemic area of HTLV-I. But the prevalence of anti-ATLA in Saga prefecture was reportedly relatively low. In this study, in order to determine the distribution of antibody to ATL-associated antigen (anti-ATLA) in the Karatsu and Higashimatsuura districts of the northern Kyusyu, the determination of anti-ATLA status of patients in Karatsu Red Cross Hospital was carried out from September to October, 1985. Sera from 757 patients were tested for presence of anti-ATLA by Enzyme immunoassay (EIA) prepared by Eisai Co., Ltd. Tokyo, Japan. Results obtained are as follows: 1) Overall prevalence of anti-ATLA was 13.7 per cent (104 of 757 individuals). Prevalence of anti-ATLA increased with age, reaching a maximum of 21.1 per cent for people from 60 to 69 years old. 2) Prevalence of anti-ATLA was 9.5 per cent (36 of 376) in males and 17.8 per cent (68 of 381) in females. A significant difference by sex was recognized. (p less than 0.001) 3) The positive rates of patients with non-malignant diseases were high in the Chinzei, Hizen, and Hamatama areas facing the Sea of Genkai. The positive rate of the seaside area was significantly higher than that of the mountain area. (p less than 0.001). 4) Anti-ATLA was most prevalent in the patients with neoplasms (26.1%). The positive rate of ATL patients was 100 per cent, and that of patients with malignancies other than ATL was 25.9 per cent. These results suggest that HTLV-I infection is likely to increase the incidence of other types of malignancy.

Prevalence of risk factors for non-communicable diseases in rural & urban Tamil Nadu

PubMed Central

Oommen, Anu Mary; Abraham, Vinod Joseph; George, Kuryan; Jose, V. Jacob

2016-01-01

Background & objectives: Surveillance of risk factors is important to plan suitable control measures for non-communicable diseases (NCDs). The objective of this study was to assess the behavioural, physical and biochemical risk factors for NCDs in Vellore Corporation and Kaniyambadi, a rural block in Vellore district, Tamil Nadu, India. Methods: This cross-sectional study was carried out among 6196 adults aged 30-64 yr, with 3799 participants from rural and 2397 from urban areas. The World Health Organization-STEPS method was used to record behavioural risk factors, anthropometry, blood pressure, fasting blood glucose and lipid profile. Multiple logistic regression was used to assess associations between risk factors. Results: The proportion of tobacco users (current smoking or daily use of smokeless tobacco) was 23 per cent in the rural sample and 18 per cent in the urban, with rates of smoking being similar. Ever consumption of alcohol was 62 per cent among rural men and 42 per cent among urban men. Low physical activity was seen among 63 per cent of the urban and 43 per cent of the rural sample. Consumption of fruits and vegetables was equally poor in both. In the urban sample, 54 per cent were overweight, 29 per cent had hypertension and 24 per cent diabetes as compared to 31, 17 and 11 per cent, respectively, in the rural sample. Physical inactivity was associated with hypertension, body mass index (BMI) ≥25 kg/m2, central obesity and dyslipidaemia after adjusting for other factors. Increasing age, male sex, BMI ≥25 kg/m2 and central obesity were independently associated with both hypertension and diabetes. Interpretation & conclusions: Diabetes, hypertension, dyslipidaemia, physical inactivity and overweight were higher in the urban area as compared to the rural area which had higher rates of smokeless tobacco use and alcohol consumption. Smoking and inadequate consumption of fruits and vegetables were equally prevalent in both the urban and rural samples. There is an urgent need to address behavioural risk factors such as smoking, alcohol consumption, physical inactivity and inadequate intake of fruits and vegetables through primary prevention. PMID:28139545

Integrated Pollution Prevention and Control: a review of health authorities' experience.

PubMed

Lanser, Shelley; Pless-Mulloli, Tanja

2003-09-01

In August 2000, health authorities in England and Wales became statutory consultees for permits issued to industry by the Environment Agency as part of the implementation of EU directives. This responsibility has since been delegated to Primary Care Trusts. To assess health authority responses to applications made under the Integrated Pollution Prevention and Control (IPPC) regulations, we collected data from public registers during the first 12 months of this new regulatory regime. There was evidence of 27 applications, of which 59 per cent had substantive comments from health authorities. There was wide variation in the length and content. Responses were from Consultants in Communicable Disease Control (57 per cent) or Directors of Public Health (43 per cent). Only two health authorities had a dedicated resource for responding to IPPC applications. Capacity and capability are lacking and require resources invested for consistent, effective public health input to the process of permitting potentially polluting industries.

BETA-GAMMA PERSONNEL DOSIMETER

DOEpatents

Davis, D.M.; Gupton, E.D.; Hart, J.C.; Hull, A.P.

1961-01-17

A personnel dosimeter is offered which is sensitive to both gamma and soft beta radiations from all directions within a hemisphere. The device is in the shape of a small pill box which is worn on a worker-s wrist. The top and sides of the device are provided with 50 per cent void areas to give 50 per cent response to the beta rays and complete response to the gamma rays. The device is so constructed as to have a response which will approximate the dose received by the basal layer of the human epidermis.

Serological responses of adult dogs to revaccination against distemper, parvovirus and rabies.

PubMed

Ottiger, H-P; Neimeier-Förster, M; Stärk, K D C; Duchow, K; Bruckner, L

2006-07-01

Serum antibody titres to canine distemper virus (CDV), canine parvovirus (CPV) and rabies were measured in dogs that had not been revaccinated annually and compared with the titres in a control group of regularly vaccinated animals; 83 per cent (171 of 207) of the dogs vaccinated against CDV one or more years earlier had serum neutralising antibody titres equal to or greater than 16; 64 per cent (136 of 213) of the dogs vaccinated against CPV one or more years earlier had haemagglutination inhibiting titres equal to or greater than 80; and 59 per cent (46 of 78) of the dogs vaccinated against rabies two or more years earlier had serum neutralising antibody titres equal to or greater than 0.5 iu/ml. Three weeks after a single booster vaccination the dogs' antibody titres against CDV had increased above the threshold level in 94 per cent of the dogs, against CPV in 68 per cent, and against rabies in 100 per cent.

Extended family households among children in the United States: Differences by race/ethnicity and socio-economic status.

PubMed

Cross, Christina J

2018-07-01

This study uses nationally representative longitudinal data from the Panel Study of Income Dynamics, to examine the prevalence and predictors of extended family households among children in the United States and to explore variation by race/ethnicity and socio-economic status (SES). Findings suggest that extended family households are a common living arrangement for children, with 35 per cent of youth experiencing this family structure before age 18. Racial/ethnic and SES differences are substantial: 57 per cent of Black and 35 per cent of Hispanic children ever live in an extended family, compared with 20 per cent of White children. Further, 47 per cent of children whose parents did not finish high school spend time in an extended family, relative to 17 per cent of children whose parents earned a bachelor's degree or higher. Models of predictors show that transitions into extended families are largely a response to social and economic needs.

Exploring the safety measures by doctors on after-hours house call services.

PubMed

Ifediora, Chris

2015-01-01

Aggression against doctors involved in after-hours house calls (AHHC) is widely perceived to be high. It is, however, unclear how doctors who perform this service manage the risk of aggressive patients during home visits. The aim of this paper is to explore if and how doctors manage the risk of violence against them during AHHC. A survey was designed and administered to all 300 Australian-based doctors engaged in AHHC under the National Home Doctor Service (NHDS). The survey was conducted from September 2014 to November 2014. There were 172 responses (57.3 per cent). Only 43 per cent of respondents adopted personal protective measures. The remaining 57 per cent had none; of those 6 per cent had never considered protective measures, and 31.8 per cent were aware of the risk of violence, but were unsure of what to do. Measures adopted include the use of chaperones/security personnel (34.1 per cent), dependence on surgery policies (31.2 per cent), de-escalation techniques (15.2 per cent), panic buttons (7.2 per cent), personal alarms (6.1 per cent), and others (6.5 per cent). Females were more likely to adopt personal protective measures than males (OR 4.94; p<0.01; CI 1.70-14.34), and Australian-trained doctors were less likely to do so relative to overseas-trained doctors (OR 0.35; p=0.04; CI 0.12-0.99). Just over half of the doctors involved in AHHC took no precautions against aggressive attacks while on duty, and nearly one-third relied on the policies of their employing surgeries.

Quality improvement tools for chronic disease care--more effective processes are less likely to be implemented in developing countries.

PubMed

Hashim, Muhammad Jawad; Prinsloo, Adrianna; Mirza, Deen M

2013-01-01

Chronic disease services may be improved if care management processes (CMPs), such as disease-specific flowsheets and chronic disease registries, are used. The newly industrialized Gulf state health service has underdeveloped primary care but higher diabetes prevalence. This paper's aim is to investigate care management processes in United Arab Emirates (UAE) primary care clinics to explore these issues. A cross-sectional survey using self-administered questionnaires given to family physicians and nurses attending a UAE University workshop was used to collect data. All 38 participants completed the questionnaire: 68 per cent were women and 81 per cent physicians. Care management processes in use included: medical records, 76 per cent; clinical guidelines, 74 per cent; chronic disease care rooms, 74 per cent; disease-specific flowsheets, 61 per cent; medical record audits, 57 per cent; chronic disease nurse-educators, 58 per cent; electronic medical records (EMR), 34 per cent; and incentive plans based on clinical performance, 21 per cent. Only 62 per cent and 48 per cent reported that flowsheets and problem lists, respectively, were completed by physicians. Responses to the open-ended question included using traditional quality improvement (QI) approaches such as continuing education and staff meetings, but not proactive systems such as disease registries and self-management. The study used a small, non-random sample and the survey instrument's psychometric properties were not collected. Chronic disease care CMPs are present in UAE clinics but use is limited. Quality improvement should include disease registries, reminder-tracking systems, patient self-management support and quality incentives. This report highlights the lag regarding adopting more effective CMPs in developing countries.

Surgical Site Infection Reduction Bundle: Implementation and Challenges at Ventura County Medical Center.

PubMed

Losh, Joseph M; Gough, Amy; Rutherford, Richard; Romero, Javier; Diaz, Graal; Schweitzer, Jeremy

2017-10-01

Surgical Site Infections (SSIs) are a significant cause of morbidity and increased cost in the postoperative patient occurring in 2-5 per cent of those undergoing inpatient surgery. Ventura County Medical Center (VCMC) initiated an SSI reduction bundle in 2013, to try to reduce the incidence of SSI. The bundle is a series of best practices including preoperative, perioperative, intraoperative, and postoperative components, as well as items focused on the staff and electronic medical record. VCMC started with a 6.1 per cent SSI rate in 2013. A consistent reduction in SSI rate followed each quarter after that for a rate of less than 2.0 per cent in early 2016. The most critical aspect of this process was the necessary collaboration between disparate departments and the ongoing investment of the staff to this challenging process; the people at the heart of the collaborative process were the key to its success.

Multi-band polarimetry of post-asymptotic giant branch stars - I. Optical measurements

NASA Astrophysics Data System (ADS)

Akras, S.; Ramírez Vélez, J. C.; Nanouris, N.; Ramos-Larios, G.; López, J. M.; Hiriart, D.; Panoglou, D.

2017-04-01

We present new optical broad-band (UBVRI) aperture polarimetric observations of 53 post-asymptotic giant branch (AGB) stars selected to exhibit a large near-infrared excess. 24 out of the 53 stars (45 per cent of our sample) are presented for the first time. A statistical analysis shows four distinctive groups of polarized post-AGB stars: unpolarized or very lowly polarized (degree of polarization or DoP < 1 per cent), lowly polarized (1 per cent < DoP < 4 per cent), moderately polarized (4 per cent < DoP < 8 per cent) and highly polarized (DoP > 8 per cent). 23 out of the 53 (66 per cent) belong to the first group, 10 (19 per cent) to the second, five (9 per cent) to the third and only three (6 per cent) to the last group. Approximately 34 per cent of our sample was found to be unpolarized objects, which is close to the percentage of round planetary nebulae. On average, the low and moderate groups show a wavelength-dependent polarization that increases towards shorter wavelengths, implying an intrinsic origin of the polarization, which signifies a Rayleigh-like scattering spectrum typical for non-symmetrical envelopes composed principally of small dust grains. The moderately polarized stars exhibit higher K - W3 and W1 - W3 colour indices compared with the group of lowly polarized stars, suggesting a possible relation between DoP and mass-loss rate. Moreover, they are found to be systematically colder (redder in B - V), which may be associated with the condensation process close to these stars that results in a higher degree of polarization. We also provide evidence that multiple scattering in optically thin polar outflows is the mechanism that gives high DoP in post-AGB stars with bipolar or multi-polar envelopes.

Oral rehydration therapy in a rural area, northern Thailand.

PubMed

Varavithya, W; Sangshaisirisak, S; Ramaboot, S; Ruangkanchanasetr, S; Vivatwongkasem, C

1989-01-01

A cross-sectional sampling survey of mothers' practice of ORT in Amphoe Bunpotphesai in the northern part of Thailand included 1,619 children under five. Two hundred and six children were reported to have 223 diarrheal episodes. The incidence of diarrhea in children under five was 3.4 episodes per child per year. When children had diarrhea 65.5 per cent of mothers sought help from health providers, 25.2 per cent treated their children with drugs bought from stores, 2.3 per cent used herbal medicine and 6.1 per cent did not treat their children. 50.7 per cent of diarrheal episodes mother gave ORT, using ORS 19.7, commercial electrolytes mixture 16.6 and home available fluid 14.4 per cent. The accuracy of dilution of electrolytes powder from the packets was checked in 80 incidences. 31.8 and 27.8 per cent of mothers made correct dilution of ORS and commercial electrolytes products respectively. Health providers carried both ORS and commercial electrolytes packets. ORS added to a glass of water was found in 13.6 per cent which was 3 times concentrated. Commercial electrolytes products were too dilute in 72.2 per cent. 17.5 per cent of mothers divided electrolytes powder to add in one spoon of water to treat their children as one drug dose. Data showed that the ORT use rate was 50.7 per cent. Home available fluid was used by 14.4 per cent. ORT should be further promoted to control diarrheal diseases and health providers should give instructions to every mother or child minder on how to dispense ORS or electrolytes packets for appropriate dilution and use.

Prevalence & consequences of anaemia in pregnancy.

PubMed

Kalaivani, K

2009-11-01

Prevalence of anaemia in India is among the highest in the world. Prevalence of anaemia is higher among pregnant women and preschool children. Even among higher income educated segments of population about 50 per cent of children, adolescent girls and pregnant women are anaemic. Inadequate dietary iron, folate intake due to low vegetable consumption, perhaps low B12 intake and poor bioavailability of dietary iron from the fibre, phytate rich Indian diets are the major factors responsible for high prevalence of anaemia. Increased requirement of iron during growth and pregnancy and chronic blood loss contribute to higher prevalence in specific groups. In India, anaemia is directly or indirectly responsible for 40 per cent of maternal deaths. There is 8 to 10-fold increase in MMR when the Hb falls below 5 g/dl. Early detection and effective management of anaemia in pregnancy can contribute substantially to reduction in maternal mortality. Maternal anaemia is associated with poor intrauterine growth and increased risk of preterm births and low birth weight rates. This in turn results in higher perinatal morbidity and mortality, and higher infant mortality rate. A doubling of low birth weight rate and 2 to 3 fold increase in the perinatal mortality rates is seen when the Hb is <8 g/dl. Intrauterine growth retardation and low birth weight inevitably lead to poor growth trajectory in infancy, childhood and adolescence and contribute to low adult height. Parental height and maternal weight are determinants of intrauterine growth and birth weight. Thus maternal anaemia contributes to intergenerational cycle of poor growth in the offspring. Early detection and effective management of anaemia in pregnancy can lead to substantial reduction in undernutrition in childhood, adolescence and improvement in adult height.

Resection and drainage of hilar cholangiocarcinoma: an 11-year experience of a single center in mainland China.

PubMed

Zheng-Rong, Lian; Hai-Bo, You; Xin, Chen; Chuan-Xin, Wu; Zuo-Jin, Liu; Bing, Tu; Jian-Ping, Gong; Sheng-Wei, Li

2011-05-01

The purpose of this study is to provide appropriate approaches for resection and drainage of hilar cholangiocarcinomas. Surgical approaches and postoperative survival rates of the patients were analyzed retrospectively. The 1-, 3-, and 5-year cumulative survival rates for patients who underwent resection were 76.6, 36.2, and 10.6 per cent, which was higher than those of 60, 14.3, and 0 per cent, respectively, in palliative operation. Moreover, the 1-, 3-, and 5-year cumulative survival rates for patients who underwent R0 were 88.9, 44.4, and 13.9 per cent, which was improved compared with those of 36.4, 9.1, and 0 per cent, respectively, in nonR0 resection. In addition, the overall survival time of patients who underwent R0 resection combined with hemihepatectomy and caudate lobe resection was longer than of those who underwent R0 without this extra operation, especially within 3 years after operation. After endoscopic metal biliary endoprothesis for patients who were intolerant of resection, liver function was improved at 2 weeks postoperation and the 1-, 3-, and 5-year cumulative survival rates for these patients were 72.7, 18.2, and 0 per cent, respectively. Treatment should be personalized. Resection is the most efficacious therapy, and negative histologic margins should be achieved in radical operation and "skeletonized" surgical operation is the basic requirement of radical treatment of hilar cholangiocarcinoma. Portal vein resection is beneficial to long-term survival and R0 resection combined with caudate lobe resection and hemihepatectomy is more efficacious for patients with Bismuth-Corlette type III hilar cholangiocarcinoma. The preferred approach of drainage in palliative operation is endoscopic metal biliary endoprothesis, which is more appropriate than tumor resection for the patients who suffer from serious comorbidities.

The KMOS Redshift One Spectroscopic Survey (KROSS): dynamical properties, gas and dark matter fractions of typical z ˜ 1 star-forming galaxies

NASA Astrophysics Data System (ADS)

Stott, John P.; Swinbank, A. M.; Johnson, Helen L.; Tiley, Alfie; Magdis, Georgios; Bower, Richard; Bunker, Andrew J.; Bureau, Martin; Harrison, Chris M.; Jarvis, Matt J.; Sharples, Ray; Smail, Ian; Sobral, David; Best, Philip; Cirasuolo, Michele

2016-04-01

The KMOS Redshift One Spectroscopic Survey (KROSS) is an ESO-guaranteed time survey of 795 typical star-forming galaxies in the redshift range z = 0.8-1.0 with the KMOS instrument on the Very Large Telescope. In this paper, we present resolved kinematics and star formation rates for 584 z ˜ 1 galaxies. This constitutes the largest near-infrared Integral Field Unit survey of galaxies at z ˜ 1 to date. We demonstrate the success of our selection criteria with 90 per cent of our targets found to be H α emitters, of which 81 per cent are spatially resolved. The fraction of the resolved KROSS sample with dynamics dominated by ordered rotation is found to be 83 ± 5 per cent. However, when compared with local samples these are turbulent discs with high gas to baryonic mass fractions, ˜35 per cent, and the majority are consistent with being marginally unstable (Toomre Q ˜ 1). There is no strong correlation between galaxy averaged velocity dispersion and the total star formation rate, suggesting that feedback from star formation is not the origin of the elevated turbulence. We postulate that it is the ubiquity of high (likely molecular) gas fractions and the associated gravitational instabilities that drive the elevated star formation rates in these typical z ˜ 1 galaxies, leading to the 10-fold enhanced star formation rate density. Finally, by comparing the gas masses obtained from inverting the star formation law with the dynamical and stellar masses, we infer an average dark matter to total mass fraction within 2.2re (9.5 kpc) of 65 ± 12 per cent, in agreement with the results from hydrodynamic simulations of galaxy formation.

Prevalence of cardiovascular risk factors in the urban population of Soussa in Tunisia.

PubMed

Ghannem, H; Hadj Fredj, A

1997-12-01

With the epidemiological transition phenomenon, Tunisia is now facing the growing prevalence of chronic diseases. Environmental and behavioural changes such as the adoption of new dietary habits and a sedentary lifestyle, and the stress of urbanization and of working conditions all lead to the rise in cardiovascular disease (CVD) risk factors. The aim of this study is to estimate the prevalence of the main CVD risk factors in an urban context. For this, we have undertaken a household epidemiological survey of a representative sample of the adult urban population of Soussa, Tunisia (n = 957). This study shows high prevalences of hypertension (blood pressure >160/95 mmHg) of 18.8 per cent with an adjusted rate of 15.6 per cent, history of diabetes of 10.2 per cent, and obesity (body mass index > 30) of 27.7 per cent [significantly higher in women (34.4 per cent)], android obesity 36 per cent, smoking habits 21.5 per cent [significantly higher in men (61.4 per cent)]. With this profile of CVD risk factors, Tunisia must implement a national strategy of primary prevention and heart health promotion in addition to the efforts recently made in secondary prevention of some chronic diseases such as hypertension and diabetes.

A core city problem: recruitment and retention of salaried physicians.

PubMed

Paxton, G S; Sbarbaro, J A; Nossaman, N

1975-03-01

The professional and personal characteristics of all physicians recruited into a large urban governmentally sponsored health system were evaluated and correlated to staff retention and loss. The results were tabulated for 84 physicians, approximately 90 per cent of the physician work force, over a three-year period. Eighty per cent resided in either Denver or the state of Colorado prior to entry. This is further reflected in a significant percentage being enrolled in the local medical school or training programs prior to entry. These facts suggest a possible source of manpower for beginning programs. Twenty-six per cent came from private practice, 32 per cent from the military and 14 per cent from the Public Health Service. The turnover rate averaged 6.2 per cent per year, with 4.4 per cent being initiated by the physician and 1.8 per cent leaving because of administrative pressure. Data from other studies are reviewed. Factors which appear to influence retention positively were residency training (pediatricians), sex (females), age (over 38) and those with team experience. These factors suggest directions as to the type of physician who, if recruited, tend to reduce turnover. The establishment of a group practice atmosphere with rewards for clinical skills and the offering of unusual specialty opportunities are proposed as positive factors in the retention of staff.

Evaluation of glucose as a cryoprotectant for boar semen.

PubMed

De los Reyes, M; Saenz, L; Lapierre, L; Crosby, J; Barros, C

2002-10-19

Fertility parameters of boar spermatozoa were evaluated in vitro, after freeze-thawing the semen in three different extenders containing permeable and non-permeable cryoprotectants: A (111.0 mM Tris, 31.4 mM citric acid, 185.0 mM glucose, 20 per cent egg yolk, 3 per cent glycerol and 100 iu/ml penicillin G); B (200 mM Tris; 70.8 mM citric acid, 55.5 mM glucose, 20 per cent egg yolk, three per cent glycerol and 100 iu/ml penicillin G); C (200 mM Tris, 70.8 mM citric acid, 55.5 mM fructose, 20 per cent egg yolk, 3 per cent glycerol and 100 iu/ml penicillin G). The freeze-thawing techniques were the same for each extender. Eight ejaculates from four boars were obtained; the sperm-rich fraction of each ejaculate was extended in each of the three media at a final concentration of 400 x 106 sperm/ml, loaded into 0.5 ml straws and frozen at a rate of 30 degrees C/minute to -196 degrees C. The straws were thawed at 60 degrees C for eight seconds. Sperm motility, acrosomal integrity and in vitro sperm penetration through the zona pellucida of gilt oocytes matured in vitro were evaluated. The motility of unfrozen spermatozoa was 93.1 per cent compared with 60.7 per cent, 48.2 per cent and 35 per cent for sperm frozen in extenders A, B and C respectively; these values were all significantly different (P<0.05). There was no significant decline in sperm motility after incubation for 30 minutes in extender A, but there were significant decreases in sperm motility after 30 minutes of incubation in B and C. The percentage acrosomal integrities were 97.2 per cent for the control and 45.5 per cent, 30.3 per cent and 16.8 per cent for the frozen-thawed spermatozoa in extenders A, B and C respectively. The results of the in vitro penetration assay were 80.7 per cent when using control spermatozoa, and 42.2 per cent, 18.4 per cent and 3.3 per cent when using frozen-thawed spermatozoa in extenders A, B and C respectively

Postoperative infections in colonic surgery after enteral bacitracin-neomycin-clindamycin or parenteral mezlocillin-oxacillin prophylaxis.

PubMed

Schiessel, R; Huk, I; Starlinger, M; Wunderlich, M; Rotter, M; Wewalka, G; Schemper, M

1984-09-01

In a prospective randomized, blind trial, three groups of patients undergoing elective colonic surgery were compared for frequency of surgical wound infection, intra-operative wound contamination and other postoperative infections. All patients allotted to the three groups received whole gut irrigation (101 balanced salt solution) by gastric tube on the evening before surgery and were treated as follows. Group A: no antibiotics; Group B: neomycin (1 g/l) + bacitracin (50,000 IU/l) + clindamycin (900 mg/l), contained in the last 31 of irrigation fluid; Group C: mezlocillin (4 g) + oxacillin (2 g) intravenously (iv) at induction of anaesthesia, followed by two identical doses at 8 and 16 h. The rate of postoperative wound infection was highest in A (38 per cent) and much lower in B (3.3 per cent, P less than 0.002) and C (6.9 per cent, P less than 0.004). The difference between B and C was statistically not significant. In A a correlation was established between the degree of wound contamination and the occurrence of wound infection. Intra-operative wound contamination was lowest in B (30 per cent), equal in A (58.1 per cent) and B (55.2 per cent). Other infections were least frequent in group C (four of 29 patients), but were not significantly different to groups B (six of 30) and A (nine of 31). It is concluded that antibiotics together with an effective mechanical preparation considerably reduce the rate of wound infection in colonic surgery.

Clinical motivation and the surgical safety checklist.

PubMed

Yu, X; Huang, Y; Guo, Q; Wang, Y; Ma, H; Zhao, Y

2017-03-01

Although the surgical safety checklist (SSC) has been adopted worldwide, its efficacy can be diminished by poor clinical motivation. Systematic methods for improving implementation are lacking. A multicentre prospective study was conducted in 2015 in four academic/teaching hospitals to investigate changes during revision of the SSC for content, staffing and workflow. All modifications were based on feedback from medical staff. Questionnaires were used to monitor dynamic changes in surgeons', nurses' and anaesthetists' perceptions. Complete information was obtained from 30 654 operations in which the newly developed SSC system was used. Implementation quality was evaluated in 1852 operations before, and 1822 after the changes. The revised SSC content was simplified from 34 to 22 items. Anaesthetists achieved widespread recommendation as SSC coordinators. Completion rates of all stages reached over 80·0 per cent at all sites (compared with 10·2-59·5 per cent at the sign-out stage in the baseline survey). There was a significant change in doctors who participated (for example, surgeon: from 24·6 to 64·5 per cent at one site). The rates of hasty (15·1-33·7 per cent) or casual (0·4-4·4 per cent) checking decreased to less than 6·0 per cent overall. Perceptions about the SSC were studied from 2211 forms. They improved, with a converging trend among the three different professions, to a uniform 80·0 per cent agreeing on the need for its regular use. Medical staff members are both the users and owners of the SSC. High-quality SSC implementation can be achieved by clinically motivated adaptation. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

Breastfeeding knowledge among health workers in rural South Africa.

PubMed

Shah, Sonal; Rollins, Nigel C; Bland, Ruth

2005-02-01

The aim of the study was to conduct a rapid assessment of breastfeeding knowledge amongst health workers in an area of high HIV prevalence. A cross-sectional survey using semi-structured questionnaires and problem-based scenarios was carried out. Responses were compared to those recommended in the World Health Organization (WHO) Breastfeeding Counselling Course. The setting was a rural area of KwaZulu Natal, with a population of 220 000 people. At the time of the study approximately 36 per cent of pregnant women were HIV-infected and no programme to prevent mother-to-child transmission was in place. A convenient sample of 71 healthcare workers (14 doctors, 25 professional nurses, 16 staff nurses, and 16 community health workers) were included in the study. Over 50% of respondents had given breastfeeding advice to clients over the previous month. However, there were significant discrepancies in breastfeeding knowledge compared to WHO recommendations. Ninety-three per cent (n = 13) of doctors knew that breastfeeding should be initiated within 30 min of delivery, but 71 per cent (n = 10) would recommend water, and 50 per cent (n = 7) solids to breastfed infants under 6 months of age. Fifty-seven per cent (n = 8) considered glucose water necessary for neonatal jaundice, constipation, and for infants immediately after delivery. Only 44 per cent (n = 7) of staff nurses and 56 per cent (n = 14) of professional nurses knew that breastfeeding should be on demand. The majority would recommend water, formula milk, and solids to breastfed infants under 6 months of age, and glucose water for neonatal jaundice and immediately after delivery. Knowledge of community health workers differed most from WHO recommendations: only 37 per cent (n = 6) knew that breastfeeding should be initiated within 30 min of delivery, 68 per cent (n = 11) thought breastfeeding should be on schedule and not on demand, and the majority would recommend supplements to infants under 6 months of age. Few respondents suggested taking a feeding history or observing a breastfeed in response to the problem scenarios. The most commonly given responses to problems of babies who were perceived to be thirsty, unsatisfied, or crying after feeds was to supplement with other fluids or feeds. There is a need for systematic and ongoing training in breastfeeding and infant feeding counselling in the context of HIV, so that breastfeeding is not undermined by the current HIV pandemic, and exclusive breastfeeding continues to be promoted for all HIV-uninfected women, women of unknown status, and HIV-infected women who choose to breastfeed.

[Study of the labor market for dentists who recieved Norwegian authorization during 1972-1975. I. Waiting time and alternative employment before the 1st relevant job].

PubMed

Haugejorden, O

1977-07-01

The purpose of the investigation was to monitor changes in the labour market situation for dentists who received authorization to practise dentistry in Norway during the years 1972-1975. Data was collected by postal questionnaire during April/May of the year following authorization, except for the 1972 cohort, which was contacted the second year after authorization. A 92-95 per cent response rate was achieved using one follow-up (Table 1). The percentage of respondents who waited 8 weeks or more to acquire a job in dentistry increased from 15 for those authorized in 1972 to 36 for the 1975 group (Table 3). The proportion of dentists who took paid employment other than dentistry, increased from just over 3 per cent for the 1973 to 14 per cent for the 1975 cohort (Table 4). This development has occured despite a decrease in the number of dentists receiving authorization each year and has resulted in a limited emigration of dentists. It is suggested that the favourable supply of dentists in relation to existing demand for dental services presents an ideal opportunity for attempting to solve dental health problems which have received inadequate attention in the past.

Early definitive treatment rate as a quality indicator of care in acute gallstone pancreatitis.

PubMed

Green, R; Charman, S C; Palser, T

2017-11-01

Early definitive treatment (cholecystectomy or endoscopic sphincterotomy in the same admission or within 2 weeks after discharge) of gallstone disease after a biliary attack of acute pancreatitis is standard of care. This study investigated whether compliance with early definitive treatment for acute gallstone pancreatitis can be used as a care quality indicator for the condition. A retrospective cohort study was conducted using the Hospital Episode Statistics database. All emergency admissions to National Health Service hospitals in England with a first time diagnosis of acute gallstone pancreatitis in the financial years 2008, 2009 and 2010 were examined. Trends in early definitive treatment between hospital trusts were examined and patient morbidity outcomes were determined. During the study interval there were 19 510 patients with an overall rate of early definitive treatment at 34·7 (range 9·4-84·7) per cent. In the 1-year follow-up period, 4661 patients (23·9 per cent) had one or more emergency readmissions for complications related to gallstone pancreatitis. Of these, 2692 (57·8 per cent) were readmissions for acute pancreatitis; 911 (33·8 per cent) were within the first 2 weeks of discharge, with the remaining 1781 (66·2 per cent) occurring after the point at which definitive treatment should have been received. Early definitive treatment resulted in a 39 per cent reduction in readmission risk (adjusted risk ratio (RR) 0·61, 95 per cent c.i. 0·58 to 0·65). The risk was further reduced for acute pancreatitis readmissions to 54 per cent in the early definitive treatment group (adjusted RR 0·46, 0·42 to 0·51). In acute gallstone pancreatitis, compliance with recommended early definitive treatment varied considerably, with associated variation in outcomes. Compliance should be used as a quality indicator to improve care. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

Fatal occupational injuries of women, Texas 1975-84.

PubMed Central

Davis, H; Honchar, P A; Suarez, L

1987-01-01

A review of Texas death certificates for 1975-84 identified 348 cases of fatal occupational injuries of civilian females. Homicides accounted for 53 per cent and motor vehicle-related injuries accounted for 26 per cent of the deaths. Injuries from firearms caused 70 per cent of the homicides. One hundred thirty-three deaths occurred to women employed in the retail trade industry; of these, 77 per cent resulted from homicide. Women workers in gasoline service stations, food-bakery-and-dairy stores, and eating-and-drinking places had especially high risks of homicide. Texas female heavy-truck drivers had the highest fatal-injury rate, with motor-vehicle-related injuries causing 89 per cent of their deaths. These results indicate that effective strategies to prevent fatal occupational injuries of Texas women will need to address the problems of workplace violence and the hazards posed by motor vehicles. PMID:3674251

[Reduction in the mortality from acute diarrheal diseases. The experiences of an action-research program].

PubMed

Gutiérrez, G; Guiscafré, H; Reyes, H; Pérez, R; Vega, R; Tomé, P

1994-01-01

In order to accelerate the descending mortality rate of acute diarrhea in children under five years of age in Mexico, six strategies were implemented. The results showed that after nine months, 49 per cent of mothers had been trained, and improved significantly their home management of diarrhea. The use of oral rehydration salts increased from 10 to 30 per cent; use of oral rehydration therapy increased from 77 to 83 per cent; and timely and appropriate demand for medical help increased from 51 to 62 per cent (p < 0.05). One hundred percent of all physicians received training, and they improved their therapeutic practices, as shown by a decrease in the use of antibiotics from 48 to 34 per cent; prescription of restrictive diets diminished from 33 to 4 per cent; and oral rehydration therapy increased from 74 to 87 per cent. Thirty-four verbal autopsies were carried out, and they showed that 70 per cent of the children who died did so in their homes or in their way to the hospital, despite the fact that 94 per cent of them had received medical care previous to their death, and that 84 per cent of these had been seen by a doctor within 24 hours previous to their death. In 85 per cent of these cases, the physician involved was a private physician of rural or marginal areas. Monthly analysis of death certificates showed that, during the first year of the program (1991), deaths due to diarrhea diminished 20 per cent, while the corresponding figure for 1992 was 52 per cent. In conclusion, the combination of strategies followed in the program made it possible to accelerate, on a short-term basis, the descending trend of deaths due to diarrhea. It was also shown that an intervention project such as the one presented here may efficiently link results from research to decisions taken by policy-makers, and that these can be effectively turned into actions.

Carcinoma of penis. Review of cases treated by surgery and radiation therapy 1960-1977

DOE Office of Scientific and Technical Information (OSTI.GOV)

Krieg, R.M.; Luk, K.H.

1981-08-01

Cases of squamous cell carcinoma of the penis treated by surgery and radiation therapy at Moffitt Hospital, University of California, and Mount Zion Hospital and Medical Center are reviewed. Only cases followed for more than three years or with autopsy findings are presented. For the primary lesion, over-all surgical control rate locally was 15/17 or 88 per cent. Over-all control rate with radiation therapy alone was 9/12 (75 per cent), and with surgical salvage 11/12 (92 per cent). Radiation therapy appears to be the treatment of choice for early stage lesions, reserving surgery for salvage. Prophylactic ilioinguinal lymph node dissectionmore » for N0 lesions is not warranted. The role of chemotherapy needs further investigation.« less

Addressing refractive error visual impairment: volunteer organisations' alignment with Vision 2020 and public health principles.

PubMed

Pearce, Matthew G; Pearce, Nicole

2012-11-01

Eye care professionals have been making short visits to developing countries for decades in an effort to reduce visual impairment caused by refractive error. A 2006 survey revealed that volunteer organisations were not working within the Vision 2020 framework. Recommendations were made for volunteer organisations that would better align their work with accepted Vision 2020 and public health principles. This study re-evaluates the alignment of volunteer organisations with Vision 2020 and public health principles. To determine their philosophies and methods, a web-based survey was sent to 89 volunteer organisations identified from an internet search. The response rate was 48 per cent. Many (70.7 per cent) organisations exclusively mention direct service provision in their statement of purpose, often provided by student volunteers (75.6 per cent). A few (19.5 per cent) provide short training in refraction, not necessarily following best principles. The majority (82.1 per cent) dispenses recycled spectacles and many use medications not on national essential drug lists. Few attempt to follow aid effectiveness principles with only 26.8 per cent stating they follow Vision 2020 country plans. Overall, as in 2006, the work of these organisations is largely not in alignment with Vision 2020 and public health principles. Organisations interested in decreasing visual impairment due to refractive error in the developing world are encouraged to transition to organisations that not only recognise but also implement public health principles. This should include reprioritisation of their work to developing human resources and infrastructure, determining the burden and causes of disease, assisting in the training of mid-level personnel and providing professional and community education, collaborating via partnerships, discontinuing the use of recycled spectacles and inappropriate medications, and evaluating their outcomes. Following these recommendations as well as creating a better alignment with public health principles in general will increase the likelihood that their programs will be effective in decreasing visual impairment due to refractive error in the developing world. © 2012 The Authors. Clinical and Experimental Optometry © 2012 Optometrists Association Australia.

Meta‐analysis of the procedural risks of carotid endarterectomy and carotid artery stenting over time

PubMed Central

Lokuge, K.; de Waard, D. D.; Halliday, A.; Gray, A.; Bulbulia, R.

2017-01-01

Background Stroke/death rates within 30 days of carotid endarterectomy (CEA) and carotid artery stenting (CAS) in RCTs inform current clinical guidelines. However, the risks may have changed in recent years with wider use of effective stroke prevention therapies, especially statins, improved patient selection and growing operator expertise. The aim of this study was to investigate whether the procedural stroke/death risks from CEA and CAS have changed over time. Methods MEDLINE and Embase were searched systematically from inception to May 2016 for observational cohort studies of CEA and CAS. Studies included reported on more than 1000 patients, with 30‐day outcomes after the procedure according to patients' symptom status (recent stroke or transient ischaemic attack). Restricted maximum likelihood random‐effects and meta‐regressions methods were used to synthesize procedural stroke/death rates of CEA and CAS according to year of study recruitment completion. Results Fifty‐one studies, including 223 313 patients undergoing CEA and 72 961 undergoing CAS, were reviewed. Procedural stroke/death risks of CEA decreased over time in symptomatic and asymptomatic patients. Risks were substantially lower in studies completing recruitment in 2005 or later, both in symptomatic (5·11 per cent before 2005 versus 2·68 per cent from 2005 onwards; P = 0·002) and asymptomatic (3·17 versus 1·50 per cent; P < 0·001) patients. Procedural stroke/death rates of CAS did not change significantly over time (4·77 per cent among symptomatic and 2·59 per cent among asymptomatic patients). There was substantial heterogeneity in event rates and recruitment periods were long. Conclusions Risks of procedural stroke/death following CEA appear to have decreased substantially. There was no evidence of a change in stroke/death rates following CAS. PMID:29205297

Renovascular hypertension: ten years' experience in a regional centre.

PubMed

Sellars, L; Siamopoulos, K; Hacking, P M; Proud, G; Taylor, R M; Essenhigh, D M; Wilkinson, R

1985-07-01

In a unit serving a population of three million, 60 hypertensive patients with renovascular disease were identified over a 10-year period. The presence of renovascular disease was usually suggested by intravenous urography (IVU), although this was falsely negative in 21 per cent of cases; isotope renography (IR) was normal in a similar proportion of patients (25 per cent). Eight patients were treated medically and 52 underwent surgical procedures; nephrectomy in 32, autotransplantation in 10, by pass graft in six and percutaneous transluminal angioplasty in four. Twenty-three per cent of patients were cured, 37 per cent improved and 40 per cent unchanged one year after surgery, but the response could not be accurately predicted. Clinical features were of some value in that those patients most likely to benefit from surgery were younger, had less severe hypertension of shorter duration, smoked less, had less severe retinopathy and less cardiomegaly. There was also a trend for those with better renal function and less electrocardiographic evidence of left ventricular hypertrophy to benefit from surgery. The IVU and IR did not predict response to surgery but arteriographic appearances of fibromuscular dysplasia indicated there should be a favourable response. The renal vein renin ratio, basal or stimulated, was of no prognostic value since approximately two-thirds of patients with ratios above or below the threshold value had some benefit from surgery. We conclude that the surgical treatment of renovascular hypertension is worthwhile but the number of patients suitable for surgery is small. Clinical features and the results of simple investigations provided the best guide to surgical outcome in our patients.

Parasitic disease control in a residential facility for the mentally retarded.

PubMed Central

Thacker, S B; Simpson, S; Gordon, T J; Wolfe, M; Kimball, A M

1979-01-01

Asymptomatic infection with either Entameba histolytica or Giardia lamblia was found in 61 per cent of the residents of a dormitory in an institution for the mentally retarded; two other dormitories had rates of 20 per cent and 22 per cent. Drug therapy was successfully undertaken in all three dormitories, and environmental improvements were introduced in the heavily infected dormitory. A one-year follow-up showed a reduction in parasitic disease in two dormitories but, in the most heavily infected dormitory, infection had returned to pretreatment levels. PMID:389070

Sex differences in mortality after abdominal aortic aneurysm repair in the UK

PubMed Central

Saratzis, A.; Sweeting, M. J.; Michaels, J.; Powell, J. T.; Thompson, S. G.; Bown, M. J.

2017-01-01

Background The UK abdominal aortic aneurysm (AAA) screening programmes currently invite only men for screening because the benefit in women is uncertain. Perioperative risk is critical in determining the effectiveness of screening, and contemporary estimates of these risks in women are lacking. The aim of this study was to compare mortality following AAA repair between women and men in the UK. Methods Anonymized data from the UK National Vascular Registry (NVR) for patients undergoing AAA repair (January 2010 to December 2014) were analysed. Co‐variables were extracted for analysis by sex. The primary outcome measure was in‐hospital mortality. Secondary outcome measures included mortality by 5‐year age groups and duration of hospital stay. Logistic regression was performed to adjust for age, calendar time, AAA diameter and smoking status. NVR‐based outcomes were checked against Hospital Episode Statistics (HES) data. Results A total of 23 245 patients were included (13·0 per cent women). Proportionally, more women than men underwent open repair. For elective open AAA repair, the in‐hospital mortality rate was 6·9 per cent in women and 4·0 per cent in men (odds ratio (OR) 1·48, 95 per cent c.i. 1·08 to 2·02; P = 0·014), whereas for elective endovascular AAA repair it was 1·8 per cent in women and 0·7 per cent in men (OR 2·86, 1·72 to 4·74; P < 0·001); the results in HES were similar. For ruptured AAA, there was no sex difference in mortality within the NVR; however, in HES, for ruptured open AAA repair, the in‐hospital mortality rate was higher in women (33·6 versus 27·1 per cent; OR 1·36, 1·16 to 1·59; P < 0·001). Conclusion Women have a higher in‐hospital mortality rate than men after elective AAA repair even after adjustment. This higher mortality may have an impact on the benefit offered by any screening programme offered to women. PMID:28745403

Idiopathic granulomatous mastitis: in search of a therapeutic paradigm.

PubMed

Wilson, Jason P; Massoll, Nicole; Marshall, Julia; Foss, Robin M; Copeland, Edward M; Grobmyer, Stephen R

2007-08-01

Idiopathic granulomatous mastitis, also known as idiopathic granulomatous lobular mastitis, is a benign breast lesion that represents both a diagnostic and therapeutic dilemma. We report two cases of granulomatous mastitis recently evaluated and managed at our institution. To better understand this rare disease, we analyzed treatment outcomes in reported cases of granulomatous mastitis. One hundred sixteen cases were subsequently analyzed. Primary management strategies included observation (n = 9), steroids (n = 29), partial mastectomy (n = 75), and mastectomy (n = 3). Success rates with each treatment were observation, 56 per cent; steroids, 42 per cent; partial mastectomy, 79 per cent; and mastectomy, 100 per cent. Based on this analysis, we propose a clinically useful algorithm for both workup and management of these challenging cases.

Prevention of deaths and injuries caused by house fires: survey of local authority smoke alarm policies.

PubMed

Rowland, Diane; Afolabi, Elizabeth; Roberts, Ian

2002-09-01

Despite an increased risk of fire in disadvantaged households, smoke alarm ownership is considerably lower than in the general population. The government currently recommends that local authorities install battery-operated smoke alarms in all public sector properties regardless of tenure. However, the extent to which local authorities comply is currently not known. We conducted a survey of local authorities to establish the extent of their smoke alarm provision to public sector households. A telephone survey of all 405 local authorities within England and Wales was carried out. We obtained responses from 390 (97 per cent) local authorities, 266 of which had responsibility for housing. Over half of all public-sector households are offered smoke alarms by the local authorities. The majority of local authorities offer ionization and/or optical sensor alarm types (78 per cent), with many local authorities providing battery-operated alarms alone (17 per cent) or in combination with hardwired alarms (31 per cent). Many local authorities offer smoke alarm provision to their public-sector households. Whether this represents an effective and cost-effective use of resources requires further investigation.

Presence of the glycogen synthase 1 (GYS1) mutation causing type 1 polysaccharide storage myopathy in continental European draught horse breeds.

PubMed

Baird, J D; Valberg, S J; Anderson, S M; McCue, M E; Mickelson, J R

2010-11-13

The purpose of this study was to determine which continental European draught horse breeds harbour a mutation in the glycogen synthase 1 gene (GYS1) that is known to be responsible for type 1 polysaccharide storage myopathy in quarter horses and North American draught horses. Of a non-random selection of continental European draught horses belonging to 13 breeds, 62 per cent (250 of 403) tested were found to carry the mutant allele. The horses were located in Belgium, France, Germany, The Netherlands, Spain and Sweden. The mutation was identified in animals from each of the breeds examined. In the breeds in which more than 15 animals were available for testing, the highest percentages of GYS1-positive horses were found in the Belgian trekpaard (92 per cent; 35 of 38 horses tested), Comtois (80 per cent; 70 of 88), Netherlands trekpaard (74 per cent; 17 of 23), Rheinisch-Deutsches kaltblut (68 per cent; 30 of 44) and Breton (64 per cent; 32 of 51).

Outcome after associating liver partition and portal vein ligation for staged hepatectomy and conventional two-stage hepatectomy for colorectal liver metastases.

PubMed

Adam, R; Imai, K; Castro Benitez, C; Allard, M-A; Vibert, E; Sa Cunha, A; Cherqui, D; Baba, H; Castaing, D

2016-10-01

Although associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has been increasingly adopted by many centres, the oncological outcome for colorectal liver metastases compared with that after two-stage hepatectomy is still unknown. Between January 2010 and June 2014, all consecutive patients who underwent either ALPPS or two-stage hepatectomy for colorectal liver metastases in a single institution were included in the study. Morbidity, mortality, disease recurrence and survival were compared. The two groups were comparable in terms of clinicopathological characteristics. ALPPS was completed in all 17 patients, whereas the second-stage hepatectomy could not be completed in 15 of 41 patients. Ninety-day mortality rates for ALPPS and two-stage resection were 0 per cent (0 of 17) versus 5 per cent (2 of 41) (P = 0·891). Major complication rates (Clavien grade at least III) were 41 per cent (7 of 17) and 39 per cent (16 of 41) respectively (P = 0·999). Overall survival was significantly lower after ALPPS than after two-stage hepatectomy: 2-year survival 42 versus 77 per cent respectively (P = 0·006). Recurrent disease was more often seen in the liver in the ALPPS group. Salvage surgery was less often performed after ALPPS (2 of 8 patients) than after two-stage hepatectomy (10 of 17). Although major complication and 90-day mortality rates of ALPPS were similar to those of two-stage hepatectomy, overall survival was significantly lower following ALPPS. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

Prevalence of allergic rhinitis among elementary and middle school students in Changsha city and its impact on quality of life.

PubMed

Song, Y; Wang, M; Xie, J; Li, W; Zhang, X; Wang, T; Tan, G

2015-11-01

To investigate the prevalence of allergic rhinitis among elementary and middle school students and examine its impact on their quality of life. Stratified sampling and cluster sampling surveys were performed among 10-17-year-old students in Changsha city from June 2011 to April 2012. In the stratified sampling survey, the self-reported allergic rhinitis rate was 42.5 per cent. Further examination demonstrated that the average prevalence of allergic rhinitis was 19.4 per cent. The cluster sampling survey demonstrated that 214 of 814 students appeared to be atopic (26.3 per cent). The prevalence of allergic rhinitis and asthma was 17.2 and 2.1 per cent, respectively. In total, 71 atopic individuals (8.7 per cent) were without any symptoms of allergic disease. Further analysis showed that allergic rhinitis influenced the students' sleep, emotions and memory (p < 0.001). The prevalence of allergic rhinitis was 15.8 -19.4 per cent, showing an increase with age. Allergic rhinitis affected students' sleep, emotions and memory.

Role of the Australian Paediatric Surveillance Unit in monitoring communicable diseases of childhood.

PubMed

Williams, K; Elliott, E

1998-12-24

The Australian Paediatric Surveillance Unit (APSU) conducts active national surveillance of conditions affecting children, including communicable diseases and their complications. By mailing over 900 clinicians each month the APSU gathers national information, not available from other sources, about the incidence, demographic and clinical features of these conditions. In some conditions APSU data supplements that available from existing schemes. The APSU has monitored 20 conditions to date. Eight of these are communicable diseases or their complications, two have a possible infectious aetiology and one frequently presents with infection. Since its inception in 1993 the return rate of monthly report cards by the mailing list has increased from 88 per cent to 94 per cent. Return rate of questionnaires for the communicable diseases studied ranged from 74 per cent to 100 per cent. Studies have enabled estimation of disease incidence, identification of risk factors and possible preventive strategies and provision of detailed clinical information. Although the APSU cannot serve a public health role by case identification and contact tracing it provides information that contributes to the communicable disease strategy for Australia.

Change in primary midwife-led care in the Netherlands in 2000–2008: A descriptive study of caesarean sections and other interventions among 807,437 low-risk births.

PubMed

Offerhaus, Pien M; de Jonge, Ank; van der Pal-de-Bruin, Karin M; Hukkelhoven, Chantal W P M; Scheepers, Peer L H; Lagro-Janssen, Antoine L M

2015-06-01

to study whether an increase in intrapartum referrals in primary midwife-led care births in the Netherlands is accompanied by an increase in caesarean sections. nationwide descriptive study. The Netherlands Perinatal Registry. 807,437 births of nine year cohorts of women with low risk pregnancies in primary midwife-led care at the onset of labour between 2000 and 2008. primary outcome is the caesarean section rate. Vaginal instrumental childbirth, augmentation with oxytocin, and pharmacological pain relief are secondary outcomes. Trends in outcomes are described. We used logistic regression to explore whether changes in the planned place of birth and other maternal characteristics were associated with the caesarean section rate. the caesarean section rate increased from 6.2 to 8.3 per cent for nulliparous and from 0.8 to 1.1 per cent for multiparous women. After controlling for maternal characteristics the year by year increase in the caesarean section rate was still significant for nulliparous women (adj OR 1.03; 95% CI 1.02–1.03). The vaginal instrumental birth declined from 18.2 to 17.4 per cent for nulliparous women (multiparous women: 1.7–1.5 per cent). Augmentation of labour and/or pharmacological pain relief increased from 23.1 to 38.1 per cent for nulliparous women and from 5.4 to 9.6 per cent for multiparous women. the rise in augmentation of labour, pharmacological pain relief and electronic fetal monitoring in the period 2000–2008 among women in primary midwife-led care was accompanied by an increase in caesarean section rate for nulliparous women. The vaginal instrumental deliveries declined for both nulliparous and multiparous women. primary care midwives should evaluate whether they can strengthen the opportunities for nulliparous women to achieve a physiological birth, without augmentation or pharmacological pain relief. If such interventions are considered necessary to achieve a spontaneous vaginal birth, the current disadvantage of discontinuity of care should be reduced. In a more integrated care system, women could receive continuous care and support from their own primary care midwife, as long as only supportive interventions are needed.

Contribution of surgical specialization to improved colorectal cancer survival.

PubMed

Oliphant, R; Nicholson, G A; Horgan, P G; Molloy, R G; McMillan, D C; Morrison, D S

2013-09-01

Reorganization of colorectal cancer services has led to surgery being increasingly, but not exclusively, delivered by specialist surgeons. Outcomes from colorectal cancer surgery have improved, but the exact determinants remain unclear. This study explored the determinants of outcome after colorectal cancer surgery over time. Postoperative mortality (within 30 days of surgery) and 5-year relative survival rates for patients in the West of Scotland undergoing surgery for colorectal cancer between 1991 and 1994 were compared with rates for those having surgery between 2001 and 2004. The 1823 patients who had surgery in 2001-2004 were more likely to have had stage I or III tumours, and to have undergone surgery with curative intent than the 1715 patients operated on in 1991-1994. The proportion of patients presenting electively who received surgery by a specialist surgeon increased over time (from 14·9 to 72·8 per cent; P < 0·001). Postoperative mortality increased among patients treated by non-specialists over time (from 7·4 to 10·3 per cent; P = 0·026). Non-specialist surgery was associated with an increased risk of postoperative death (adjusted odds ratio 1·72, 95 per cent confidence interval (c.i.) 1·17 to 2·55; P = 0·006) compared with specialist surgery. The 5-year relative survival rate increased over time and was higher among those treated by specialist compared with non-specialist surgeons (62·1 versus 53·0 per cent; P < 0·001). Compared with the earlier period, the adjusted relative excess risk ratio for the later period was 0·69 (95 per cent c.i. 0·61 to 0·79; P < 0·001). Increased surgical specialization accounted for 18·9 per cent of the observed survival improvement. Increased surgical specialization contributed significantly to the observed improvement in longer-term survival following colorectal cancer surgery. © 2013 British Journal of Surgery Society Ltd. Published by John Wiley & Sons Ltd.

FLORA™: Phase I development of a functional vision assessment for prosthetic vision users.

PubMed

Geruschat, Duane R; Flax, Marshall; Tanna, Nilima; Bianchi, Michelle; Fisher, Andy; Goldschmidt, Mira; Fisher, Lynne; Dagnelie, Gislin; Deremeik, Jim; Smith, Audrey; Anaflous, Fatima; Dorn, Jessy

2015-07-01

Research groups and funding agencies need a functional assessment suitable for an ultra-low vision population to evaluate the impact of new vision-restoration treatments. The purpose of this study was to develop a pilot assessment to capture the functional visual ability and well-being of subjects whose vision has been partially restored with the Argus II Retinal Prosthesis System. The Functional Low-Vision Observer Rated Assessment (FLORA) pilot assessment involved a self-report section, a list of functional visual tasks for observation of performance and a case narrative summary. Results were analysed to determine whether the interview questions and functional visual tasks were appropriate for this ultra-low vision population and whether the ratings suffered from floor or ceiling effects. Thirty subjects with severe to profound retinitis pigmentosa (bare light perception or worse in both eyes) were enrolled in a clinical trial and implanted with the Argus II System. From this population, 26 subjects were assessed with the FLORA. Seven different evaluators administered the assessment. All 14 interview questions were asked. All 35 tasks for functional vision were selected for evaluation at least once, with an average of 20 subjects being evaluated for each test item. All four rating options—impossible (33 per cent), difficult (23 per cent), moderate (24 per cent) and easy (19 per cent)—were used by the evaluators. Evaluators also judged the amount of vision they observed the subjects using to complete the various tasks, with 'vision only' occurring 75 per cent on average with the System ON, and 29 per cent with the System OFF. The first version of the FLORA was found to contain useful elements for evaluation and to avoid floor and ceiling effects. The next phase of development will be to refine the assessment and to establish reliability and validity to increase its value as an assessment tool for functional vision and well-being. © 2015 The Authors. Clinical and Experimental Optometry © 2015 Optometry Australia.

Assessing deforestation in the coastal zone of the Campeche State, Mexico

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mas, J.F.; Vega, A.P.; Aponte, G.P.

1997-06-01

In order to determine rates of deforestation in the State of Campeche, Mexico, forest maps of 1978/80 and 1992 were compared within a geographic information system (GIS). Results indicate that more than 25 per cent of the tropical forest and mangroves were deforested and other 29 per cent were fragmented during this period. The rate of deforestation in the whole state is about 4.4 per cent per year, but the analysis showed that rates of deforestation are much higher in the coastal zone. For this reason an attempt was made to study deforestation patterns in the coastal zone. Data suchmore » as distance from roads and from settlements images were incorporated in the GIS data base and a model which represents influence of population on its environment was developed in order to establish the influence of socioeconomic factors on forest clearing. Results indicate that deforestation presents a higher correlation with levels of poverty and social abandonment than with demographic aspects.« less

Recent trends in the management of combined pancreatoduodenal injuries.

PubMed

Lopez, Peter P; Benjamin, Robert; Cockburn, Mark; Amortegui, Jose D; Schulman, Carl I; Soffer, Dror; Blackbourne, Lorne H; Habib, Fahim; Jerokhimov, Igor; Trankel, Susan; Cohn, Stephen M

2005-10-01

In an effort to better characterize the natural history of pancreatoduodenal injuries, we present a review of clinical experiences in the treatment of combined traumatic pancreatoduodenal injuries, focusing on patients in extremis. Records of patients with abdominal trauma admitted to a level 1 trauma center from 1997 to 2001 were reviewed. Of 240 patients who sustained a pancreatic or duodenal injury, 33 had combined pancreatoduodenal injuries. Eighty-two per cent of the patients (27/33) in this series had penetrating injuries, 72 per cent (24) sustained gunshot wounds (GSW). Thirty-one patients were male, and the mean age was 33 years (range, 7-74). These patients presented with an average Injury Severity Score (ISS) of 22 +/- 12 and an average Glasgow Coma Score of 14 +/- 2. Overall length of stay was 39 +/- 59 days (range, 0-351 days). These 33 patients underwent a total of 57 laparotomies with an average of 1.7 operations per patient (range, 1 to 5 operations). Eighty-four per cent of the patients had an associated gastrointestinal injury and 45 per cent had a major vascular injury. Thirteen of the 33 (39%) patients presented in extremis, all 13 underwent an abbreviated laparotomy. The complication rate was 36 per cent, including fistula, abscess, pancreatitis, and organ dysfunction. There were 6 hospital deaths for a mortality rate of 18 per cent. Pancreatoduodenal injuries are associated with a variety of other serious injuries, which add to the overall complexity of these patients. Abbreviated laparotomy may be helpful when managing combined pancreatoduodenal injuries in patients who are in extremis.

Menstrual characteristics and night work among nurses.

PubMed

Moen, Bente E; Baste, Valborg; Morken, Tone; Alsaker, Kjersti; Pallesen, Ståle; Bjorvatn, Bjørn

2015-01-01

Night work has been associated with adverse effects in terms of reproductive health. Specifically, menstruation has been suggested to be negatively impacted by night work, which again may influence fertility. This study investigated whether working nights is related to menstrual characteristics and if there is a relationship between shift work disorder (SWD) and menstruation. The study was cross-sectional, response rate 38%. The sample comprised female nurses who were members of the Norwegian Nurses Association; below 50 yr of age, who were not pregnant, did not use hormonal pills or intrauterine devices and who had not reached menopause (n=766). The nurses answered a postal survey including questions about night work and menstrual characteristics. Fifteen per cent reported to have irregular menstruations. Thirty-nine per cent of the nurses were classified as having SWD. Logistic regression analyses concerning the relationship between irregular menstruations and night work did not show any associations. Furthermore, no associations were found between cycle length or bleeding period and night work parameters. No associations were found between menstrual characteristics and SWD.

Residential Water Conservation in a Noncrisis Setting: Results of a New Jersey Experiment

NASA Astrophysics Data System (ADS)

Palmini, Dennis J.; Shelton, Theodore B.

1982-08-01

East Brunswick Township, New Jersey, conducted a water conservation program in 1980 by distributing to 564 households free packets of water-saving devices purchased with municipal funds. The program was not a response to a current water supply crisis, and appeals for cooperation were based on the private economic benefits of water conservation. Statistical procedures were developed to measure the proportions of households installing each of the devices distributed, water savings and program costs. Two-thirds of the households receiving the packets installed at least one device. Average annual water savings per home receiving a packet were estimated at 5010 gallons (18.96 kl). Amortized over ten years at a 10% discount rate, the program cost was approximately 35 cents per 1000 gallons of water saved (9.2 cents per kl). The East Brunswick results compare well to the results obtained from similar conservation programs in a pair of California communities during the 1976-1977 drought.

Evaluation of long-term community recovery from Hurricane Andrew: sources of assistance received by population sub-groups.

PubMed

McDonnell, S; Troiano, R P; Barker, N; Noji, E; Hlady, W G; Hopkins, R

1995-12-01

Two three-stage cluster surveys were conducted in South Dade County, Florida, 14 months apart, to assess recovery following Hurricane Andrew. Response rates were 75 per cent and 84 per cent. Sources of assistance used in recovery from Hurricane Andrew differed according to race, per capita income, ethnicity, and education. Reports of improved living situation post-hurricane were not associated with receiving relief assistance, but reports of a worse situation were associated with loss of income, being exploited, or job loss. The number of households reporting problems with crime and community violence doubled between the two surveys. Disaster relief efforts had less impact on subjective long-term recovery than did job or income loss or housing repair difficulties. Existing sources of assistance were used more often than specific post-hurricane relief resources. The demographic make-up of a community may determine which are the most effective means to inform them after a disaster and what sources of assistance may be useful.

Pharmacokinetics of insulin following intravenous and subcutaneous administration in canines.

PubMed

Ravis, W R; Comerci, C; Ganjam, V K

1986-01-01

Studies were conducted to examine the absorption and disposition kinetics of insulin in dogs following intravenous (IV) and subcutaneous (SC) administration of commercial preparations. After IV and SC dosing, the plasma levels were described by models which considered basal insulin level contributions. Intersubject variation in the disposition kinetics was small with half-lives of 0.52 +/- 0.05 h and total body clearances of 16.21 +/- 2.08 ml min-1 kg-1. Calculated insulin plasma secretion rates in the canines were 14.4 +/- 3.3 mUh-1 kg-1. Following SC injection of regular insulin, the rate and extent of absorption were noted to be quite variable. The absorption process appeared first-order with half-life values of 2.3 +/- 1.3 h and extents of absorption of 78 +/- 15 per cent with a range of 55-101 per cent. Insulin absorption from SC NPH preparations was evaluated as being composed of two zero-order release phases, a rapid and a slow release phase. With a dose of 1.65 U kg-1, the rapid release phase had an average duration of 1.5 h and a rate of 580 +/- 269 mUh-1 (4.2 per cent of dose) while the slow phase had a zero-order rate of 237 +/- 92 mU h-1 which continued beyond 12 h. The extent of absorption from the NPH preparation was 23.6 +/- 5.1 per cent and was significantly lower than that for the regular injection.

78 FR 10211 - Notice of Lodging of Proposed Consent Decree Under the Comprehensive Environmental Response...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-13

... upon written request and payment of reproduction costs. Please mail your request and payment to... money order for $253.75 (25 cents per page reproduction costs for 1,015 pages for the entire Decree plus... is $28.75 (25 cents per page reproduction costs for 115 pages). Henry Friedman, Assistant Chief...

GERIATRIC PATIENTS IN A MENTAL HOSPITAL

PubMed Central

Ernst, Franklin H.; Oliver, W. A.; Simon, Alexander; Malamud, Nathan

1956-01-01

An intensive study was made of men 55 years of age and over admitted to Napa State Hospital with either senile or arteriosclerotic brain disease. A ward treatment program, combining both the medical and psychiatric approaches, was applied to one-half of such patients admitted to a state hospital, with the aim of determining what, if any, effect this program would have on the course of the illnesses. Special laboratory studies showed: (a) Serial electroencephalograms and hospital adjustment ratings appeared to be positively correlated with the patients' clinical course; (b) In 35 per cent of cases the electrocardiographic tracings at the time of admittance were within normal limits; (c) A “pathological level” of blood bromides was found in only one of 340 consecutive admissions in this age group. Sociopsychiatric study of 100 consecutively admitted patients revealed that: (a) 35 per cent of the patients were from the middle, and 65 per cent from the lower classes of society; (b) Only 59 per cent were admitted because of activities specifically psychotic. (c) 63 per cent needed admittance to this state hospital for observation and diagnosis, but only 44 per cent needed to stay for care and treatment; (d) In 88 per cent, specific emotional stresses were present just preceding and coincident with the clinical appearance of the organic brain syndrome. PMID:13304672

Prenatal diagnosis of beta-thalassaemia: experience in a developing country.

PubMed

Saxena, R; Jain, P K; Thomas, E; Verma, I C

1998-01-01

We present our experience with the amplification refractory mutation system (ARMS) for the prenatal diagnosis of beta-thalassaemia in 415 pregnancies of 360 women. Five mutations of the beta-thalassaemia gene common in Asian Indians accounted for 89.2 per cent and rare mutations for 7.2 per cent of all mutant chromosomes, while 3.3 per cent of chromosomes remained uncharacterized. Identical mutations were present in both parents in 43.2 per cent of cases, due to caste-based marriages in India. A confirmed diagnosis was given in 401 (98.3 per cent) cases, of which a complete diagnosis (whether the fetus was normal, a carrier, or homozygous) was possible in 391 (94.2 per cent) of the cases. In 15 couples, the mutation was identified in only one parent. In nine of these, the identified mutation was not present in the fetus, predicting normal/carrier status, while in five the identified mutation was present in the fetus, suggesting carrier/affected status. The abortion rate was 3.9 per cent. Pitfalls in diagnosis were failure of oligonucleotides to work, maternal contamination, and false paternity. The ARMS provides an inexpensive, robust and non-isotopic method for the prenatal diagnosis of beta-thalassaemia in India. Recommendations are outlined for establishing a prenatal diagnostic service in developing countries.

Water cycle changes over the Mediterranean: a comparison study of a super-high-resolution global model with CMIP3.

PubMed

Jin, Fengjun; Kitoh, Akio; Alpert, Pinhas

2010-11-28

Water cycle components over the Mediterranean for both a current run (1979-2007) and a future run (2075-2099) are studied with the Japan Meteorological Agency's 20 km grid global climate model. Results are compared with another study using the Coupled Model Intercomparison Project Phase 3 ensemble model (hereafter, the Mariotti model). Our results are surprisingly close to Mariotti's. The projected mean annual change rates of precipitation (P) between the future and the current run for sea and land are -11 per cent and -10 per cent, respectively, which are not as high as Mariotti's. Projected changes for evaporation (E) are +9.3 per cent and -3.6 per cent, compared with +7.2 per cent and -8.1 per cent in Mariotti's study, respectively. However, no significant difference in the change in P-E over the sea body was found between these two studies. The increased E over the eastern Mediterranean was found to be higher than that in the western Mediterranean, but the P decrease was lower. The net moisture budget, P-E, shows that the eastern Mediterranean will become even drier than the western Mediterranean. The river model suggests decreasing water inflow to the Mediterranean of approximately 36 per cent (excluding the Nile).

Blunt traumatic bladder rupture: a 10-year perspective.

PubMed

Matlock, Kinzie A; Tyroch, Alan H; Kronfol, Ziad N; McLean, Susan F; Pirela-Cruz, Miguel A

2013-06-01

The purpose of this study was to determine the incidence, features, and associated injuries of intraperitoneal (IP) and extraperitoneal (EP) bladder rupture (BR) resulting from blunt trauma. A retrospective study from September 2001 to August 2011 was performed for blunt traumatic BR in adults. Demographics, mean Injury Severity Score (ISS), mean length of stay (LOS), incidence, mortality, operative repair, and associated injuries were evaluated. Of 15,168 adult blunt trauma admissions over 10 years, 54 patients had BR (EP = 22, IP = 27, EP + IP = 5; incidence = 0.36%). Sixty-three per cent were male. The mean age, ISS, and LOS were 40 years, 29, and 15 days, respectively. The mortality rate was 11 per cent. Fifty-two per cent of BR was the result of a motor vehicle crash. Most BRs were diagnosed by computed tomography cystogram. Eighty per cent had pelvic fracture. Hollow viscus injury was present in 34.5 per cent of patients. Colonic injury was seen in 24 per cent and 9.3 per cent had a rectal injury. Although BR is rare in adult blunt trauma, it is associated with high ISS, LOS, and mortality. Pelvic fractures are essentially present in all patients with EP BR. Hollow viscus injuries, especially colonic and rectal injuries, are more prominent in IP BR.

DayCent-Chem Simulations of Ecological and Biogeochemical Processes of Eight Mountain Ecosystems in the United States

USGS Publications Warehouse

Hartman, Melannie D.; Baron, Jill S.; Clow, David W.; Creed, Irena F.; Driscoll, Charles T.; Ewing, Holly A.; Haines, Bruce D.; Knoepp, Jennifer; Lajtha, Kate; Ojima, Dennis S.; Parton, William J.; Renfro, Jim; Robinson, R. Bruce; Van Miegroet, Helga; Weathers, Kathleen C.; Williams, Mark W.

2009-01-01

Atmospheric deposition of nitrogen (N) and sulfur (S) cause complex responses in ecosystems, from fertilization to forest ecosystem decline, freshwater eutrophication to acidification, loss of soil base cations, and alterations of disturbance regimes. DayCent-Chem, an ecosystem simulation model that combines ecosystem nutrient cycling and plant dynamics with aqueous geochemical equilibrium calculations, was developed to address ecosystem responses to combined atmospheric N and S deposition. It is unique among geochemically-based models in its dynamic biological cycling of N and its daily timestep for investigating ecosystem and surface water chemical response to episodic events. The model was applied to eight mountainous watersheds in the United States. The sites represent a gradient of N deposition across locales, from relatively pristine to N-saturated, and a variety of ecosystem types and climates. Overall, the model performed best in predicting stream chemistry for snowmelt-dominated sites. It was more difficult to predict daily stream chemistry for watersheds with deep soils, high amounts of atmospheric deposition, and a large degree of spatial heterogeneity. DayCent-Chem did well in representing plant and soil carbon and nitrogen pools and fluxes. Modeled stream nitrate (NO3-) and ammonium (NH4+) concentrations compared well with measurements at all sites, with few exceptions. Simulated daily stream sulfate (SO42-) concentrations compared well to measured values for sites where SO42- deposition has been low and where SO42- adsorption/desorption reactions did not seem to be important. The concentrations of base cations and silica in streams are highly dependent on the geochemistry and weathering rates of minerals in each catchment, yet these were rarely, if ever, known. Thus, DayCent-Chem could not accurately predict weathering products for some catchments. Additionally, few data were available for exchangeable soil cations or the magnitude of base cation deposition as a result of dry and fog inputs. The uncertainties related to weathering reactions, deposition, soil cation exchange capacity, and groundwater contributions influenced how well the simulated acid neutralizing capacity (ANC) and pH estimates compared to observed values. Daily discharge was well represented by the model for most sites. The chapters of this report describe the parameterization for each site and summarize model results for ecosystem variables, stream discharge, and stream chemistry. This intersite comparison exercise provided insight about important and possibly not well understood processes.

Lightweight tire concept for space shuttle

NASA Technical Reports Server (NTRS)

Shufflebotham, W. T.

1973-01-01

Various tests were conducted on a 49x17/26 PR aircraft tire that had been designed as a lightweight tire for use on the C-5A military transport. This tire is approximately 25 per cent lighter than a tire of the same size and ply rating that would be used in commercial airline service. The tires were tested at 40 per cent, 37 per cent, and 35 per cent deflections. These deflections were obtained by adjusting the inflation pressure while the load on the tire remained constant at 60,000 pounds. It was determined that the tire would operate successfully under the test conditions at 35% deflection. Prior to testing, the tires were subjected to conditions of high vacuum and low temperature. It was determined that the tires were not adversely affected by these conditions.

A Sense of Belonging: Improving Student Retention

ERIC Educational Resources Information Center

O'Keeffe, Patrick

2013-01-01

The purpose of this paper is to explore the causes and potential solutions to, student attrition. With student attrition rates reaching between 30 and 50 per cent in the United States, and over 20 per cent in Australia, the inability of higher education institutions to retain their students is a significant issue. This paper cites key risk factors…

Long-term responses of rainforest erosional systems at different spatial scales to selective logging and climatic change.

PubMed

Walsh, R P D; Bidin, K; Blake, W H; Chappell, N A; Clarke, M A; Douglas, I; Ghazali, R; Sayer, A M; Suhaimi, J; Tych, W; Annammala, K V

2011-11-27

Long-term (21-30 years) erosional responses of rainforest terrain in the Upper Segama catchment, Sabah, to selective logging are assessed at slope, small and large catchment scales. In the 0.44 km(2) Baru catchment, slope erosion measurements over 1990-2010 and sediment fingerprinting indicate that sediment sources 21 years after logging in 1989 are mainly road-linked, including fresh landslips and gullying of scars and toe deposits of 1994-1996 landslides. Analysis and modelling of 5-15 min stream-suspended sediment and discharge data demonstrate a reduction in storm-sediment response between 1996 and 2009, but not yet to pre-logging levels. An unmixing model using bed-sediment geochemical data indicates that 49 per cent of the 216 t km(-2) a(-1) 2009 sediment yield comes from 10 per cent of its area affected by road-linked landslides. Fallout (210)Pb and (137)Cs values from a lateral bench core indicate that sedimentation rates in the 721 km(2) Upper Segama catchment less than doubled with initially highly selective, low-slope logging in the 1980s, but rose 7-13 times when steep terrain was logged in 1992-1993 and 1999-2000. The need to keep steeplands under forest is emphasized if landsliding associated with current and predicted rises in extreme rainstorm magnitude-frequency is to be reduced in scale.

Aspiration and tetracycline sclerotherapy of hydroceles.

PubMed

Levine, L A; DeWolf, W C

1988-05-01

Aspiration and sclerotherapy of hydroceles have been considered an effective outpatient procedure. We report on our experience with modification of this procedure in the treatment of 28 hydroceles. A 10 per cent solution of tetracycline hydrochloride was used as the sclerosant. In this series the mean followup was 15 months and there was an over-all 93 per cent success rate. A single treatment was successful in 75 per cent of the hydroceles. Complications included a hematoma in 2 patients and epididymitis in 1. We consider aspiration and sclerotherapy of hydroceles to be a reasonable alternative to an operation.

Mortality of emergency abdominal surgery in high-, middle- and low-income countries.

PubMed

2016-07-01

Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI). This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression. Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1·6 per cent at 24 h (high 1·1 per cent, middle 1·9 per cent, low 3·4 per cent; P < 0·001), increasing to 5·4 per cent by 30 days (high 4·5 per cent, middle 6·0 per cent, low 8·6 per cent; P < 0·001). Of the 578 patients who died, 404 (69·9 per cent) did so between 24 h and 30 days following surgery (high 74·2 per cent, middle 68·8 per cent, low 60·5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2·78, 95 per cent c.i. 1·84 to 4·20) and low-income (OR 2·97, 1·84 to 4·81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days. Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role. NCT02179112 (http://www.clinicaltrials.gov). © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

Protein requirements of bobwhite chicks for survival, growth and efficiency of feed utilization

USGS Publications Warehouse

Nestler, R.B.; Bailey, W.W.; McClure, H.E.

1942-01-01

During the summer and fall of 1939 four experiments were conducted at the Patuxent Research Refuge, Bowie, Maryland, to determine the protein requirements of bobwhite chicks. A total of 816 chicks were used to compare six levels of protein, namely, 22,24,26, 28, 30, and 32 per cent.....From the three standpoints of survival, rate of growth, and efficiency of feed utilization for the first ten weeks of life, the 28 per cent level of protein gave the best results. During the ninth and tenth weeks, the highest efficiency of feed utilization was obtained on the 22 per cent level. The results indicate that after the birds have reached about twothirds of their mature weight, the difference in efficiency between a diet containing 28 per cent of protein and one containing 22 per cent may be small enough to justify, in the interest of economy, the use of a diet containing the lower percentage of protein.

Methods for the investigation of the statistics of the commercial fisheries of the Great Lakes

USGS Publications Warehouse

Hile, Ralph; Duden, William R.

1933-01-01

During the summer and fall of 1939 four experiments were conducted at the Patuxent Research Refuge, Bowie, Maryland, to determine the protein requirements of bobwhite chicks. A total of 816 chicks were used to compare six levels of protein, namely, 22,24,26, 28, 30, and 32 per cent.....From the three standpoints of survival, rate of growth, and efficiency of feed utilization for the first ten weeks of life, the 28 per cent level of protein gave the best results. During the ninth and tenth weeks, the highest efficiency of feed utilization was obtained on the 22 per cent level. The results indicate that after the birds have reached about twothirds of their mature weight, the difference in efficiency between a diet containing 28 per cent of protein and one containing 22 per cent may be small enough to justify, in the interest of economy, the use of a diet containing the lower percentage of protein.

Anaemia in pet rabbits: causes, severity and reticulocyte response.

PubMed

Dettweiler, Alexandra; Klopfleisch, Robert; Müller, Kerstin

2017-12-16

The objective of the study was to determine the causes and the severity of anaemia in pet rabbits ( Oryctolagus cuniculus ), to classify anaemia and to compare the reticulocyte counts from healthy and anaemic rabbits. Over a time period of 11 years (2000-2011) a retrospective and prospective study of 223 pet rabbits was performed. Based on the clinic's own reference range for healthy pet rabbits (packed cell volume [PCV] levels 0.33-0.45 l/l), animals with a PCV level below 0.33 l/l were considered anaemic. Anaemia was mostly caused by inflammation (65/223, 29 per cent) and bleeding (54/223, 24 per cent). Seven per cent (15/223) of the rabbits suffered from renal diseases and one rabbit got diagnosed with haemolysis caused by liver lobe torsion. In 14 per cent (32/223) of the rabbits more than one underlying pathomechanism, like inflammation and bleeding, was diagnosed as possible cause of anaemia. In 25 per cent (56/223) of the anaemic rabbits no cause was found. Most anaemias were mild (156/223, 70 per cent). Moderate (43/223, 19 per cent) or severe (24/223, 11 per cent) anaemia was diagnosed more rarely. Anaemic rabbits showed similar reticulocyte counts to healthy rabbits with no significant difference. Therefore, a differentiation of regenerative and non-regenerative anaemia was not possible. © British Veterinary Association (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Homelessness as viewed by incarcerated women: participatory research.

PubMed

Martin, Ruth Elwood; Hanson, Debra; Hemingway, Christine; Ramsden, Vivian; Buxton, Jane; Granger-Brown, Alison; Condello, Lara-Lisa; Macaulay, Ann; Janssen, Patti; Hislop, T Gregory

2012-01-01

The purpose of this paper is to describe the development, by incarcerated women who were members of a prison participatory health research team, of a survey tool regarding homelessness and housing, the survey findings and recommendations for policy. A survey was developed by incarcerated women in a minimum/medium security women's prison in Canada. Associations were examined between socio-demographic factors and reports of difficulty finding housing upon release, homelessness contributing to a return to crime, and a desire for relocation to another city upon release. Open-ended questions were examined to look for recurrent themes and to illuminate the survey findings. In total, 83 women completed the survey, a 72 per cent response rate. Of the 71 who were previously incarcerated, 56 per cent stated that homelessness contributed to their return to crime. Finding housing upon release was a problem for 63 per cent and 34 per cent desired relocation to another city upon release. Women indicated that a successful housing plan should incorporate flexible progressive staged housing. The present study focuses only on incarcerated women but could be expanded in future to include men. Incarcerated women used the findings to create a housing proposal for prison leavers and created a resource database of the limited housing resources for women prison leavers. Lack of suitable housing is a major factor leading to recidivism. This study highlights the reality of the cycle of homelessness, poverty, crime for survival, street-life leading to drug use and barriers to health, education and employment that incarcerated women face. Housing is a recognized basic determinant of health. No previous studies have used participatory research to address homelessness in a prison population.

THE BIOLOGY OF DEUTERIUM

DOE Office of Scientific and Technical Information (OSTI.GOV)

Katz, J.J.; Crespi, H.L.; Finkel, A.J.

1958-10-31

g been noted, but the full scope and nature of these effects still remain largely unexplored. Early work was greatly hampered by the difficulties of obtaining deuterium but the development of a vast nuclear energy technology has made deuterium available on a larghe scale. It has now become opportune to undertake comprehensive reports work undertaken on algae, fungi, bacteria, and mammals. Mice will tolerate up to about 40 per cent D/sub 2/O in the drinking water for at least four months; of about 30 per cent heavy water. When deuteration is into various tissues and organs to the amount ofmore » from 40 to 50 per cent of the deuterium in the body fluids. 25 atom per cent, for as long as 12 months without obcal effects of deuterium is the kinetic isotpe effect. In general, bonds to deuterium react less readily than bonds to hydrogen; in consequence, reaction reates are decreased, and a depression in tissue metabolism should result. At concentrations about 30 atom per cen deuterium mice and rats show weakness, neutrmuscular por and death Since neoplastic cells metabolize rapidly, presumably these should be particularly sensitive to the effects of deuteration. Deuteration of host mice resulted in reduced growth rates of injected Krebs-2 ascites tumors and of inoculated P-1534 lymphatic leukemia. The general effects of deuterium on growth has been Chlorella vulgaris and Scenedesmus obliquus, have been have been harvested that yield water of combustion containing more than 90 atom per cent deuterium. The e were altered by deuteration. The fungi Penicillium notatum and Aspergillus fonsecaeus have been grown in media containing various concentrations of D/sub 2/O up to 99.6 per cent, and here, too, morphology, sporulation, pigment production, and growth rate were all affected by deuteration. The results obtained with algae clearly indicate the feasibility of producing fully deuterated compounds of biological significance by biosynthetic procedures. Bacterial studies on Group C hemolytic streptococci, Type I pnemococci, Mycobacterium tuberculosis and M.phlei, and Escherichia coli showed that the growth rates were diminished with elevation of the D/.sub 2/O concentration above 50 per cent and that cessation of growth uniformly occurred at D/sub 2/O levels greater than 90 per cent. Deuterium may also be utilized in the study of metabolism by the administration of deuterated essential metabolites. Experiments are described wherein fungi have been grown on glucose in which the hydrogen on carbon-1 (D-glucose-d/sub 1/) has been completely replaced by deuterium. (auth)« less

Multicentre prospective cohort study of body mass index and postoperative complications following gastrointestinal surgery.

PubMed

2016-08-01

There is currently conflicting evidence surrounding the effects of obesity on postoperative outcomes. Previous studies have found obesity to be associated with adverse events, but others have found no association. The aim of this study was to determine whether increasing body mass index (BMI) is an independent risk factor for development of major postoperative complications. This was a multicentre prospective cohort study across the UK and Republic of Ireland. Consecutive patients undergoing elective or emergency gastrointestinal surgery over a 4-month interval (October-December 2014) were eligible for inclusion. The primary outcome was the 30-day major complication rate (Clavien-Dindo grade III-V). BMI was grouped according to the World Health Organization classification. Multilevel logistic regression models were used to adjust for patient, operative and hospital-level effects, creating odds ratios (ORs) and 95 per cent confidence intervals (c.i.). Of 7965 patients, 2545 (32·0 per cent) were of normal weight, 2673 (33·6 per cent) were overweight and 2747 (34·5 per cent) were obese. Overall, 4925 (61·8 per cent) underwent elective and 3038 (38·1 per cent) emergency operations. The 30-day major complication rate was 11·4 per cent (908 of 7965). In adjusted models, a significant interaction was found between BMI and diagnosis, with an association seen between BMI and major complications for patients with malignancy (overweight: OR 1·59, 95 per cent c.i. 1·12 to 2·29, P = 0·008; obese: OR 1·91, 1·31 to 2·83, P = 0·002; compared with normal weight) but not benign disease (overweight: OR 0·89, 0·71 to 1·12, P = 0·329; obese: OR 0·84, 0·66 to 1·06, P = 0·147). Overweight and obese patients undergoing surgery for gastrointestinal malignancy are at increased risk of major postoperative complications compared with those of normal weight. © 2016 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.

Effect of age on rates of palliative surgery and chemotherapy use in patients with locally advanced or metastatic gastric cancer.

PubMed

Nelen, S D; van Putten, M; Lemmens, V E P P; Bosscha, K; de Wilt, J H W; Verhoeven, R H A

2017-12-01

This study assessed trends in the treatment and survival of palliatively treated patients with gastric cancer, with a focus on age-related differences. For this retrospective, population-based, nationwide cohort study, all patients diagnosed between 1989 and 2013 with non-cardia gastric cancer with metastasized disease or invasion into adjacent structures were selected from the Netherlands Cancer Registry. Trends in treatment and 2-year overall survival were analysed and compared between younger (age less than 70 years) and older (aged 70 years or more) patients. Analyses were done for five consecutive periods of 5 years, from 1989-1993 to 2009-2013. Multivariable logistic regression analysis was used to examine the probability of undergoing surgery. Multivariable Cox regression analysis was used to identify independent risk factors for death. Palliative resection rates decreased significantly in both younger and older patients, from 24·5 and 26·2 per cent to 3·0 and 5·0 per cent respectively. Compared with patients who received chemotherapy alone, both younger (21·6 versus 6·3 per cent respectively; P < 0·001) and older (14·7 versus 4·6 per cent; P < 0·001) patients who underwent surgery had better 2-year overall survival rates. Multivariable analysis demonstrated that younger and older patients who received chemotherapy alone had worse overall survival than patients who had surgery only (younger: hazard ratio (HR) 1·22, 95 per cent c.i. 1·12 to 1·33; older: HR 1·12, 1·01 to 1·24). After 2003 there was no association between period of diagnosis and overall survival in younger or older patients. Despite changes in the use of resection and chemotherapy as palliative treatment, overall survival rates of patients with advanced and metastatic gastric cancer did not improve. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

Antibody production by the pig colon during infection with Treponema hyodysenteriae.

PubMed

Rees, A S; Lysons, R J; Stokes, C R; Bourne, F J

1989-09-01

When 47 pigs were dosed orally with cultures of Treponema hyodysenteriae, 44 (94 per cent) developed swine dysentery. Of those which recovered and were rechallenged, nine of 21 (43 per cent) showed clinical signs, as did one of 10 (10 per cent) challenged on a third occasion. Clinical disease was associated with development of specific IgG, IgA and IgM antibodies in serum and the local production of IgA in gut mucosal tissues. The appearance of antibody was not directly related to protection but rather indicated either prolonged exposure (in the case of serum IgG) or recent exposure to T hyodysenteriae (for secretory IgA). Infection also resulted in the appearance of IgG and IgA memory cells in gut-associated lymphoid tissue. However, these studies indicated that humoral immunity alone is not responsible for the onset of a protective response to T hyodysenteriae in the colon.

The influence of performance-based payment on childhood immunisation coverage.

PubMed

Merilind, Eero; Salupere, Rauno; Västra, Katrin; Kalda, Ruth

2015-06-01

Pay-for-performance, also called the quality system (QS) in Estonia, was implemented in 2006 and one indicator for achievement is the childhood immunisation coverage rate. The WHO vaccination coverage in Europe for diphtheria, tetanus and pertussis, and measles in children aged around one year old should meet or exceed 90 per cent. The study was conducted using a database from the Estonian Health Insurance Fund. The study compared childhood immunisation coverage rates of all Estonian family physicians in two groups, joined and not joined to the quality system during the observation period 2006-2012. Immunisation coverage was calculated as the percentage of persons in the target age group who received a vaccine dose by a given age. The target level of immunisations in Estonia is set at 90 per cent and higher. Immunisation coverage rates of family doctors (FD) in Estonia showed significant differences between two groups of doctors: joined to the quality system and not joined. Doctors joined to the quality system met the 90 per cent vaccination criterion more frequently compared to doctors not joined to the quality system. Doctors not joined to the quality system were below the 90 per cent vaccination criterion in all vaccinations listed in the Estonian State Immunisation Schedule. Pay-for-performance as a financial incentive encourages higher levels of childhood immunisations. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ukwatta, T. N.; Wozniak, P. R.; Gehrels, N.

Studies of high-redshift gamma-ray bursts (GRBs) provide important information about the early Universe such as the rates of stellar collapsars and mergers, the metallicity content, constraints on the re-ionization period, and probes of the Hubble expansion. Rapid selection of high-z candidates from GRB samples reported in real time by dedicated space missions such as Swift is the key to identifying the most distant bursts before the optical afterglow becomes too dim to warrant a good spectrum. Here, we introduce ‘machine-z’, a redshift prediction algorithm and a ‘high-z’ classifier for Swift GRBs based on machine learning. Our method relies exclusively onmore » canonical data commonly available within the first few hours after the GRB trigger. Using a sample of 284 bursts with measured redshifts, we trained a randomized ensemble of decision trees (random forest) to perform both regression and classification. Cross-validated performance studies show that the correlation coefficient between machine-z predictions and the true redshift is nearly 0.6. At the same time, our high-z classifier can achieve 80 per cent recall of true high-redshift bursts, while incurring a false positive rate of 20 per cent. With 40 per cent false positive rate the classifier can achieve ~100 per cent recall. As a result, the most reliable selection of high-redshift GRBs is obtained by combining predictions from both the high-z classifier and the machine-z regressor.« less

Machine-z: Rapid Machine-Learned Redshift Indicator for Swift Gamma-Ray Bursts

NASA Technical Reports Server (NTRS)

Ukwatta, T. N.; Wozniak, P. R.; Gehrels, N.

2016-01-01

Studies of high-redshift gamma-ray bursts (GRBs) provide important information about the early Universe such as the rates of stellar collapsars and mergers, the metallicity content, constraints on the re-ionization period, and probes of the Hubble expansion. Rapid selection of high-z candidates from GRB samples reported in real time by dedicated space missions such as Swift is the key to identifying the most distant bursts before the optical afterglow becomes too dim to warrant a good spectrum. Here, we introduce 'machine-z', a redshift prediction algorithm and a 'high-z' classifier for Swift GRBs based on machine learning. Our method relies exclusively on canonical data commonly available within the first few hours after the GRB trigger. Using a sample of 284 bursts with measured redshifts, we trained a randomized ensemble of decision trees (random forest) to perform both regression and classification. Cross-validated performance studies show that the correlation coefficient between machine-z predictions and the true redshift is nearly 0.6. At the same time, our high-z classifier can achieve 80 per cent recall of true high-redshift bursts, while incurring a false positive rate of 20 per cent. With 40 per cent false positive rate the classifier can achieve approximately 100 per cent recall. The most reliable selection of high-redshift GRBs is obtained by combining predictions from both the high-z classifier and the machine-z regressor.

Behavioural responses of poultry during kosher slaughter and their implications for the birds' welfare.

PubMed

Barnett, J L; Cronin, G M; Scott, P C

2007-01-13

Measurements were made during Shechita (kosher) slaughter of 692 meat chickens, including the behaviour of the birds during the procedure and the times from their removal from the crate, to neck cutting, bleed-out and shackling. Four of 100 birds showed a mild physical response to neck cutting but the others showed no response. Approximately 60 per cent of the birds showed a physical response to touching the eye or eyelid at up to 5 seconds after neck cutting, but by 15 seconds none showed this response. The birds became unable to retain their posture and suffered involuntary muscular contractions at 12 to 15 seconds after neck cutting and had lost approximately 40 per cent of their total blood volume by 30 seconds after neck cutting.

The National Health Service Breast Screening Programme and British Association of Surgical Oncology audit of quality assurance in breast screening 1996-2001.

PubMed

Sauven, P; Bishop, H; Patnick, J; Walton, J; Wheeler, E; Lawrence, G

2003-01-01

The National Health Service Breast Screening Programme (NHSBSP) is an example of a nationally coordinated quality assurance programme in which all the professional groups involved participate. Surgeons, radiologists and pathologists defined the clinical outcome measures against which they would subsequently be audited. The NHSBSP and the Association of Breast Surgery at BASO are jointly responsible for coordinating an annual audit of all surgical activities undertaken within the NHSBSP. The trends for key outcome measures between 1996 and 2001 are provided. The preoperative diagnosis rate (minimum standard 70 per cent or more) improved from 63 to 87 per cent. This rise was mirrored by an increase in the use of core biopsy in preference to fine-needle cytology. The proportion of patients in whom lymph node status was recorded improved from 81 to 93 per cent. There was no significant change in the number of women treated by low case-load surgeons and waiting times for surgery increased through the study interval. The BASO-NHSBSP Breast Audit has recorded major changes in clinical practice over 5 years. A key feature has been the dissemination of good practice through feedback of the results at local and national level. Copyright 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons Ltd

Effect of preoperative biliary drainage on bacterial flora in bile of patients with periampullary cancer.

PubMed

Scheufele, F; Aichinger, L; Jäger, C; Demir, I E; Schorn, S; Sargut, M; Erkan, M; Kleeff, J; Friess, H; Ceyhan, G O

2017-01-01

Patients with obstructive jaundice due to periampullary tumours may undergo preoperative biliary drainage (PBD). The effect of PBD on the microbiome of the biliary system and on postoperative outcome remains unclear. A single-centre retrospective study of patients with obstructive jaundice due to periampullary cancer, treated between July 2007 and July 2015, was undertaken. Intraoperative bile samples were obtained for microbiological analysis after transection of the common bile duct. Postoperative complications were registered. Of 290 patients treated, intraoperative bile samples were present for 172 patients (59·3 per cent) who had PBD and 118 (40·7 per cent) who did not. Contamination of bile was increased significantly in patients who underwent stenting (97·1 per cent versus 18·6 per cent in those without stenting; P < 0·001). PBD resulted in a shift in the biliary microbiome from Escherichia coli in non-stented patients (45 per cent versus 19·2 per cent in stented patients; P = 0·009) towards increased contamination with Enterococcus faecalis (9 versus 37·7 per cent respectively; P = 0·008) and Enterobacter cloacae (0 versus 20·4 per cent; P = 0·033). This shift was associated with a high incidence of bacterial resistance against ampicillin-sulbactam (63·6 per cent versus 18 per cent in patients with no PBD; P < 0·001), piperacillin-tazobactam (30·1 versus 0 per cent respectively; P = 0·003), ciprofloxacin (28·5 versus 5 per cent; P = 0·047) and imipenem (26·6 versus 0 per cent; P = 0·011). The rate of wound infection was higher in patients with a positive bile culture (21·0 per cent versus 6 per cent in patients with sterile bile; P = 0·002). Regression analysis revealed the presence of Enterococcus faecium (odds ratio 2·83, 95 per cent c.i. 1·17 to 6·84; P = 0·021) and Citrobacter species (odds ratio 5·09, 1·65 to 15·71; P = 0·005) as independent risk factors for postoperative wound infection. There are fundamental differences in the biliary microbiome of patients with periampullary cancer who undergo PBD and those who do not. PBD induces a shift of the biliary microbiome towards a more aggressive and resistant spectrum, which requires a differentiated perioperative antibiotic treatment strategy. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

Comparing the curative efficacy of topical treatment with thiamphenicol and oxytetracycline on digital dermatitis lesions in dairy cattle.

PubMed

Holzhauer, M; Ploegmakers-van Deventer, R; Smits, D; Swart, W

2017-05-20

The efficacy of two topically applied antibiotics for the treatment of painful ulcerative stage of bovine digital dermatitis (BDD) lesions was compared in a clinical trial conducted on five dairy farms in the Netherlands during the autumn of 2015. A total of 109 cows with an ulcerative (M2) stage of BDD were randomly appointed a treatment with an antibiotic-based spray. One treatment contained thiamphenicol as active ingredient (TAF). The other treatment had oxytetracycline as active ingredient (ENG). The experimental unit for this study was the hind claw with the presence of an ulcerative BDD lesion. On day 0, claws with ulcerative BDD lesions were trimmed, cleaned, photographed and thereafter treated randomly either with TAF or ENG. Cure was defined as the transition of an ulcerative lesion into a non-painful chronic (M4) or into a healed (M0) stage of BDD at day 28 post-treatment. The cure rate at day 28 of M2 BDD lesions treated with TAF was 89 per cent (95 per cent CI 0.78 to 0.94), and for ENG 75 per cent (95 per cent CI 0.67 to 0.86). So the difference in cure rate was 14 per cent (95 per cent CI 0.00 to 0.27), which was statistically significant. The P value in this experiment is very close to 0.05 indicating that the effect is quite small. If a two-sided test would be used, the small significant effect, in this experiment, will disappear. Overall, the significant better curative effect of TAF on BDD M2 lesions was small, compared with ENG. British Veterinary Association.

Facial attractiveness of skeletal Class II patients before and after mandibular advancement surgery as perceived by people with different backgrounds.

PubMed

Ng, Doreen; De Silva, Rohana Kumara; Smit, Ryan; De Silva, Harsha; Farella, Mauro

2013-08-01

The purpose of this study was to determine the perceived level of improvement in facial attractiveness as assessed by people with different backgrounds in skeletal Class II patients treated by mandibular advancement with bilateral sagittal split osteotomy (BSSO). The frontal and lateral pre- and post-operative photographs of 10 Caucasian patients were selected. Changes in frontal and profile attractiveness were assessed by 10 orthodontists, 10 art students, and 10 laypersons. Frontal and lateral pre- and post-operative photographs were randomly distributed throughout two surveys. For each photograph, the evaluators ranked the attractiveness of face, chin, and lips on visual analogue scales. A third survey was administered to orthodontists only, by presenting the same pre and post-operative photographs but paired side-by-side with pre- and post-operative status disclosed. Overall, attractiveness scores after BSSO showed an 11.5 per cent improvement (95 per cent confidence intervals: 9.4-13.5 per cent) on the lateral post-operative photographs and a 7.5 per cent improvement (95 per cent confidence intervals: 5.4-9.5 per cent) on the frontal post-operative photographs. Attractiveness scores differed significantly between the groups (P = 0.015), with orthodontists being more generous with their improvement ratings and the art students tending to give a more critical assessment. There were no significant differences between male and female evaluators (P > 0.05). Ratings of before-after attractiveness almost doubled when the pre- and post-operative status was disclosed as compared to blinded evaluations, thus indicating that prior knowledge of pre- and post-treatment status markedly influences aesthetic evaluations, with a bias towards a more favourable outcome.

Proactive dairy cattle disease control in the UK: veterinary surgeons' involvement and associated characteristics

PubMed Central

Higgins, H. M.; Huxley, J. N.; Wapenaar, W.; Green, M. J.

2013-01-01

Characteristics of 94 veterinary surgeons associated with delivering preventive herd-level strategies to control mastitis, lameness and Johne's disease were investigated using two multinomial models. The response variables were ‘Gold Standard Monitoring’ (including on-going data analysis, risk assessments and laboratory testing), and a lower level of involvement called ‘Regular Control Advice’. Although the sample was biased towards those who spend the majority of their time with dairy cows, 69 per cent currently had no involvement in Gold Standard Monitoring for lameness, 60 per cent no involvement with Johne's, and 52 per cent no involvement with mastitis. The final model predicted that an assistant without a postgraduate cattle qualification, who had spent no time on dairy cattle continuous professional development (CPD) in the last year, had an 88 per cent chance of having no involvement with Gold Standard Monitoring for any disease, versus <5 per cent chance for a CPD ‘enriched’ partner with a postgraduate cattle qualification; there was <1 per cent chance this assistant would be involved with Gold Standard Monitoring of all three diseases on one or more farms, versus a 58 per cent chance for this partner. CPD and employment status were also associated with markedly different probabilities for delivering Regular Control Advice. Increased postgraduate education may further veterinary involvement of this nature. PMID:23887976

Is raised plasma peptide YY after intestinal resection in the rat responsible for the trophic response?

PubMed Central

Savage, A P; Gornacz, G E; Adrian, T E; Ghatei, M A; Goodlad, R A; Wright, N A; Bloom, S R

1985-01-01

The relationship between the adaptive response and plasma PYY concentrations after small bowel resection has been investigated. Seventy five per cent proximal small bowel resection resulted in a rise in plasma PYY at six days from 28 +/- 3.1 to 85 +/- 12.3 pmol/l (p less than 0.001) and this difference was maintained to 48 days. Plasma PYY correlates both with crypt cell production rate (CCPR) in the ileum and with plasma enteroglucagon levels. In a second study, PYY or saline was infused over a 12 day period. There were no significant changes in intestinal wet weight or CCPR in any part of the bowel studied. This indicates that it is unlikely that PYY exerts a major trophic effect on the gastrointestinal tract. PMID:3841330

Is raised plasma peptide YY after intestinal resection in the rat responsible for the trophic response?

PubMed

Savage, A P; Gornacz, G E; Adrian, T E; Ghatei, M A; Goodlad, R A; Wright, N A; Bloom, S R

1985-12-01

The relationship between the adaptive response and plasma PYY concentrations after small bowel resection has been investigated. Seventy five per cent proximal small bowel resection resulted in a rise in plasma PYY at six days from 28 +/- 3.1 to 85 +/- 12.3 pmol/l (p less than 0.001) and this difference was maintained to 48 days. Plasma PYY correlates both with crypt cell production rate (CCPR) in the ileum and with plasma enteroglucagon levels. In a second study, PYY or saline was infused over a 12 day period. There were no significant changes in intestinal wet weight or CCPR in any part of the bowel studied. This indicates that it is unlikely that PYY exerts a major trophic effect on the gastrointestinal tract.

Clearance by the mucociliary system in 'simple chronic otitis media'.

PubMed

Hadas, E; Sadé, J

1979-08-01

This is a study of the rate of middle ear clearance in chronic otitis media and atelectatic ears. The clearance rate was measured with the aid of non-soluble saccharin, introduced into the middle ear through an existing perforation in 'chronic ears', or through a ventilating tube in atelectatic ears. Cholesteatomatous ears were excluded. Altogether 122 ears were examined and about two-thirds of the subjects felt the sweet taste in their mouths thereafter. The average time it took for the saccharin to be transported from the middle ear to the taste buds was 33' 22" minutes in non-infected (i.e. dry) chronic ears (38 patients or 66 per cent). Wet or infected ears with chronic otitis media (30 patients, or 58 per cent) showed a slower transport rate, averaging 54' 22" minutes--the difference was significant at the 0.01 level. 8 (63 per cent) of the atelectatic ears transported the saccharin at an average rate of 50' 25". This study demonstrated that most ears with 'simple' chronic otitis media and atelectatic ears have a patent eustachian tube and that their mucociliary system can transport foreign particles through it. When the ear is infected, transport tends to be slowed down.

Compliance and use of the World Health Organization checklist in U.K. operating theatres.

PubMed

Pickering, S P; Robertson, E R; Griffin, D; Hadi, M; Morgan, L J; Catchpole, K C; New, S; Collins, G; McCulloch, P

2013-11-01

The World Health Organization (WHO) Surgical Safety Checklist is reported to reduce surgical morbidity and mortality, and is mandatory in the U.K. National Health Service. Hospital audit data show high compliance rates, but direct observation suggests that actual performance may be suboptimal. For each observed operation, WHO time-out and sign-out attempts were recorded, and the quality of the time-out was evaluated using three measures: all information points communicated, all personnel present and active participation. Observation of WHO checklist performance was conducted for 294 operations, in five hospitals and four surgical specialties. Time-out was attempted in 257 operations (87.4 per cent) and sign-out in 26 (8.8 per cent). Within time-out, all information was communicated in 141 (54.9 per cent), the whole team was present in 199 (77.4 per cent) and active participation was observed in 187 (72.8 per cent) operations. Surgical specialty did not affect time-out or sign-out attempt frequency (P = 0.453). Time-out attempt frequency (range 42-100 per cent) as well as all information communicated (15-83 per cent), all team present (35-90 per cent) and active participation (15-93 per cent) varied between hospitals (P < 0.001 for all). Meaningful compliance with the WHO Surgical Safety Checklist is much lower than indicated by administrative data. Sign-out compliance is generally poor, suggesting incompatibility with normal theatre work practices. There is variation between hospitals, but consistency across studied specialties, suggesting a need to address organizational culture issues. © 2013 British Journal of Surgery Society Ltd. Published by John Wiley & Sons Ltd.

UK pet owners' use of the internet for online pet health information.

PubMed

Kogan, Lori; Oxley, James A; Hellyer, Peter; Schoenfeld, Regina; Rishniw, Mark

2018-05-26

The internet has been found to be a popular source for human health information. However, there is a lack of information on pet owners' use of the internet to source pet health information and implications for the owner-veterinarian relationship. Therefore, the aim of this study was to address this gap in knowledge by focusing on UK pet owners' general use of the internet to find online pet health information and the impact of this behaviour on the owner-veterinarian relationship. An online survey targeting UK pet owners resulted in 571 respondents. Respondents reported the most frequently used source for pet health information was the internet (78.6 per cent), followed by their veterinarian (72 per cent). Veterinarians and other pet owners, however, were rated as the most trustworthy sources. The topics searched for most often online were specific medical problems (61.3 per cent) and diet/nutrition (58.5 per cent). Regarding the owner-veterinarian relationship, 42.1 per cent of participants reported discussing information they found online 'sometimes' with their veterinarian. When asked if their veterinarian recommended specific websites, nearly half (49.6 per cent) stated that their veterinarian 'never' made such recommendations, yet over 90 per cent said they would visit veterinarian-recommended websites. © British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Overview of Nonoperative Blunt Splenic Injury Management with Associated Splenic Artery Pseudoaneurysm.

PubMed

Morrison, Chet A; Gross, Brian W; Kauffman, Matthew; Rittenhouse, Katelyn J; Rogers, Frederick B

2017-06-01

The delayed development of splenic artery pseudoaneurysm (SAP) can complicate the nonoperative management of splenic injuries. We sought to determine the utility of repeat imaging in diagnosing SAP in patients managed nonoperatively without angioembolization. We hypothesized that a significant rate of SAPs would be found in this population on repeat imaging. Patients undergoing nonoperative splenic injury management from January 2011 to June 2015 were queried from the trauma registry. Rates of repeat imaging, angioembolization, readmission, and SAP development were analyzed. Further, subanalyses investigating the incidence of SAP in patients managed nonoperatively without angioembolization were conducted. A total of 133 patients met inclusion criteria. Repeat imaging rate was 40 per cent, angioembolization rate was 26 per cent, and readmission rate was 6 per cent. Within the study population, nine SAPs were found (8/9 in patients with splenic injury grade ≥III). Of these nine SAPs, three (33%) were identified on initial scans and embolized, whereas six (67%) were found on repeat imaging in patients not initially receiving angioembolization. Splenic injuries are typically managed nonoperatively without serious complications. Our results suggest patients with splenic injuries grade ≥III managed nonoperatively without angioembolization should have repeat imaging within 48 hours to rule out the possibility of SAP.

A prospective study of nurse and patient education on compliance with sequential compression devices.

PubMed

Stewart, David; Zalamea, Nia; Waxman, Ken; Schuster, Rob; Bozuk, Michael

2006-10-01

Sequential compression devices (SCD) have become the most common form of prophylaxis against the formation of deep venous thrombosis (DVT) among surgical patients. However, compliance with SCD has traditionally been poor. The aim of this study was to assess the affect of patient and nurse education by surgeons on SCD compliance. This was a prospective study involving a single teaching hospital. Compliance was checked twice daily. The main outcomes were compliance rates with SCD use before and after nurse and patient education. Nurses were not aware of the study. Surgical floors had a history of resident and attending interactions regarding SCD, whereas nonsurgical floors did not. A handout that emphasized SCD importance was also given to patients on surgical units. Before education, surgical units had a compliance rate of 61.5 per cent, whereas nonsurgical units had a 48 per cent compliance rate. This difference was significant (P = 0.014). After nursing and patient education on the busiest surgical floor, compliance rates on the surgical ward increased to 65 per cent, a difference that was not of statistical significance (P = 0.515). A nursing unit's daily experience is the most important factor in their compliance rates with SCD use. Focused nursing lectures and patient education may have incremental value.

Umbilical Hernia Repair: Analysis After 934 Procedures.

PubMed

Porrero, José L; Cano-Valderrama, Oscar; Marcos, Alberto; Bonachia, Oscar; Ramos, Beatriz; Alcaide, Benito; Villar, Sol; Sánchez-Cabezudo, Carlos; Quirós, Esther; Alonso, María T; Castillo, María J

2015-09-01

There is a lack of consensus about the surgical management of umbilical hernias. The aim of this study is to analyze the medium-term results of 934 umbilical hernia repairs. In this study, 934 patients with an umbilical hernia underwent surgery between 2004 and 2010, 599 (64.1%) of which were evaluated at least one year after the surgery. Complications, recurrence, and the reoperation rate were analyzed. Complications were observed in 5.7 per cent of the patients. With a mean follow-up time of 35.5 months, recurrence and reoperation rates were 3.8 per cent and 4.7 per cent, respectively. A higher percentage of female patients (60.9 % vs 29 %, P = 0.001) and a longer follow-up time (47.4 vs 35 months, P = 0.037) were observed in patients who developed a recurrence. No significant differences were observed between complications and the reoperation rate in patients who underwent Ventralex(®) preperitoneal mesh reinforcement and suture repair; however, a trend toward a higher recurrence rate was observed in patients with suture repair (6.5 % vs 3.2 %, P = 0.082). Suture repair had lower recurrence and reoperation rates in patients with umbilical hernias less than 1 cm. Suture repair is an appropriate procedure for small umbilical hernias; however, for larger umbilical hernias, mesh reinforcement should be considered.

The need for innovative strategies to improve immunisation services in rural Zimbabwe.

PubMed

Chadambuka, Addmore; Chimusoro, Anderson; Apollo, Tsitsilina; Tshimanga, Mufuta; Namusisi, Olivia; Luman, Elizabeth T

2012-01-01

Gokwe South, a rural district in Midlands Province, Zimbabwe, reported the lowest rate of immunisation coverage in the country in 2005: 55 per cent of children vaccinated with three doses of diphtheria/pertussis/tetanus vaccine (DPT3) and 35 per cent dropout between the first and third dose of DPT. In January 2007, the authors assessed local barriers to immunisation and proposed strategies to improve immunisation rates in the district, in the face of nationwide economic and political challenges. A situational analysis was performed to assess barriers to immunisation using focus-group discussions with health workers, key informant interviews with health management and community leaders, and desk reviews of records. Responses were categorised and solutions proposed. Health workers and key informants reported that immunisation service delivery was hampered by insufficient availability of gas for cold-chain equipment, limited transport and fuel to conduct basic activities, and inadequate staff and supervision. Improving coverage will require prioritising gas for vaccine cold-chain equipment, identifying reliable transportation or alternative transportation solutions, and increased staff, training and supervision. Local assessment is critical to pinpointing site-specific barriers, and innovative strategies are needed to overcome existing contextual challenges. © 2012 The Author(s). Disasters © Overseas Development Institute, 2012.

Why history matters for quantitative target setting: Long-term trends in socioeconomic and racial/ethnic inequities in US infant death rates (1960-2010).

PubMed

Krieger, Nancy; Singh, Nakul; Chen, Jarvis T; Coull, Brent A; Beckfield, Jason; Kiang, Mathew V; Waterman, Pamela D; Gruskin, Sofia

2015-08-01

Policy-oriented population health targets, such as the Millennium Development Goals and national targets to address health inequities, are typically based on trends of a decade or less. To test whether expanded timeframes might be more apt, we analyzed 50-year trends in US infant death rates (1960-2010) jointly by income and race/ethnicity. The largest annual per cent changes in the infant death rate (between -4 and -10 per cent), for all racial/ethnic groups, in the lowest income quintile occurred between the mid-1960s and early 1980s, and in the second lowest income quintile between the mid-1960s and 1973. Since the 1990s, these numbers have hovered, in all groups, between -1 and -3 per cent. Hence, to look back only 15 years (in 2014, to 1999) would ignore gains achieved prior to the onset of neoliberal policies after 1980. Target setting should be informed by a deeper and longer-term appraisal of what is possible to achieve.

Night emergency cover for ENT in England: a national survey.

PubMed

Biswas, D; Rafferty, A; Jassar, P

2009-08-01

To evaluate the quality of out-of-hours ENT on-call cover by junior doctors, in view of the European Working Time Directive and the recent changes in the National Health Service workforce due to the 'Modernising Medical Careers' initiative, in England. We performed a national survey of first-on-call doctors for ENT, using a telephone questionnaire. Hospital contact details were sourced from the National Health Service website. The inclusion criterion was hospitals providing acute ENT facilities overnight in England. One hundred and nineteen hospitals were contacted; 91 were eligible, and 83 interviews were conducted. The grade of the first-on-call ENT doctor ranged from foundation year two (19 per cent) to registrar level or above (13 per cent). Forty-nine respondents (68 per cent) reported having no previous ENT experience. Fifty-three respondents (74 per cent) covered more than one speciality at night, with seven (10 per cent) covering four or more specialities. The second-on-call doctor was non-resident in 63 cases (88 per cent). Thirty respondents (42 per cent) stated that they did not feel comfortable managing common ENT emergencies as the first doctor on call. Otorhinolaryngology induction courses were offered in 37 of the respondents' hospitals (51 per cent), these courses were of varying duration. Night-time ENT care is often provided by junior doctors with little experience of the speciality, who are often also responsible for covering multiple specialities. Many reported not feeling comfortable managing common ENT emergencies. Structured induction programmes would help to provide basic knowledge and should be mandatory for all doctors covering ENT.

Efficacy and safety of a new intravenous immunoglobulin 10% formulation (octagam® 10%) in patients with immune thrombocytopenia.

PubMed

Robak, Tadeusz; Mainau, Claudia; Pyringer, Barbara; Chojnowski, Krzysztof; Warzocha, Krzysztof; Dmoszynska, Anna; Straub, Jan; Imbach, Paul

2010-10-01

Intravenous immunoglobulin (IVIg) has an established role in the treatment of immune thrombocytopenia (ITP). The safety and efficacy of a new ready-to-use IVIg 10% formulation (octagam(®) 10%) were investigated in a prospective phase III study in 116 adult patients with ITP (platelet count ≤20×10(9)/l). Sixty-six patients had chronic ITP and 49 were newly diagnosed. Patients received octagam 10% 1 g/kg/day on two consecutive days; infusion rate was adjusted according to tolerability to a maximum of 0·12 ml/kg/minute. Eighty per cent of patients attained the primary efficacy endpoint of clinical response (platelet count ≥50×10(9)/l within 6 days of dosing). The median time to response was 2 days and the median duration of response was 12 days; mean response duration was 24·1 days. octagam 10% was well tolerated and effective in this population representative of adult patients with ITP, even at the maximum infusion rate of 0·12 ml/kg/minute, without unexpected safety issues.

Retention and Attrition of Students in Higher Education: Challenges in Modern Times to What Works

ERIC Educational Resources Information Center

Maher, Marguerite; Macallister, Helen

2013-01-01

Retention and attrition rates in higher education have long been a focus of research. This paper presents findings of a single case study, undertaken in a School of Education, which identify important strategies that have led to attrition of five to eight per cent, compared with 18 per cent cross the education sector in Australia (Department of…

Coagulation Profile Changes Due to Thromboprophylaxis and Platelets in Trauma Patients at High-Risk for Venous Thromboembolism.

PubMed

Allen, Casey J; Murray, Clark R; Meizoso, Jonathan P; Ray, Juliet J; Teisch, Laura F; Ruiz, Xiomara D; Hanna, Mena M; Guarch, Gerardo A; Manning, Ronald J; Livingstone, Alan S; Ginzburg, Enrique; Schulman, Carl I; Namias, Nicholas; Proctor, Kenneth G

2015-07-01

We hypothesize there are coagulation profile changes associated both with initiation of thromboporphylaxis (TPX) and with change in platelet levels in trauma patients at high-risk for venous thromboembolism (VTE). A total of 1203 trauma intensive care unit patients were screened with a VTE risk assessment profile. In all, 302 high-risk patients (risk assessment profile score ≥ 10) were consented for weekly thromboelastography. TPX was initiated between initial and follow-up thromboelastography. Seventy-four patients were analyzed. Upon admission, 87 per cent were hypercoagulable, and 81 per cent remained hypercoagulable by Day 7 (P = 0.504). TPX was initiated 3.4 ± 1.4 days after admission; 68 per cent received unfractionated heparin and 32 per cent received low-molecular-weight heparin. The VTE rate was 18 per cent, length of stay 38 (25-37) days, and mortality of 17.6 per cent. In all, 76 per cent had a rapid clotting time at admission versus 39 per cent at Day 7 (P < 0.001); correcting from 7.75 (6.45-8.90) minutes to 10.45 (7.90-15.25) minutes (P < 0.001). At admission, 41 per cent had an elevated maximum clot formation (MCF) and 85 per cent had at Day 7 (P < 0.001); increasing from 61(55-65) mm to 75(69-80) mm (P < 0.001). Platelets positively correlated with MCF at admission (r = 0.308, R(2) = 0.095, P = 0.008) and at Day 7 (r = 0.516, R(2) = 0.266, P < 0.001). Change in platelet levels correlated with change in MCF (r = 0.332, R(2) = 0.110, P = 0.005). In conclusion, hypercoagulability persists despite the use of TPX. Although clotting time normalizes, MCF increases in correlation with platelet levels. As platelet function is a dominant contributor to sustained trauma-evoked hypercoagulability, antiplatelet therapy may be indicated in the management of severely injured trauma patients.

Tick testing as a method of controlling Rocky Mountain spotted fever.

PubMed Central

Sacks, J J; Pinner, T A; Parker, R L

1983-01-01

In South Carolina, 1974-1980, only two matches were found between 536 Rocky Mountain spotted fever (RMSF) cases and 965 individuals who submitted ticks that tested rickettsial antigen positive. In neither case did the positive test prevent RMSF. Tick rickettsial positivity rates varied inversely with human RMSF attack rates in different geographic areas. A physician survey established it as unlikely that RMSF occurred in positive tick submitters (PTS), and that although not recommended, 34 per cent of asymptomatic PTS received prophylactic treatment. Only 18 per cent of positive ticks were engorged. Tick testing appears ineffective in preventing RMSF. PMID:6869643

Risk of decline and chance of improvement in olfaction among patients with post-traumatic olfactory loss.

PubMed

Kuo, C-L; Shu, C-H

2015-12-01

To evaluate the chance of improvement and risk of decline in olfaction among patients with post-traumatic olfactory loss. This study comprised 80 patients. Changes in olfaction were determined using a visual analogue scale and the 'Sniffin' Sticks' test. Logistic regression was used to identify predictors for olfactory changes. Olfactory changes were observed in 9-35 per cent of patients. The rates of improvement and decline according to visual analogue scale scores were 35 per cent and 10 per cent respectively, whereas those in the Sniffin' Sticks test were 9 per cent and 11 per cent respectively. There was a predictive link between non-anosmia and decline in Sniffin' Sticks test scores (odds ratio = 16.61, p = 0.003). A positive correlation was observed between the scores in the first and last examinations (rho = 0.532, p < 0.001). Patients should be informed that they may experience an improvement or decline in olfaction following post-traumatic olfactory dysfunction. This study provides evidence to support comprehensive counselling regarding prognosis as an integral part of management strategies.

[Experiment to study some suspension media for the lyophilization of actinomycetes].

PubMed

Semenov, S M

1975-09-01

Viability and cultural properties of 59 actinomycetes and 17 bacteria lyophilized in polyvinylpyrrolidone (PVP), sodium glutamate, their combinations and horse serum were studied after storage for 2 years at a temperature of 4-10 degrees. A 5 per cent solution of sodium glutamate had a high protective effect on viability of the above organisms. The solution containing 3 per cent of sodium glutamate and 3 per cent of PVP was somewhat less effective. The cultures lyophilized in 5 per cent solution of sodium glutamate had the same viability levels as those lyophilized in horse serum, while the latter had better growth rates on their plating out on nutrient media. A 5 per cent solution of PVP had no advantages over sodium glutamate or horse serum with respect to preservation of the organism viability. No significant differences in the cultural properties: colour of the aerial and substrate mycelium and pigment production were noted in the actinomycetes lyophilized in various protective media and the analogous control cultures maintained by means of passages on fresh nutrient media.

Resident perceptions of the impact of paging on intraoperative education.

PubMed

Rose, Joel S; Waibel, Brett H; Schenarts, Paul J

2012-06-01

Our purpose was to evaluate the impact of paging on perceptions of intraoperative learning. Intraoperative logs of pager interruptions were kept by surgical residents at a university hospital over a 30-day period. The postgraduate year, number of pages, category of caller, reason for call, and level of urgency were recorded during each operation. At the conclusion of each operation, residents also completed a two-item survey with responses on a 5-point scale (1 = strongly disagree to 5 = strongly agree), querying if interruptions negatively impacted the intraoperative experience and if a message taken by a third party was effective in limiting interruptions. Logs were completed for 124 of 204 operations. Fifty-five per cent of operations were interrupted at least once with 49 per cent interrupted two to five times and 6 per cent were interrupted six or more times. Junior residents had 69 per cent of their operations interrupted compared with 39 per cent of senior residents (P = 0.001). Ninety-two per cent of pages were nonurgent. Residents did not perceive pager interruptions negatively impacted their educational experience (mean 2.3) but were neutral with respect if messages taken by a third party decreased interruptions (mean 3.8). Although our hypothesis was that pager interruptions were frequent and disrupt resident education, our data demonstrate the opposite.

Machine- z: Rapid machine-learned redshift indicator for Swift gamma-ray bursts

DOE PAGES

Ukwatta, T. N.; Wozniak, P. R.; Gehrels, N.

2016-03-08

Studies of high-redshift gamma-ray bursts (GRBs) provide important information about the early Universe such as the rates of stellar collapsars and mergers, the metallicity content, constraints on the re-ionization period, and probes of the Hubble expansion. Rapid selection of high-z candidates from GRB samples reported in real time by dedicated space missions such as Swift is the key to identifying the most distant bursts before the optical afterglow becomes too dim to warrant a good spectrum. Here, we introduce ‘machine-z’, a redshift prediction algorithm and a ‘high-z’ classifier for Swift GRBs based on machine learning. Our method relies exclusively onmore » canonical data commonly available within the first few hours after the GRB trigger. Using a sample of 284 bursts with measured redshifts, we trained a randomized ensemble of decision trees (random forest) to perform both regression and classification. Cross-validated performance studies show that the correlation coefficient between machine-z predictions and the true redshift is nearly 0.6. At the same time, our high-z classifier can achieve 80 per cent recall of true high-redshift bursts, while incurring a false positive rate of 20 per cent. With 40 per cent false positive rate the classifier can achieve ~100 per cent recall. As a result, the most reliable selection of high-redshift GRBs is obtained by combining predictions from both the high-z classifier and the machine-z regressor.« less

Effect of central compartment neck dissection on hypocalcaemia incidence after total thyroidectomy for carcinoma.

PubMed

Mitra, I; Nichani, J R; Yap, B; Homer, J J

2011-05-01

Central compartment neck dissection is increasingly performed as part of surgical management of differentiated thyroid carcinoma. However, elective central neck dissection remains controversial due to complications and lack of evidence of survival benefit. To investigate and compare rates of transient and permanent hypocalcaemia following total thyroidectomy alone, compared with total thyroidectomy with central neck dissection, for differentiated thyroid carcinoma. Retrospective study of 127 consecutive patients referred with differentiated thyroid carcinoma, 2004-2006; 78 patients had undergone total thyroidectomy (group one) and 49 total thyroidectomy with central compartment node dissection (group two). Surgery was performed in various hospitals by both otolaryngologists and endocrine surgeons. In groups one and two, the incidence of transient hypocalcaemia was 18 per cent (14/78) and 51 per cent (25/49) (p < 0.001), and the incidence of permanent hypocalcaemia 1 per cent (one of 77) and 12 per cent (six of 49) (p < 0.01), respectively. Most patients undergoing central neck dissection had evidence of pathological level six lymphadenopathy (29/49). Total thyroidectomy combined with central neck dissection for the treatment of differentiated thyroid carcinoma is more likely to result in transient (51 per cent) and permanent (12 per cent) hypocalcaemia. Elective neck dissection should be performed selectively, with a high expectation of post-operative hypocalcaemia.

Surgery for disc-associated wobbler syndrome in the dog--an examination of the controversy.

PubMed

Jeffery, N D; McKee, W M

2001-12-01

Controversy surrounds treatment of disc-associated 'wobbler' syndrome in the dog, centring on the choice of method of surgical decompression used. In this review, details of previously published case series are summarised and critically examined in an attempt to compare success rates and complications of different types of surgery. Unequivocally accurate comparisons were difficult because of differences in methods of case recording between series. Short-term success rates were high (approximately 80 per cent), but there was a high rate of recurrence (around 20 per cent) after any surgical treatment, suggesting the possibility that the syndrome should be considered a multifocal disease of the caudal cervical region. Statistical analysis revealed no significant differences in success rates between the various reported decompressive surgical techniques

Role of clay minerals in the transportation of iron

USGS Publications Warehouse

Carroll, D.

1958-01-01

The clay minerals have iron associated with them in several ways: 1. (1) as an essential constituent 2. (2) as a minor constituent within the crystal lattice where it is in isomorphous substitution and 3. (3) as iron oxide on the surface of the mineral platelets. Nontronite, "hydromica," some chlorites, vermiculite, glauconite and chamosite contain iron as an essential constituent. Kaolinite and halloysite have no site within the lattice for iron, but in certain environments iron oxide (goethite or hematite) is intimately associated as a coating on the micelles. Analyses of clay minerals show that the content of Fe2O3 varies: 29 per cent (nontronite), 7??3 per cent (griffithite), 4.5 per cent ("hydromica"), 5.5 per cent (chlorite), 4 per cent (vermiculite) and 18 per cent (glauconite). The FeO content is: 40 per cent (chamosite), 7.8 per cent (griffithite), 1-2 per cent ("hydromica"), 3 per cent (glauconite) and 2 per cent (chlorite). The iron associated with the clay minerals remains stable in the environment in which the minerals occur, but if either pH or Eh or both are changed the iron may be affected. Change of environment will cause: 1. (1) removal of iron by reduction of Fe3+ to Fe2+; 2. (2) ion-exchange reactions; 3. (3) instability of the crystal lattice. Experiments using bacterial activity to produce reducing conditions with kaolinite and halloysite coated with iron oxides and with nontronite in which ferric iron is in the octahedral position within the lattice showed that ferric oxide is removed at Eh +0??215 in fresh water and at Eh +0.098 in sea water. Hematite, goethite, and indefinite iron oxides were removed at different rates. Red ferric oxides were changed to black indefinite noncrystalline ferrous sulphide at Eh -0.020 but reverted to ferric oxide under oxidizing conditions. Nontronite turned bright green under reducing conditions and some of the ferrous iron remained within the lattice on a return to oxidizing conditions. Bacterial activity seems to be necessary for maintaining reducing conditions in the environments studied. ?? 1958.

Understanding Americans' views on opioid pain reliever abuse.

PubMed

Barry, Colleen L; Kennedy-Hendricks, Alene; Gollust, Sarah E; Niederdeppe, Jeff; Bachhuber, Marcus A; Webster, Daniel W; McGinty, Emma E

2016-01-01

Opioid pain reliever abuse rates have increased sharply in the United States. This study examines Americans' personal experience with opioid pain reliever use and abuse, and views about the seriousness of the problem, factors causing it, responsibility for addressing it and support for policies to resolve it. Public opinion survey. A nationally representative US adult sample (n = 1111). Experiences with opioid pain relievers and views about the seriousness, causes of and responsibility for addressing the problem, and support for policies to reduce opioid pain reliever abuse. 28.2 per cent of Americans reported using opioid pain relievers in the last 12 months, 69.5% have used them in their life-time and 17.3% reported using these medications when not prescribed to them. Fifty-eight per cent ranked the problem as serious, on a par with other major health concerns. Individual-orientated factors, including a lack of understanding about how easy it is to become addicted (80.0%) and improper storage (65.1%) and disposal (64.1%), ranked highest as causes, and those abusing opioid pain relievers (83.8%) and their physicians (78.0%) were viewed as most responsible for solving the problem. Of the policies recommended to curb the epidemic, 14 of 16 were supported by a majority of Americans. Americans view the problem of opioid pain reliever abuse as serious, and support nearly all the policies recommended by medical, law enforcement, disease control and public health experts to curb the epidemic. © 2015 Society for the Study of Addiction.

Long-term responses of rainforest erosional systems at different spatial scales to selective logging and climatic change

PubMed Central

Walsh, R. P. D.; Bidin, K.; Blake, W. H.; Chappell, N. A.; Clarke, M. A.; Douglas, I.; Ghazali, R.; Sayer, A. M.; Suhaimi, J.; Tych, W.; Annammala, K. V.

2011-01-01

Long-term (21–30 years) erosional responses of rainforest terrain in the Upper Segama catchment, Sabah, to selective logging are assessed at slope, small and large catchment scales. In the 0.44 km2 Baru catchment, slope erosion measurements over 1990–2010 and sediment fingerprinting indicate that sediment sources 21 years after logging in 1989 are mainly road-linked, including fresh landslips and gullying of scars and toe deposits of 1994–1996 landslides. Analysis and modelling of 5–15 min stream-suspended sediment and discharge data demonstrate a reduction in storm-sediment response between 1996 and 2009, but not yet to pre-logging levels. An unmixing model using bed-sediment geochemical data indicates that 49 per cent of the 216 t km−2 a−1 2009 sediment yield comes from 10 per cent of its area affected by road-linked landslides. Fallout 210Pb and 137Cs values from a lateral bench core indicate that sedimentation rates in the 721 km2 Upper Segama catchment less than doubled with initially highly selective, low-slope logging in the 1980s, but rose 7–13 times when steep terrain was logged in 1992–1993 and 1999–2000. The need to keep steeplands under forest is emphasized if landsliding associated with current and predicted rises in extreme rainstorm magnitude-frequency is to be reduced in scale. PMID:22006973

Replacing the projected retiring baby boomer nursing cohort 2001 – 2026

PubMed Central

Schofield, Deborah J

2007-01-01

Background The nursing population in Australia is ageing. However, there is little information on the rate and timing of nursing retirement. Methods Specifically designed health workforce extracts from the Australian Bureau of Statistics (ABS) censuses from 1986 to 2001 are used to estimate the rate of nursing retirement. The 2001 nursing data are then "aged" and retirement of the nursing workforce projected through to 2026. ABS population projections are used to examine the future age structure of the population and the growth and age distribution of the pool of labour from which future nurses will be drawn. Results Attrition rates for nurses aged 45 and over are projected to be significantly higher between the base year of 2006 and 2026, than they were between 1986 and 2001 (p < 0.001). Between 2006 and 2026 the growth in the labour force aged 20 to 64 is projected to slow from 7.5 per cent every five years to about 2 per cent, and over half of that growth will be in the 50 to 64 year age group. Over this period Australia is projected to lose almost 60 per cent of the current nursing workforce to retirement, an average of 14 per cent of the nursing workforce every five years and a total of about 90,000 nurses. Conclusion The next 20 years will see a large number of nursing vacancies due to retirement, with ageing already impacting on the structure of the nursing workforce. Retirement income policies are likely to be a key driver in the retirement rate of nurses, with some recent changes in Australia having some potential to slow retirement of nurses before the age of 60 years. However, if current trends continue, Australia can expect to have substantially fewer nurses than it needs in 2026. PMID:17572906

Menstrual characteristics and night work among nurses

PubMed Central

MOEN, Bente E.; BASTE, Valborg; MORKEN, Tone; ALSAKER, Kjersti; PALLESEN, Ståle; BJORVATN, Bjørn

2015-01-01

Night work has been associated with adverse effects in terms of reproductive health. Specifically, menstruation has been suggested to be negatively impacted by night work, which again may influence fertility. This study investigated whether working nights is related to menstrual characteristics and if there is a relationship between shift work disorder (SWD) and menstruation. The study was cross-sectional, response rate 38%. The sample comprised female nurses who were members of the Norwegian Nurses Association; below 50 yr of age, who were not pregnant, did not use hormonal pills or intrauterine devices and who had not reached menopause (n=766). The nurses answered a postal survey including questions about night work and menstrual characteristics. Fifteen per cent reported to have irregular menstruations. Thirty-nine per cent of the nurses were classified as having SWD. Logistic regression analyses concerning the relationship between irregular menstruations and night work did not show any associations. Furthermore, no associations were found between cycle length or bleeding period and night work parameters. No associations were found between menstrual characteristics and SWD. PMID:25914071

Three-year experience with neonatal ventilation from a tertiary care hospital in Delhi.

PubMed

Singh, M; Deorari, A K; Paul, V K; Mittal, M; Shanker, S; Munshi, U; Jain, Y

1993-06-01

Ninety neonates were ventilated over a period of 33 months of whom 50 (55.5%) survived. Fifty seven babies received IPPV while 33 CPAP. IPPV mode was being used more frequently recently and survival rates have steadily improved over past 3 years. Survival was cent per cent in babies above 1.5 kg on CPAP mode while 16/26 (57.7%) survived on IPPV mode. Of 22 extremely VLBW (< 1 kg) babies, six survived. HMD was the commonest indication of ventilation (50%), of which 53% (24/45) survived. The other important indications of ventilation were apnea in 13 and transient tachypnea in 11 babies. All babies requiring ventilation for transient tachypnea survived. Nosocomial infections were common in association with ventilation 34/90 (37.7%), out of which in 14 was responsible for about a third of deaths. Pulmonary air leaks developed in 12 babies of which 6 died. Two babies developed BPD and one ROP. Neonatal ventilation should be ventured in centres where basic facilities for level II care already exist. It may not be cost effective to ventilate extremely low birth weight neonates.

Spatial econometric model of natural disaster impacts on human migration in vulnerable regions of Mexico.

PubMed

Saldaña-Zorrilla, Sergio O; Sandberg, Krister

2009-10-01

Mexico's vast human and environmental diversity offers an initial framework for comprehending some of the prevailing great disparities between rich and poor. Its socio-economic constructed vulnerability to climatic events serves to expand this understanding. Based on a spatial econometric model, this paper tests the contribution of natural disasters to stimulating the emigration process in vulnerable regions of Mexico. Besides coping and adaptive capacity, it assesses the effects of economic losses due to disasters as well as the adverse production and trade conditions of the 1990s on emigration rates in 2000 at the municipality level. Weather-related disasters were responsible for approximately 80 per cent of economic losses in Mexico between 1980 and 2005, mostly in the agricultural sector, which continues to dominate many parts of the country. It is dramatic that this sector generates around only four per cent of gross domestic product but provides a livelihood to about one-quarter of the national population. It is no wonder, therefore, that most emigration from this country arises in vulnerable rural areas.

Support needs of veterinary surgeons during the first few years of practice: perceptions of recent graduates and senior partners.

PubMed

Routly, J E; Taylor, I R; Turner, R; McKernan, E J; Dobson, H

2002-02-09

Postal surveys or personal interviews of 76 recent veterinary graduates and their 49 employers were undertaken to establish their perceptions of good practice when integrating a new graduate into a business and their preferred methods of assessment and development. Practice type and location were the main influences on graduates looking for their first job. Interviews were mostly informal. Employers expected basic veterinary competence and candidates expected good quality support. Most graduates (93 per cent) had their own consultations on the first day. During early consultations 2 per cent of senior vets accompanied the new graduate, 95 per cent of practices provided senior back-up either in person or by telephone but in 3 per cent no back-up was available. Most new graduates (90 per cent) were satisfied with their workload. Three-fifths were on-call within the first week, and 95 per cent within a month. Graduates received calls directly in 45 per cent of practices, in 9 per cent seniors screened the calls, and the remainder used a third party. Assistance from experienced lay staff varied greatly. Discussion of problems was mainly informal. There was little spontaneous feedback and problems resulted from inadequate communication. One in three new graduates left their first job within two years, and one in six identified lack of support, heavy workload, stress or clashes with staff as a primary reason. This high turnover was a problem for employers. From the new graduates' perspectives, initial problems included: being on call (59 per cent), financial aspects (47 per cent) and surgery (43 per cent). Communicating with clients and learning to prioritise jobs were also difficult. New graduates took longer over procedures (79 per cent of employers commented) and required extra back-up (91 per cent) both of which reduced income (59 per cent). Nearly all the seniors felt that their current new graduates had coped 'quite well', although it was claimed that new graduates lacked the ability to talk to clients at the appropriate level, wanted to bring all their scientific knowledge to bear on every case, and often failed to consider the obvious or to appreciate clients' needs. Only 18 per cent of practices had formal and regular review procedures but all monitored the response of clients and watched the new graduate perform. Feedback to their new colleague was considered 'adequate' by 85 per cent of seniors, although 45 per cent of graduates felt they had not received enough. Eighty-three per cent of new graduates felt 'moderately prepared' by their undergraduate course, and 76 per cent of senior vets were 'generally satisfied' Both wanted improvements in extramural studies and increased exposure to routine cases. Senior partners sought greater commitment in the undergraduate curriculum to financial/legal issues and communication skills. Over a third of employers (38 per cent) had a 'great influence' on the choice of continuing professional development courses for their recent graduates. New graduates chose courses to deal with a perceived weakness, or to specialise, and welcomed opportunities to meet other new graduates and share early experiences. It was concluded that turnover and staff problems would be reduced if practices became more effective in coping with new arrivals, especially by supporting their development.

Comparison of Cox's and relative survival models when estimating the effects of prognostic factors on disease-specific mortality: a simulation study under proportional excess hazards.

PubMed

Le Teuff, Gwenaël; Abrahamowicz, Michal; Bolard, Philippe; Quantin, Catherine

2005-12-30

In many prognostic studies focusing on mortality of persons affected by a particular disease, the cause of death of individual patients is not recorded. In such situations, the conventional survival analytical methods, such as the Cox's proportional hazards regression model, do not allow to discriminate the effects of prognostic factors on disease-specific mortality from their effects on all-causes mortality. In the last decade, the relative survival approach has been proposed to deal with the analyses involving population-based cancer registries, where the problem of missing information on the cause of death is very common. However, some questions regarding the ability of the relative survival methods to accurately discriminate between the two sources of mortality remain open. In order to systematically assess the performance of the relative survival model proposed by Esteve et al., and to quantify its potential advantages over the Cox's model analyses, we carried out a series of simulation experiments, based on the population-based colon cancer registry in the French region of Burgundy. Simulations showed a systematic bias induced by the 'crude' conventional Cox's model analyses when individual causes of death are unknown. In simulations where only about 10 per cent of patients died of causes other than colon cancer, the Cox's model over-estimated the effects of male gender and oldest age category by about 17 and 13 per cent, respectively, with the coverage rate of the 95 per cent CI for the latter estimate as low as 65 per cent. In contrast, the effect of higher cancer stages was under-estimated by 8-28 per cent. In contrast to crude survival, relative survival model largely reduced such problems and handled well even such challenging tasks as separating the opposite effects of the same variable on cancer-related versus other-causes mortality. Specifically, in all the cases discussed above, the relative bias in the estimates from the Esteve et al.'s model was always below 10 per cent, with the coverage rates above 81 per cent. Copyright 2005 John Wiley & Sons, Ltd.

Using dental care resources optimally: quality-efficiency trade-offs in a competitive private market.

PubMed

Prasad, Banuru Muralidhara; Varatharajan, D

2011-01-01

Modern lifestyle changes led to increased dental care needs in India. Consequently, there has been a sharp rise in dentist numbers. Karnataka state alone produces 2,500 dentists annually, who are engaged in the non-government sector owing to inadequate public sector opportunities. This article aims to assess Karnataka private dental clinic quality and efficiency. Dentists were interviewed using a close-ended, structured interview schedule and their clinics were assessed using a checklist adopted from guidelines for providing machinery and equipment under the National Oral Health Care Programme (NOHCP). Dental "hotel" and clinical quality were scored based on this checklist. Clinical quality was "excellent" in 12 per cent of clinics and poor in 49 per cent. Clinics with better infrastructure charged higher price (p < 0.05). Multi-chair clinics charging fixed rates were high (81 per cent). According to 59.5 per cent of dentists, competition did not improve quality while 27 per cent felt that competition increased price, not quality. About 30.9 per cent of the poor quality clinics, 41 per cent average quality clinics and 26 per cent good quality clinics were technically efficient. The multi chair clinics offered better quality at higher prices and single chair clinics provided poorer quality at lower prices. In other words, they had a sub-optimal price-quality mix. Therefore, there is a need to regulate price and quality in all clinics to arrive at an optimal price-quality mix so that clients are not overburdened financially even while receiving good quality dental care. The article advocates that resources are used optimally as a way to achieve value for money and to achieve break-even points thereby providing quality care in a competitive market. Factors that influence dental practitioner behaviour are evaluated.

Prey and predator emigration responses in the acarine system Tetranychus urticae-Phytoseiulus persimilis.

PubMed

Bernstein, C

1984-01-01

Some of the processes that influence the emigration of prey and predatory mites from bean plants were investigated experimentally. The emigration of the prey depends on the damage they cause to the plants and on predator density. The predator's emigration rate is a decreasing function of prey density, and does not change (or it slightly decreases) when prey and predator numbers are increased maintaining the same prey/predator ratio. The probability of emigration of the predators is independent of their own density when prey are absent and density dependent when prey density is kep constant. Forty three per cent of the variability in the predator's instantaneous rate of emigration in the different experiments is accounted for by a two parameter negative exponential function of capture rate (number of prey eaten per predator and per unit of time).

A catalogue of clusters of galaxies identified from all sky surveys of 2MASS, WISE, and SuperCOSMOS

NASA Astrophysics Data System (ADS)

Wen, Z. L.; Han, J. L.; Yang, F.

2018-03-01

We identify 47 600 clusters of galaxies from photometric data of Two Micron All Sky Survey (2MASS), Wide-field Infrared Survey Explorer (WISE), and SuperCOSMOS, among which 26 125 clusters are recognized for the first time and mostly in the sky outside the Sloan Digital Sky Survey (SDSS) area. About 90 per cent of massive clusters of M500 > 3 × 1014 M⊙ in the redshift range of 0.025 < z < 0.3 have been detected from such survey data, and the detection rate drops down to 50 per cent for clusters with a mass of M500 ˜ 1 × 1014 M⊙. Monte Carlo simulations show that the false detection rate for the whole cluster sample is less than 5 per cent. By cross-matching with ROSAT and XMM-Newton sources, we get 779 new X-ray cluster candidates which have X-ray counterparts within a projected offset of 0.2 Mpc.

Stellar binary black holes in the LISA band: a new class of standard sirens

NASA Astrophysics Data System (ADS)

Del Pozzo, Walter; Sesana, Alberto; Klein, Antoine

2018-04-01

The recent Advanced LIGO detections of coalescing black hole binaries (BHBs) imply a large population of such systems emitting at milli-Hz frequencies, accessible to the Laser Interferometer Space Antenna (LISA). We show that these systems provide a new class of cosmological standard sirens. Direct LISA luminosity distance - Dl - measurements, combined with the inhomogeneous redshift - z - distribution of possible host galaxies provide an effective way to populate the Dl-z diagram at z < 0.1, thus allowing a precise local measurement of the Hubble expansion rate. To be effective, the method requires a sufficiently precise LISA distance determination and sky localization of a sizeable number of BHBs, which is best achieved for a six-link detector configuration. We find that, for a BHB population consistent with current fiducial LIGO rates, the Hubble constant H0 can be determined at the ˜5 per cent and ˜2 per cent level (68 per cent confidence), assuming two and five million kilometre arm-length, respectively.

To fear or to feed: the effects of turbidity on perception of risk by a marine fish.

PubMed

Leahy, Susannah M; McCormick, Mark I; Mitchell, Matthew D; Ferrari, Maud C O

2011-12-23

Coral reefs are currently experiencing a number of worsening anthropogenic stressors, with nearshore reefs suffering from increasing sedimentation because of growing human populations and development in coastal regions. In habitats where vision and olfaction serve as the primary sources of information, reduced visual input from suspended sediment may lead to significant alterations in prey fish behaviour. Here, we test whether prey compensate for reduced visual information by increasing their antipredator responses to chemically mediated risk cues in turbid conditions. Experiments with the spiny damselfish, Acanthochromis polyacanthus, found that baseline activity levels were reduced by 23 per cent in high turbidity conditions relative to low turbidity conditions. Furthermore, risk cues elicited strong antipredator responses at all turbidity levels; the strongest antipredator responses were observed in high turbidity conditions, with fish reducing their foraging by almost 40 per cent, as compared with 17 per cent for fish in clear conditions. This provides unambiguous evidence of sensory compensation in a predation context for a tropical marine fish, and suggests that prey fish may be able to behaviourally offset some of the fitness reductions resulting from anthropogenic sedimentation of their habitats.

To fear or to feed: the effects of turbidity on perception of risk by a marine fish

PubMed Central

Leahy, Susannah M.; McCormick, Mark I.; Mitchell, Matthew D.; Ferrari, Maud C. O.

2011-01-01

Coral reefs are currently experiencing a number of worsening anthropogenic stressors, with nearshore reefs suffering from increasing sedimentation because of growing human populations and development in coastal regions. In habitats where vision and olfaction serve as the primary sources of information, reduced visual input from suspended sediment may lead to significant alterations in prey fish behaviour. Here, we test whether prey compensate for reduced visual information by increasing their antipredator responses to chemically mediated risk cues in turbid conditions. Experiments with the spiny damselfish, Acanthochromis polyacanthus, found that baseline activity levels were reduced by 23 per cent in high turbidity conditions relative to low turbidity conditions. Furthermore, risk cues elicited strong antipredator responses at all turbidity levels; the strongest antipredator responses were observed in high turbidity conditions, with fish reducing their foraging by almost 40 per cent, as compared with 17 per cent for fish in clear conditions. This provides unambiguous evidence of sensory compensation in a predation context for a tropical marine fish, and suggests that prey fish may be able to behaviourally offset some of the fitness reductions resulting from anthropogenic sedimentation of their habitats. PMID:21849308

2005 survey of seat belt wearing rates

DOT National Transportation Integrated Search

2005-01-01

The 2005 seat belt survey showed a minor improvement in driver wearing : rates. Over the 2003 2005 period, estimated wearing rates for male drivers : increased by one percentage point to 83 per cent, and for female drivers : increased by two perc...

Identification of inadequate maternal progesterone concentrations in nulliparous dairy heifers and treatment with human chorionic gonadotrophin.

PubMed

King, S G; Dobson, H; Royal, M D; Christley, R M; Murray, R D; Routly, J E; Smith, R F; Mann, G E

2013-11-09

Plasma progesterone concentrations were estimated for 381 nulliparous dairy heifers from eight farms on days 4-6 after insemination. Heifers were synchronised using two treatments of prostaglandin F2α (PGF2α) 11 days apart. Alternate heifers were treated with 1500 IU human chorionic gonadotrophin (hCG) at the time of sampling, and the pregnancy status assessed ~35 days after insemination. Heifers with no corpus luteum (CL; n-30) at the second PGF2α had lower progesterone concentrations (P<0.001) and pregnancy rates (PR; P=0.001) compared with heifers with CL (n=351, defined as cyclic). The risk of no CL increased in heifers <15 months of age (OR=7.5, P<0.001) and with body condition score <2.5 (OR=4.5, P=0.001). Those with no CL were removed from further analysis. The 20 per cent cyclic control heifers with progesterone concentrations ≤2 ng/ml on days 4-6 had lower PRs compared with those with higher concentrations (42 per cent vs 64 per cent, OR=0.3, P=0.01). There was no overall effect of hCG on PR compared with controls (51 per cent vs 60 per cent, P=0.10). However, heifers with high progesterone on days 4-6 (>2 ng/ml) had a lower PR after treatment (51 per cent vs 64 per cent, OR=0.6, P=0.02). Heifers inseminated with sexed (n=18) compared with conventional (n=333) semen had a decreased PR (33 per cent vs 57 per cent, OR=0.2, P=0.01). This study demonstrates that higher plasma progesterone concentrations as early as days 4-6 after insemination have a positive effect on first insemination PR, but there was no beneficial effect of hCG treatment on these days in dairy heifers.

Diagnostic value of three-dimensional magnetic resonance imaging of inner ear after intratympanic gadolinium injection, and clinical application of magnetic resonance imaging scoring system in patients with delayed endolymphatic hydrops.

PubMed

Gu, X; Fang, Z-M; Liu, Y; Lin, S-L; Han, B; Zhang, R; Chen, X

2014-01-01

Three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging of the inner ear after intratympanic injection of gadolinium, together with magnetic resonance imaging scoring of the perilymphatic space, were used to investigate the positive identification rate of hydrops and determine the technique's diagnostic value for delayed endolymphatic hydrops. Twenty-five patients with delayed endolymphatic hydrops underwent pure tone audiometry, bithermal caloric testing, vestibular-evoked myogenic potential testing and three-dimensional magnetic resonance imaging of the inner ear after bilateral intratympanic injection of gadolinium. The perilymphatic space of the scanned images was analysed to investigate the positive identification rate of endolymphatic hydrops. According to the magnetic resonance imaging scoring of the perilymphatic space and the diagnostic standard, 84 per cent of the patients examined had endolymphatic hydrops. In comparison, the positive identification rates for vestibular-evoked myogenic potential and bithermal caloric testing were 52 per cent and 72 per cent respectively. Three-dimensional magnetic resonance imaging after intratympanic injection of gadolinium is valuable in the diagnosis of delayed endolymphatic hydrops and its classification. The perilymphatic space scoring system improved the diagnostic accuracy of magnetic resonance imaging.

Risk modelling study for carotid endarterectomy.

PubMed

Kuhan, G; Gardiner, E D; Abidia, A F; Chetter, I C; Renwick, P M; Johnson, B F; Wilkinson, A R; McCollum, P T

2001-12-01

The aims of this study were to identify factors that influence the risk of stroke or death following carotid endarterectomy (CEA) and to develop a model to aid in comparative audit of vascular surgeons and units. A series of 839 CEAs performed by four vascular surgeons between 1992 and 1999 was analysed. Multiple logistic regression analysis was used to model the effect of 15 possible risk factors on the 30-day risk of stroke or death. Outcome was compared for four surgeons and two units after adjustment for the significant risk factors. The overall 30-day stroke or death rate was 3.9 per cent (29 of 741). Heart disease, diabetes and stroke were significant risk factors. The 30-day predicted stroke or death rates increased with increasing risk scores. The observed 30-day stroke or death rate was 3.9 per cent for both vascular units and varied from 3.0 to 4.2 per cent for the four vascular surgeons. Differences in the outcomes between the surgeons and vascular units did not reach statistical significance after risk adjustment. Diabetes, heart disease and stroke are significant risk factors for stroke or death following CEA. The risk score model identified patients at higher risk and aided in comparative audit.

Tephra, trees, and trouble: forest dieback delays landslide response to pyroclastic eruption

NASA Astrophysics Data System (ADS)

Korup, Oliver; Seidemann, Jan; Mohr, Christian

2017-04-01

Large explosive eruptions may substantially transform landscapes by burying topography under thick layers of tephra. The excess pyroclastic sediment that is gradually washed into rivers following such eruptions is responsible for some of the highest specific sediment yields ever documented. The handful of detailed quantitative studies of such catastrophic fluvial response has hardly looked at how hillslopes respond to tephra loads, however. We studied whether three recent eruptions in Chile's Southern Volcanic Zone (SVZ) noticeably changed hillslope erosion rates, and found a strikingly delayed increase in shallow landslide activity. In the case of Chaitén volcano, which erupted in 2008, densely forested hillslopes nearby gained steadily in landslides abundance and area, and most rapidly some eight years after being covered by tephra. In 2016 alone, more than 75 per cent of the volume of all slope failures since the eruption (more than 2 million cubic metres) occurred in an area of 250 square kilometres around the volcano. Neighboring regions of comparable topography, forest cover, rainfall, and lithology have landslide rates at least ten times lower, so that we argue that successive loss of shear strength due to delayed tree-root decay and suppressed vegetation regrowth promotes slope failures near the volcano, especially where pristine rainforests were obliterated by tephra loads. These shallow landslides scrape sediment, soils, and dead wood from hillslopes, and reinforce the supply to rivers with high sediment and organic carbon loads nearly a decade after the eruption. We estimate that 0.1-0.2 Mt C were mobilized by these slope failures, and thus more than 25 per cent of the total post-eruptive organic carbon flux bound for the nearby north Patagonian fjords. Given that explosive eruptions in the SVZ have a mean return period of ca. 275 years, we propose that protracted landslide response of densely forested hillslopes to explosive eruptions plays an important, though largely ignored, part in long-term sediment and organic carbon budgets. Our results also indicate that monitoring of post-eruptive sediment and biogeochemical fluxes should account for lagged landslide response of tephra-covered forested hillslopes to avoid substantial underestimates.

5 CFR 532.253 - Special rates or rate ranges for leader, supervisory, and production facilitating positions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PREVAILING RATE SYSTEMS Prevailing Rate Determinations § 532... facilitating grade on the regular schedule, plus the cents per hour difference between the prevailing rate of the appropriate nonsupervisory grade on the regular schedule and the prevailing rate of the special...

Preliminary design and economic investigations of Diffuser Augmented Wind Turbines (DAWT)

NASA Astrophysics Data System (ADS)

Foreman, K. M.

1981-12-01

A preferred design and configuration approach for the diffuser augmented wind turbines (DAWT) innovative wind energy conversion system is proposed. A preliminary economic assessment for limited production rates of units between 5 and 150 kw rated output was made. It is estimated that for farm and REA cooperative end users, the COE can range between 2 and 3.5 cents/kWh for sites with annual average wind speeds of 16 and 12 mph respectively and 150 kW rated units. No tax credits are included in these COE figures. For commercial end users of these 150 kW units the COE ranges between 4.0 and 6.5 cents/kWh for 16 and 12 mph sites. These estimates in 1979 dollars are lower than DOE goals set in 1978 for the rating size and end applications.

Effect of signs of oestrus, disease stressors and cow activity on pregnancy rate following artificial insemination.

PubMed

Bijker, I; Christley, R M; Smith, R F; Dobson, H

2015-04-18

The objective was to examine (a) how pregnancy rate on one farm (500 cows) was affected by signs of oestrus and disease stressors and (b) whether pregnancy rate could be maximised by considering cow activity. The signs of oestrus and timings were recorded at artificial insemination (AI), and cow activity was monitored by neck collars. Pregnancy rate tended to be higher in animals that displayed standing oestrus (35 v 26 per cent; P=0.06) but was 10 per cent lower in those cows with an elevated somatic cell count (SCC; >200,000 cells/ml milk) within 0-4 or 4-8 weeks prior to AI (P=0.01 and 0.05, respectively), irrespective of the incidence of clinical mastitis prior to AI. Cow activity data were available for 525 inseminations (from a total of 1299). The mean interval from increased activity to AI in all cows (11 hours 32 minutes; 95 per cent CI 10 hours 40 minutes to 12 hours 24 minutes) was not different for cows that did or did not establish a pregnancy (P=0.90). The pregnancy rate improved to the average of unaffected cows if AI was delayed by about eight hours in animals with an elevated SCC 0-4 weeks prior to AI (P=0.025), indicating that, in cows with prior elevated SCC, AI could be repeated approximately eight hours later to achieve maximum pregnancy rates. British Veterinary Association.

Survey of UK-based veterinary surgeons' opinions on the use of surgery and chemotherapy in the treatment of canine high-grade mast cell tumour, splenic haemangiosarcoma and appendicular osteosarcoma.

PubMed

Barker, D A; Foale, R D; Holmes, M A; Demetriou, J L

2016-12-03

The objective of this study was to determine the frequency of recommendation of adjuvant chemotherapy by UK-based general veterinary practitioners (GVPs) for canine patients with high-grade mast cell tumours (HGMCTs), splenic haemangiosarcomas (SHSs) and appendicular osteosarcomas (AOSs); to determine which chemotherapeutic protocols are used by GVPs; and to evaluate reasons why chemotherapy may or may not be recommended postoperatively. An internet survey was created in 2013 using an online programme and was distributed to GVPs. Questions relating to the use of adjuvant chemotherapy for three tumours were selected. In total, 300 responses were generated. Surgery was seen as primary therapy by most GVPs for HGMCT (91 per cent) and SHS (88 per cent), but less frequently for AOS (59 per cent). Also, 90, 40 and 57 per cent of respondents recommended adjuvant chemotherapy for HGMCT, SHS and AOS, respectively. Of these, an appropriate chemotherapy protocol was not known by 25, 51 and 36 per cent of GVPs for HGMCT, SHS and AOS, respectively. From the GVPs not recommending chemotherapy, 29, 64 and 66 per cent did not believe chemotherapy to be efficacious for these tumours. The frequency of recommendation regarding postoperative chemotherapy is variable by tumour type. Reasons given why postoperative chemotherapy is not recommended also vary by tumour type. British Veterinary Association.

Estimating average annual per cent change in trend analysis

PubMed Central

Clegg, Limin X; Hankey, Benjamin F; Tiwari, Ram; Feuer, Eric J; Edwards, Brenda K

2009-01-01

Trends in incidence or mortality rates over a specified time interval are usually described by the conventional annual per cent change (cAPC), under the assumption of a constant rate of change. When this assumption does not hold over the entire time interval, the trend may be characterized using the annual per cent changes from segmented analysis (sAPCs). This approach assumes that the change in rates is constant over each time partition defined by the transition points, but varies among different time partitions. Different groups (e.g. racial subgroups), however, may have different transition points and thus different time partitions over which they have constant rates of change, making comparison of sAPCs problematic across groups over a common time interval of interest (e.g. the past 10 years). We propose a new measure, the average annual per cent change (AAPC), which uses sAPCs to summarize and compare trends for a specific time period. The advantage of the proposed AAPC is that it takes into account the trend transitions, whereas cAPC does not and can lead to erroneous conclusions. In addition, when the trend is constant over the entire time interval of interest, the AAPC has the advantage of reducing to both cAPC and sAPC. Moreover, because the estimated AAPC is based on the segmented analysis over the entire data series, any selected subinterval within a single time partition will yield the same AAPC estimate—that is it will be equal to the estimated sAPC for that time partition. The cAPC, however, is re-estimated using data only from that selected subinterval; thus, its estimate may be sensitive to the subinterval selected. The AAPC estimation has been incorporated into the segmented regression (free) software Joinpoint, which is used by many registries throughout the world for characterizing trends in cancer rates. Copyright © 2009 John Wiley & Sons, Ltd. PMID:19856324

Clinical characteristics of canine fibrocartilaginous embolic myelopathy (FCE): a systematic review of 393 cases (1973-2013).

PubMed

Bartholomew, K A; Stover, K E; Olby, N J; Moore, S A

2016-12-24

Fibrocartilaginous embolic myelopathy (FCE) is common in dogs; however, there is conflicting information in the veterinary literature regarding clinical characteristics and data on recovery in severe cases is sparse. A systematic review of canine FCE was performed to delineate the natural history of this disease. 322 previously reported cases and 71 previously unreported cases were identified for inclusion. Source publications were identified via PubMed central search and by references from review articles. Previously unreported cases were identified via computerised medical records search at two veterinary institutions. FCE was most common in middle-aged large breed dogs (30 per cent); however, the miniature schnauzer was the most frequently reported individual breed and small breeds comprised 24 per cent of all reported cases. The most common neuroanatomical localisation was a T3-L3 myelopathy (33.1 per cent). Prognosis for recovery of ambulation was good to excellent with 85 per cent of cases regaining the ability to walk unassisted, most within 3 weeks. Persistent neurological deficits were common in patients that recovered ambulation (49.1 per cent). When nociception was absent in the affected limbs at initial presentation, rate of recovery was lower (10 per cent); however, this data is likely biased by limited follow-up in more severe cases. Future prospective studies should evaluate prognosis for more severely affected patients. British Veterinary Association.

Progress and Challenges in Predicting Crop Responses to Atmospheric [CO2

NASA Astrophysics Data System (ADS)

Kent, J.; Paustian, K.

2017-12-01

Increasing atmospheric [CO2] directly accelerates photosynthesis in C3 crops, and indirectly promotes yields by reducing stomatal conductance and associated water losses in C3 and C4 crops. Several decades of experiments have exposed crops to eCO2 in greenhouses and other enclosures and observed yield increases on the order of 33%. FACE systems were developed in the early 1990s to better replicate open-field growing conditions. Some authors contend that FACE results indicate lower crop yield responses than enclosure studies, while others maintain no significant difference or attribute differences to various methodological factors. The crop CO2 response processes in many crop models were developed using results from enclosure experiments. This work tested the ability of one such model, DayCent, to reproduce crop responses to CO2 enrichment from several FACE experiments. DayCent performed well at simulating yield and transpiration responses in C4 crops, but significantly overestimated yield responses in C3 crops. After adjustment of CO2-response parameters, DayCent was able to reproduce mean yield responses for specific crops. However, crop yield responses from FACE experiments vary widely across years and sites, and likely reflect complex interactions between conditions such as weather, soils, cultivars, and biotic stressors. Further experimental work is needed to identify the secondary variables that explain this variability so that models can more reliably forecast crop yields under climate change. Likewise, CO2 impacts on crop outcomes such as belowground biomass allocation and grain N content have implications for agricultural C fluxes and human nutrition, respectively, but are poorly understood and thus difficult to simulate with confidence.

Social inequalities in fatal childhood accidents and assaults: England and Wales, 2001-03.

PubMed

Siegler, Veronique; Al-Hamad, Alaa; Blane, David

2010-01-01

This article presents age-specific mortality rates of children for selected causes of accidents and assault using the National Statistics Socio-economic Classification (NS-SEC). The study is an analysis of the social inequalities in fatal childhood accidents and assault at the start of the 21st century. It aims to identify the causes and age groups for which these inequalities are the widest. In order to classify children by NS-SEC, the most advantaged class of the biological or adoptive parents was used. Death registrations provided the number of deaths from accidents and assault for children aged from 28 days to 15 years, in England and Wales, between 2001 and 2003. The population of children by NS-SEC and age group was obtained from the 2001 Census. Age-specific mortality rates were estimated. Inequalities were measured using socio-economic gradients in mortality. There were wide social inequalities in fatal accidents and assaults for children aged between 28 days and 15 years. The overall mortality rate in the routine class was 64 per million children aged up to 15, 4.5 times the rate of children with parents in the higher managerial and professional class. The greatest inequalities in accidental mortality for children in that age group were observed for fire and pedestrian accidents, followed by accidental suffocation. Infants at least 28 days but less than one year were subject to the widest inequalities of all age groups in fatal accidents and assault. The highest mortality rate in this study resulted from assault on babies whose parents could not be classified by occupation. Pedestrian and other transport accidents were the greatest causes of death for children between 5 and 15 years old. Inequalities were much larger for pedestrian than for other transport accidents for children aged 14 years and under. The leading cause of death for children aged less than five years was suffocation, followed by drowning and exposure to fire/hot substances. In that age group, the risk of death from exposure to fire was significantly higher for children whose parents could not be classified by occupation. Substantial social inequalities in childhood mortality from accidents and assault existed in 2001-03. Reducing the large inequalities between the most advantaged class and the most disadvantaged group in the non-occupied category, would make a substantial impact on childhood deaths from accidents and assaults. If the mortality rates in the latter group were the same as in the most advantaged managerial and professional class, deaths of infants of at least 28 days but less than one year, from assault would be reduced by 62 per cent. Deaths from fire, accidental suffocation and pedestrian accidents in the under fives would be reduced by 50 per cent, 25 per cent and 28 per cent respectively. Deaths in pedestrian and transport accidents for children aged 5-15 would be reduced by 25 per cent and 16 per cent respectively.

Structural features of the rice chromosome 4 centromere.

PubMed

Zhang, Yu; Huang, Yuchen; Zhang, Lei; Li, Ying; Lu, Tingting; Lu, Yiqi; Feng, Qi; Zhao, Qiang; Cheng, Zhukuan; Xue, Yongbiao; Wing, Rod A; Han, Bin

2004-01-01

A complete sequence of a chromosome centromere is necessary for fully understanding centromere function. We reported the sequence structures of the first complete rice chromosome centromere through sequencing a large insert bacterial artificial chromosome clone-based contig, which covered the rice chromosome 4 centromere. Complete sequencing of the 124-kb rice chromosome 4 centromere revealed that it consisted of 18 tracts of 379 tandemly arrayed repeats known as CentO and a total of 19 centromeric retroelements (CRs) but no unique sequences were detected. Four tracts, composed of 65 CentO repeats, were located in the opposite orientation, and 18 CentO tracts were flanked by 19 retroelements. The CRs were classified into four types, and the type I retroelements appeared to be more specific to rice centromeres. The preferential insert of the CRs among CentO repeats indicated that the centromere-specific retroelements may contribute to centromere expansion during evolution. The presence of three intact retrotransposons in the centromere suggests that they may be responsible for functional centromere initiation through a transcription-mediated mechanism.

A content analysis of tobacco control policy in the U.S. Department of Defense.

PubMed

Hoffman, Kevin M; Poston, Walker S C; Jitnarin, Nattinee; Jahnke, Sara A; Hughey, Joseph; Lando, Harry A; Williams, Larry N; Haddock, Keith

2011-08-01

We conducted a content analysis of the US military tobacco policies at the Department of Defense, each respective military service (Army, Air Force, Navy, and Marine Corps), and their Major Commands (MAJCOM). Ninety-seven policies were evaluated using the Military Tobacco Policy Rating Form (MTPRF). More than three quarters addressed the following domains: (1) deleterious health effects of tobacco use; (2) environmental tobacco smoke; (3) designation of smoking areas; (4) tobacco prevention/cessation programs; and (5) smokeless tobacco. Few policies (2.1 per cent) mentioned relevant Department of Defense and respective service tobacco use prevalence statistics. Smoking as non-normative or incompatible with military service, the impact of tobacco use on military readiness, and the tobacco industry were addressed infrequently (6.2 per cent, 33.0 per cent, and 8.2 per cent, respectively). Future military tobacco policies should address important omissions of critical information such as the current service tobacco use prevalence, effects on readiness, and smoking as non-normative.

On the uncertain nature of the core of α Cen A

NASA Astrophysics Data System (ADS)

Bazot, M.; Christensen-Dalsgaard, J.; Gizon, L.; Benomar, O.

2016-08-01

High-quality astrometric, spectroscopic, interferometric and, importantly, asteroseismic observations are available for α Cen A, which is the closest binary star system to earth. Taking all these constraints into account, we study the internal structure of the star by means of theoretical modelling. Using the Aarhus STellar Evolution Code (ASTEC) and the tools of Computational Bayesian Statistics, in particular a Markov chain Monte Carlo algorithm, we perform statistical inferences for the physical characteristics of the star. We find that α Cen A has a probability of approximately 40 per cent of having a convective core. This probability drops to few per cent if one considers reduced rates for the 14N(p,γ)15O reaction. These convective cores have fractional radii less than 8 per cent when overshoot is neglected. Including overshooting also leads to the possibility of a convective core mostly sustained by the ppII chain energy output. We finally show that roughly 30 per cent of the stellar models describing α Cen A are in the subgiant regime.

A content analysis of tobacco control policy in the US Department of Defense

PubMed Central

Hoffman, Kevin M.; Poston, Walker S.C.; Jitnarin, Nattinee; Jahnke, Sara A.; Hughey, Joseph; Lando, Harry A.; Williams, Larry N.; Haddock, Keith

2011-01-01

We conducted a content analysis of the US military tobacco policies at the Department of Defense, each respective military service (Army, Air Force, Navy, and Marine Corps), and their Major Commands (MAJCOM). Ninety-seven policies were evaluated using the Military Tobacco Policy Rating Form (MTPRF). More than three quarters addressed the following domains: (1) deleterious health effects of tobacco use; (2) environmental tobacco smoke; (3) designation of smoking areas; (4) tobacco prevention/cessation programs; and (5) smokeless tobacco. Few policies (2.1 per cent) mentioned relevant Department of Defense and respective service tobacco use prevalence statistics. Smoking as non-normative or incompatible with military service, the impact of tobacco use on military readiness, and the tobacco industry were addressed infrequently (6.2 per cent, 33.0 per cent, and 8.2 per cent, respectively). Future military tobacco policies should address important omissions of critical information such as the current service tobacco use prevalence, effects on readiness, and smoking as non-normative. PMID:21368849

Rapid situation & response assessment of diarrhoea outbreak in a coastal district following tropical cyclone AILA in India

PubMed Central

Panda, Samiran; Pati, Kamala Kanta; Bhattacharya, Mihir Kumar; Koley, Hemanta; Pahari, Sobha; Nair, G. Balakrish

2011-01-01

Background & objectives: Cyclone AILA hit Indian States on eastern coast on May 25, 2009. An investigation was conducted to examine if AILA was responsible for increased reporting of diarrhoea cases from the district of East-Medinipur in West Bengal. Identifying causative organisms for diarrhoea and assessing their antibiotic susceptibility profile were other objectives. Methods: Rapid situation and response assessment technique was employed to triangulate primary and secondary data collected through field visits. Prescription audit was also conducted. Results: Significantly increased occurrence of diarrhoea was observed in June 2009 in two subdivisions namely Haldia and Egra (OR 1.6 and 1.3 respectively; 95% CI 1.52-1.65 and 1.21-1.32 P<0.001) considering 2007 as baseline. Vibrio cholerae grew from 54 per cent of the stool samples (21/39; 17 V. cholerae O1-Ogawa and 4 non-O1-non-O139), confirming a community outbreak of cholera. Shigella flexneri 3a was isolated from 5 per cent stool specimens. Increased rate of admission in treatment centres due to diarrhoea in the whole district coincided with the formation of cyclone and showed over two-fold rise compared to the admission recorded 6 days ago. Haldia subdivision had the highest attack rate of 9 per 1000 in the month of June, 2009 whereas for the whole district it was 5 per 1000 in the same month. All the isolates of V. cholerae were resistant to ampicillin and furazolidone and sensitive to norfloxacin and azithromycin. Interpretation & conclusions: Pre-AILA changes in the environment, AILA and seasonality of diarrhoea in the study district interplayed towards increased occurrence of diarrhoea. Continuous tracking of ‘seasonality of diarrhoea in the community with vulnerability assessment of potential hosts’, ‘antibiotic sensitivity profile of the causative microorganisms’, and ‘prescription practice of physicians’ would help appropriate disaster management. PMID:21537092

Long-term symptom control of gastro-oesophageal reflux disease 12 years after laparoscopic Nissen or 180° anterior partial fundoplication in a randomized clinical trial.

PubMed

Roks, D J; Broeders, J A; Baigrie, R J

2017-06-01

Laparoscopic 180° anterior fundoplication has been shown to achieve similar reflux control to Nissen fundoplication, with fewer side-effects, up to 5 years. However, there is a paucity of long-term follow-up data on this technique and antireflux surgery in general. This study reports 12-year outcomes of a double-blind RCT comparing laparoscopic Nissen versus 180° laparoscopic anterior fundoplication for gastro-oesophageal reflux disease (GORD). Patients with proven GORD were randomized to laparoscopic Nissen or 180° anterior fundoplication. The 12-year outcome measures included reflux control, dysphagia, gas-related symptoms and patient satisfaction. Measures included scores on a visual analogue scale, a validated Dakkak score for dysphagia and Visick scores. Of the initial 163 patients randomized (Nissen 84, anterior 79), 90 (55·2 per cent) completed 12-year follow-up (Nissen 52, anterior 38). There were no differences in heartburn, dysphagia, gas-related symptoms, patient satisfaction or surgical reintervention rate. Use of acid-suppressing drugs was less common after Nissen than after 180° anterior fundoplication: four of 52 (8 per cent) and 11 of 38 (29 per cent) respectively (P = 0·008). The proportion of patients with absent or only mild symptoms was slightly higher after Nissen fundoplication: 45 of 50 (90 per cent) versus 28 of 38 (74 per cent) (P = 0·044). The two surgical procedures provided similar control of heartburn and post-fundoplication symptoms, with similar patient satisfaction and reoperation rates on long-term follow-up. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

Multicentre analysis of long-term outcome after surgical resection for gastric cancer liver metastases.

PubMed

Kinoshita, T; Kinoshita, T; Saiura, A; Esaki, M; Sakamoto, H; Yamanaka, T

2015-01-01

The efficacy of surgical resection for gastric cancer liver metastases (GCLMs) is currently debated. Hitherto, no large-scale clinical studies have been conducted. This retrospective multicentre study analysed a database of consecutive patients with either synchronous or metachronous metastases who underwent surgical R0 resection for GCLM between 1990 and 2010. Clinical data were collected from five cancer centres in Japan. Survival curves were assessed, and clinical parameters were evaluated to identify predictors of prognosis. A total of 256 patients were enrolled. The mean(s.d.) number of hepatic tumours resected was 2.0(2.4). The surgical mortality rate was 1.6 per cent. Median follow-up was 65 (range 1-261) months. Recurrences were detected in 192 patients (75.0 per cent). The median interval from hepatic resection to recurrence was 7 (range 1-72) months, and the dominant site of recurrence was the liver (72.4 per cent). Actuarial 1-, 3- and 5-year overall and recurrence-free survival rates were 77.3, 41.9 and 31.1 per cent, and 43.6, 32.4 and 30.1 per cent, respectively. Median overall and recurrence-free survival times were 31.1 and 9.4 months respectively. Multivariable analysis identified serosal invasion of the primary gastric cancer (hazard ratio (HR) 1.50; P = 0.012), three or more liver metastases (HR 2.33; P < 0.001) and liver tumour diameter at least 5 cm (HR 1.62; P = 0.005) as independent predictors of poor survival. Clinically resectable GCLM is rare, but strict and careful patient selection can lead to long-term survival following R0 surgical resection. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

Concomitant injuries are an important determinant of outcome of high-grade blunt hepatic trauma.

PubMed

Schnüriger, B; Inderbitzin, D; Schafer, M; Kickuth, R; Exadaktylos, A; Candinas, D

2009-01-01

Little is known about the clinical importance of concomitant injuries in polytraumatized patients with high-grade blunt liver injury. A retrospective single-centre study was performed to investigate the safety of non-operative management of liver injury and the impact of concomitant intra- and extra-abdominal injuries on clinical outcome. Some 183 patients with blunt liver injury were admitted to Berne University Hospital, Switzerland, between January 2000 and December 2006. Grade 3-5 injuries were considered to be high grade. Immediate laparotomy was required by 35 patients (19.1 per cent), owing to extrahepatic intra-abdominal injury (splenic and vascular injuries, perforations) in 21 cases. The mortality rate was 16.9 per cent; 22 of the 31 deaths were due to concomitant lesions. Of 81 patients with high-grade liver injury, 63 (78 per cent) were managed without surgery; liver-related and extra-abdominal complication rates in these patients were 11 and 17 per cent respectively. Grades 4 and 5 liver injury were associated with hepatic-related and extra-abdominal complications. Concomitant injuries are a major determinant of outcome in patients with blunt hepatic injury and should be given high priority by trauma surgeons. An algorithm for the management of blunt liver injury is proposed. Copyright (c) 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

An atraumatic restorative treatment (ART) technique: evaluation after one year.

PubMed

Frencken, J E; Songpaisan, Y; Phantumvanit, P; Pilot, T

1994-10-01

Extraction is the most common dental treatment provided for people in rural and suburban areas in many less-industrialised countries. By comparison, restorative care is rarely provided. In order to improve such situations, a treatment technique has been developed based only on hand excavation of carious lesions and using glass-ionomer cement as a filling material and a sealant. This Atraumatic Restorative Treatment (ART) technique follows the concept of minimal intervention and does not require electrically driven equipment. This paper reports on the longevity of fillings and sealants placed using the technique under field conditions in rural Thailand. Dental caries was treated using the ART technique in one village, whilst the population in a second village received restorative care (amalgam fillings) through mobile dental units. A third village was the control. After one year, 79 per cent of single surface ART fillings and 55 per cent of ART fillings of greater than one surface placed in deciduous teeth were judged successful. The success rate of ART fillings in the permanent dentition (mainly single surface fillings) was 93 per cent and the retention rate for sealants was 78 per cent. Children were pleased at having received treatment by this technique and showed little fear. The ART technique is a promising caries treatment procedure for use in rural and sub-urban areas in less-industrialised countries.

A county-level cross-sectional analysis of positive deviance to assess multiple population health outcomes in Indiana.

PubMed

Hendryx, Michael; Guerra-Reyes, Lucia; Holland, Benjamin D; McGinnis, Michael Dean; Meanwell, Emily; Middlestadt, Susan E; Yoder, Karen M

2017-10-11

To test a positive deviance method to identify counties that are performing better than statistical expectations on a set of population health indicators. Quantitative, cross-sectional county-level secondary analysis of risk variables and outcomes in Indiana. Data are analysed using multiple linear regression to identify counties performing better or worse than expected given traditional risk indicators, with a focus on 'positive deviants' or counties performing better than expected. Counties in Indiana (n=92) constitute the unit of analysis. Per cent adult obesity, per cent fair/poor health, low birth weight per cent, per cent with diabetes, years of potential life lost, colorectal cancer incidence rate and circulatory disease mortality rate. County performance that outperforms expectations is for the most part outcome specific. But there are a few counties that performed particularly well across most measures. The positive deviance approach provides a means for state and local public health departments to identify places that show better health outcomes despite demographic, social, economic or behavioural disadvantage. These places may serve as case studies or models for subsequent investigations to uncover best practices in the face of adversity and generalise effective approaches to other areas. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Communicable Diseases Network Australia National Arbovirus and Malaria Advisory Committee annual report, 2005-06.

PubMed

Liu, Conan; Johansen, Cheryl; Kurucz, Nina; Whelan, Peter

2006-01-01

This report describes the epidemiology of mosquito-borne disease in Australia for the mosquito-borne disease season 1 July 2005 to 30 June 2006, in which the second largest number of notifications since 1995-96 was reported. Ross River virus (RRV) infections (66%), Barmah Forest virus (BFV) infections (23%) and malaria (9%) were the most common mosquito-borne diseases reported in 2005-06. National RRV notifications were the fifth largest on record. The Northern Territory had the highest rate of RRV notifications and the peak notification rate (in January 2006) was the third highest since 2000. National BFV notification rates were the highest on record. The Northern Territory also reported the highest BFV notification rate this season, peaking in February-March 2006, which was the highest reported BFV notification rate on record. BFV notification rates were significantly higher in teenagers compared to previous seasons. There were 731 notifications of malaria in 2005-06 of which none was reported as locally acquired. This was the third highest reporting period for malaria notifications since 2000. In contrast to previous years in which Plasmodium vivax was the predominant species, Plasmodium falciparum was reported as the infecting species in 45 per cent of the malaria notifications and Plasmodium vivax for 42 per cent of cases. Young adults in the 20-24 year age group had the highest number of cases and children in the 5-9 year age group accounted for 22 per cent of notifications. There were two cases of Kunjin virus (KUNV) infection and one case of Murray Valley encephalitis virus (MVEV) infection reported in 2005-06, all from Western Australia. Sentinel chicken surveillance data for flaviviruses and sentinel pig surveillance data for Japanese encephalitis virus are reported. There were 200 notifications of dengue virus (DENV) infection in 2005-06, of which 46 per cent (n = 92) was reported as having been acquired overseas. Dengue serotypes 2 and 3 were detected in two outbreaks of locally-acquired dengue in Queensland this season.

Poor compliance with standard precautions against infections during minor gynaecological procedures.

PubMed

Maharaj, Dushyant; Lawton, Beverley; Garrett, Sue

2012-06-01

Splash injuries occurring during minor surgical procedures are associated with a significant infective risk to the operator. It is a common misconception that minor operations carry low risks. To determine the prevalence of the practice of Standard Precautions by medical staff in the obstetric and gynaecology (O & G) units of two hospitals in New Zealand, and to assess self-observed splash injury rates. A cross-sectional survey of all doctors working in the O & G units of two public hospitals servicing a population of 435 000. A self-administered questionnaire was provided to 43 doctors with questions related to the use of Standard Precautions, perceived likelihood of infection from a splash and splash injuries sustained during procedures. The response rate was 76.6% (n = 33/43). Of the respondents, only 30.3% (n = 10) used Standard Precautions during minor procedures. Sixty-four per cent (n = 21) routinely used goggles/visor for eye protection. Forty-five per cent (n = 15) thought they were likely to get an infection from a splash, and 55% (n = 18) of clinicians had experienced a splash injury. Of the minor procedures during which splash injuries had occurred, repair of episiotomy 45.8% (n = 11) was the commonest. This survey shows poor compliance with guidelines for Standard Precautions to protect from infection despite self-reported rates of splash injury being high at 55%. Effective interventions are needed to increase compliance and prevent infection. © 2012 The Authors ANZJOG © 2012 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Use of evidence-based management in healthcare administration decision-making.

PubMed

Guo, Ruiling; Berkshire, Steven D; Fulton, Lawrence V; Hermanson, Patrick M

2017-07-03

Purpose The purpose of this paper is to examine whether healthcare leaders use evidence-based management (EBMgt) when facing major decisions and what types of evidence healthcare administrators consult during their decision-making. This study also intends to identify any relationship that might exist among adoption of EBMgt in healthcare management, attitudes towards EBMgt, demographic characteristics and organizational characteristics. Design/methodology/approach A cross-sectional study was conducted among US healthcare leaders. Spearman's correlation and logistic regression were performed using the Statistical Package for the Social Sciences (SPSS) 23.0. Findings One hundred and fifty-four healthcare leaders completed the survey. The study results indicated that 90 per cent of the participants self-reported having used an EBMgt approach for decision-making. Professional experiences (87 per cent), organizational data (84 per cent) and stakeholders' values (63 per cent) were the top three types of evidence consulted daily and weekly for decision-making. Case study (75 per cent) and scientific research findings (75 per cent) were the top two types of evidence consulted monthly or less than once a month. An exploratory, stepwise logistic regression model correctly classified 75.3 per cent of all observations for a dichotomous "use of EBMgt" response variable using three independent variables: attitude towards EBMgt, number of employees in the organization and the job position. Spearman's correlation indicated statistically significant relationships between healthcare leaders' use of EBMgt and healthcare organization bed size ( r s = 0.217, n = 152, p < 0.01), attitude towards EBMgt ( r s = 0.517, n = 152, p < 0.01), and the number of organization employees ( r s = 0.195, n = 152, p = 0.016). Originality/value This study generated new research findings on the practice of EBMgt in US healthcare administration decision-making.

Retinal and gastrointestinal disease due to cytomegalovirus in patients with the acquired immune deficiency syndrome: prevalence, natural history, and response to ganciclovir therapy.

PubMed

Jacobson, M A; O'Donnell, J J; Porteous, D; Brodie, H R; Feigal, D; Mills, J

1988-06-01

Of 760 AIDS patients seen at San Francisco General Hospital in 1986, 5.7 per cent had retinitis and 2.2 per cent had gastrointestinal disease caused by cytomegalovirus. We reviewed the records of 44 patients treated with ganciclovir for culture-confirmed cytomegalovirus retinal (31 patients) or gastrointestinal disease (17 patients) or both (four patients) in 1986. Retinitis stabilized or improved during initial treatment with ganciclovir in 22 of 27 (81.5 per cent) patients. Following a median 10-day induction course, 16 patients with retinitis continued to have serial ophthalmologic assessments: eight patients were maintained on treatment and eight had maintenance treatment deferred. Before treatment, the two groups were comparable in age, Karnofsky scores, hematologic assessment, visual acuity, and history with respect to Pneumocystis carinii pneumonia. Retinitis did not progress for a median 53.8 days in the immediate maintenance group compared to 18.8 days for the deferred maintenance group (p = 0.01). In 17 patients with CMV gastrointestinal disease, nine of 14 (64 per cent) had resolution of pain and eight of 11 (73 per cent) had resolution of diarrhea when treated initially with ganciclovir. In both retinitis and gastrointestinal disease patients, ganciclovir decreased recovery of CMV from urine and blood markedly. Ganciclovir also caused a decrease in mean absolute neutrophil counts to about half of baseline values; decreases in mean platelet count and hemoglobin were also noted but were less than 25 per cent. Neutropenia severe enough to require dose adjustment (less than 800 cells/microliters) occurred in 31 per cent of patients receiving maintenance ganciclovir.

Student assessment of the educational benefits of using a CD-ROM for instruction of basic surgical skills.

PubMed

Howe, Lisa M; Boothe, Harry W; Hartsfield, Sandee M

2005-01-01

At Texas A&M University, introductory-level surgical lecture and laboratory notes were converted to a CD-ROM format that included illustrative photographs as well as instructional videos demonstrating the basic surgical skills that all students were required to master. The CD-ROM was distributed to all students in place of traditional paper notes in the second-year surgical class in the professional veterinary curriculum. The study reported here was designed to evaluate the educational benefits of the use of the CD-ROM in place of traditional paper notes by examining the attitudes and practices of students before and after exposure to the CD-ROM format. An anonymous survey was distributed to students in the second-year introductory surgery course on the first day of class and again on the last day of class. Responses to questions were tabulated, response frequencies determined, and Chi-square analysis performed to determine differences between initial and final responses. On the final survey, 89 per cent of students responded that the instructional videos definitely helped them prepare for the laboratory, and 77 per cent responded that they were more likely to practice techniques learned from the CD-ROM videos than those learned from traditional study materials. The majority of students believed that the CD-ROM improved both the course (60 per cent) and their learning experience (62 per cent) as compared to traditional paper notes. Including instructional videos on the CD-ROM enhanced the educational experience of the students by promoting preparedness for laboratories and promoting practice of techniques learned from the videos outside of the laboratory.

Application of a coupled ecosystem-chemical equilibrium model, DayCent-Chem, to stream and soil chemistry in a Rocky Mountain watershed

USGS Publications Warehouse

Hartman, M.D.; Baron, Jill S.; Ojima, D.S.

2007-01-01

Atmospheric deposition of sulfur and nitrogen species have the potential to acidify terrestrial and aquatic ecosystems, but nitrate and ammonium are also critical nutrients for plant and microbial productivity. Both the ecological response and the hydrochemical response to atmospheric deposition are of interest to regulatory and land management agencies. We developed a non-spatial biogeochemical model to simulate soil and surface water chemistry by linking the daily version of the CENTURY ecosystem model (DayCent) with a low temperature aqueous geochemical model, PHREEQC. The coupled model, DayCent-Chem, simulates the daily dynamics of plant production, soil organic matter, cation exchange, mineral weathering, elution, stream discharge, and solute concentrations in soil water and stream flow. By aerially weighting the contributions of separate bedrock/talus and tundra simulations, the model was able to replicate the measured seasonal and annual stream chemistry for most solutes for Andrews Creek in Loch Vale watershed, Rocky Mountain National Park. Simulated soil chemistry, net primary production, live biomass, and soil organic matter for forest and tundra matched well with measurements. This model is appropriate for accurately describing ecosystem and surface water chemical response to atmospheric deposition and climate change. ?? 2006 Elsevier B.V. All rights reserved.

Cohort study of corticosteroid use and risk of hospital admission for diverticular disease.

PubMed

Hjern, F; Mahmood, M W; Abraham-Nordling, M; Wolk, A; Håkansson, N

2015-01-01

Medication has been suggested as a potential risk factor for diverticular disease. The objective of this study was to investigate the association between the intake of corticosteroids, indometacin or aspirin and diverticular disease. This was a prospective population-based cohort study of middle-aged women in the Swedish Mammography Cohort. Use of corticosteroids (oral or inhaled), indometacin or aspirin in 1997 was determined from questionnaires. Cases of diverticular disease were identified from the Swedish national registers until the end of 2010. The relative risk (RR) of diverticular disease requiring hospital admission according to the use of medication was estimated using Cox proportional hazards models, adjusted for age, body mass index, physical activity, fibre intake, diabetes, hypertension, alcohol, smoking and education. A total of 36 586 middle-aged women in the Swedish Mammography Cohort were included, of whom 674 (1.8 per cent) were hospitalized with diverticular disease at least once. Some 7.2 per cent of women reported intake of oral corticosteroids and 8.5 per cent use of inhaled corticosteroids. In multivariable analysis, women who reported oral corticosteroid intake had a 37 per cent (RR 1.37, 95 per cent c.i. 1.06 to 1.78; P = 0.012) increased risk of diverticular disease compared with those who reported no intake at all. Use of inhaled corticosteroids was associated with an even more pronounced increase in risk of 71 per cent (RR 1.71, 1.36 to 2.14; P < 0.001). There was a significant dose-response relationship, with the risk increasing with longer duration of inhaled corticosteroids (P for trend < 0.001). Use of indometacin (2.5 per cent of women) or aspirin (44.2 per cent) did not influence the risk. There was a significant relationship between corticosteroids (especially inhaled) and diverticular disease requiring hospital admission. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

Dispersal, environmental niches and oceanic-scale turnover in deep-sea bivalves

PubMed Central

McClain, Craig R.; Stegen, James C.; Hurlbert, Allen H.

2012-01-01

Patterns of beta-diversity or distance decay at oceanic scales are completely unknown for deep-sea communities. Even when appropriate data exist, methodological problems have made it difficult to discern the relative roles of environmental filtering and dispersal limitation for generating faunal turnover patterns. Here, we combine a spatially extensive dataset on deep-sea bivalves with a model incorporating ecological dynamics and shared evolutionary history to quantify the effects of environmental filtering and dispersal limitation. Both the model and empirical data are used to relate functional, taxonomic and phylogenetic similarity between communities to environmental and spatial distances separating them for 270 sites across the Atlantic Ocean. This study represents the first ocean-wide analysis examining distance decay as a function of a broad suite of explanatory variables. We find that both strong environmental filtering and dispersal limitation drive turnover in taxonomic, functional and phylogenetic composition in deep-sea bivalves, explaining 26 per cent, 34 per cent and 9 per cent of the variation, respectively. This contrasts with previous suggestions that dispersal is not limiting in broad-scale biogeographic and biodiversity patterning in marine systems. However, rates of decay in similarity with environmental distance were eightfold to 44-fold steeper than with spatial distance. Energy availability is the most influential environmental variable evaluated, accounting for 3.9 per cent, 9.4 per cent and 22.3 per cent of the variation in functional, phylogenetic and taxonomic similarity, respectively. Comparing empirical patterns with process-based theoretical predictions provided quantitative estimates of dispersal limitation and niche breadth, indicating that 95 per cent of deep-sea bivalve propagules will be able to persist in environments that deviate from their optimum by up to 2.1 g m−2 yr−1 and typically disperse 749 km from their natal site. PMID:22189399

The second Herschel-ATLAS Data Release - III. Optical and near-infrared counterparts in the North Galactic Plane field

NASA Astrophysics Data System (ADS)

Furlanetto, C.; Dye, S.; Bourne, N.; Maddox, S.; Dunne, L.; Eales, S.; Valiante, E.; Smith, M. W.; Smith, D. J. B.; Ivison, R. J.; Ibar, E.

2018-05-01

This paper forms part of the second major public data release of the Herschel Astrophysical Terahertz Large Area Survey (H-ATLAS). In this work, we describe the identification of optical and near-infrared counterparts to the submillimetre detected sources in the 177 deg2 North Galactic Plane (NGP) field. We used the likelihood ratio method to identify counterparts in the Sloan Digital Sky Survey and in the United Kingdom InfraRed Telescope Imaging Deep Sky Survey within a search radius of 10 arcsec of the H-ATLAS sources with a 4σ detection at 250 μm. We obtained reliable (R ≥ 0.8) optical counterparts with r < 22.4 for 42 429 H-ATLAS sources (37.8 per cent), with an estimated completeness of 71.7 per cent and a false identification rate of 4.7 per cent. We also identified counterparts in the near-infrared using deeper K-band data which covers a smaller ˜25 deg2. We found reliable near-infrared counterparts to 61.8 per cent of the 250-μm-selected sources within that area. We assessed the performance of the likelihood ratio method to identify optical and near-infrared counterparts taking into account the depth and area of both input catalogues. Using catalogues with the same surface density of objects in the overlapping ˜25 deg2 area, we obtained that the reliable fraction in the near-infrared (54.8 per cent) is significantly higher than in the optical (36.4 per cent). Finally, using deep radio data which covers a small region of the NGP field, we found that 80-90 per cent of our reliable identifications are correct.

Randomized clinical trial assessing the side-effects of glyceryl trinitrate and diltiazem hydrochloride in the treatment of chronic anal fissure.

PubMed

Kocher, H M; Steward, M; Leather, A J M; Cullen, P T

2002-04-01

Glyceryl trinitrate (GTN) ointment (0 small middle dot2 per cent) has an efficacy of up to 68 per cent in healing chronic anal fissure, but with headache as a major side-effect. Diltiazem hydrochloride (DTZ) cream (2 per cent) is expected to have fewer side-effects. A prospective double-blind randomized two-centre trial requiring at least 26 patients in each group (alpha = 0.05, beta = 0.9) was instituted after approval of the local ethics committee, to compare the incidence of side-effects (primary endpoint) with 0.2 per cent GTN ointment and 2 per cent DTZ cream in the treatment of chronic anal fissure. Treatments were applied perianally, twice daily for 6-8 weeks. All patients gave written informed consent. Both groups were comparable in patient demographics and clinical characteristics. Twelve patients violated the protocol, withdrew or did not attend follow-up. There were more side-effects with GTN (21 of 29 patients) than with DTZ (13 of 31) (relative risk (RR) 1.84 (95 per cent confidence interval (c.i.) 1.11 to 3.04), P = 0.01). In particular, more headaches occurred with GTN (17 of 29 patients) than with DTZ (eight of 31) (RR 2.06 (95 per cent c.i. 1.18 to 3.59), P = 0.01). There were no significant differences in healing and symptomatic improvement rates between patients receiving GTN (25 of 29) and DTZ (24 of 31). DTZ cream caused substantially fewer headaches than GTN ointment. There was no significant difference in the healing or improvement of chronic anal fissure between the treatments. DTZ may be the preferred first-line treatment for chronic anal fissure.

Comparison of a CHOP-LAsp-based protocol with and without maintenance for canine multicentric lymphoma.

PubMed

Lautscham, E M; Kessler, M; Ernst, T; Willimzig, L; Neiger, R

2017-03-25

The recommendation to treat canine lymphoma with a discontinuous protocol is based on small case numbers and mostly historic controls. This study compares duration of first remission (DFR) and overall survival time (ST) with a discontinuous protocol to the same protocol with maintenance phase. 408 dogs were treated with a CHOP-LAsp (C=cyclophosphamide; H=hydroxydaunorubicin; O=Oncovin; P=prednisolone; LAsp=l-asparaginase)-based 28-week induction protocol. In 75 dogs (cohort 1), this was followed by a maintenance phase consisting of vincristine, chlorambucil and actinomycin-D with a total treatment duration of two years. In the subsequent 333 dogs, therapy was discontinued after induction (cohort 2). Median DFR and ST in cohort 1 were 216 and 375 days and 184 and 304 days in cohort 2. 6-Month, 1-year and 2-year survival rates in cohort 1 were 73 per cent, 50 per cent, 24 per cent and 67 per cent, 39 per cent, 21 per cent in cohort 2. There was no significant difference between the two protocols (P=0.291 for ST, P=0.071 for DFR). On multivariate analysis, corticosteroid pretreatment (P=0.005), thrombocytopenia at diagnosis (P=0.019), stage (P=0.009), substage b at relapse (P<0.001), age (P=0.002) and incomplete or unstable remission necessitating intensification of therapy (P=0.004) were negatively correlated with ST in both groups. This study supports the use of a discontinuous protocol for canine multicentric lymphoma. British Veterinary Association.

Helioseismic and neutrino data-driven reconstruction of solar properties

NASA Astrophysics Data System (ADS)

Song, Ningqiang; Gonzalez-Garcia, M. C.; Villante, Francesco L.; Vinyoles, Nuria; Serenelli, Aldo

2018-06-01

In this work, we use Bayesian inference to quantitatively reconstruct the solar properties most relevant to the solar composition problem using as inputs the information provided by helioseismic and solar neutrino data. In particular, we use a Gaussian process to model the functional shape of the opacity uncertainty to gain flexibility and become as free as possible from prejudice in this regard. With these tools we first readdress the statistical significance of the solar composition problem. Furthermore, starting from a composition unbiased set of standard solar models (SSMs) we are able to statistically select those with solar chemical composition and other solar inputs which better describe the helioseismic and neutrino observations. In particular, we are able to reconstruct the solar opacity profile in a data-driven fashion, independently of any reference opacity tables, obtaining a 4 per cent uncertainty at the base of the convective envelope and 0.8 per cent at the solar core. When systematic uncertainties are included, results are 7.5 per cent and 2 per cent, respectively. In addition, we find that the values of most of the other inputs of the SSMs required to better describe the helioseismic and neutrino data are in good agreement with those adopted as the standard priors, with the exception of the astrophysical factor S11 and the microscopic diffusion rates, for which data suggests a 1 per cent and 30 per cent reduction, respectively. As an output of the study we derive the corresponding data-driven predictions for the solar neutrino fluxes.

Maximal compression of the redshift-space galaxy power spectrum and bispectrum

NASA Astrophysics Data System (ADS)

Gualdi, Davide; Manera, Marc; Joachimi, Benjamin; Lahav, Ofer

2018-05-01

We explore two methods of compressing the redshift-space galaxy power spectrum and bispectrum with respect to a chosen set of cosmological parameters. Both methods involve reducing the dimension of the original data vector (e.g. 1000 elements) to the number of cosmological parameters considered (e.g. seven ) using the Karhunen-Loève algorithm. In the first case, we run MCMC sampling on the compressed data vector in order to recover the 1D and 2D posterior distributions. The second option, approximately 2000 times faster, works by orthogonalizing the parameter space through diagonalization of the Fisher information matrix before the compression, obtaining the posterior distributions without the need of MCMC sampling. Using these methods for future spectroscopic redshift surveys like DESI, Euclid, and PFS would drastically reduce the number of simulations needed to compute accurate covariance matrices with minimal loss of constraining power. We consider a redshift bin of a DESI-like experiment. Using the power spectrum combined with the bispectrum as a data vector, both compression methods on average recover the 68 {per cent} credible regions to within 0.7 {per cent} and 2 {per cent} of those resulting from standard MCMC sampling, respectively. These confidence intervals are also smaller than the ones obtained using only the power spectrum by 81 per cent, 80 per cent, and 82 per cent respectively, for the bias parameter b1, the growth rate f, and the scalar amplitude parameter As.

The importance of the diurnal and annual cycle of air traffic for contrail radiative forcing.

PubMed

Stuber, Nicola; Forster, Piers; Rädel, Gaby; Shine, Keith

2006-06-15

Air traffic condensation trails, or contrails, are believed to have a net atmospheric warming effect, although one that is currently small compared to that induced by other sources of human emissions. However, the comparably large growth rate of air traffic requires an improved understanding of the resulting impact of aircraft radiative forcing on climate. Contrails have an effect on the Earth's energy balance similar to that of high thin ice clouds. Their trapping of outgoing longwave radiation emitted by the Earth and atmosphere (positive radiative forcing) is partly compensated by their reflection of incoming solar radiation (negative radiative forcing). On average, the longwave effect dominates and the net contrail radiative forcing is believed to be positive. Over daily and annual timescales, varying levels of air traffic, meteorological conditions, and solar insolation influence the net forcing effect of contrails. Here we determine the factors most important for contrail climate forcing using a sophisticated radiative transfer model for a site in southeast England, located in the entrance to the North Atlantic flight corridor. We find that night-time flights during winter (December to February) are responsible for most of the contrail radiative forcing. Night flights account for only 25 per cent of daily air traffic, but contribute 60 to 80 per cent of the contrail forcing. Further, winter flights account for only 22 per cent of annual air traffic, but contribute half of the annual mean forcing. These results suggest that flight rescheduling could help to minimize the climate impact of aviation.

Gastroenterology training in Australia: how much is enough?

PubMed

Leung, C; De Cruz, P; Jones, A; Sliwka, G; Bell, S J; Hebbard, G S

2013-04-01

Advanced training in gastroenterology currently consists of 2 years of core training and 1 elective (non-core) year. We surveyed gastroenterologists 2-7 years following completion of training to determine the strengths and weaknesses of their training. All gastroenterologists were invited to participate in an anonymous online survey. There was a 46% response rate (49/110). Eighty-one per cent were male with most aged 36-45. Respondents felt that the current training programme prepared them well for public practice and endoscopy but less well for private practice, ambulatory care, surgical aspects of gastroenterology and functional gastrointestinal disorders. Most had faced challenges transitioning to consultant practice. The majority (53%) spent more than the standard 3 years to complete training in gastroenterology. The top three subspecialty Fellowships were in endoscopy (45%), inflammatory bowel disease (29%) and hepatology (23%). In their elective year, 42% undertook a predominantly clinical year (registrar-type position in general or subspecialty gastroenterology), 28% engaged in research while 24% trained in another specialty. Seventy-eight per cent were in full-time work, and 36% were supervising trainees. Ninety-eight per cent felt that it was beneficial for trainees to move between hospitals during the core years of their advanced training. The current Australian gastroenterology training programme is generally adequate in preparing trainees for consultant practice but could be improved by increased emphasis on areas such as private practice, ambulatory gastroenterology and functional gastrointestinal diseases. Exposure to a variety of experiences by training in several different hospitals during core training was universally viewed as being important. © 2012 The Authors; Internal Medicine Journal © 2012 Royal Australasian College of Physicians.

Can you refuse these discounts? An evaluation of the use and price discount impact of price-related promotions among US adult smokers by cigarette manufacturers

PubMed Central

Caraballo, Ralph S; Wang, Xu; Xu, Xin

2014-01-01

Objectives The raising unit price of cigarette has been shown to be one of the most effective ways of reducing cigarette consumption and increasing rates of successful quitting. However, researchers have shown that price-sensitive smokers have used a variety of strategies to mitigate the effect of the rising price of cigarettes on their smoking habits. In particular, 23–34% of adult smokers in the US use cheaper brands, and 18–55% use coupons or promotions. Little is known about the discount use by type of brands. As such, the main purpose of this analysis is to evaluate the uses and price discount effects of these price-related discounts by manufacturers and major brands. Setting An analysis based on the cross-sectional 2009–2010 National Adult Tobacco Survey (NATS). Participants 11 766 current smokers aged 18 or above in the USA. Primary outcome measures Price-related discount was defined as smokers who used coupons, rebates, buy-one-get-one-free, two-for-one or any other special promotions for their last cigarettes purchase. Results The use of price-related discounts and associated price impact vary widely by cigarette manufacturer and brand. Approximately one of three Camel, one of four Marlboro and one of eight Newport smokers used price-related discounts on their latest cigarette purchases. The average price reductions of discounts offered by Philip Morris (PM) or R.J. Reynolds (RJR) were around 29 cents per pack while that of Lorillard (Newport only) was 24 cents per pack. Cigarette brands that provided significant per pack price reductions include: PM Marlboro (28 cents), RJR brand Camel (41 cents), Doral (50 cents), Kool (73 cents) and Salem (80 cents), and Lorillard Newport (24 cents). Conclusions Policies that decrease price-minimisation strategies will benefit public health. PMID:24898086

Can you refuse these discounts? An evaluation of the use and price discount impact of price-related promotions among US adult smokers by cigarette manufacturers.

PubMed

Caraballo, Ralph S; Wang, Xu; Xu, Xin

2014-06-04

The raising unit price of cigarette has been shown to be one of the most effective ways of reducing cigarette consumption and increasing rates of successful quitting. However, researchers have shown that price-sensitive smokers have used a variety of strategies to mitigate the effect of the rising price of cigarettes on their smoking habits. In particular, 23-34% of adult smokers in the US use cheaper brands, and 18-55% use coupons or promotions. Little is known about the discount use by type of brands. As such, the main purpose of this analysis is to evaluate the uses and price discount effects of these price-related discounts by manufacturers and major brands. An analysis based on the cross-sectional 2009-2010 National Adult Tobacco Survey (NATS). 11 766 current smokers aged 18 or above in the USA. Price-related discount was defined as smokers who used coupons, rebates, buy-one-get-one-free, two-for-one or any other special promotions for their last cigarettes purchase. The use of price-related discounts and associated price impact vary widely by cigarette manufacturer and brand. Approximately one of three Camel, one of four Marlboro and one of eight Newport smokers used price-related discounts on their latest cigarette purchases. The average price reductions of discounts offered by Philip Morris (PM) or R.J. Reynolds (RJR) were around 29 cents per pack while that of Lorillard (Newport only) was 24 cents per pack. Cigarette brands that provided significant per pack price reductions include: PM Marlboro (28 cents), RJR brand Camel (41 cents), Doral (50 cents), Kool (73 cents) and Salem (80 cents), and Lorillard Newport (24 cents). Policies that decrease price-minimisation strategies will benefit public health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Assessing the cost of laparotomy at a rural district hospital in Rwanda using time‐driven activity‐based costing

PubMed Central

Odhiambo, J.; Riviello, R.; Lin, Y.; Nkurunziza, T.; Shrime, M.; Maine, R.; Omondi, J. M.; Mpirimbanyi, C.; de la Paix Sebakarane, J.; Hagugimana, P.; Rusangwa, C.; Hedt‐Gauthier, B.

2018-01-01

Background In low‐ and middle‐income countries, the majority of patients lack access to surgical care due to limited personnel and infrastructure. The Lancet Commission on Global Surgery recommended laparotomy for district hospitals. However, little is known about the cost of laparotomy and associated clinical care in these settings. Methods This costing study included patients with acute abdominal conditions at three rural district hospitals in 2015 in Rwanda, and used a time‐driven activity‐based costing methodology. Capacity cost rates were calculated for personnel, location and hospital indirect costs, and multiplied by time estimates to obtain allocated costs. Costs of medications and supplies were based on purchase prices. Results Of 51 patients with an acute abdominal condition, 19 (37 per cent) had a laparotomy; full costing data were available for 17 of these patients, who were included in the costing analysis. The total cost of an entire care cycle for laparotomy was US$1023·40, which included intraoperative costs of US$427·15 (41·7 per cent) and preoperative and postoperative costs of US$596·25 (58·3 per cent). The cost of medicines was US$358·78 (35·1 per cent), supplies US$342·15 (33·4 per cent), personnel US$150·39 (14·7 per cent), location US$89·20 (8·7 per cent) and hospital indirect cost US$82·88 (8·1 per cent). Conclusion The intraoperative cost of laparotomy was similar to previous estimates, but any plan to scale‐up laparotomy capacity at district hospitals should consider the sizeable preoperative and postoperative costs. Although lack of personnel and limited infrastructure are commonly cited surgical barriers at district hospitals, personnel and location costs were among the lowest cost contributors; similar location‐related expenses at tertiary hospitals might be higher than at district hospitals, providing further support for decentralization of these services.

Interferon-γ-inducible protein-10 in chronic hepatitis C: Correlations with insulin resistance, histological features & sustained virological response.

PubMed

Crisan, Dana; Grigorescu, Mircea Dan; Radu, Corina; Suciu, Alina; Grigorescu, Mircea

2017-04-01

One of the multiple factors contributing to virological response in chronic hepatitis C (CHC) is interferon-gamma-inducible protein-10 (IP-10). Its level reflects the status of interferon-stimulated genes, which in turn is associated with virological response to antiviral therapy. The aim of this study was to evaluate the role of serum IP-10 levels on sustained virological response (SVR) and the association of this parameter with insulin resistance (IR) and liver histology. Two hundred and three consecutive biopsy proven CHC patients were included in the study. Serum levels of IP-10 were determined using ELISA method. IR was evaluated by homeostasis model assessment-IR (HOMA-IR). Histological features were assessed invasively by liver biopsy and noninvasively using FibroTest, ActiTest and SteatoTest. Predictive factors for SVR and their interrelations were assessed. A cut-off value for IP-10 of 392 pg/ml was obtained to discriminate between responders and non-responders. SVR was obtained in 107 patients (52.70%). Area under the receiver operating characteristic curve for SVR was 0.875 with a sensitivity of 91.6 per cent, specificity 74.7 per cent, positive predictive value 80.3 per cent and negative predictive value 88.7 per cent. Higher values of IP-10 were associated with increasing stages of fibrosis (P<0.01) and higher grades of inflammation (P=0.02, P=0.07) assessed morphologically and noninvasively through FibroTest and ActiTest. Significant steatosis and IR were also associated with increased levels of IP-10 (P=0.01 and P=0.02). In multivariate analysis, IP-10 levels and fibrosis stages were independently associated with SVR. Our findings showed that the assessment of serum IP-10 level could be a predictive factor for SVR and it was associated with fibrosis, necroinflammatory activity, significant steatosis and IR in patients with chronic HCV infection.

Missile injuries of the abdomen in Zimbabwe-Rhodesia.

PubMed

Dent, R I; Jena, G P

1980-05-01

One hundred and thirteen patients with missile injuries of the abdomen were seen over a 3-year period at one hospital in Zimbabwe-Rhodesia. The details of these injuries and the results of their treatment are presented. Twenty-four patients died (21 per cent). Twenty of these patients had sustained high velocity missile injuries, 18 had damaged colons and 3 died from major vascular injuries before surgery. Excluding these last 3 patients, the mortality rate for high velocity wounds of the colon was 52 per cent and that for all other patients was 6 per cent (P less than 0.01). More than half the postoperative deaths were due to septicaemia. The importance is stressed is stressed of early and effective resuscitation, including appropriate antibiotic therapy and rapid evacuation to facilities for major surgery.

Poverty in Edwardian Britain.

PubMed

Gazeley, Ian; Newell, Andrew

2011-01-01

This article introduces a newly discovered household budget data set for 1904. We use these data to estimate urban poverty among working families in the British Isles. Applying Bowley's poverty line, we estimate that at least 23 per cent of people in urban working households and 18 per cent of working households had income insufficient to meet minimum needs. This is well above Rowntree's estimate of primary poverty for York in 1899 and high in the range that Bowley found in northern towns in 1912–13. The skill gradient of poverty is steep; for instance, among labourers' households, the poverty rates are close to 50 per cent. Measures of the depth of poverty are relatively low in the data, suggesting that most poor male-headed working households were close to meeting Bowley's new standard.

H-, He-like recombination spectra - II. l-changing collisions for He Rydberg states

NASA Astrophysics Data System (ADS)

Guzmán, F.; Badnell, N. R.; Williams, R. J. R.; van Hoof, P. A. M.; Chatzikos, M.; Ferland, G. J.

2017-01-01

Cosmological models can be constrained by determining primordial abundances. Accurate predictions of the He I spectrum are needed to determine the primordial helium abundance to a precision of <1 per cent in order to constrain big bang nucleosynthesis models. Theoretical line emissivities at least this accurate are needed if this precision is to be achieved. In the first paper of this series, which focused on H I, we showed that differences in l-changing collisional rate coefficients predicted by three different theories can translate into 10 per cent changes in predictions for H I spectra. Here, we consider the more complicated case of He atoms, where low-l subshells are not energy degenerate. A criterion for deciding when the energy separation between l subshells is small enough to apply energy-degenerate collisional theories is given. Moreover, for certain conditions, the Bethe approximation originally proposed by Pengelly & Seaton is not sufficiently accurate. We introduce a simple modification of this theory which leads to rate coefficients which agree well with those obtained from pure quantal calculations using the approach of Vrinceanu et al. We show that the l-changing rate coefficients from the different theoretical approaches lead to differences of ˜10 per cent in He I emissivities in simulations of H II regions using spectral code CLOUDY.

Long-term survival outcomes in patients with surgically treated oropharyngeal cancer and defined human papilloma virus status.

PubMed

Dale, O T; Sood, S; Shah, K A; Han, C; Rapozo, D; Mehanna, H; Winter, S C

2016-11-01

This study investigated long-term survival outcomes in surgically treated oropharyngeal cancer patients with known human papilloma virus status. A case note review was performed of all patients undergoing primary surgery for oropharyngeal cancer in a single centre over a 10-year period. Human papilloma virus status was determined via dual modality testing. Associations between clinicopathological variables and survival were identified using a log-rank test. Of the 107 cases in the study, 40 per cent (n = 41) were human papilloma virus positive. The positive and negative predictive values of p16 immunohistochemistry for human papilloma virus status were 57 per cent and 100 per cent, respectively. At a mean follow up of 59.5 months, 5-year overall and disease-specific survival estimates were 78 per cent and 69 per cent, respectively. Human papilloma virus status (p = 0.014), smoking status (p = 0.021) and tumour stage (p = 0.03) were significant prognostic indicators. The long-term survival rates in surgically treated oropharyngeal cancer patients were comparable to other studies. Variables including human papilloma virus status and tumour stage were associated with survival in patients treated with primary surgery; however, nodal stage and presence of extracapsular spread were non-prognostic.

National proficiency-gain curves for minimally invasive gastrointestinal cancer surgery.

PubMed

Mackenzie, H; Markar, S R; Askari, A; Ni, M; Faiz, O; Hanna, G B

2016-01-01

Minimal access surgery for gastrointestinal cancer has short-term benefits but is associated with a proficiency-gain curve. The aim of this study was to define national proficiency-gain curves for minimal access colorectal and oesophagogastric surgery, and to determine the impact on clinical outcomes. All adult patients undergoing minimal access oesophageal, colonic and rectal surgery between 2002 and 2012 were identified from the Hospital Episode Statistics database. Proficiency-gain curves were created using risk-adjusted cumulative sum analysis. Change points were identified, and bootstrapping was performed with 1000 iterations to identify a confidence level. The primary outcome was 30-day mortality; secondary outcomes were 90-day mortality, reintervention, conversion and length of hospital stay. Some 1696, 15 008 and 16 701 minimal access oesophageal, rectal and colonic cancer resections were performed during the study period. The change point in the proficiency-gain curve for 30-day mortality for oesophageal, rectal and colonic surgery was 19 (confidence level 98·4 per cent), 20 (99·2 per cent) and three (99·5 per cent) procedures; the mortality rate fell from 4·0 to 2·0 per cent (relative risk reduction (RRR) 0·50, P = 0·033), from 2·1 to 1·2 per cent (RRR 0·43, P < 0·001) and from 2·4 to 1·8 per cent (RRR 0·25, P = 0·058) respectively. The change point in the proficiency-gain curve for reintervention in oesophageal, rectal and colonic resection was 19 (98·1 per cent), 32 (99·5 per cent) and 26 (99·2 per cent) procedures respectively. There were also significant proficiency-gain curves for 90-day mortality, conversion and length of stay. The introduction of minimal access gastrointestinal cancer surgery has been associated with a proficiency-gain curve for mortality and major morbidity at a national level. Unnecessary patient harm should be avoided by appropriate training and monitoring of new surgical techniques. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

Outcome of selective non-operative management of penetrating abdominal injuries from the North American National Trauma Database.

PubMed

Zafar, S N; Nabeel Zafar, S; Rushing, A; Haut, E R; Kisat, M T; Villegas, C V; Chi, A; Stevens, K; Efron, D T; Zafar, H; Haider, A H

2012-01-01

The aim of this study was to investigate trends in the practice of selective non-operative management (SNOM) for penetrating abdominal injury (PAI) and to determine factors associated with its failure. The National Trauma Data Bank for 2002-2008 was reviewed. Patients with PAI were categorized as those who underwent successful SNOM (operative management not required) and those who failed SNOM (surgery required more than 4 h after admission). Yearly rates of SNOM versus non-therapeutic laparotomy (NTL) were plotted. Multivariable regression analysis was performed to identify factors associated with failed SNOM and mortality. A total of 12 707 patients with abdominal gunshot and 13 030 with stab wounds were identified. Rates of SNOM were 22.2 per cent for gunshot and 33.9 per cent for stab wounds, and increased with time (P < 0.001). There was a strong correlation between the rise in SNOM and the decline in NTL (r = - 0.70). SNOM failed in 20.8 and 15.2 per cent of patients with gunshot and stab wounds respectively. Factors predicting failure included the need for blood transfusion (odds ratio (OR) 1.96, 95 per cent confidence interval 1.11 to 3.46) and a higher injury score. Failed SNOM was independently associated with mortality in both the gunshot (OR 4.48, 2.07 to 9.70) and stab (OR 9.83, 3.44 to 28.00) wound groups. The practice of SNOM is increasing, with an associated decrease in the rate of NTL for PAI. In most instances SNOM is successful; however, its failure is associated with increased mortality. Careful patient selection and adherence to protocols designed to decrease the failure rate of SNOM are recommended. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

A global slowdown of tropical-cyclone translation speed.

PubMed

Kossin, James P

2018-06-01

As the Earth's atmosphere warms, the atmospheric circulation changes. These changes vary by region and time of year, but there is evidence that anthropogenic warming causes a general weakening of summertime tropical circulation 1-8 . Because tropical cyclones are carried along within their ambient environmental wind, there is a plausible a priori expectation that the translation speed of tropical cyclones has slowed with warming. In addition to circulation changes, anthropogenic warming causes increases in atmospheric water-vapour capacity, which are generally expected to increase precipitation rates 9 . Rain rates near the centres of tropical cyclones are also expected to increase with increasing global temperatures 10-12 . The amount of tropical-cyclone-related rainfall that any given local area will experience is proportional to the rain rates and inversely proportional to the translation speeds of tropical cyclones. Here I show that tropical-cyclone translation speed has decreased globally by 10 per cent over the period 1949-2016, which is very likely to have compounded, and possibly dominated, any increases in local rainfall totals that may have occurred as a result of increased tropical-cyclone rain rates. The magnitude of the slowdown varies substantially by region and by latitude, but is generally consistent with expected changes in atmospheric circulation forced by anthropogenic emissions. Of particular importance is the slowdown of 30 per cent and 20 per cent over land areas affected by western North Pacific and North Atlantic tropical cyclones, respectively, and the slowdown of 19 per cent over land areas in the Australian region. The unprecedented rainfall totals associated with the 'stall' of Hurricane Harvey 13-15 over Texas in 2017 provide a notable example of the relationship between regional rainfall amounts and tropical-cyclone translation speed. Any systematic past or future change in the translation speed of tropical cyclones, particularly over land, is therefore highly relevant when considering potential changes in local rainfall totals.

Tests for penicillin allergy in man

PubMed Central

Vickers, Margaret R.; Assem, E. S. K.

1974-01-01

The value of using benzylpenicilloyl (BPO) conjugates rather than benzylpenicillin (B.Pen.) itself in skin tests and in in vitro diagnostic tests for penicillin allergy in man is assessed. The effect of various carriers on the outcome of these tests has also been investigated in order to find the most appropriate. Skin tests with B.Pen. and BPO conjugates (with polylysine, PL, and human serum albumin, HSA) in penicillin allergic patients were positive in 36 per cent and up to 50 per cent respectively. The two carriers used were equally effective. Negative results were obtained in the non-allergic control subjects. For in vitro studies two tests were selected on the basis of their well established value, the lymphocyte transformation test (LTT) and histamine release from sensitized leucocytes (HRL). In the HRL test BPO conjugates with PL, HSA, bovine serum albumin (BSA) and bovine gamma globulin (BGG) were also compared with B.Pen. The BPO conjugates were all more effective than B.Pen. and the proportion of patients giving positive results with these conjugates was much higher than with B.Pen. (up to 86 per cent compared with 29 per cent). The rank order of effectiveness of the various carriers as judged from maximal histamine release by various penicilloyl conjugates was PL

Randomized clinical trial of Appendicitis Inflammatory Response score-based management of patients with suspected appendicitis.

PubMed

Andersson, M; Kolodziej, B; Andersson, R E

2017-10-01

The role of imaging in the diagnosis of appendicitis is controversial. This prospective interventional study and nested randomized trial analysed the impact of implementing a risk stratification algorithm based on the Appendicitis Inflammatory Response (AIR) score, and compared routine imaging with selective imaging after clinical reassessment. Patients presenting with suspicion of appendicitis between September 2009 and January 2012 from age 10 years were included at 21 emergency surgical centres and from age 5 years at three university paediatric centres. Registration of clinical characteristics, treatments and outcomes started during the baseline period. The AIR score-based algorithm was implemented during the intervention period. Intermediate-risk patients were randomized to routine imaging or selective imaging after clinical reassessment. The baseline period included 1152 patients, and the intervention period 2639, of whom 1068 intermediate-risk patients were randomized. In low-risk patients, use of the AIR score-based algorithm resulted in less imaging (19·2 versus 34·5 per cent; P < 0·001), fewer admissions (29·5 versus 42·8 per cent; P < 0·001), and fewer negative explorations (1·6 versus 3·2 per cent; P = 0·030) and operations for non-perforated appendicitis (6·8 versus 9·7 per cent; P = 0·034). Intermediate-risk patients randomized to the imaging and observation groups had the same proportion of negative appendicectomies (6·4 versus 6·7 per cent respectively; P = 0·884), number of admissions, number of perforations and length of hospital stay, but routine imaging was associated with an increased proportion of patients treated for appendicitis (53·4 versus 46·3 per cent; P = 0·020). AIR score-based risk classification can safely reduce the use of diagnostic imaging and hospital admissions in patients with suspicion of appendicitis. Registration number: NCT00971438 ( http://www.clinicaltrials.gov). © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

Reasons for non-participation in population-based abdominal aortic aneurysm screening.

PubMed

Linne, A; Leander, K; Lindström, D; Törnberg, S; Hultgren, R

2014-04-01

A population-based screening programme for abdominal aortic aneurysm (AAA) started in 2010 in Stockholm County, Sweden. This present study used individual data from Sweden's extensive healthcare registries to identify the reasons for non-participation in the AAA screening programme. All 65-year-old men in Stockholm are invited to screening for AAA; this study included all men invited from July 2010 to July 2012. Participants and non-participants were compared for socioeconomic factors, travel distance to the examination centre and healthcare use. The influence of these factors on participation was analysed using univariable and multivariable logistic regression models. The participation rate for AAA screening was 77·6 per cent (18 876 of 24 319 men invited). The prevalence of AAA (aortic diameter more than 2·9 cm) among participants was 1·4 per cent. The most important reasons for non-participation in the multivariable regression analyses were: recent immigration (within 5 years) (odds ratio (OR) 3·25, 95 per cent confidence interval 1·94 to 5·47), low income (OR 2·76, 2·46 to 3·10), marital status single or divorced (OR 2·23, 2·08 to 2·39), low level of education (OR 1·28, 1·16 to 1·40) and long travel distance (OR 1·23, 1·10 to 1·37). Non-participants had a higher incidence of stroke (4·5 versus 2·8 per cent; P < 0·001) and chronic pulmonary disease (2·9 versus 1·3 per cent; P < 0·001). Daily smoking was more common in residential areas where the participation rate for AAA screening was low. Efforts to improve participation in AAA screening should target the groups with low income, a low level of education and immigrants. The higher morbidity in the non-participant group, together with a higher rate of smoking, make it probable that this group also has a high risk of AAA. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

Skull base osteomyelitis: current microbiology and management.

PubMed

Spielmann, P M; Yu, R; Neeff, M

2013-01-01

Skull base osteomyelitis typically presents in an immunocompromised patient with severe otalgia and otorrhoea. Pseudomonas aeruginosa is the commonest pathogenic micro-organism, and reports of resistance to fluoroquinolones are now emerging, complicating management. We reviewed our experience of this condition, and of the local pathogenic organisms. A retrospective review from 2004 to 2011 was performed. Patients were identified by their admission diagnostic code, and computerised records examined. Twenty patients were identified. A facial palsy was present in 12 patients (60 per cent). Blood cultures were uniformly negative, and culture of ear canal granulations was non-diagnostic in 71 per cent of cases. Pseudomonas aeruginosa was isolated in only 10 (50 per cent) cases; one strain was resistant to ciprofloxacin but all were sensitive to ceftazidime. Two cases of fungal skull base osteomyelitis were identified. The mortality rate was 15 per cent. The patients' treatment algorithm is presented. Our treatment algorithm reflects the need for multidisciplinary input, early microbial culture of specimens, appropriate imaging, and prolonged and systemic antimicrobial treatment. Resolution of infection must be confirmed by close follow up and imaging.

A randomized evaluation of a computer-based physician's workstation: design considerations and baseline results.

PubMed Central

Rotman, B. L.; Sullivan, A. N.; McDonald, T.; DeSmedt, P.; Goodnature, D.; Higgins, M.; Suermondt, H. J.; Young, C. Y.; Owens, D. K.

1995-01-01

We are performing a randomized, controlled trial of a Physician's Workstation (PWS), an ambulatory care information system, developed for use in the General Medical Clinic (GMC) of the Palo Alto VA. Goals for the project include selecting appropriate outcome variables and developing a statistically powerful experimental design with a limited number of subjects. As PWS provides real-time drug-ordering advice, we retrospectively examined drug costs and drug-drug interactions in order to select outcome variables sensitive to our short-term intervention as well as to estimate the statistical efficiency of alternative design possibilities. Drug cost data revealed the mean daily cost per physician per patient was 99.3 cents +/- 13.4 cents, with a range from 0.77 cent to 1.37 cents. The rate of major interactions per prescription for each physician was 2.9% +/- 1%, with a range from 1.5% to 4.8%. Based on these baseline analyses, we selected a two-period parallel design for the evaluation, which maximized statistical power while minimizing sources of bias. PMID:8563376

Esophageal Resection for End-Stage Achalasia.

PubMed

Aiolfi, Alberto; Asti, Emanuele; Bonitta, Gianluca; Siboni, Stefano; Bonavina, Luigi

2018-04-01

Achalasia is a rare disease characterized by impaired lower esophageal sphincter relaxation loss and of peristalsis in the esophageal body. Endoscopic balloon dilation and laparoscopic surgical myotomy have been established as initial treatment modalities. Indications and outcomes of esophagectomy in the management of end-stage achalasia are less defined. A literature search was conducted to identify all reports on esophagectomy for end-stage achalasia between 1987 and 2017. MEDLINE, Embase, and Cochrane databases were consulted matching the terms "achalasia," "end-stage achalasia," "esophagectomy," and "esophageal resection." Seventeen articles met the inclusion criteria and 1422 patients were included in this narrative review. Most of the patients had previous multiple endoscopic and/or surgical treatments. Esophagectomy was performed through a transthoracic (74%) or a transhiatal (26%) approach. A thoracoscopic approach was used in a minority of patients and seemed to be safe and effective. In 95 per cent of patients, the stomach was used as an esophageal substitute. The mean postoperative morbidity rate was 27.1 per cent and the mortality rate 2.1 per cent. Symptom resolution was reported in 75 to 100 per cent of patients over a mean follow-up of 43 months. Only five series including 195 patients assessed the long-term follow-up (>5 years) after reconstruction with gastric or colon conduits, and the results seem similar. Esophagectomy for end-stage achalasia is safe and effective in tertiary referral centers. A thoracoscopic approach is a feasible and safe alternative to thoracotomy and may replace the transhiatal route in the future.

Impact of surgeon volume and specialization on short-term outcomes in colorectal cancer surgery.

PubMed

Borowski, D W; Kelly, S B; Bradburn, D M; Wilson, R G; Gunn, A; Ratcliffe, A A

2007-07-01

Several studies have shown a relationship between surgeon volume and outcomes in colorectal cancer surgery. The aim of this study was to determine the impact of surgeon volume and specialization on primary tumour resection rate, restoration of bowel continuity following rectal cancer resection, anastomotic leakage and perioperative mortality. The Northern Region Colorectal Cancer Audit Group conducts a population-based audit of patients with colorectal cancer managed by surgeons. This study examined 8219 patients treated between 1998 and 2002. Outcomes were modelled using multivariate logistic regression analysis. Tumour resection was performed in 6949 (93.8 per cent) of 7411 patients. High-volume surgeons with an annual caseload of at least 18.5 (odds ratio (OR) 1.53 (95 per cent confidence interval (c.i.) 1.10 to 2.12); P = 0.012) and colorectal specialists (OR 1.42 (95 per cent c.i. 1.06 to 1.90); P = 0.018) were more likely to perform elective sphincter-saving rectal surgery. In elective surgery, the risk of perioperative death was lower for high-volume surgeons (OR 0.58 (95 per cent c.i. 0.44 to 0.76); P < 0.001), but this was not the case in emergency surgery. High-volume surgeons had lower perioperative mortality rates for elective surgery, and were more likely to use restorative rectal procedures. Copyright (c) 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Spinal deformity in children treated for neuroblastoma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mayfield, J.K.; Riseborough, E.J.; Jaffe, N.

1981-02-01

Of seventy-four children who were treated at a mean age of seventeen months for neuroblastoma and survived more than five years, fifty-six had spinal deformity due either to the disease or to the treatment after a mean follow-up of 12.9 years. Of these fifty-six, 50 per cent had post-radiation scoliosis, and 16 per cent had post-radiation kyphosis, most frequently at the thoracolumbar junction, at the time of follow-up. Two kyphotic thoracolumbar curve patterns were identified: an angular kyphosis with a short radius of curvature and its apex at the twelfth thoracic and first lumbar vertebrae, and a thoracic kyphosis withmore » a long radius of curvature that extended into the lumbar spine. The post-radiation deformity - both the scoliosis and the kyphosis - progressed with growth, the scoliosis at a rate of 1 degree per year and the kyphosis at a rate of 3 degrees per year. Epidural spread of the neuroblastoma was associated with most of the cases of severe scoliosis and kyphosis. The deformity was due either to the laminectomy or to the paraplegia acting in conjunction with the radiation. Eighteen per cent of 419 children with this malignant disease survived more than five years, and of the survivors, 20 per cent had spinal deformity severe enough to warrant treatment. The factors associated with the development of spinal deformity in patient treated for neuroblastoma were: orthovoltage radiation exceeding 3000 rads, asymmetrical radiation of the spine, thoracolumbar kyphosis, and epidural spread of the tumor.« less

Neoadjuvant chemotherapy response influences outcomes in non-colorectal, non-neuroendocrine liver metastases.

PubMed

Lucchese, A M; Kalil, A N; Ruiz, A; Karam, V; Ciacio, O; Pittau, G; Castaing, D; Cherqui, D; Sa Cunha, A; Vibert, E; Adam, R

2018-06-12

Indications for surgical resection of non-colorectal, non-neuroendocrine (NCNNE) liver metastases are unclear. This study analysed the influence of response to neoadjuvant chemotherapy and the presence of extrahepatic disease (EHD) on outcomes. Patients who underwent hepatic resection for NCNNE liver metastases and who received neoadjuvant chemotherapy at a single centre between 1982 and 2016 were analysed retrospectively. Patients were classified as having no EHD, controlled EHD or non-controlled EHD. Hepatic resection was performed in 199 patients (81·2 per cent) after partial or complete response to chemotherapy or disease stabilization, and 46 patients (18·8 per cent) after tumour progression. Patients with progressive disease after chemotherapy had worse overall survival than those without (23 versus 50·4 per cent at 5 years; P = 0·004). Median survival was 63·6 (range 31·1-94·8) months for patients without EHD, 34·8 (19·2-49·2) months for those with controlled EHD and 7·2 (1·2-13·2) months for patients with non-controlled EHD (P = 0·004). In multivariable analysis, EHD (P = 0·004), response to chemotherapy (P = 0·004) and resection margins (P = 0·002) were all independent predictors of overall survival, regardless of primary tumour site. The prognosis of patients with NCNNE liver metastases is influenced by preoperative chemotherapy and resectability. © 2018 BJS Society Ltd Published by John Wiley & Sons Ltd.

Endectocide activity of a pour-on formulation containing 1.5 per cent ivermectin +0.5 per cent abamectin in cattle.

PubMed

Silva, Heloisa Cristina; Prette, Nancy; Lopes, Welber Daniel Zanetti; Sakamoto, Cláudio Alessandro M; Buzzulini, Carolina; Dos Santos, Thais Rabelo; Cruz, Breno Cayeiro; Teixeira, Weslen F Pires; Felippelli, Gustavo; Carvalho, Rafael Silveira; Maciel, Willian Giquelin; Soares, Vando Edésio; da Costa, Alvimar José

2015-01-01

The present work aimed to evaluate, through ten different studies, the therapeutic efficacy of a new pour-on formulation, containing 1.5 per cent ivermectin +0.5 per cent abamectin, against parasites of cattle. Results obtained on trials against Rhipicephalus (Boophilus) microplus showed that the pour-on combination of 1.5 per cent ivermectin +0.5 per cent abamectin obtained superior efficacy indexes against this ectoparasite, when compared with formulations containing 0.5 per cent ivermectin, 1 per cent ivermectin and the combination of 1 per cent abamectin +20 per cent levamisole. The results of efficacy of the ivermectin+abamectin and the 0.5 per cent ivermectin against Haematobia irritans were similar. Against Cochliomyia hominivorax larvae, all pour-on formulations tested (1.5 per cent ivermectin +0.5 per cent abamectin, 0.5 per cent ivermectin and 0.5 per cent abamectin), as well as 1 per cent doramectin administered subcutaneously, were considered ineffective. Cattle medicated with 1.5 per cent ivermectin +0.5 per cent abamectin, pour-on, remained free from parasitism by Dermatobia hominis larvae during 42 days (96 per cent efficacy), while values superior to 90 per cent were obtained by 0.5 per cent ivermectin (92 per cent) and 0.5 per cent abamectin (93 per cent) until the 42nd and 35th days post treatment, respectively. Against Haemonchus placei and Oesophagostomum radiatum, the pour-on of ivermectin+abamectin showed better efficacy than the 0.5 per cent ivermectin and 0.5 per cent abamectin. As to Cooperia punctata, there was no difference regarding efficacy results obtained by the avermectins combination and abamectin. The pour-on combination of 1.5 per cent ivermectin +0.5 per cent abamectin obtained high efficacy against R. (B.) microplus, D. hominis and some species of cattle gastrointestinal helminths when compared with formulations of 0.5 per cent ivermectin and 0.5 per cent abamectin administered through the same route.

Comparison of circadian rhythms in male and female humans

NASA Technical Reports Server (NTRS)

Winget, C. M.; Deroshia, C. W.; Vernikos-Danellis, J.; Rosenblatt, W. S.; Hetherington, N. W.

1977-01-01

Heart rate (HR) and rectal temperature (RT) data were obtained from 12 female and 27 male subjects. The subjects were housed in a facility where the environment was controlled. Human male and female RT and HR exhibit a circadian rhythm with an excursion of about 1.2 C and 30 beats/min, respectively. The acrophases, amplitudes, and level crossings are only slightly different between the sexes. The male HR and RT circadian wave forms are more stable than those of the females. However, the actual RT and HR of males were always lower than that of females at all time points around the clock. The HR during sleep in females is 15 per cent below the daily mean heart rate and in males, 22 per cent.

Antimicrobial prescribing behaviour in dogs and cats by Belgian veterinarians.

PubMed

Van Cleven, Alexia; Sarrazin, Steven; de Rooster, Hilde; Paepe, Dominique; Van der Meeren, Sofie; Dewulf, Jeroen

2018-03-17

The objective of this study is to survey general prescribing behaviour by Belgian companion animal veterinarians and to assess agreement of these practices with current treatment guidelines. Therefore an online survey was administered with five realistic and frequently occurring first-line cases to primary-care veterinary practitioners. For each case a predefined pattern of questions were asked about whether or not they would prescribe antimicrobials, if they would prescribe a non-antimicrobial treatment and if they would perform additional diagnostic steps. The responses were compared with recommendations in national guidelines and recent literature. The overall most prescribed antimicrobials were potentiated amoxicillin (43.0 per cent), fluoroquinolones (14.7 per cent), third-generation and fourth-generation cephalosporins (10.9 per cent) and tetracyclines (10.9 per cent). Only 48.3 per cent of the veterinarians complied with the guidelines in nearly all of the clinical scenarios (ie, prescribing antimicrobials when indicated, not prescribing antimicrobials when it is not indicated). Moreover, when prescribing highest priority critically important antimicrobials, susceptibility testing on bacterial cultures was performed in only 12.4 per cent of the prescriptions. The results showed that the prescribing behaviour of antimicrobial compounds by primary-care veterinary practitioners in dogs and cats is often not in agreement with national guidelines. Focus in improvement of this prescribing behaviour should be on performing the appropriate diagnostic steps and decreasing the use of highest priority critically important antimicrobials. © British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

When Rating Systems Do Not Rate: Evaluating ERA's Performance

ERIC Educational Resources Information Center

Henman, Paul; Brown, Scott D.; Dennis, Simon

2017-01-01

In 2015, the Australian Government's Excellence in Research for Australia (ERA) assessment of research quality declined to rate 1.5 per cent of submissions from universities. The public debate focused on practices of gaming or "coding errors" within university submissions as the reason for this outcome. The issue was about the…

Determination of asymptomatic carrier rate of beta-haemolytic group B Streptococcus in vaginas of pregnant women in Ibadan, Nigeria.

PubMed

Olanisebe, S B; Adetosoye, A I

1986-04-01

Bacteriological studies of 500 vaginal swabs from pregnant women in second and third trimester from 4 government hospitals in Ibadan showed that 8 (1.6 per cent) were found to be culture-positive for Group B Streptococcus. Five (1.0 per cent) were found to harbour group D streptococci. All the 8 group B Streptococcus isolates were sensitive to erythromycin, methicillin, penicillin G, ampicillin and chloramphenicol in decreasing order. They were resistant to tetracycline, sulphafurazole and streptomycin.

Infant feeding practices in Bombay slums.

PubMed

Bavdekar, S B; Bavdekar, M S; Kasla, R R; Raghunandana, K J; Joshi, S Y; Hathi, G S

1994-09-01

A study was conducted in two slum areas in a Bombay suburb covering a total population of 4879. One hundred and fifty-three mothers having children below two years were interviewed. Ninety six per cent infants below the age of 4 months received breast milk, though exclusive breastfeeding was practised only in 37% infants. Timely complementary feeding rate was only 0.48. Twenty three per cent of mothers used bottle for administration of supplementary food or water. Only 15.7% of mothers used commercial milk formula and 8.5% used commercial weaning food.

Eight per cent leakage of Lyman continuum photons from a compact, star-forming dwarf galaxy.

PubMed

Izotov, Y I; Orlitová, I; Schaerer, D; Thuan, T X; Verhamme, A; Guseva, N G; Worseck, G

2016-01-14

One of the key questions in observational cosmology is the identification of the sources responsible for ionization of the Universe after the cosmic 'Dark Ages', when the baryonic matter was neutral. The currently identified distant galaxies are insufficient to fully reionize the Universe by redshift z ≈ 6 (refs 1-3), but low-mass, star-forming galaxies are thought to be responsible for the bulk of the ionizing radiation. As direct observations at high redshift are difficult for a variety of reasons, one solution is to identify local proxies of this galaxy population. Starburst galaxies at low redshifts, however, generally are opaque to Lyman continuum photons. Small escape fractions of about 1 to 3 per cent, insufficient to ionize much surrounding gas, have been detected only in three low-redshift galaxies. Here we report far-ultraviolet observations of the nearby low-mass star-forming galaxy J0925+1403. The galaxy is leaking ionizing radiation with an escape fraction of about 8 per cent. The total number of photons emitted during the starburst phase is sufficient to ionize intergalactic medium material that is about 40 times as massive as the stellar mass of the galaxy.

Survival outcomes following salvage surgery for oropharyngeal squamous cell carcinoma: systematic review.

PubMed

Kao, S S; Ooi, E H

2018-04-01

Recurrent oropharyngeal squamous cell carcinoma causes great morbidity and mortality. This systematic review analyses survival outcomes following salvage surgery for recurrent oropharyngeal squamous cell carcinoma. A comprehensive search of various electronic databases was conducted. Studies included patients with recurrent or residual oropharyngeal squamous cell carcinoma treated with salvage surgery. Primary outcomes were survival rates following salvage surgery. Secondary outcomes included time to recurrence, staging at time of recurrence, post-operative complications, and factors associated with mortality and recurrence. Methodological appraisal and data extraction were conducted as per Joanna Briggs Institute methodology. Eighteen articles were included. The two- and five-year survival rates of the patients were 52 per cent and 30 per cent respectively. Improvements in treatment modalities for recurrent oropharyngeal squamous cell carcinoma were associated with improvements in two-year overall survival rates, with minimal change to five-year overall survival rates. Various factors were identified as being associated with long-term overall survival, thus assisting clinicians in patient counselling and selection for salvage surgery.

Rhesus monkey heart rate during exercise

NASA Technical Reports Server (NTRS)

Delorge, J.; Thach, J. S., Jr.

1972-01-01

Various schedules of reinforcement and their relation to heart rates of rhesus monkeys during exercise are described. All the reinforcement schedules produced 100 per cent or higher increments in the heart rates of the monkeys during exercise. Resting heart rates were generally much lower than those previously reported, which was attributed to the lack of physical restraint of the monkeys during recording.

Population-based cohort study of outcomes following cholecystectomy for benign gallbladder diseases.

PubMed

2016-11-01

The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all-cause 30-day readmissions and complications in a prospective population-based cohort. Data were collected on consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing all-cause 30-day readmissions and complications were analysed by means of multilevel, multivariable logistic regression modelling using a two-level hierarchical structure with patients (level 1) nested within hospitals (level 2). Data were collected on 8909 patients undergoing cholecystectomy from 167 hospitals. Some 1451 cholecystectomies (16·3 per cent) were performed as an emergency, 4165 (46·8 per cent) as elective operations, and 3293 patients (37·0 per cent) had had at least one previous emergency admission, but had surgery on a delayed basis. The readmission and complication rates at 30 days were 7·1 per cent (633 of 8909) and 10·8 per cent (962 of 8909) respectively. Both readmissions and complications were independently associated with increasing ASA fitness grade, duration of surgery, and increasing numbers of emergency admissions with gallbladder disease before cholecystectomy. No identifiable hospital characteristics were linked to readmissions and complications. Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

Thirty-eight years of water fluoridation--the Singapore scenario.

PubMed

Loh, T

1996-09-01

The high caries rate in Singapore school children was of great concern to dental administrators. Remedial measures alone were not the solution. The success of water fluoridation in Grand Rapids, USA and in Brantford, Canada in reducing dental caries in children in the early 1950s prompted Singapore to introduce fluoride into its drinking water. Singapore is the first country in Asia to institute a comprehensive fluoridation programme which covers 100 per cent of the population. The water was fluoridated at 0.7 ppm fluoride using sodium silicofluoride. The ten year study on the effects of water fluoridation in Singapore showed a decrease in caries prevalence in the children. In the permanent dentition the reduction was 52.3 per cent for Chinese and 31 per cent for Malays in the 7 to 9 year old age group. A similar trend was observed in the mixed dentition in which the decrease was 32.5 per cent for Chinese and 30.6 per cent for Malays. Because of the availability and use of other fluoride products, dental fluorosis was observed in children in later years. Although the decline in dental caries after 10 years of water fluoridation was not comparable to those achieved in other countries, this study further documents water fluoridation as the most cost-effective public health measure for the prevention of dental caries.

Missed opportunities for diabetes prevention: post-pregnancy follow-up of women with gestational diabetes mellitus in England

PubMed Central

Pierce, Mary; Modder, Jo; Mortagy, Iman; Springett, Anna; Hughes, Heather; Baldeweg, Stephanie

2011-01-01

Background Women with gestational diabetes mellitus (GDM) should be followed-up to exclude ongoing diabetes and for prevention of type 2 diabetes. The National Institute for Health and Clinical Excellence (NICE) diabetes in pregnancy guideline recommends checking fasting plasma glucose (FPG) at 6 weeks postpartum (short term), and annually thereafter (long term). Aim To examine the reported practice regarding GDM follow-up. Design and setting Nationwide postal survey in England 2008-2009. Method Questionnaires were distributed to a consultant diabetologist and obstetrician in all maternity units, and to a random sample of general practices (approximately 1 in 5). Results Response rates were: 60% (915/1532) GPs, 93% (342/368) specialists; 80% of GPs and 98% of specialists reported women with GDM had short-term follow-up. More GPs (55%) than specialists (13%) used a FPG test to exclude ongoing diabetes; 26% of GPs versus 89% of specialists thought the hospital was responsible for ordering the test. Twenty per cent of GPs had difficulty in discovering women had been diagnosed with GDM in secondary care. Seventy-three per cent of specialists recommended long-term follow-up; only 39% of GPs recalled women with GDM for this. A minority of GPs and specialists had joint follow-up protocols Conclusion Follow-up of GDM in England diverged from national guidance. Despite consensus that short-term follow-up occurred, primary and secondary care doctors disagreed about the tests and responsibility for follow-up. There was lack of long-term follow-up. Agreement about the NICE guideline, its promotion and effective implementation by primary and secondary care, and the systematic recall of women with GDM for long-term follow-up is required. PMID:22152832

Adjusted hospital death rates: a potential screen for quality of medical care.

PubMed

Dubois, R W; Brook, R H; Rogers, W H

1987-09-01

Increased economic pressure on hospitals has accelerated the need to develop a screening tool for identifying hospitals that potentially provide poor quality care. Based upon data from 93 hospitals and 205,000 admissions, we used a multiple regression model to adjust the hospitals crude death rate. The adjustment process used age, origin of patient from the emergency department or nursing home, and a hospital case mix index based on DRGs (diagnostic related groups). Before adjustment, hospital death rates ranged from 0.3 to 5.8 per 100 admissions. After adjustment, hospital death ratios ranged from 0.36 to 1.36 per 100 (actual death rate divided by predicted death rate). Eleven hospitals (12 per cent) were identified where the actual death rate exceeded the predicted death rate by more than two standard deviations. In nine hospitals (10 per cent), the predicted death rate exceeded the actual death rate by a similar statistical margin. The 11 hospitals with higher than predicted death rates may provide inadequate quality of care or have uniquely ill patient populations. The adjusted death rate model needs to be validated and generalized before it can be used routinely to screen hospitals. However, the remaining large differences in observed versus predicted death rates lead us to believe that important differences in hospital performance may exist.

PENETRATION OF RADIOACTIVE SODIUM AND CHLORIDE INTO CEREBROSPINAL FLUID AND AQUEOUS HUMOR

PubMed Central

Wang, Jun-Ch'uan

1948-01-01

1. Experiments were performed on six dogs to determine the rate of penetration of Cl33 and Na24 across the blood-aqueous humor and blood-cerebrospinal fluid barriers after intravenous injection of the radioactive ions. The radioactivity measurements were made with an immersion type of Geiger-Müller counter. 2. The concentrations of the labelled ions in the anterior chamber and the cisterna magna increase slowly to approach that of plasma. The rate of penetration k is calculated from a simple exponential equation with the half-value interval t 0.5 or the time required for the labelled-ion concentration in the fluid to reach 50 per cent of that of plasma. The average t 0.5 for Cl38 and Na24 in aqueous humor are 34.3 ± 9 and 27.3 ± 9 minutes, respectively, while those for cerebrospinal fluid are 90 ± 6 and 95 ± 6 minutes, respectively. 3. A study of the radioactivity in plasma was made to determine the per cent remaining after a steady state was reached. By means of this determination the sodium and chloride space was calculated to be 33 ± 5 per cent. PMID:18920614

Temporomandibular joint involvement as a positive clinical prognostic factor in necrotising external otitis.

PubMed

Yeheskeli, E; Eta, R Abu; Gavriel, H; Kleid, S; Eviatar, E

2016-05-01

Necrotising otitis externa is associated with high morbidity and mortality rates. This study investigated whether temporomandibular joint involvement had any prognostic effect on the course of necrotising otitis externa in patients who had undergone hyperbaric oxygen therapy after failed medical and sometimes surgical therapy. A retrospective case series was conducted of patients in whom antibiotic treatment and surgery had failed, who had been hospitalised for further treatment and hyperbaric oxygen therapy. Twenty-three patients with necrotising otitis externa were identified. The temporomandibular joint was involved in four patients (17 per cent); these patients showed a constant gradual improvement in C-reactive protein and were eventually discharged free of disease, except one patient who was lost to follow up. Four patients (16 per cent) without temporomandibular joint involvement died within 90 days of discharge, while all patients with temporomandibular joint involvement were alive. Three patients (13 per cent) without temporomandibular joint involvement needed recurrent hospitalisation including further hyperbaric oxygen therapy; no patients with temporomandibular joint involvement required such treatment. Patients with temporomandibular joint involvement had lower rates of recurrent disease and no mortality. Therefore, we suggest considering temporomandibular joint involvement as a positive prognostic factor in necrotising otitis externa management.

Field evaluation of ZeroFly--an insecticide incorporated plastic sheeting against malaria vectors & its impact on malaria transmission in tribal area of northern Orissa.

PubMed

Sharma, S K; Upadhyay, A K; Haque, M A; Tyagi, P K; Mohanty, S S; Mittal, P K; Dash, A P

2009-10-01

Insecticide incorporated plastic sheeting is a new technology to control mosquitoes in emergency shelter places and also temporary habitations in different locations. Therefore, field studies were conducted to assess the efficacy of ZeroFly plastic sheeting treated with deltamethrin on prevailing disease vectors Anopheles culicifacies and An. fluviatilis and its impact on malaria transmission in one of the highly endemic areas of Orissa. The study was conducted in Birkera block of Sundargarh district, Orissa state. The study area comprised 3 villages, which were randomized as ZeroFly plastic sheet, untreated plastic sheet and no sheet area. ZeroFly plastic sheets and untreated plastic sheets were fixed in study and control villages respectively covering all the rooms in each household. Longitudinal studies were conducted on the bioefficacy with the help of cone bioassays, monitoring of the mosquito density through hand catch, floor sheet and exit trap collections and fortnightly domiciliary active surveillance in all the study villages. In ZeroFly plastic sheeting area, there was a significant reduction of 84.7 per cent in the entry rate of total mosquitoes in comparison to pre-intervention phase. There was 56.2 per cent immediate mortality in total mosquitoes in houses with ZeroFly sheeting. The overall feeding success rate of mosquitoes in the trial village was only 12.5 per cent in comparison to 49.7 and 51.1 per cent in villages with untreated plastic sheet and no sheet respectively. There was a significant reduction of 65.0 and 70.5 per cent in malaria incidence in ZeroFly plastic sheeting area as compared to untreated plastic sheet and no sheet area respectively. Our study showed that introduction of ZeroFly plastic sheets in a community-based intervention programme is operationally feasible to contain malaria especially in the high transmission difficult areas.

[Immunologic response to microorganisms from a polluted ventilation system in a working environment].

PubMed

Cernelc, S; Vozelj, M

1991-01-01

Authors point out the morbidity of employees working in ventilation systems contaminated with various microorganisms. They analysed 96 workers exposed to air conditioning system (Group A), and 71 workers (Group B) breathing normal ambient air. The workers of both groups were subjected clinically by functionally and immunologically. Preparation of antigens "MMM" (Monday morning miseries) was used as an original method by Ajello et al. for producing antigens from systemic mycotic agents and subsequently modified. The aim of the present study is to evaluate the possibility of using ELISA in clinical practice for respiratory allergy diagnosis, and especially Hypersensitivity pneumonitis. Atopic status was determined by skin prick tests with common airborne allergens including Dermatophagoides pteronyssinus, ragweed, grasses and Aspergillus fumigatus., by Enzygnost--IgE (Behringwerke AG, Marburg) and for specific IgE by RAST technique (Pharmacia, Uppsala). The skin prick tests were performed with "MMM"-antigens. PEFR (Peak Expiratory Flow-Rate) was measured by using a Wright's peak flow meter. PEFR was recorded on Monday (first day at work) and Friday (the end of the working week). Measured values of PEFR in both groups of employees from Monday to Friday were elaborated by the Wilcoxon test. Culture of scrapings from air conditioning vents were obtained and water from the humidifier system also cultured. They were grown: T. vulgaris, Aspergillus fumigatus, Thermoactinomyces vulgaris and others. Results of questionnaires, clinical evaluation and diagnostical procedures in employees of Group A and B are as follows: Thirty eight workers in Group A had a positive clinical history of "Monday illness". In the symptomatic Group A we found in 8 cases abnormal chest roentgenogram. Further, there was no correlation between the presence of antibodies (ELISA) against MMM and pulmonary function abnormalities, as measured by either spirometry or DLCO. Further, we found good agreement between ELISA and prick test results with antigen MMM. Wilcoxon test showed a statistically significant difference between the two groups (0.01). The median or central value of PEFR reduction in Group A is 10.23 per cent, and in Group B 1.49 per cent. A 30 per cent reduction of PEFR was observed in 5.21 per cent of subjects in Group A. Exposure to ventilation systems contaminated with Thermophilic actinomyces may be responsible for increased morbidity and reduced performance of employees working in air conditioning systems. Particularly the main filter should be checked regularly. Moreover, regular microbiologic examinations of dust and water from air preventing chronic obstructive lung diseases in employees working in areas served by contaminated air conditioning systems.

Managerial attitude to the implementation of quality management systems in Lithuanian support treatment and nursing hospitals.

PubMed

Buciuniene, Ilona; Malciankina, Sonata; Lydeka, Zigmas; Kazlauskaite, Ruta

2006-09-20

The regulations of the Quality Management System (QMS) implementation in health care organizations were approved by the Lithuanian Ministry of Health in 1998. Following the above regulations, general managers of health care organizations had to initiate the QMS implementation in hospitals. As no research on the QMS implementation has been carried out in Lithuanian support treatment and nursing hospitals since, the objective of this study is to assess its current stage from a managerial perspective. A questionnaire survey of general managers of Lithuanian support treatment and nursing hospitals was carried out in the period of January through March 2005. Majority of the items included in the questionnaire were measured on a seven-point Likert scale. During the survey, a total of 72 questionnaires was distributed, out of which 58 filled-in ones were returned (response rate 80.6 per cent; standard sampling error 0.029 at 95 per cent level of confidence). Quality Management Systems were found operating in 39.7 per cent of support treatment and nursing hospitals and currently under implementation in 46.6 per cent of hospitals (13.7% still do not have it). The mean of the respondents' perceived QMS significance is 5.8 (on a seven-point scale). The most critical issues related to the QMS implementation include procedure development (5.5), lack of financial resources (5.4) and information (5.1), and development of work guidelines (4.6), while improved responsibility and power sharing (5.2), better service quality (5.1) and higher patient satisfaction (5.1) were perceived by the respondents as the key QMS benefits. The level of satisfaction with the QMS among the management of the surveyed hospitals is mediocre (3.6). However it was found to be higher among respondents who were more competent in quality management, were familiar with ISO 9000 standards, and had higher numbers of employees trained in quality management. QMSs are perceived to be successfully running in one third of the Lithuanian support treatment and nursing hospitals. Its current implementation stage is dependent on the hospital size - the bigger the hospital the more success it meets in the QMS implementation. As to critical Quality Management (QM) issues, hospitals tend to encounter such major problems as lack of financial resources, information and training, as well as difficulties in procedure development. On the other hand, the key factors that assist to the success of the QMS implementation comprise managerial awareness of the QMS significance and the existence of employee training systems and audit groups in hospitals.

Confirmation of linear system theory prediction: Rate of change of Herrnstein's kappa as a function of response-force requirement.

PubMed

McDowell, J J; Wood, H M

1985-01-01

Four human subjects worked on all combinations of five variable-interval schedules and five reinforcer magnitudes ( cent/reinforcer) in each of two phases of the experiment. In one phase the force requirement on the operandum was low (1 or 11 N) and in the other it was high (25 or 146 N). Estimates of Herrnstein's kappa were obtained at each reinforcer magnitude. The results were: (1) response rate was more sensitive to changes in reinforcement rate at the high than at the low force requirement, (2) kappa increased from the beginning to the end of the magnitude range for all subjects at both force requirements, (3) the reciprocal of kappa was a linear function of the reciprocal of reinforcer magnitude for seven of the eight data sets, and (4) the rate of change of kappa was greater at the high than at the low force requirement by an order of magnitude or more. The second and third findings confirm predictions made by linear system theory, and replicate the results of an earlier experiment (McDowell & Wood, 1984). The fourth finding confirms a further prediction of the theory and supports the theory's interpretation of conflicting data on the constancy of Herrnstein's kappa.

Strategic action grids: a study in Indian hospitals.

PubMed

Padma, Panchapakesan; Lokachari, Prakash Sai; Chandrasekharan, Rajendran

2014-01-01

The purpose of this paper is to provide strategic recommendations to Indian hospital administrators for improving service quality by analysing performance dimensions and the importance attached to them by patients and attendants. Patient and attendant perceptions were collected using a questionnaire. Patients and attendants have different perceptions. Different customers have different needs of which providers need to be aware to better serve their consumers. The study captured only 408 patient and attendants' perceptions--a 32 per cent response rate. Results enable hospital administrators to develop appropriate strategies to improve their structure and function by analysing their strengths and weaknesses regarding their tangible and intangible assets. The study included attendants, specifically in an Indian healthcare context.

Intractable diarrhoea of infancy and its management: modified cost effective treatment.

PubMed

Thapa, B R

1994-06-01

One-hundred-twenty infants under 1 year of age suffering from intractable diarrhoea were studied. They had received prior treatment in the form of antimicrobials (100 per cent), stool binding substance (50 percent), antimotility agents (50 per cent), and intravenous (IV) fluids (33 per cent). One-third of them had been hospitalised in peripheral hospitals. All of them had diarrhoea of more than 2 weeks' duration, protein energy malnutrition and were very ill. In addition vomiting, dehydration, fever, paralytic ileus, perianal excoriation and rectal prolapse were present in 44, 23, 33, 9, 47, and 3 per cent of the infants, respectively. Anaemia, multiple vitamin deficiencies, and pedal oedema were seen in 70, 10, and 3 per cent of infants, respectively. The infections documented were septicaemia (22 per cent), bronchopneumonia (6 per cent), meningitis (4 per cent), urinary tract infection (3 per cent) and acute supporative otitis media in 2 per cent of infants. Fifty-three per cent of infants had secondary lactose intolerance. Intolerance to milk protein, milk protein and soyabean and milk protein, as well as soyabean and chicken was seen in 4, 2, and 1 per cent cases, respectively. Aetiological agents isolated from stool culture were E. coli, (18 per cent), Klebsiella species (9 per cent), Shigella species (6 per cent), Salmonella typhimurium (2 per cent), Cholera mitschikom (1 per cent), Giardia lamblia (6 per cent), cryptosporidium (1 per cent), and E. histolytica (1 per cent). Candida albicans was grown in 18 per cent of infants. Pseudomembranous colitis was documented in 2 per cent cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Sustained progress, but no room for complacency: Results of 2015 HIV estimations in India

PubMed Central

Pandey, Arvind; Dhingra, Neeraj; Kumar, Pradeep; Sahu, Damodar; Reddy, D.C.S.; Narayan, Padum; Raj, Yujwal; Sangal, Bhavna; Chandra, Nalini; Nair, Saritha; Singh, Jitenkumar; Chavan, Laxmikant; Srivastava, Deepika Joshi; Jha, Ugra Mohan; Verma, Vinita; Kant, Shashi; Bhattacharya, Madhulekha; Swain, Pushpanjali; Haldar, Partha; Singh, Lucky; Bakkali, Taoufik; Stover, John; Ammassari, Savina

2017-01-01

Background & objectives: Evidence-based planning has been the cornerstone of India's response to HIV/AIDS. Here we describe the process, method and tools used for generating the 2015 HIV estimates and provide a summary of the main results. Methods: Spectrum software supported by the UNAIDS was used to produce HIV estimates for India as a whole and its States/Union Territories. This tool takes into consideration the size and HIV prevalence of defined population groups and programme data to estimate HIV prevalence, incidence and mortality over time as well as treatment needs. Results: India's national adult prevalence of HIV was 0.26 per cent in 2015. Of the 2.1 million people living with HIV/AIDS, the largest numbers were in Andhra Pradesh, Maharashtra and Karnataka. New HIV infections were an estimated 86,000 in 2015, reflecting a decline by around 32 per cent from 2007. The declining trend in incidence was mirrored in most States, though an increasing trend was detected in Assam, Chandigarh, Chhattisgarh, Gujarat, Sikkim, Tripura and Uttar Pradesh. AIDS-related deaths were estimated to be 67,600 in 2015, reflecting a 54 per cent decline from 2007. There were variations in the rate and trend of decline across India for this indicator also. Interpretation & conclusions: While key indicators measured through Spectrum modelling confirm success of the National AIDS Control Programme, there is no room for complacency as rising incidence trends in some geographical areas and population pockets remain the cause of concern. Progress achieved so far in responding to HIV/AIDS needs to be sustained to end the HIV epidemic. PMID:29168464

What impact has tendering had on trainees? Results of a national survey by British Association for Sexual Health and HIV Trainees' Collaborative for audit, research and quality improvement projects.

PubMed

Wiggins, Helen; Hartley, Anna; Clarke, Emily; Foley, Elizabeth; Nandwani, Rak; Carlin, Elizabeth; Waters, Laura; Ahmed, Nadia

2018-01-01

In April 2013, local authorities gained responsibility for commissioning sexual health services in England. With many services going out to tender and resultant change in services or service provider, there is anecdotal evidence that this has impacted on the education, training and morale of genitourinary medicine (GUM) trainees. The aim of this study was to evaluate the impact of tendering on GUM trainees. An electronic survey designed by the British Association for Sexual Health and HIV Trainees' Collaborative for Audit, Research and Quality Improvement Projects (T-CARQ) was distributed to GUM trainees and newly appointed consultants. Eighty-two individuals responded (74% GUM trainees, 25% newly appointed consultants, 1% locum appointed for service). Sixty-three per cent (45/72) had experience of training within a service which was being tendered. Of these, 59% (24/41) felt their training was not considered during the tendering process and 20% (8/41) felt that it was. Forty-four per cent (18/41) felt adequately supported. Thirty per cent (12/40) reported active participation in the tendering process. On a scale of 0 (no impact) to 5 (major impact), the median score for impact of tendering on training was 2. The positive/negative impact of tendering on different training elements was rated: other than management experience the overall impact on all parameters was negative, namely morale, senior support and education. In conclusion, this survey describes the variable impact of service tendering on GUM training. Our recommendations for maintaining training standards despite tendering include actively involving trainees and education partners, inclusion of specialist GUM training in service specifications, development of guidance for commissioners and services for the management of GUM training within tendering.

Mini-Med School: promoting awareness of medicine as a career for suburban and rural high-school students.

PubMed

Shaikh, Faisal M; Babar, Mahwash; Cross, K Simon

2013-06-01

There is a global shortage of medical manpower. One approach to resolve such deficiencies is to effectively promote health careers to high-school students. Summer programmes held by medical faculties provide ideal opportunities for pre-medical students to examine the possible career opportunities in medicine. The Royal College of Surgeons in Ireland has recently launched a 'Mini-Medical School' (MMS) programme for suburban and rural high-school students in the South Eastern Region of Ireland. This paper illustrates the MMS project and describes the participants' reaction and evaluation of the programme and the factors influencing their desire to practise medicine in future. A total of 90 students completed the online survey (response rate 75%). Eighty-two per cent of the students indicated definitive and strong desire to study medicine after secondary school. There was no difference in interest between male and female students (P-value 0.665). The main factors influencing this interest were personal. Forty-four per cent of participants attributed this to the opportunity to help others while 30% to the intellectual challenge, whereas family, friends and other factors accounted for the rest of influential factors to study medicine. The majority agreed (60%) that the programme was quite accessible and easy to have a place. Opinions about the content of the programme focussed mainly on the interactive sessions. Forty-seven per cent liked the live patient-doctor interaction session the most, and 43% found the live video session very informative. The MMS is a highly effective platform for both the medical specialties and the high-school students. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

A win for the patient: Direct patient notification improves treatment rates of active Helicobacter pylori infection.

PubMed

Selvaratnam, Sriharan; Yeoh, Joey; Hsiang, John; Patrick, Alasdair B

2014-01-01

Current international guidelines recommend the commencement of effective eradication therapy as soon as active Helicobacter pylori (H. pylori) infection is confirmed. At our institution, all positive Campylobacter-like Organism (CLO) test results were automatically communicated to general practitioners (GPs) via a standardised letter, which also advised the commencement of eradication therapy. Despite this endeavour, a clinical audit conducted in 2011 demonstrated that only 66 per cent of confirmed H. pylori-positive South Auckland patients received eradication treatment and only 83 per cent of these patients received treatment within one month. Improve the timely initiation of H. pylori eradication therapy through direct patient notification. A prospective clinical audit of 109 consecutive outpatients with a positive CLO test identified at gastroscopy. In addition to standard general practitioner notification, patients were also directly notified of their positive CLO test result via a standardised letter, which provided information about H. pylori and its disease associations as well as advising patients to seek consultation with their GP to commence eradication therapy. Dispensing data was examined using Test Safe electronic records to determine the total uptake and timing of treatment compared to data from a preliminary 2011 audit. Ninety-five per cent of H. pylori-positive patients received standard triple therapy; therefore, treatment of active H. pylori infection was significantly higher when patients were directly notified in addition to standard GP notification, when compared to GP notification alone (95 per cent vs 66 per cent, p<0.001). All patients who received eradication therapy did so within one month of notification, a significant improvement compared to data from the previous audit in 2011 (100 per cent vs. 83 per cent, p<0.001). Direct patient notification using a standardised letter is a simple and economical strategy that significantly improves the timely initiation of eradication therapy for active H. pylori infection. This has since been integrated into standard practice at our District Health Board (DHB).

Compliance with the law on car seat-belt use in four cities of Thailand.

PubMed

Aekplakorn, W; Podhipak, A; Khumdee, M; Sritamanoj, W; Youngkao, K; Suriyawongpaisal, P; Punyaratabundhu, P; Narksawat, K; Sujirarat, D; Phodaeng, C

2000-04-01

Surveys to determine the scope of compliance with the law requiring seat-belt use in Thailand were conducted by observation and interviews with drivers in four cities: namely, Bangkok Metropolis, Chiang Mai, Phuket and Nakhon Ratchasima. The work was carried out in two separate sessions: during the first month following enactment of the law, and six months after its enactment. The sample comprised 46,949 vehicles in the first session (January 1996) and 76,188 vehicles in the second session (July 1996). The results showed that 42.7 per cent of drivers used seat-belts in January and 30.7 per cent in July. When the data were disaggregated according to cities, it was found that more Bangkok drivers complied with the seat-belt law than in Phuket, 24.6 per cent; Chiang Mai, 22.1 per cent; and Nakhon Ratchasima, 18.3 per cent relatively low compliance rate was encountered among drivers of pick-up trucks (including those with modified roofs) and vans, particularly farmers and the self-employed. Women drivers tended to abide by the law more often than men (OR = 1.7, 95% CI = 1.12, 1.23). Inter-city travelers wore seat-belts more than those traveling in the city (OR = 1.74, 95% CI = 1.68, 1.80). About one-fifth of non-users or those who rarely used seat-belts were unsure of the effectiveness of seat-belts in preventing serious injury or death in the case of an accident. Discomfort associated with using seat-belts and the perception that they were rendered unnecessary because of slow traffic in cities were other reasons for non-compliance in 50.6 per cent and 43.9 per cent of cases, respectively. The decline in compliance with the law six months after its enactment indicates that there may be a problem with uniform and consistent enforcement of the law.

Do marketing and alcohol treatment/public health experts think televised alcohol advertisements abide by regulatory guidelines?

PubMed

Lloyd, Kelly; Cameron, Elaine; Williams, Hannah; Banister, Emma; Donmall, Michael; Higgins, Alan; French, David P

2018-04-01

Televised alcohol advertisements in the United Kingdom must abide by the Broadcast Committee of Advertising Practice Code, which provides guidelines concerning advertisements not implying, condoning or encouraging immoderate, irresponsible or antisocial drinking. Previously, 75 per cent of 373 general public respondents were shown one of seven advertisements rated a breach of at least one guideline. This study assessed whether experts in marketing ( n = 25) and alcohol treatment/public health ( n = 25) perceived the same seven television alcohol advertisements as complying with the Broadcast Committee of Advertising Practice Code. Overall, 83 per cent of advertisements were rated as breaching at least one guideline. This provides further proof that self-regulatory alcohol guidelines are not fit for purpose.

Results after mitral valve replacement with cloth-covered Starr-Edwards prostheses (models 6300, 6310/6320, and 6400).

PubMed Central

Forman, R; Beck, W; Barnard, C N

1978-01-01

The actuarial survival and thromboembolic rates for the three types of cloth-covered Starr-Edwards mitral prostheses, models 6300, 6310/6320, and 6400 followed 6, 5, and 2 years, respectively, were not significantly different throughout the years they were followed. The combined cumulative survival and thromboembolic proportion at 5 years for these prostheses were 71 and 66 per cent, respectively. The thromboembolic rates were not different in the following two groups: (a) 238 patients receiving anticoagulants, and (b) 52 patients who had discontinued or who were not receiving anticoagulants. Four patients thrombosed their mitral prostheses. Another 8 per cent had class 3 symptoms after operation, which were attributed to myopathic or restrictive left ventricular dysfunction or other valvular disease. PMID:656234

Projected Regional Climate in 2025 Due to Urban Growth

NASA Technical Reports Server (NTRS)

Shepherd, J. Marshall; Manyin, Michael; Messen, Dmitry

2005-01-01

By 2025, 60 to 80 percent of the world s population will live in urban environments. Additionally, the following facts published by the United Nations further illustrates how cities will evolve in the future. Urban areas in the developing world are growing very rapidly. The urban growth rate will continue to be particularly rapid in the urban areas of less developed regions, averaging 2.4 per cent per year during 2000-2030, consistent with a doubling time of 29 years. The urbanization process will continue worldwide. The concentration of population in cities is expected to continue so that, by 2030, 84 percent of the inhabitants of more developed countries will be urban dwellers. Urbanization impacts the whole hierarchy of human settlements. In 2000,24.8 per cent of the world population lived in urban settlements with fewer than 500,000 inhabitants and by 2015 that proportion will likely rise to 27.1 per cent.

Utilisation of oral health services, oral health needs and oral health status in a peri-urban informal settlement.

PubMed

Westaway, M S; Viljoen, E; Rudolph, M J

1999-04-01

Interviews were conducted with 294 black residents (155 females and 138 males) of a peri-urban informal settlement in Gauteng to ascertain utilisation of oral health services, oral health needs and oral health status. Only 37 per cent of the sample had consulted a dentist or medical practitioner, usually for extractions. Teenagers and employed persons were significantly less likely to utilise dentists than the older age groups and unemployed persons. Forty per cent were currently experiencing oral health problems such as a sore mouth, tooth decay and bleeding/painful gums. Two hundred and twelve (73 per cent) interviewees wanted dental treatment or advice. Residents who rated their oral health status as fair or poor appeared to have the greatest need for oral health services. The use of interviews appears to be a cost-effective method of determining oral morbidity.

Kuiper belt analogues in nearby M-type planet-host systems

NASA Astrophysics Data System (ADS)

Kennedy, G. M.; Bryden, G.; Ardila, D.; Eiroa, C.; Lestrade, J.-F.; Marshall, J. P.; Matthews, B. C.; Moro-Martin, A.; Wyatt, M. C.

2018-06-01

We present the results of a Herschel survey of 21 late-type stars that host planets discovered by the radial velocity technique. The aims were to discover new discs in these systems and to search for any correlation between planet presence and disc properties. In addition to the known disc around GJ 581, we report the discovery of two new discs, in the GJ 433 and GJ 649 systems. Our sample therefore yields a disc detection rate of 14 per cent, higher than the detection rate of 1.2 per cent among our control sample of DEBRIS M-type stars with 98 per cent confidence. Further analysis however shows that the disc sensitivity in the control sample is about a factor of two lower in fractional luminosity than for our survey, lowering the significance of any correlation between planet presence and disc brightness below 98 per cent. In terms of their specific architectures, the disc around GJ 433 lies at a radius somewhere between 1 and 30 au. The disc around GJ 649 lies somewhere between 6 and 30 au, but is marginally resolved and appears more consistent with an edge-on inclination. In both cases the discs probably lie well beyond where the known planets reside (0.06-1.1 au), but the lack of radial velocity sensitivity at larger separations allows for unseen Saturn-mass planets to orbit out to ˜5 au, and more massive planets beyond 5 au. The layout of these M-type systems appears similar to Sun-like star + disc systems with low-mass planets.

Deep ALMA photometry of distant X-ray AGN: improvements in star formation rate constraints, and AGN identification

NASA Astrophysics Data System (ADS)

Stanley, F.; Harrison, C. M.; Alexander, D. M.; Simpson, J.; Knudsen, K. K.; Mullaney, J. R.; Rosario, D. J.; Scholtz, J.

2018-05-01

We present the star formation rates (SFRs) of a sample of 109 galaxies with X-ray selected active galactic nuclei (AGN) with moderate to high X-ray luminosities (\\mathrel {L_2-8{keV}}= 10^{42} - 10^{45} \\mathrel {erg {} s^{-1}}), at redshifts 1 < z < 4.7, that were selected to be faint or undetected in the Herschel bands. We combine our deep ALMA continuum observations with deblended 8-500\\mathrel {μ m} photometry from Spitzer and Herschel, and use infrared (IR) SED fitting and AGN - star formation decomposition methods. The addition of the ALMA photometry results in an order of magnitude more X-ray AGN in our sample with a measured SFR (now 37 per cent). The remaining 63 per cent of the sources have SFR upper limits that are typically a factor of 2-10 times lower than the pre-ALMA constraints. With the improved constraints on the IR SEDs, we can now identify a mid-IR (MIR) AGN component in 50 per cent of our sample, compared to only ˜1 per cent previously. We further explore the F_{870\\mathrel {μ m}}/F_{24\\mathrel {μ m}}-redshift plane as a tool for the identification of MIR emitting AGN, for three different samples representing AGN dominated, star formation dominated, and composite sources. We demonstrate that the F_{870\\mathrel {μ m}}/F_{24\\mathrel {μ m}}-redshift plane can successfully split between AGN and star formation dominated sources, and can be used as an AGN identification method.

Strategies to improve the outcome of emergency surgery for perforated peptic ulcer.

PubMed

Søreide, K; Thorsen, K; Søreide, J A

2014-01-01

Perforated peptic ulcer (PPU) is a common surgical emergency that carries high mortality and morbidity rates. Globally, one-quarter of a million people die from peptic ulcer disease each year. Strategies to improve outcomes are needed. PubMed was searched for evidence related to the surgical treatment of patients with PPU. The clinical registries of trials were examined for other available or ongoing studies. Randomized clinical trials (RCTs), systematic reviews and meta-analyses were preferred. Deaths from peptic ulcer disease eclipse those of several other common emergencies. The reported incidence of PPU is 3.8-14 per 100,000 and the mortality rate is 10-25 per cent. The possibility of non-operative management has been assessed in one small RCT of 83 patients, with success in 29 (73 per cent) of 40, and only in patients aged less than 70 years. Adherence to a perioperative sepsis protocol decreased mortality in a cohort study, with a relative risk (RR) reduction of 0.63 (95 per cent confidence interval (c.i.) 0.41 to 0.97). Based on meta-analysis of three RCTs (315 patients), laparoscopic and open surgery for PPU are equivalent, but patient selection remains a challenge. Eradication of Helicobacter pylori after surgical repair of PPI reduces both the short-term (RR 2.97, 95 per cent c.i. 1.06 to 8.29) and 1-year (RR 1.49, 1.10 to 2.03) risk of ulcer recurrence. Mortality and morbidity from PPU can be reduced by adherence to perioperative strategies. © 2013 BJS Society Ltd. Published by John Wiley & Sons Ltd.

Outcomes of simultaneous pancreas-kidney transplantation from brain-dead and controlled circulatory death donors.

PubMed

Qureshi, M S; Callaghan, C J; Bradley, J A; Watson, C J E; Pettigrew, G J

2012-06-01

Organ scarcity has prompted increased use of organs from donation after circulatory death (DCD) donors. An early single-centre experience of simultaneous pancreas-kidney (SPK) transplantation from controlled DCD donors is described here. Outcomes of SPK transplants from DCD and donation after brain death (DBD) donors between August 2008 and January 2011 were reviewed retrospectively. SPK transplants from 20 DCD and 40 DBD donors were carried out. Donor and recipient characteristics were similar for both groups, although pancreas cold ischaemia times were shorter in DCD recipients: median (range) 8·2 (5·9-10·5) versus 9·5 (3·8-12·5) h respectively (P = 0·004). Median time from treatment withdrawal to cold perfusion was 24 (range 16-110) min for DCD donors. There were no episodes of delayed pancreatic graft function in either group; the graft thrombosis rates were both 5 per cent. Similarly, there were no differences in haemoglobin A1c level at 12 months: median (range) 5·4 (4·9-7·7) per cent in DCD group versus 5·4 (4·1-6·2) per cent in DBD group (P = 0·910). Pancreas graft survival rates were not significantly different, with Kaplan-Meier 1-year survival estimates of 84 and 95 per cent respectively (P = 0·181). DCD SPK grafts had comparable short-term outcomes to DBD grafts, even when procured from selected donors with a prolonged agonal phase. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Awareness of malocclusion and desire for orthodontic treatment in 11 to 14 year-old Nigerian schoolchildren and their parents.

PubMed

Kolawole, Kikelomo A; Otuyemi, Olayinka D; Jeboda, Sonny O; Umweni, Alice A

2008-05-01

To investigate Nigerian children's and their parents' satisfaction with the children's facial and dental appearances and their desire for orthodontic treatment, and to compare their assessments of treatment need with those determined by an orthodontist. The subjects were 242 11-14 year-old schoolchildren randomly selected from private and public schools in the Ife Central Local Government area, Nigeria. A questionnaire was used to obtain information from the children and their parents of their liking of the facial and dental appearances of the children and the need and desire for orthodontic treatment. The children, the parents and an orthodontist used the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) to assess the need for treatment. More parents liked their child's facial and dental appearances than the children liked themselves. Almost twice as many schoolchildren thought they needed (27 per cent) and desired (29 per cent) orthodontic treatment than their parents (115 per cent). Low, but statistically significant correlations, were found between the children's, their parents' and an orthodontist's assessments of treatment need using the AC scale. Only 8 per cent of the children and 3 per cent of the parents considered that there was a 'moderate-definite' need of treatment. The orthodontist considered 38 per cent of the children had a 'moderate-definite' need of treatment. The children's responses suggest greater concern about their facial and dental appearances, a greater perception of the need for orthodontic treatment and greater desire for treatment than their parents. These findings require further investigation as previous studies have reported that parents are usually more motivated for orthodontic treatment than their children.

Investing in learning and training refugee doctors.

PubMed

Ong, Yong Lock; Trafford, Penny; Paice, Elisabeth; Jackson, Neil

2010-06-01

Medically qualified refugees seek to build a new life and return to clinical medicine. The National Health Service (NHS) in the UK needs to develop a workforce to meet the needs of the communities it serves, and refugee doctors have the potential to contribute to the NHS, using their experience and skills to benefit patients. Fifty-four per cent of refugee doctors in the UK live in London, so in response, the London Deanery (Postgraduate Department of Medical and Dental Education, London University) has undertaken a series of initiatives over the past 8 years assisting refugee doctors back into medical employment. Clinical attachments, supernumerary 6-month posts and general practitioner (GP) training rotations have been offered. The projects, doctors involved, educational provision and outcomes are reported. The obstacles and barriers to returning to substantive posts in medicine are also discussed. Fifty-six per cent of the refugee doctors were known to be working after the schemes, 52 per cent gained substantive posts and 39 per cent entered training grades. Investing in innovative and creative work-based training programmes for refugee doctors is worthwhile, but needs to be adequately resourced if refugee doctors are to bring ultimate benefit to the NHS. © Blackwell Publishing Ltd 2010.

Impacting the problem of inner-city youth violence: "Educating Kids About Gun Violence" program.

PubMed

Hayward, Thomas Z; Simons, Clark J; St John, Wendy; Waymire, Michelle; Stucky, Thomas D

2011-04-01

The Educating Kids Against Gun Violence (EKG) program was developed in response to high levels of gun violence in an urban inner-city county through a partnership between the county prosecutor's office, local law enforcement, and a Level 1 trauma center. This program incorporates short video clips and interactive presentations, which address legal and medical consequences of gun violence. The program was presented to youths varying in age and degree of prior contact with the criminal justice system. Pre and post surveys were used to evaluate the short-term impact of the EKG program on the legal and medical knowledge and attitudes of youth participants. There were 130 pre and post surveys that could be exactly matched. Sixty-three per cent of participants had been arrested and 35 per cent had been convicted of a crime. On the post survey, 79 per cent stated that "the program will help keep me out of trouble" and 69 per cent stated that "in the future because of this program I will be less likely to carry a gun". The EKG program seemed to have positive short-term impacts on youth knowledge of legal and medical consequences and attitudes regarding gun violence.

Factors associated with non-attendance in a general practice super clinic population in regional Australia: A retrospective cohort study.

PubMed

Nancarrow, Susan; Bradbury, Joanne; Avila, Catherine

2014-01-01

Non-attendance at medical appointments is associated with increased patient morbidity and is a significant drain on health service resources. Australian studies have focused on secondary healthcare settings, screening, and interventions to reduce non-attendance. To explore factors associated with non-attendance in a regional primary care setting. A retrospective cohort of all patients with a scheduled appointment between October 2011 and October 2013 at a regional, primary care clinic providing medical and allied health services in a region of New South Wales (NSW) serving a large Aboriginal population (10.7 per cent). Using multivariate logistic regression, non-attendance was regressed on a range of covariates, including number of appointments per person, gender and ethnicity, and day of the week. The overall proportion of missed appointments was 7.6 per cent. Risk factors for non-attendance were day of the week [Mondays (8.1 per cent), Fridays (8.0 per cent), and Thursdays (7.9 per cent), (χ2(4)= 20.208, p<0.0005], having fewer scheduled appointments [≤5 appointments resulted in 19.1 per cent greater risk of failure to attend (FTA) (95% CI: 11-28%)]; Aboriginality (OR=4.022, 95% CI: 3.263, 4.956), and female gender (OR=1.077; 95% CI 1.024, 1.132). There was a trend toward an interaction between gender and Aboriginality, with Aboriginal females being the group most likely to miss appointments (OR=1.272, 95% CI: 0.949, 1.705). This is the largest study of non-attendance in an Australian primary healthcare setting. While not a typical setting, the study had the advantage of a large, mixed population. The suggested high rates of non-attendance by Aboriginal females have potentially important policy implications.

Access to low-vision rehabilitation services: barriers and enablers.

PubMed

Matti, Albert I; Pesudovs, Konrad; Daly, Andrew; Brown, Margaret; Chen, Celia S

2011-03-01

The current mismatch between the need for and uptake of low-vision services has been attributed to various barriers including different service delivery models and referral pathways. This study evaluates the referral pathway and low-vision service provision of the Royal Society for the Blind (RSB) in South Australia. All new referrals from the 2008-2009 financial year to the RSB were reviewed. Initially, patients were contacted by a triage officer within one week of referral. Initial appointments were made in the Low Vision Clinic with a multidisciplinary team. Reasons for declining the appointment or non-attendance were tracked via telephone. There were 1116 patients referred over a 12-month period and 1082 (97 per cent) were reviewed in the Low Vision Clinic. Most attendees (92 per cent) lived within 50 kilometres of the clinic. There were 34 referred patients, who declined or did not attend the assessment. All non-attendees also lived within 50 kilometres of the Low Vision Centre. Concurrent major health problems (27 per cent) and patients not feeling the need for low-vision rehabilitation (27 per cent) were the most common reasons for not accessing the service. Only 125 patients (11.6 per cent) accessed volunteer transport services and only 24 patients (2.2 per cent) needed an interpreter service. The attendance rate is significantly higher than in other published studies. The distance to travel or transport difficulties were not significant barriers. Patient perception that either the service was not required or would not help them was the main barrier. The referral and triage process appeared to be a major enabler of low-vision service uptake. © 2010 The Authors. Clinical and Experimental Optometry © 2010 Optometrists Association Australia.

A survey of how and why medical students and junior doctors choose a career in ENT surgery.

PubMed

Bhutta, M; Mandavia, R; Syed, I; Qureshi, A; Hettige, R; Wong, B Y W; Saeed, S; Cartledge, J

2016-11-01

To ascertain determinants of an interest in a career in ENT surgery through a survey of medical students and junior doctors. A survey was administered, comprising Likert scales, forced response and single option questions, and free text responses, at five different courses or events for those interested in a career in ENT. The survey had an 87 per cent response rate; respondents consisted of 43 applicants for national selection, 15 foundation doctors and 23 medical students. The most important factors that encourage ENT as a career included: the variety of operative procedures, work-life balance, inherent interest in this clinical area and inspirational senior role models. Exposure to ENT in undergraduate or post-graduate training is critical in deciding to pursue this specialty. It is important to promote those aspects of ENT surgery that attract people to it, and to argue for greater exposure to ENT during undergraduate and post-graduate training.

Development of Postoperative Diabetes Mellitus in Patients Undergoing Distal Pancreatectomy versus Whipple Procedure.

PubMed

Nguyen, Adrienne; Demirjian, Aram; Yamamoto, Maki; Hollenbach, Kathryn; Imagawa, David K

2017-10-01

Because the islets of Langerhans are more prevalent in the body and tail of the pancreas, distal pancreatectomy (DP) is believed to increase the likelihood of developing new onset diabetes mellitus (NODM). To determine whether the development of postoperative diabetes was more prevalent in patients undergoing DP or Whipple procedure, 472 patients undergoing either a DP (n = 122) or Whipple (n = 350), regardless of underlying pathology, were analyzed at one month postoperatively. Insulin or oral hypoglycemic requirements were assessed and patients were stratified into preoperative diabetic status: NODM or preexisting diabetes. A retrospective chart review of the 472 patients between 1996 and 2014 showed that the total rate of NODM after Whipple procedure was 43 per cent, which was not different from patients undergoing DP (45%). The incidence of preoperative diabetes was 12 per cent in patients undergoing the Whipple procedure and 17 per cent in the DP cohort. Thus, the overall incidence of diabetes after Whipple procedure was 54 and 49 per cent in the DP group. The development of diabetes was unrelated to the type of resection performed. Age more than 65 and Caucasian ethnicity were associated with postoperative diabetes regardless of the type of resection performed.

Prognosis of patients after open mitral commissurotomy. Actuarial analysis of late results in 100 patients.

PubMed

Housman, L B; Bonchek, L; Lambert, L; Grunkemeier, G; Starr, A

1977-05-01

The continuing controversy between proponents of open and closed commissurotomy might be clarified by analysis of late follow-up with modern actuarial techniques that provide a true perspective of patient risk. We have used open mitral commissurotomy exclusively for 15 years in 100 patients. There was one operative death from pancreatitis and one late death from cancer; the actuarially projected survival rate (+/- the standard error) at 10 years is 97 per cent (+/- 2). Thirteen patients had preoperative emboli, 6 of whom were in sinus rhythm and 7 in atrial fibrillation. Two patients had postoperative emboli, both in sinus rhythm. The actuarial chance of remaining free of embolism at 10 years is 97 per cent (+/- 2). Sixteen patients required reoperation on the mitral valve for functional deterioration. The remaining survivors were in Class I or II when last seen. The actuarial chance of not requiring a reoperation after 5 years is 91 per cent (+/- 4) and at 10 years, 38 per cent(+/- 16). Results in different centers are difficult to compare for many reasons, but imprecise statistical methods further obscure such comparisons. The use of actuarial techniques may help to define the role of open mitral commissurotomy.

The clinical effectiveness of Movicol in children with severe constipation: an outcome audit.

PubMed

Hanson, Sandra; Bansal, Nav

2006-03-01

This audit reviewed the clinical effectiveness of polyethylene glycol 3350 plus electrolytes (PEG+E, Movicol) in the management of severe paediatric constipation. A seven-day disimpaction regimen was initiated followed by a maintenance dose as appropriate. An information and support service was provided by the community children's nursing team (CCNT) at Darent Valley Hospital. Twenty-three parents completed questionnaires on their children's experiences with previous and current laxative treatments, bowel movement status, in-patient admissions or home visits required and the perceived value of the back up service. The mean age of children studied was 6.7 years. Prior to PEG+E treatment, 57 per cent of children were admitted to hospital and 26 per cent required home visits for constipation treatment. After treatment, no child needed either intervention. Thirty-nine percent of parents used the support service, of which 96 per cent rated the information it provided as adequate. When asked about their satisfaction with the control of their children's constipation, 96 per cent of parents were 'more than happy' after treatment with PEG+E. The treatment of severe paediatric constipation with PEG+E in conjunction with a support and advice service was both clinically and economically effective.

2016 American College of Rheumatology/European League Against Rheumatism criteria for minimal, moderate, and major clinical response in adult dermatomyositis and polymyositis: An International Myositis Assessment and Clinical Studies Group/Paediatric Rheumatology International Trials Organisation Collaborative Initiative.

PubMed

Aggarwal, Rohit; Rider, Lisa G; Ruperto, Nicolino; Bayat, Nastaran; Erman, Brian; Feldman, Brian M; Oddis, Chester V; Amato, Anthony A; Chinoy, Hector; Cooper, Robert G; Dastmalchi, Maryam; Fiorentino, David; Isenberg, David; Katz, James D; Mammen, Andrew; de Visser, Marianne; Ytterberg, Steven R; Lundberg, Ingrid E; Chung, Lorinda; Danko, Katalin; García-De la Torre, Ignacio; Song, Yeong Wook; Villa, Luca; Rinaldi, Mariangela; Rockette, Howard; Lachenbruch, Peter A; Miller, Frederick W; Vencovsky, Jiri

2017-05-01

To develop response criteria for adult dermatomyositis (DM) and polymyositis (PM). Expert surveys, logistic regression, and conjoint analysis were used to develop 287 definitions using core set measures. Myositis experts rated greater improvement among multiple pairwise scenarios in conjoint analysis surveys, where different levels of improvement in 2 core set measures were presented. The PAPRIKA (Potentially All Pairwise Rankings of All Possible Alternatives) method determined the relative weights of core set measures and conjoint analysis definitions. The performance characteristics of the definitions were evaluated on patient profiles using expert consensus (gold standard) and were validated using data from a clinical trial. The nominal group technique was used to reach consensus. Consensus was reached for a conjoint analysis-based continuous model using absolute per cent change in core set measures (physician, patient, and extramuscular global activity, muscle strength, Health Assessment Questionnaire, and muscle enzyme levels). A total improvement score (range 0-100), determined by summing scores for each core set measure, was based on improvement in and relative weight of each core set measure. Thresholds for minimal, moderate, and major improvement were ≥20, ≥40, and ≥60 points in the total improvement score. The same criteria were chosen for juvenile DM, with different improvement thresholds. Sensitivity and specificity in DM/PM patient cohorts were 85% and 92%, 90% and 96%, and 92% and 98% for minimal, moderate, and major improvement, respectively. Definitions were validated in the clinical trial analysis for differentiating the physician rating of improvement (p<0.001). The response criteria for adult DM/PM consisted of the conjoint analysis model based on absolute per cent change in 6 core set measures, with thresholds for minimal, moderate, and major improvement. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

GPS-derived coupling estimates for the Central America subduction zone and volcanic arc faults: El Salvador, Honduras and Nicaragua

NASA Astrophysics Data System (ADS)

Correa-Mora, F.; DeMets, C.; Alvarado, D.; Turner, H. L.; Mattioli, G.; Hernandez, D.; Pullinger, C.; Rodriguez, M.; Tenorio, C.

2009-12-01

We invert GPS velocities from 32 sites in El Salvador, Honduras and Nicaragua to estimate the rate of long-term forearc motion and distributions of interseismic coupling across the Middle America subduction zone offshore from these countries and faults in the Salvadoran and Nicaraguan volcanic arcs. A 3-D finite element model is used to approximate the geometries of the subduction interface and strike-slip faults in the volcanic arc and determine the elastic response to coupling across these faults. The GPS velocities are best fit by a model in which the forearc moves 14-16 mmyr-1 and has coupling of 85-100 per cent across faults in the volcanic arc, in agreement with the high level of historic and recent earthquake activity in the volcanic arc. Our velocity inversion indicates that coupling across the potentially seismogenic areas of the subduction interface is remarkably weak, averaging no more than 3 per cent of the plate convergence rate and with only two poorly resolved patches where coupling might be higher along the 550-km-long segment we modelled. Our geodetic evidence for weak subduction coupling disagrees with a seismically derived coupling estimate of 60 +/- 10 per cent from a published analysis of earthquake damage back to 1690, but agrees with three other seismologic studies that infer weak subduction coupling from 20th century earthquakes. Most large historical earthquakes offshore from El Salvador and western Nicaragua may therefore have been intraslab normal faulting events similar to the Mw 7.3 1982 and Mw 7.7 2001 earthquakes offshore from El Salvador. Alternatively, the degree of coupling might vary with time. The evidence for weak coupling indirectly supports a recently published hypothesis that much of the Middle American forearc is escaping to the west or northwest away from the Cocos Ridge collision zone in Costa Rica. Such a hypothesis is particularly attractive for El Salvador, where there is little or no convergence obliquity to drive the observed trench-parallel forearc motion.

Images of otoscopy: rate and extent of non-compliance with good practice standards.

PubMed

Crundwell, G; Harmer, J; Maltby, M; Mills, T; Neumann, C; Walsh, L; Baguley, D

2015-01-01

The British Society of Audiology has produced clear guidelines as to how otoscopy should be undertaken; however, no nationally recognised guidelines exist for the wider clinical community. Images of otoscopy appear in many books, journals, magazines and websites. This study aimed to determine the rate of non-compliance with good practice in images of otoscopy, the seriousness of the breach, and whether this is more common in sites for professionals or the general public. Google Images was searched using the terms 'otoscopy' and 'ear examination'. A total of 200 images were identified and collated. The images were reviewed for compliance with good practice standards. Only 12.75 per cent of the images were graded as having no breach of good practice standards. Professional websites have a responsibility to show best practice. When choosing an image, the source of the image needs to be carefully considered.

Seed germination in response to chemicals: effect of nitrogen and pH in the media.

PubMed

Pérez-Fernández, M A; Calvo-Magro, E; Montanero-Fernández, J; Oyola-Velasco, J A

2006-01-01

Seed germination generally presents a peak in the next growing season after a fire. Among other factors associated with fire are the increase of soil nitrogen and changes in the pH of the soil. In this study, we addressed the question, whether or not the germination response of eight species is linked with the increase in pH and nitrogenous compounds in the germination media? We assessed the separate and combined effects of nitrogenous compounds and pH on the percentage and rate of germination of seeds of Medicago arabica (L.) Hudson, Epilobium hirsutum L., Foeniculum vulgare Miller, Daucus carota L., Thapsia villosa L., Cynosurus cristatus L., Dactylis glomerata L. and Rumex crispus L. All these species are well represented in the Mediterranean ecosystems of the central-west Spain. Water and CaCl2 were used as controls. Nitrogenous compounds increased percent germination (level) and rate in three of the species studied. High pH negatively affected the germination rate of seeds from most species, but had no effect on the per cent germination of any of the species. The higher concentration of the nutritious solutions affected negatively the germination level and rate. The different germination responses of seeds of the studied species could not be exclusively attributed to pH values in the media, whereas the amount and form of Nitrogen in the media has a greater effect on it. These differences in germination are species dependent.

How do we use language? Shared patterns in the frequency of word use across 17 world languages

PubMed Central

Calude, Andreea S.; Pagel, Mark

2011-01-01

We present data from 17 languages on the frequency with which a common set of words is used in everyday language. The languages are drawn from six language families representing 65 per cent of the world's 7000 languages. Our data were collected from linguistic corpora that record frequencies of use for the 200 meanings in the widely used Swadesh fundamental vocabulary. Our interest is to assess evidence for shared patterns of language use around the world, and for the relationship of language use to rates of lexical replacement, defined as the replacement of a word by a new unrelated or non-cognate word. Frequencies of use for words in the Swadesh list range from just a few per million words of speech to 191 000 or more. The average inter-correlation among languages in the frequency of use across the 200 words is 0.73 (p < 0.0001). The first principal component of these data accounts for 70 per cent of the variance in frequency of use. Elsewhere, we have shown that frequently used words in the Indo-European languages tend to be more conserved, and that this relationship holds separately for different parts of speech. A regression model combining the principal factor loadings derived from the worldwide sample along with their part of speech predicts 46 per cent of the variance in the rates of lexical replacement in the Indo-European languages. This suggests that Indo-European lexical replacement rates might be broadly representative of worldwide rates of change. Evidence for this speculation comes from using the same factor loadings and part-of-speech categories to predict a word's position in a list of 110 words ranked from slowest to most rapidly evolving among 14 of the world's language families. This regression model accounts for 30 per cent of the variance. Our results point to a remarkable regularity in the way that human speakers use language, and hint that the words for a shared set of meanings have been slowly evolving and others more rapidly evolving throughout human history. PMID:21357232

Randomized clinical trial of oral and intravenous versus intravenous antibiotic prophylaxis for laparoscopic colorectal resection.

PubMed

Ikeda, A; Konishi, T; Ueno, M; Fukunaga, Y; Nagayama, S; Fujimoto, Y; Akiyoshi, T; Yamaguchi, T

2016-11-01

The use of oral prophylactic antibiotics for the prevention of surgical-site infection (SSI) in patients undergoing laparoscopic surgery for colorectal cancer is controversial. The aim of this RCT was to evaluate whether intravenous perioperative antibiotics are inferior to combined preoperative oral and perioperative intravenous antibiotics in this setting. Patients undergoing elective laparoscopic colorectal resection in a single cancer centre were assigned randomly to combined preoperative oral antibiotics (metronidazole and kanamycin) and perioperative intravenous antibiotics (cefmetazole) (oral/IV group) or to perioperative intravenous antibiotics (cefmetazole) alone (IV-only group). Patients were stratified for the analyses based on type of operation (colonic surgery, anterior resection or abdominoperineal resection), preoperative use of mechanical bowel preparation, preoperative chemoradiotherapy and the presence of diabetes mellitus. The primary endpoint was the overall rate of SSI. Secondary endpoints were the rates of incisional site infection, organ/space infection, anastomotic leakage, intra-abdominal abscess, adverse events and postoperative complications. Of 540 patients offered participation in the trial in 2013-2014, 515 agreed to take part and were randomized. Some 256 patients in the IV-only group and 255 in the oral/IV group completed the treatment per protocol. The overall rate of SSI was 7·8 per cent (20 of 256) in the IV-only group and 7·8 per cent (20 of 255) in the oral/IV group, confirming that perioperative administration of intravenous antibiotics alone was not inferior to the combined regimen (P = 0·017). There were no differences in rates of incisional site infection (5·5 versus 5·9 per cent respectively), organ/space infection (2·3 versus 2·0 per cent) or other secondary endpoints between the two groups. Intravenous perioperative antimicrobial prophylaxis alone is not inferior to combined preoperative oral and intravenous perioperative prophylaxis with regard to SSI in patients with colorectal cancer undergoing elective laparoscopic resection. Registration number: UMIN000019339 ( http://www.umin.ac.jp/ctr/). © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

Measuring molecular abundances in comet C/2014 Q2 (Lovejoy) using the APEX telescope

NASA Astrophysics Data System (ADS)

de Val-Borro, M.; Milam, S. N.; Cordiner, M. A.; Charnley, S. B.; Coulson, I. M.; Remijan, A. J.; Villanueva, G. L.

2018-02-01

Comet composition provides critical information on the chemical and physical processes that took place during the formation of the Solar system. We report here on millimetre spectroscopic observations of the long-period bright comet C/2014 Q2 (Lovejoy) using the Atacama Pathfinder Experiment (APEX) band 1 receiver between 2015 January UT 16.948 and 18.120, when the comet was at heliocentric distance of 1.30 au and geocentric distance of 0.53 au. Bright comets allow for sensitive observations of gaseous volatiles that sublimate in their coma. These observations allowed us to detect HCN, CH3OH (multiple transitions), H2CO and CO, and to measure precise molecular production rates. Additionally, sensitive upper limits were derived on the complex molecules acetaldehyde (CH3CHO) and formamide (NH2CHO) based on the average of the strongest lines in the targeted spectral range to improve the signal-to-noise ratio. Gas production rates are derived using a non-LTE molecular excitation calculation involving collisions with H2O and radiative pumping that becomes important in the outer coma due to solar radiation. We find a depletion of CO in C/2014 Q2 (Lovejoy) with a production rate relative to water of 2.0 per cent, and relatively low abundances of Q(HCN)/Q(H2O), 0.1 per cent, and Q(H2CO)/Q(H2O), 0.2 per cent. In contrast, the CH3OH relative abundance Q(CH3OH)/Q(H2O), 2.2 per cent, is close to the mean value observed in other comets. The measured production rates are consistent with values derived for this object from other facilities at similar wavelengths taking into account the difference in the fields of view. Based on the observed mixing ratios of organic molecules in four bright comets including C/2014 Q2, we find some support for atom addition reactions on cold dust being the origin of some of the molecules.

Precontrol observations on lymphatic filariasis & geo-helminthiases in two coastal districts of rural Orrisa.

PubMed

Chhotray, G P; Ranjit, M R; Khuntia, H K; Acharya, A S

2005-11-01

Lymphatic filariasis (LF) is a major public health problem in India, accounting for 40 per cent of the global burden. The World Health Organization has launched a global programme to eliminate LF by 2020 and India is a signatory to it. Orissa, an eastern Indian State has long been known to be endemic for LF. Prior to implementation of mass drug administration programme it is important to collect baseline data on filariasis and geo-helminthiases in the State. The present cross-sectional survey was therefore carried out between February and December 2001 to obtain baseline information on both LF and geo-helminthiases before application of the control measures. The study was carried out in rural areas of Puri and Ganjam districts in two phases. In phase I, the distribution of microfilaraemia in two district was mapped out in randomly selected primary health centres (PHCs), and 12 microfilaraemic villages were identified in each district by cluster analysis for the phase II study. In phase II, detailed clinical and parasitological survey for LF and geo-helminthiases was carried out following the standard procedures. Wuchereria bancrofti was found to be widely prevalent in Puri district with certain pockets of Brugia malayi while W. bancrofti was the only species in Ganjam district. The microfilaraemia (Mf) rate was found to be 9.5 and 11.1 per cent; and circulating filarial antigenaemia (CFA) was 16.8 and 17.8 per cent in Puri and Ganjam respectively. The geometric mean intensity (GMI) of Mf per ml of blood among positive individuals was 387 in Puri and 454 in Ganjam. The overall disease rate in Puri was 7.9 and 8.9 per cent in Ganjam. The prevalence of chronic manifestations was found to be significantly higher (P<0.001) than the acute manifestations in both the districts. The prevalence of geo-helminthiases was 31.8 per cent in Puri and 42.1 per cent in Ganjam; and the heavy infection was found to be significantly higher (P<0.001) in Ganjam compared to Puri district. The present study identified LF and geo-helminthiases as widely distributed health problem in rural areas of coastal Orissa which warrants intervention measures along the lines recommended by the global programme for elimination of LF and geo-helminthiases to reduce the disease burden.

The Oxford Ankle Foot Questionnaire for children: responsiveness and longitudinal validity.

PubMed

Morris, Christopher; Doll, Helen; Davies, Neville; Wainwright, Andrew; Theologis, Tim; Willett, Keith; Fitzpatrick, Ray

2009-12-01

To evaluate how scores from the Oxford Ankle Foot Questionnaire change over time and with treatment using both distribution-based and anchor-based approaches. Eighty children aged 5-16 and their parent or career completed questionnaires at orthopaedic or trauma outpatient clinics. They were asked to complete and return a second set of questionnaires again within 2 weeks (retest), and then mailed a third set of questionnaires to complete again after 2 months (follow-up). The follow-up questionnaires included a global rating of change 'transition' item. Child- and parent-reported mean domain scores (Physical, School & Play, and Emotional) were all stable at retest, whereas positive mean changes were observed at follow-up. As we hypothesised, trauma patients had poorer scores than elective patients at baseline, and showed greater improvement at follow-up. For trauma patients, mean changes in per cent scores were large (scores improved between 40 and 56 for the Physical and School & Play domains, and 17 and 21 for Emotional); all effect sizes (ES) were large (>0.8). For elective patients, the mean improvement in per cent scores were more moderate (Physical: child 10, ES = 0.4, parent 11, ES = 0.5; School & Play child 0, ES = 0, parent 9 ES = 0.4; Emotional: child 6, ES = 0.2; parents 8, ES > 0.3). Minimal detectable change (MDC(90)), an indication of measurement error, ranged from 6 to 8. Half the standard deviation of baseline scores ranged from 11 to 18. Minimal important difference could only be calculated for elective patients (9 child and 13 parent ratings), these ranged from 7 to 17. The findings support the responsiveness and longitudinal validity of the scales. Changes in domain scores of, or exceeding, the MDC(90) (6-8) are likely to be beyond measurement error; further work is required to refine the estimate of change that can be considered important.

Evaluation of a rapid IgM detection test for diagnosis of acute leptospirosis in dogs.

PubMed

Lizer, J; Grahlmann, M; Hapke, H; Velineni, S; Lin, D; Kohn, B

2017-05-27

Recently, a lateral flow assay (LFA) for detection of Leptospira -specific IgM in canine sera became commercially available in Europe. The present study aims to evaluate the diagnostic performance of this assay using canine sera from a collection of diagnostic accessions. Diagnostic sensitivity was assessed by testing 37 acute-phase and 9 corresponding convalescent-phase sera from dogs with a confirmed diagnosis of leptospirosis. Specificity was determined by testing sera from sick dogs with non-leptospiral infections (n=15) and healthy dogs with incomplete history of vaccination (n=45). During acute phase of illness, LFA scored positive for 28/37 sera with a sensitivity of 75.7 per cent while only 9/37 (24.3 per cent) samples were positive on microscopic agglutination test. The specificity of the LFA was 98.3 per cent (59/60). This test showed 89.7 and 100 per cent overall agreements with clinical diagnosis for acute-phase and convalescent-phase sera, respectively. The impact of vaccination on the LFA was also determined and vaccine-stimulated IgM responses were negative in 19/25 (76 per cent) dogs at 12 weeks post vaccination. In conclusion, the LFA is a rapid and reliable test for early detection of Leptospira -specific IgM during acute phase of canine leptospirosis. However, interpretation of a positive result must be made in the context of clinical signs and vaccination history. British Veterinary Association.

Haemophilus influenzae: an underrated cause of vulvovaginitis in young girls.

PubMed Central

Cox, R A

1997-01-01

AIMS: To establish the common pathogens associated with infective vulvovaginitis in young girls in the local population and to determine current management of this condition. METHODS: A prospective laboratory based survey was carried out over 19 months. A questionnaire was then sent to local general practitioners and hospital doctors. RESULTS: One hundred and six swabs were received during the study period of which 43 (40.5%) yielded organisms recognised as causes of vulvovaginitis. The most common pathogen was group A beta haemolytic streptococcus (19), with Haemophilus influenzae the second most common (11). Candida was isolated on nine occasions. The users' questionnaire had an overall response rate of 52%. Forty one per cent of respondents nominated candida as the most common cause of this condition. Forty six per cent were aware that beta haemolytic streptococci caused juvenile vulvovaginitis, but only four (3.6%) knew that H influenzae was a possible pathogen. The most popular agent for empirical treatment of vulvovaginitis was topical clotrimazole cream, although 24 respondents (22%) prescribed antibiotics that are active against both group A beta haemolytic streptococci and H influenzae. CONCLUSIONS: Although H influenzae is the second most common infective cause of juvenile vulvovaginitis in the local population, most doctors managing these patients were unaware of its importance and may not be prescribing appropriate empirical treatment. Images PMID:9389978

Coping with pressures in acute medicine--the second RCP consultant questionnaire survey.

PubMed

Mather, H M; Connor, H

2000-01-01

The second questionnaire survey of consultant physicians involved in acute unselected takes in 1999 achieved a 76% response rate, and the results have been compared with those from the first survey of 1997. The proportion of consultants whose trainees worked partial shifts had increased from 42% to 61%, although these patterns of duty were adjudged to have detrimental effects on the quality and continuity of care, and on junior staff education and training. The benefits of ward-based systems were counterbalanced by their disadvantages, but introductions of admission wards and assessment units were considered a resounding success. The number of hospitals with 'physician of the week' schemes had increased from 12 to 23, but opinion of their value was sharply divided. The provision and competence of all grades of locums was identified as an increasing problem. Seventy per cent of respondents stated that they would never participate in 'hands-on' emergency care, although 86% thought that future consultants might have to do so. Seventy-nine per cent reported increases in the pressures of their posts and in their working hours, and the tensions between general and specialist duties were highlighted. Most consultants considered that the only long-term solution to the staffing crisis was a marked expansion in the numbers of all grades of medical staff.

Community pharmacy practice in Japan--results of a survey.

PubMed

Iguchi, S; Ohnishi, M; Nishiyama, T; Hosono, K; Umezawa, C

1998-06-01

To survey the present condition of community pharmacies as future sites for pharmacy students' externship in Japan. A questionnaire consisting of 55 questions was sent to 425 graduates from Kobe Gakuin University, School of Pharmacy, who owned or worked in community pharmacies. Of the 85 responders, about half were owners and half employees of pharmacies. Ninety per cent of pharmacy owners operated three and fewer pharmacies. Fifty per cent of pharmacies only dispensed drugs, 32% handled both OTC drugs and dispensing, and 18% handled only OTC drugs. Among the 44 dispensing pharmacies, 16 were one-to-one type pharmacies, 13 were located in front of the big medical institutions, nine dispensed prescriptions from various medical institutions and five were hospital-owned pharmacies. Forty-five per cent of pharmacies employed 1-4 part-time pharmacists and 52% employed 1-4 pharmacist assistants. Thirty-one per cent of prescriptions came from internal medicine departments and the daily number of prescriptions dispensed by each pharmacy was in the range 10-99 for 41% of the pharmacies and 100-199 for 36% of the pharmacies. The average daily number of prescriptions dispersed by each pharmacist was in the range 30-39 for 29% of pharmacies and in the range 20-29 for 22% of pharmacies. Pharmaceutical information was provided at 73% of pharmacies and patients were counselled orally on their medication at 80% of pharmacies. Patients' medication histories were recorded at 88% pharmacies. Only 15% of pharmacies conducted patients' medication counselling at their home, but 34% of pharmacies were planning to start this service. Community pharmacists attended very few professional meetings or continuing education programmes and only 20% of them obtained information through computers. Forty-seven pharmacists out of the 85 obtained their information from medical representatives of pharmaceutical companies and 32 pharmacists through marketing specialists of wholesalers. Ninety per cent of community pharmacists who responded thought that separation of prescribing and dispensing functions would progress further in the future and 50% of them thought positively about the future social status of pharmacists. Most of our graduates who responded were willing to accept pharmacy students from Kobe Gakuin University as externs at their pharmacies. Despite the low response rate, our survey suggests that community pharmacy in Japan requires substantial improvement. This is to ensure that pharmacists working in that sector can provide the quality information that is required for the optimum management of patients and that the environment is suitable for pharmacy externships.

Galaxy And Mass Assembly (GAMA): testing galaxy formation models through the most massive galaxies in the Universe

NASA Astrophysics Data System (ADS)

Oliva-Altamirano, P.; Brough, S.; Lidman, C.; Couch, W. J.; Hopkins, A. M.; Colless, M.; Taylor, E.; Robotham, A. S. G.; Gunawardhana, M. L. P.; Ponman, T.; Baldry, I.; Bauer, A. E.; Bland-Hawthorn, J.; Cluver, M.; Cameron, E.; Conselice, C. J.; Driver, S.; Edge, A. C.; Graham, A. W.; van Kampen, E.; Lara-López, M. A.; Liske, J.; López-Sánchez, A. R.; Loveday, J.; Mahajan, S.; Peacock, J.; Phillipps, S.; Pimbblet, K. A.; Sharp, R. G.

2014-05-01

We have analysed the growth of Brightest Group Galaxies and Brightest Cluster Galaxies (BGGs/BCGs) over the last 3 billion years using a large sample of 883 galaxies from the Galaxy And Mass Assembly survey. By comparing the stellar mass of BGGs and BCGs in groups and clusters of similar dynamical masses, we find no significant growth between redshift z = 0.27 and 0.09. We also examine the number of BGGs/BCGs that have line emission, finding that approximately 65 per cent of BGGs/BCGs show Hα in emission. From the galaxies where the necessary spectroscopic lines were accurately recovered (54 per cent of the sample), we find that half of this (i.e. 27 per cent of the sample) harbour ongoing star formation with rates up to 10 M⊙ yr-1, and the other half (i.e. 27 per cent of the sample) have an active nucleus (AGN) at the centre. BGGs are more likely to have ongoing star formation, while BCGs show a higher fraction of AGN activity. By examining the position of the BGGs/BCGs with respect to their host dark matter halo, we find that around 13 per cent of them do not lie at the centre of the dark matter halo. This could be an indicator of recent cluster-cluster mergers. We conclude that BGGs and BCGs acquired their stellar mass rapidly at higher redshifts as predicted by semi-analytic models, mildly slowing down at low redshifts.

A statistical experiment design approach for optimizing biodegradation of weathered crude oil in coastal sediments.

PubMed

Mohajeri, Leila; Aziz, Hamidi Abdul; Isa, Mohamed Hasnain; Zahed, Mohammad Ali

2010-02-01

This work studied the bioremediation of weathered crude oil (WCO) in coastal sediment samples using central composite face centered design (CCFD) under response surface methodology (RSM). Initial oil concentration, biomass, nitrogen and phosphorus concentrations were used as independent variables (factors) and oil removal as dependent variable (response) in a 60 days trial. A statistically significant model for WCO removal was obtained. The coefficient of determination (R(2)=0.9732) and probability value (P<0.0001) demonstrated significance for the regression model. Numerical optimization based on desirability function were carried out for initial oil concentration of 2, 16 and 30 g per kg sediment and 83.13, 78.06 and 69.92 per cent removal were observed respectively, compare to 77.13, 74.17 and 69.87 per cent removal for un-optimized results.

Doctors currently in jobs with academic content and their future intentions to pursue clinical academic careers: questionnaire surveys.

PubMed

Lambert, Trevor W; Smith, Fay; Goldacre, Michael J

2015-02-01

Our aim was to report on doctors' descriptions of their current post at about 12 years after qualification, in respect of academic content, and to compare this with their long-term intentions. By academic content, we mean posts that are designated as clinical academic posts or clinical service posts that include research and/or teaching commitments. Questionnaire survey. All UK medical graduates of 1996 contacted in 2007, graduates of 1999 in 2012, and graduates of 2000 in 2012. UK. Responses about current posts and future intentions. Postal and email questionnaires. The response rate was 61.9% (6713/10844). Twenty eight per cent were working in posts with academic content (3.3% as clinical academics, 25% in clinical posts with some academic content). Seventeen per cent of women were working in clinical posts with some teaching and research, compared with 29% of men. A higher percentage of men than women intended to be clinical academics as their eventual career choice (3.9% overall, 5.4% of men, 2.7% of women). More doctors wished to move to a job with an academic component than away from one (N = 824 compared with 236). This was true for both men (433 compared with 118) and women (391 compared with 118). Women are under-represented both in holding posts with academic content and in aspirations to do so. It is noteworthy that many more doctors hoped to move into an academic role than to move out of one. Policy should facilitate this wish in order to address current shortfalls in clinical academic medicine.

Tidal breakup of triple stars in the Galactic Centre

NASA Astrophysics Data System (ADS)

Fragione, Giacomo; Gualandris, Alessia

2018-04-01

The last decade has seen the detection of fast moving stars in the Galactic halo, the so-called hypervelocity stars (HVSs). While the bulk of this population is likely the result of a close encounter between a stellar binary and the supermassive black hole (MBH) in the Galactic Centre (GC), other mechanims may contribute fast stars to the sample. Few observed HVSs show apparent ages, which are shorter than the flight time from the GC, thereby making the binary disruption scenario unlikely. These stars may be the result of the breakup of a stellar triple in the GC, which led to the ejection of a hypervelocity binary (HVB). If such binary evolves into a blue straggler star due to internal processes after ejection, a rejuvenation is possible that make the star appear younger once detected in the halo. A triple disruption may also be responsible for the presence of HVBs, of which one candidate has now been observed. We present a numerical study of triple disruptions by the MBH in the GC and find that the most likely outcomes are the production of single HVSs and single/binary stars bound to the MBH, while the production of HVBs has a probability ≲ 1 per cent regardless of the initial parameters. Assuming a triple fraction of ≈ 10 per cent results in an ejection rate of ≲ 1 Gyr - 1, insufficient to explain the sample of HVSs with lifetimes shorter than their flight time. We conclude that alternative mechanisms are responsible for the origin of such objects and HVBs in general.

The sensitivity of auditory-motor representations to subtle changes in auditory feedback while singing

PubMed Central

Keough, Dwayne; Jones, Jeffery A.

2009-01-01

Singing requires accurate control of the fundamental frequency (F0) of the voice. This study examined trained singers’ and untrained singers’ (nonsingers’) sensitivity to subtle manipulations in auditory feedback and the subsequent effect on the mapping between F0 feedback and vocal control. Participants produced the consonant-vowel ∕ta∕ while receiving auditory feedback that was shifted up and down in frequency. Results showed that singers and nonsingers compensated to a similar degree when presented with frequency-altered feedback (FAF); however, singers’ F0 values were consistently closer to the intended pitch target. Moreover, singers initiated their compensatory responses when auditory feedback was shifted up or down 6 cents or more, compared to nonsingers who began compensating when feedback was shifted up 26 cents and down 22 cents. Additionally, examination of the first 50 ms of vocalization indicated that participants commenced subsequent vocal utterances, during FAF, near the F0 value on previous shift trials. Interestingly, nonsingers commenced F0 productions below the pitch target and increased their F0 until they matched the note. Thus, singers and nonsingers rely on an internal model to regulate voice F0, but singers’ models appear to be more sensitive in response to subtle discrepancies in auditory feedback. PMID:19640048

An observational radiative constraint on hydrologic cycle intensification.

PubMed

DeAngelis, Anthony M; Qu, Xin; Zelinka, Mark D; Hall, Alex

2015-12-10

Intensification of the hydrologic cycle is a key dimension of climate change, with substantial impacts on human and natural systems. A basic measure of hydrologic cycle intensification is the increase in global-mean precipitation per unit surface warming, which varies by a factor of three in current-generation climate models (about 1-3 per cent per kelvin). Part of the uncertainty may originate from atmosphere-radiation interactions. As the climate warms, increases in shortwave absorption from atmospheric moistening will suppress the precipitation increase. This occurs through a reduction of the latent heating increase required to maintain a balanced atmospheric energy budget. Using an ensemble of climate models, here we show that such models tend to underestimate the sensitivity of solar absorption to variations in atmospheric water vapour, leading to an underestimation in the shortwave absorption increase and an overestimation in the precipitation increase. This sensitivity also varies considerably among models due to differences in radiative transfer parameterizations, explaining a substantial portion of model spread in the precipitation response. Consequently, attaining accurate shortwave absorption responses through improvements to the radiative transfer schemes could reduce the spread in the predicted global precipitation increase per degree warming for the end of the twenty-first century by about 35 per cent, and reduce the estimated ensemble-mean increase in this quantity by almost 40 per cent.

The sensitivity of auditory-motor representations to subtle changes in auditory feedback while singing.

PubMed

Keough, Dwayne; Jones, Jeffery A

2009-08-01

Singing requires accurate control of the fundamental frequency (F0) of the voice. This study examined trained singers' and untrained singers' (nonsingers') sensitivity to subtle manipulations in auditory feedback and the subsequent effect on the mapping between F0 feedback and vocal control. Participants produced the consonant-vowel /ta/ while receiving auditory feedback that was shifted up and down in frequency. Results showed that singers and nonsingers compensated to a similar degree when presented with frequency-altered feedback (FAF); however, singers' F0 values were consistently closer to the intended pitch target. Moreover, singers initiated their compensatory responses when auditory feedback was shifted up or down 6 cents or more, compared to nonsingers who began compensating when feedback was shifted up 26 cents and down 22 cents. Additionally, examination of the first 50 ms of vocalization indicated that participants commenced subsequent vocal utterances, during FAF, near the F0 value on previous shift trials. Interestingly, nonsingers commenced F0 productions below the pitch target and increased their F0 until they matched the note. Thus, singers and nonsingers rely on an internal model to regulate voice F0, but singers' models appear to be more sensitive in response to subtle discrepancies in auditory feedback.

Research in higher surgical training--the West Midlands view.

PubMed

Kmiot, W A; Neoptolemos, J P; Temple, J G

1993-09-01

A questionnaire on the role of research in higher surgical training was posted to all in-post NHS Consultants (n = 96) and Higher Surgical Trainees (n = 42) in the West Midlands Region. Replies were received from 80 consultants (83 per cent) and 37 trainees (88 per cent). Over 95 per cent of responders had undertaken some research activity previously. The vast majority of consultants (90 per cent) and trainees (95 per cent) thought that their research period had been beneficial; most would undertake research again even if not essential for higher surgical training (consultants 80 per cent, trainees 70 per cent). Research was felt to be essential for all trainees by 50 per cent of respondents in both groups; 78 per cent of consultants and 86 per cent of trainees also thought that all potential academics should obtain a degree by thesis. Most of the study participants thought that the appropriate time for research activity was as a post-FRCS registrar (consultants 72 per cent, trainees 80 per cent); 80 per cent of consultants and 67 per cent of trainees felt that this research period should be funded by the NHS. A planned, supervised and funded one-year period of research was favoured by the majority of consultants (54 per cent) and trainees (73 per cent) for non-academic general surgical trainees in the future.

Incidence of depression and anxiety: the Stirling County Study.

PubMed Central

Murphy, J M; Olivier, D C; Monson, R R; Sobol, A M; Leighton, A H

1988-01-01

Prevalence studies in psychiatric epidemiology out-number incidence investigations by a wide margin. This report gives descriptive information about the incidence of depression and anxiety disorders in a general population. Using data gathered in a 16-year follow-up of an adult sample selected as part of the Stirling County Study (Canada), the incidence of these types of disorders was found to be approximately nine cases per 1,000 persons per year. The data suggest that for every man who became ill for the first time with one of these disorders, three women became ill. Incidence tended to be higher among relatively young persons. These incidence rates are consistent with prevalence rates of approximately 10 per cent to 15 per cent for depression and anxiety disorders aggregated together, given an estimated average duration of illness of about 10 years. It is concluded that these incidence rates are fairly realistic in view of evidence that disorders of these types tend to be chronic. PMID:3258479

25 CFR 214.10 - Royalty rates.

Code of Federal Regulations, 2011 CFR

2011-04-01

... crude material, and 60 cents per ton on refined substances. (d) For substances other than gold, silver, copper, lead, zinc, coal, and asphaltum the lessee shall pay quarterly a royalty of 10 percent of the... paid for lead and zinc shall be computed for each mineral at the same rate that the amount of the...

25 CFR 214.10 - Royalty rates.

Code of Federal Regulations, 2010 CFR

2010-04-01

... crude material, and 60 cents per ton on refined substances. (d) For substances other than gold, silver, copper, lead, zinc, coal, and asphaltum the lessee shall pay quarterly a royalty of 10 percent of the... paid for lead and zinc shall be computed for each mineral at the same rate that the amount of the...

The SAMI Galaxy Survey: Data Release One with emission-line physics value-added products

NASA Astrophysics Data System (ADS)

Green, Andrew W.; Croom, Scott M.; Scott, Nicholas; Cortese, Luca; Medling, Anne M.; D'Eugenio, Francesco; Bryant, Julia J.; Bland-Hawthorn, Joss; Allen, J. T.; Sharp, Rob; Ho, I.-Ting; Groves, Brent; Drinkwater, Michael J.; Mannering, Elizabeth; Harischandra, Lloyd; van de Sande, Jesse; Thomas, Adam D.; O'Toole, Simon; McDermid, Richard M.; Vuong, Minh; Sealey, Katrina; Bauer, Amanda E.; Brough, S.; Catinella, Barbara; Cecil, Gerald; Colless, Matthew; Couch, Warrick J.; Driver, Simon P.; Federrath, Christoph; Foster, Caroline; Goodwin, Michael; Hampton, Elise J.; Hopkins, A. M.; Jones, D. Heath; Konstantopoulos, Iraklis S.; Lawrence, J. S.; Leon-Saval, Sergio G.; Liske, Jochen; López-Sánchez, Ángel R.; Lorente, Nuria P. F.; Mould, Jeremy; Obreschkow, Danail; Owers, Matt S.; Richards, Samuel N.; Robotham, Aaron S. G.; Schaefer, Adam L.; Sweet, Sarah M.; Taranu, Dan S.; Tescari, Edoardo; Tonini, Chiara; Zafar, T.

2018-03-01

We present the first major release of data from the SAMI Galaxy Survey. This data release focuses on the emission-line physics of galaxies. Data Release One includes data for 772 galaxies, about 20 per cent of the full survey. Galaxies included have the redshift range 0.004 < z < 0.092, a large mass range (7.6 < log M*/ M⊙ < 11.6), and star formation rates of ˜10-4 to ˜101M⊙ yr-1. For each galaxy, we include two spectral cubes and a set of spatially resolved 2D maps: single- and multi-component emission-line fits (with dust-extinction corrections for strong lines), local dust extinction, and star formation rate. Calibration of the fibre throughputs, fluxes, and differential atmospheric refraction has been improved over the Early Data Release. The data have average spatial resolution of 2.16 arcsec (full width at half-maximum) over the 15 arcsec diameter field of view and spectral (kinematic) resolution of R = 4263 (σ = 30 km s-1) around H α. The relative flux calibration is better than 5 per cent, and absolute flux calibration has an rms of 10 per cent. The data are presented online through the Australian Astronomical Observatory's Data Central.

Skin-sparing mastectomy: a survey based approach to defining standard of care.

PubMed

Shen, Jeannie; Ellenhorn, Joshua; Qian, Dajun; Kulber, David; Aronowitz, Joel

2008-10-01

Skin-sparing mastectomy (SSM) followed by immediate reconstruction has been advocated as an effective treatment option for patients with early-stage breast carcinoma. It markedly improves the quality of breast reconstruction through preservation of the natural skin envelope and a smaller incision. The purpose of this study was to investigate general surgeons' attitudes towards SSM. A postal questionnaire survey of California general surgeons was conducted regarding SSM. Of 370 respondents who stated they performed breast cancer surgery, 331 perform mastectomy for cancer with planned immediate reconstruction. Ninety per cent of respondents did not feel that SSM resulted in higher rates of local recurrence. In addition, 70 per cent felt that the cosmetic results of immediate breast reconstruction after SSM were better than those after a standard mastectomy. Despite this, only 61 per cent perform SSM in most cases when immediate breast reconstruction is planned. The majority of general surgeons perform SSM and therefore it should be considered standard of care. Despite a growing body of literature demonstrating high rates of patient satisfaction and long-term oncologic safety with SSM, there remains significant variation in practice patterns among general surgeons. Additional effort in general surgery education regarding the feasibility and safety of SSM is needed.

Ensemble candidate classification for the LOTAAS pulsar survey

NASA Astrophysics Data System (ADS)

Tan, C. M.; Lyon, R. J.; Stappers, B. W.; Cooper, S.; Hessels, J. W. T.; Kondratiev, V. I.; Michilli, D.; Sanidas, S.

2018-03-01

One of the biggest challenges arising from modern large-scale pulsar surveys is the number of candidates generated. Here, we implemented several improvements to the machine learning (ML) classifier previously used by the LOFAR Tied-Array All-Sky Survey (LOTAAS) to look for new pulsars via filtering the candidates obtained during periodicity searches. To assist the ML algorithm, we have introduced new features which capture the frequency and time evolution of the signal and improved the signal-to-noise calculation accounting for broad profiles. We enhanced the ML classifier by including a third class characterizing RFI instances, allowing candidates arising from RFI to be isolated, reducing the false positive return rate. We also introduced a new training data set used by the ML algorithm that includes a large sample of pulsars misclassified by the previous classifier. Lastly, we developed an ensemble classifier comprised of five different Decision Trees. Taken together these updates improve the pulsar recall rate by 2.5 per cent, while also improving the ability to identify pulsars with wide pulse profiles, often misclassified by the previous classifier. The new ensemble classifier is also able to reduce the percentage of false positive candidates identified from each LOTAAS pointing from 2.5 per cent (˜500 candidates) to 1.1 per cent (˜220 candidates).

Non-accidental Trauma Injury Patterns and Outcomes: A Single Institutional Experience.

PubMed

Ward, Austin; Iocono, Joseph A; Brown, Samuel; Ashley, Phillip; Draus, John M

2015-09-01

Non-accidental trauma (NAT) victims account for a significant percentage of our pediatric trauma population. We sought to better understand the injury patterns and outcomes of NAT victims who were treated at our level I pediatric trauma center. Trauma registry data were used to identify NAT victims between January 2008 and December 2012. Demographic data, injury severity, hospital course, and outcomes were evaluated. One hundred and eighty-eight cases of suspected NAT were identified. Children were mostly male and white. The median age was 1.1 years; the median Injury Severity Score was 9. Traumatic brain injuries, lower extremity fractures, and skull fractures were the most common injuries. Twenty-seven per cent required medical procedures; most were performed by orthopedic surgery. Twenty-four per cent required admission to the pediatric intensive care unit. The median length of stay was two days. The mortality rate was 9.6 per cent. We generated a hot spot map of our catchment area and identified areas of our state where NAT occurs at increased rates. NAT victims sustain significant morbidity and mortality. Due to the severity of injuries, pediatric trauma surgeons should be involved in the evaluation and management of these children. Much work is needed to prevent the death and disability incurred by victims of child abuse.

Trampoline-related injuries.

PubMed

Larson, B J; Davis, J W

1995-08-01

Two hundred and seventeen patients who had sustained an injury during the recreational use of a trampoline were managed in the emergency room of Logan Regional Hospital in Logan, Utah, from January 1991 through December 1992. We retrospectively reviewed the charts and radiographs of these patients to categorize the injuries. Additional details regarding the injuries of seventy-two patients (33 per cent) were obtained by means of a telephone interview with use of a questionnaire. The injuries occurred from February through November, with the peak incidence in July. The patients were eighteen months to forty-five years old (average, ten years old); ninety-four patients (43 per cent) were five to nine years old. Eighty-four patients (39 per cent) sustained a fracture; fifty-four (25 per cent), a sprain or strain; forty-five (21 per cent), a laceration; and thirty-four (16 per cent), a contusion. Fifty-seven injuries (26 per cent) involved the elbow or forearm; forty-six (21 per cent), the head or neck; forty (18 per cent), the ankle or foot; thirty-three (15 per cent), the knee or leg; nineteen (9 per cent), the trunk or back; thirteen (6 per cent), the shoulder or arm; and nine (4 per cent), the wrist or hand. Thirteen patients (6 per cent) had a back injury, but none of them had a permanent neurological deficit. One patient who had an ocular injury was transferred to a tertiary care center. One hundred and fifty-six patients (72 per cent) were evaluated radiographically, fifteen (7 per cent) were admitted to the hospital, and thirteen (6 per cent) had an operation.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparative analysis of the outcomes of elective abdominal aortic aneurysm repair in England and Sweden

PubMed Central

Karthikesalingam, A.; Holt, P. J.; Vidal‐Diez, A.; Thompson, M. M.; Wanhainen, A.; Bjorck, M.; Mani, K.

2018-01-01

Background There is substantial international variation in mortality after abdominal aortic aneurysm (AAA) repair; many non‐operative factors influence risk‐adjusted outcomes. This study compared 90‐day and 5‐year mortality for patients undergoing elective AAA repair in England and Sweden. Methods Patients were identified from English Hospital Episode Statistics and the Swedish Vascular Registry between 2003 and 2012. Ninety‐day mortality and 5‐year survival were compared after adjustment for age and sex. Separate within‐country analyses were performed to examine the impact of co‐morbidity, hospital teaching status and hospital annual caseload. Results The study included 36 249 patients who had AAA treatment in England, with a median age of 74 (i.q.r. 69–79) years, of whom 87·2 per cent were men. There were 7806 patients treated for AAA in Sweden, with a median of age 73 (68–78) years, of whom 82·9 per cent were men. Ninety‐day mortality rates were poorer in England than in Sweden (5·0 versus 3·9 per cent respectively; P < 0·001), but were not significantly different after 2007. Five‐year survival was poorer in England (70·5 versus 72·8 per cent; P < 0·001). Use of EVAR was initially lower in England, but surpassed that in Sweden after 2010. In both countries, poor outcome was associated with increased age. In England, institutions with higher operative annual volume had lower mortality rates. Conclusion Mortality for elective AAA repair was initially poorer in England than Sweden, but improved over time alongside greater uptake of EVAR, and now there is no difference. Centres performing a greater proportion of EVAR procedures achieved better results in England. PMID:29468657

Measurement of knee stiffness and laxity in patients with documented absence of the anterior cruciate ligament.

PubMed

Markolf, K L; Kochan, A; Amstutz, H C

1984-02-01

Thirty-five patients with documented absence of the anterior cruciate ligament were tested on the University of California, Los Angeles, instrumented clinical knee-testing apparatus and we measured the response curves for the following testing modes: anterior-posterior force versus displacement at full extension and at 20 and 90 degrees of flexion; varus-valgus moment versus angulation at full extension and 20 degrees of flexion; and tibial torque versus rotation at 20 degrees of flexion. Absolute values of stiffness and laxity and right-left differences for these injured knees were compared with identical quantities measured previously for a control population of forty-nine normal subjects with no history of treatment for injury to the knee. For both the uninjured knees and the knees without an anterior cruciate ligament, at 20 and 90 degrees of flexion the anterior-posterior laxity was greatest at approximately 15 degrees of external rotation of the foot. The injured knees demonstrated significantly increased total anterior-posterior laxity and decreased anterior stiffness when compared with the uninjured knees in all tested positions of the foot and knee. The mean increase in paired anterior-posterior laxity for the injured knees in this group of patients at +/- 200 newtons of applied anterior-posterior force was 3.1 millimeters (+39 per cent) at full extension, 5.5 millimeters (+57 per cent) at 20 degrees of flexion, and 2.5 millimeters (+34 per cent) at 90 degrees of flexion. The mean reduction in anterior stiffness for injured knees was also greatest (-54 per cent) at 20 degrees of knee flexion. Only slight reduction in posterior stiffness (-16 per cent) was measured at 20 degrees of flexion, and this probably reflected the presence of associated capsular and meniscal injuries. In the group of anterior cruciate-deficient knees, the patients with an absent medial meniscus showed greater total anterior-posterior laxity in all three positions of knee flexion than did the patients with an intact or torn meniscus. Varus-valgus laxity at full extension increased an average of 1.7 degrees (+36 per cent) for the injured knees, while varus and valgus stiffness decreased 21 per cent and 24 per cent. Absence of the medial meniscus (in a knee with absence of the anterior cruciate ligament) increased varus-valgus laxity at zero and 20 degrees of flexion.(ABSTRACT TRUNCATED AT 400 WORDS)

Predisposing factors and outcome of treatment of non-union of long-bone fractures in Ibadan, Nigeria.

PubMed

Ogunlade, S O; Omololu, A B; Alonge, T O; Diete, S T; Obawonyi, J E

2011-03-01

This study was done to find out factors that contribute to development of Non-union of long bone fractures in this environment and the outcome of operative intervention. This is a prospective hospital based study. All patients with Non-union of long bone fracture that presented in the hospital since January 1997 were recruited into the study. The data included causative factors, treatment given before presenting in the hospital, type of surgical procedure and result of treatment. The study was completed in December, 2005. 78 patients presented with 87 Non-union of long bones. A male, female ratio of 1.6:1 was encountered while 69.2 per cent of the patients were below the age 55years. Road Traffic Accident accounted for 68 fractures (78.2 per cent) while duration of injury before presentation varies from 6 months to 22 months. Atrophic non-union occurred in 60 cases (69.0 per cent) and hypertrophic non-union in 21 cases. Non-union of the femur occurred in 33 cases (37.9 per cent) humerus in 24 cases (27.6 per cent), tibia in 16 cases (18.4 per cent), radius and ulna in 14 cases (16.1 per cent). The initial treatments of the fresh fracture in the 78 patients with nonunion were by the traditional bonesetters in 51 patients (65.4 per cent) while the remaining fractures were treated by plaster of paris in hospital. Open reduction and internal fixation using plate and screws with bone grafting was the most common procedure for treating the non-union in most cases. Union was achieved in the entire patients following surgical intervention. Important factor that appears to contribute to non-union of long bone in this environment is soft tissue interposition between the fracture ends of the bone, which is found in all fractures with more than one diameter displacement. Another factor is interference with periosteal blood supply from disruption of soft tissue envelope as a result of high energy injuries which is also responsible for the displacements that were observed in these fractures. The treatment by traditional bone setters which entails daily massage of the fracture creating a macro movement at the fracture site is also an important contributing factor.

Corneal transplantation in the United Kingdom and Republic of Ireland.

PubMed Central

Vail, A; Gore, S M; Bradley, B A; Easty, D L; Rogers, C A

1993-01-01

The Corneal Transplant Follow up Study has registered 4560 corneal grafts performed in the United Kingdom and Republic of Ireland from July 1987 to June 1991. Rates of reported grafts doubled during that time. This increase was greater for surgeons and regions reporting fewer grafts, but was consistent across patient factors. Eleven of 428 consultants were responsible for over 25% of grafts, and their patients' characteristics differed significantly from others. Overall, reasons for grafting were visual only (77%), visual and other (16%), and non-visual (7%). Most frequent diagnoses were endothelial failure (38%), inflammation (26%), and keratoconus (20%). Age ranged from 2 months to 97 years, and differed markedly with diagnosis. Eighteen per cent of transplants were regrafts, and 40% were vascularised preoperatively. PMID:8218035

Risky decisions and their consequences: neural processing by boys with Antisocial Substance Disorder.

PubMed

Crowley, Thomas J; Dalwani, Manish S; Mikulich-Gilbertson, Susan K; Du, Yiping P; Lejuez, Carl W; Raymond, Kristen M; Banich, Marie T

2010-09-22

Adolescents with conduct and substance problems ("Antisocial Substance Disorder" (ASD)) repeatedly engage in risky antisocial and drug-using behaviors. We hypothesized that, during processing of risky decisions and resulting rewards and punishments, brain activation would differ between abstinent ASD boys and comparison boys. We compared 20 abstinent adolescent male patients in treatment for ASD with 20 community controls, examining rapid event-related blood-oxygen-level-dependent (BOLD) responses during functional magnetic resonance imaging. In 90 decision trials participants chose to make either a cautious response that earned one cent, or a risky response that would either gain 5 cents or lose 10 cents; odds of losing increased as the game progressed. We also examined those times when subjects experienced wins, or separately losses, from their risky choices. We contrasted decision trials against very similar comparison trials requiring no decisions, using whole-brain BOLD-response analyses of group differences, corrected for multiple comparisons. During decision-making ASD boys showed hypoactivation in numerous brain regions robustly activated by controls, including orbitofrontal and dorsolateral prefrontal cortices, anterior cingulate, basal ganglia, insula, amygdala, hippocampus, and cerebellum. While experiencing wins, ASD boys had significantly less activity than controls in anterior cingulate, temporal regions, and cerebellum, with more activity nowhere. During losses ASD boys had significantly more activity than controls in orbitofrontal cortex, dorsolateral prefrontal cortex, brain stem, and cerebellum, with less activity nowhere. Adolescent boys with ASD had extensive neural hypoactivity during risky decision-making, coupled with decreased activity during reward and increased activity during loss. These neural patterns may underlie the dangerous, excessive, sustained risk-taking of such boys. The findings suggest that the dysphoria, reward insensitivity, and suppressed neural activity observed among older addicted persons also characterize youths early in the development of substance use disorders.

Gravitational lensing of gravitational waves: a statistical perspective

NASA Astrophysics Data System (ADS)

Li, Shun-Sheng; Mao, Shude; Zhao, Yuetong; Lu, Youjun

2018-05-01

In this paper, we study the strong gravitational lensing of gravitational waves (GWs) from a statistical perspective, with particular focus on the high frequency GWs from stellar binary black hole coalescences. These are most promising targets for ground-based detectors such as Advanced Laser Interferometer Gravitational Wave Observatory (aLIGO) and the proposed Einstein Telescope (ET) and can be safely treated under the geometrical optics limit for GW propagation. We perform a thorough calculation of the lensing rate, by taking account of effects caused by the ellipticity of lensing galaxies, lens environments, and magnification bias. We find that in certain GW source rate scenarios, we should be able to observe strongly lensed GW events once per year (˜1 yr-1) in the aLIGO survey at its design sensitivity; for the proposed ET survey, the rate could be as high as ˜80 yr-1. These results depend on the estimate of GW source abundance, and hence can be correspondingly modified with an improvement in our understanding of the merger rate of stellar binary black holes. We also compute the fraction of four-image lens systems in each survey, predicting it to be ˜30 per cent for the aLIGO survey and ˜6 per cent for the ET survey. Finally, we evaluate the possibility of missing some images due to the finite survey duration, by presenting the probability distribution of lensing time delays. We predict that this selection bias will be insignificant in future GW surveys, as most of the lens systems ({˜ } 90{per cent}) will have time delays less than ˜1 month, which will be far shorter than survey durations.

PHAGE FORMATION IN STAPHYLOCOCCUS MUSCAE CULTURES

PubMed Central

Price, Winston H.

1952-01-01

1. The synthesis of ribonucleic acid, desoxyribomicleic acid, and protein in S. muscae has been studied: (a) during the lag phase, (b) during the early log phase, and (c) while the cells are forming an adaptive enzyme for lactose utilization. 2. During the lag phase there may be a 60 per cent increase in ribonucleic acid and protein and a 50 per cent increase in dry weight without a change in cell count, as determined microscopically, or an increase in turbidity. 3. During this period, the increase in protein closely parallels the increase in ribonucleic acid, in contrast to desoxyribonucleic acid, which begins to be synthesized about 45 minutes after the protein and ribonucleic acid have begun to increase. 4. The RNA N/protein N ratio is proportional to the growth rate of all S. muscae strains studied. 5. While the RNA content per cell during the early log phase depends upon the growth rate, the DNA content per cell is fairly constant irrespective of the growth rate of the cell. 6. Resting cells of S. muscae have approximately the same RNA content per cell irrespective of their prospective growth rate. 7. While the cells are adapting to lactose, during which time there is little or no cellular division, there is never an increase of protein without a simultaneous increase in ribonucleic acid, the RNA N/protein N ratio during these intervals being approximately 0.15. 8. Lactose-adapting cells show a loss of ribonucleic acid. The purines-pyrimidines of the ribonucleic acid can be recovered in the cold 5 per cent trichloroacetic acid fraction, but the ribose component is completely lost from the system. 9. The significance of these results is discussed in relation to the importance of ribonucleic acid for protein synthesis. PMID:14955617

Efficacy & safety evaluation of Ayurvedic treatment (Ashwagandha powder & Sidh Makardhwaj) in rheumatoid arthritis patients: a pilot prospective study.

PubMed

Kumar, Gajendra; Srivastava, Amita; Sharma, Surinder Kumar; Rao, T Divakara; Gupta, Yogendra Kumar

2015-01-01

In the traditional system of medicine in India Ashwagandha powder and Sidh Makardhwaj have been used for the treatment of rheumatoid arthritis. However, safety and efficacy of this treatment have not been evaluated. Therefore, the present study was carried out to evaluate the efficacy and safety of Ayurvedic treatment (Ashwagandha powder and Sidh Makardhwaj) in patients with rheumatoid arthritis. One hundred and twenty five patients with joint pain were screened at an Ayurvedic hospital in New Delhi, India. Eighty six patients satisfied inclusion criteria and were included in the study. Detailed medical history and physical examination were recorded. Patients took 5g of Ashwagandha powder twice a day for three weeks with lukewarm water or milk. Sidh Makardhwaj (100 mg) with honey was administered daily for the next four weeks. The follow up of patients was carried out every two weeks. The primary efficacy end point was based on American College of Rheumatology (ACR) 20 response. Secondary end points were ACR50, ACR70 responses, change from baseline in disease activity score (DAS) 28 score and ACR parameters. Safety assessments were hepatic function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), bilirubin and ß2 microglobulin], renal function (urea and creatinine and NGAL) tests and urine mercury level. The study was completed by 90.7 per cent (78/86) patients. Patients with moderate and high disease activity were 57.7 per cent (45/78) and 42.3 per cent (33/78), respectively. All patients were tested positive for rheumatoid factor and increased ESR level. Ashwagandha and Sidh Makardhwaj treatment decreased RA factor. A significant change in post-treatment scores of tender joint counts, swollen joint counts, physician global assessment score, patient global assessment score, pain assessment score, patient self assessed disability index score and ESR level were observed as compared to baseline scores. ACR20 response was observed in 56.4 per cent (44/78) patients (American College of Rheumatology criteria) and moderate response in 39.74 per cent (31/78) patients [European League Against Rheumatism (EULAR) criteria]. Ayurvedic treatment for seven weeks in rheumatoid arthritis patients showed normal kidney and liver function tests. However, increased urinary mercury levels were was observed after treatment. The findings of the present study suggest that this Ayurvedic treatment (Ashwagandha powder and Sidh Makardhwaj) has a potential to be used for the treatment of rheumatoid arthritis. However, due to small sample size, short duration, non randomization and lack of a control group as study limitations, further studies need to be done to confirm these findings.

Efficacy & safety evaluation of Ayurvedic treatment (Ashwagandha powder & Sidh Makardhwaj) in rheumatoid arthritis patients: a pilot prospective study

PubMed Central

Kumar, Gajendra; Srivastava, Amita; Sharma, Surinder Kumar; Rao, T. Divakara; Gupta, Yogendra Kumar

2015-01-01

Background & objectives: In the traditional system of medicine in India Ashwagandha powder and Sidh Makardhwaj have been used for the treatment of rheumatoid arthritis. However, safety and efficacy of this treatment have not been evaluated. Therefore, the present study was carried out to evaluate the efficacy and safety of Ayurvedic treatment (Ashwagandha powder and Sidh Makardhwaj) in patients with rheumatoid arthritis. Methods: One hundred and twenty five patients with joint pain were screened at an Ayurvedic hospital in New Delhi, India. Eighty six patients satisfied inclusion criteria and were included in the study. Detailed medical history and physical examination were recorded. Patients took 5g of Ashwagandha powder twice a day for three weeks with lukewarm water or milk. Sidh Makardhwaj (100 mg) with honey was administered daily for the next four weeks. The follow up of patients was carried out every two weeks. The primary efficacy end point was based on American College of Rheumatology (ACR) 20 response. Secondary end points were ACR50, ACR70 responses, change from baseline in disease activity score (DAS) 28 score and ACR parameters. Safety assessments were hepatic function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), bilirubin and ß2 microglobulin], renal function (urea and creatinine and NGAL) tests and urine mercury level. Results: The study was completed by 90.7 per cent (78/86) patients. Patients with moderate and high disease activity were 57.7 per cent (45/78) and 42.3 per cent (33/78), respectively. All patients were tested positive for rheumatoid factor and increased ESR level. Ashwagandha and Sidh Makardhwaj treatment decreased RA factor. A significant change in post-treatment scores of tender joint counts, swollen joint counts, physician global assessment score, patient global assessment score, pain assessment score, patient self assessed disability index score and ESR level were observed as compared to baseline scores. ACR20 response was observed in 56.4 per cent (44/78) patients (American College of Rheumatology criteria) and moderate response in 39.74 per cent (31/78) patients [European League Against Rheumatism (EULAR) criteria]. Ayurvedic treatment for seven weeks in rheumatoid arthritis patients showed normal kidney and liver function tests. However, increased urinary mercury levels were was observed after treatment. Interpretation & conclusions: The findings of the present study suggest that this Ayurvedic treatment (Ashwagandha powder and Sidh Makardhwaj) has a potential to be used for the treatment of rheumatoid arthritis. However, due to small sample size, short duration, non randomization and lack of a control group as study limitations, further studies need to be done to confirm these findings. PMID:25857501

Investigating the Lyman photon escape in local starburst galaxies with the Cosmic Origins Spectrograph

NASA Astrophysics Data System (ADS)

Hernandez, Svea; Leitherer, Claus; Boquien, Médéric; Buat, Véronique; Burgarella, Denis; Calzetti, Daniela; Noll, Stefan

2018-07-01

We present a study of seven star-forming galaxies from the Cosmic Evolution Survey observed with the Cosmic Origins Spectrograph (COS) onboard the Hubble Space Telescope (HST). The galaxies are located at relatively low redshifts, z ˜ 0.3, with morphologies ranging from extended and disturbed to compact and smooth. To complement the HST observations, we also analyse observations taken with the Visible Multi-object Spectrograph (VIMOS) on the Very Large Telescope (VLT). In our galaxy sample, we identify three objects with double peak Lyman-α profiles similar to those seen in Green Pea compact galaxies and measure peak separations of 655, 374, and 275 km s-1. We measure Lyman-α escape fractions with values ranging between 5 per cent and 13 per cent. Given the low flux levels in the individual COS exposures, we apply a weighted stacking approach to obtain a single spectrum. From this COS combined spectrum, we infer upper limits for the absolute and relative Lyman continuum escape fractions of f_abs(LyC) = 0.4^{+10.1}_{-0.4} per cent and f_res(LyC) = 1.7^{+15.2}_{-1.7}per cent, respectively. Finally, we find that most of these galaxies have moderate ultraviolet and optical star formation rates (SFRs) (SFRs ≲10 M⊙ yr-1).

On the stability and collisions in triple stellar systems

NASA Astrophysics Data System (ADS)

He, Matthias Y.; Petrovich, Cristobal

2018-02-01

A significant fraction of main-sequence (MS) stars are part of a triple system. We study the long-term stability and dynamical outcomes of triple stellar systems using a large number of long-term direct N-body integrations with relativistic precession. We find that the previously proposed stability criteria by Eggleton & Kiseleva and Mardling & Aarseth predict the stability against ejections reasonably well for a wide range of parameters. Assuming that the triple stellar systems follow orbital and mass distributions from FGK binary stars in the field, we find that ˜ 1 per cent and ˜ 0.5 per cent of the triple systems lead to a direct head-on collision (impact velocity ˜ escape velocity) between MS stars and between a MS star and a stellar-mass compact object, respectively. We conclude that triple interactions are the dominant channel for direct collisions involving a MS star in the field with a rate of one event every ˜100 years in the Milky Way. We estimate that the fraction of triple systems that form short-period binaries is up to ˜ 23 per cent with only up to ˜ 13 per cent being the result of three-body interactions with tidal dissipation, which is consistent with previous work using a secular code.

Diseases associated with pronounced eosinophilia: a study of 105 dogs in Sweden.

PubMed

Lilliehöök, I; Gunnarsson, L; Zakrisson, G; Tvedten, H

2000-06-01

Records of 105 dogs with pronounced eosinophilia (>2.2 x 10(9) eosinophils/litre) were evaluated in a retrospective study to determine diseases associated with the abnormality in dogs in Sweden. Inflammatory disease in organs with large epithelial surfaces, such as the gut, lungs or skin, was found in 36 per cent of the dogs. A further one-quarter of the 105 cases were placed in the 'miscellaneous' category, which comprised various diseases found at low frequency. The most well defined diagnosis was pulmonary infiltrates with eosinophils in 12 per cent of the dogs. A further 11 per cent had parasitic disease caused by either sarcoptic mange or nasal mite. No atopic dog was found and rottweilers were over-represented in most disease groups. Pronounced eosinophilia, in many cases transient, seems to be associated with a variety of disorders in dogs. In the present study, rottweilers appeared to be more prone to a high eosinophil response than other breeds.

Microscopic and clinical evidence for Anaplasma (Ehrlichia) phagocytophilum infection in Italian cats.

PubMed

Tarello, W

2005-06-11

Fifteen cats from Italy with Ehrlichia-like inclusion bodies in their neutrophils were studied. They were diagnosed with Anaplasma (Ehrlichia) phagocytophilum infection on the basis of cytological observation of morulae within 1 to 21 per cent of their neutrophils, clinical signs characteristic of ehrlichiosis and their response to doxycycline. The predominant signs of disease were anorexia, lethargy, hyperaesthesia, muscle and joint pain, lameness, neck rigidity, lymphadenomegaly, gingivitis/periodontitis, conjunctivitis, weight loss, incoordination, pale mucous membranes and hyperglobulinaemia. The cat with inclusions in 21 per cent of its neutrophils had suffered arthralgia, tachypnoea, neck rigidity, vomiting and thrombocytopenia for four months, but recovered promptly after treatment with doxycycline.

Quantifying cosmic variance

NASA Astrophysics Data System (ADS)

Driver, Simon P.; Robotham, Aaron S. G.

2010-10-01

We determine an expression for the cosmic variance of any `normal' galaxy survey based on examination of M* +/- 1 mag galaxies in the Sloan Digital Sky Survey (SDSS) Data Release 7 (DR7) data cube. We find that cosmic variance will depend on a number of factors principally: total survey volume, survey aspect ratio and whether the area surveyed is contiguous or comprising independent sightlines. As a rule of thumb cosmic variance falls below 10 per cent once a volume of 107h-30.7Mpc3 is surveyed for a single contiguous region with a 1:1 aspect ratio. Cosmic variance will be lower for higher aspect ratios and/or non-contiguous surveys. Extrapolating outside our test region we infer that cosmic variance in the entire SDSS DR7 main survey region is ~7 per cent to z < 0.1. The equation obtained from the SDSS DR7 region can be generalized to estimate the cosmic variance for any density measurement determined from normal galaxies (e.g. luminosity densities, stellar mass densities and cosmic star formation rates) within the volume range 103-107h-30.7Mpc3. We apply our equation to show that two sightlines are required to ensure that cosmic variance is <10 per cent in any ASKAP galaxy survey (divided into Δ z ~ 0.1 intervals, i.e. ~1Gyr intervals for z < 0.5). Likewise 10 MeerKAT sightlines will be required to meet the same conditions. GAMA, VVDS and zCOSMOS all suffer less than 10 per cent cosmic variance (~3-8 per cent) in Δ z intervals of 0.1, 0.25 and 0.5, respectively. Finally we show that cosmic variance is potentially at the 50-70 per cent level, or greater, in the Hubble Space Telescope (HST) Ultra Deep Field depending on assumptions as to the evolution of clustering. 100 or 10 independent sightlines will be required to reduce cosmic variance to a manageable level (<10 per cent) for HST ACS or HST WFC3 surveys, respectively (in Δ z ~ 1 intervals). Cosmic variance is therefore a significant factor in the z > 6 HST studies currently underway.

The effect of lengthening life expectancy on future pension and long-term care expenditure in England, 2007 to 2032.

PubMed

Malley, Juliette; Hancock, Ruth; Murphy, Mike; Adams, John; Wittenberg, Raphael; Comas-Herrera, Adelina; Curry, Chris; King, Derek; James, Sean; Morciano, Marcello; Pickard, Linda

2011-01-01

The aim of this analysis is to examine the effect of different assumptions about future trends in life expectancy (LE) on the sustainability of the pensions and long-term care (LTC) systems. The context is the continuing debate in England about the reform of state pensions and the reform of the system for financing care and support. Macro and micro simulation models are used to make projections of future public expenditure on LTC services for older people and on state pensions and related benefits, making alternative assumptions on increases in future LE. The projections cover the period 2007 to 2032 and relate to England. Results are presented for a base case and for specified variants to the base case. The base case assumes that the number of older people by age and gender rises in line with the Office for National Statistics' principal 2006-based population projection for England. It also assumes no change in disability rates, no changes in patterns of care, no changes in policy and rises in unit care costs and real average earnings by 2 per cent per year. Under these assumptions public expenditure on pensions and related benefits is projected to rise from 4.7 per cent of Gross Domestic Product (GDP) in 2007 to 6.2 per cent of GDP in 2032 and public expenditure on LTC from 0.9 per cent of GDP in 2007 to 1.6 per cent of GDP in 2032. Under a very high LE variant to the GAD principal projection, however, public expenditure on pensions and related benefits is projected to reach 6.8 per cent of GDP in 2032 and public expenditure on LTC 1.7 per cent of GDP in 2032. Policymakers developing reform proposals need to recognise that, since future LE is inevitably uncertain and since variant assumptions about future LE significantly affect expenditure projections, there is a degree of uncertainty about the likely impact of demographic pressures on future public expenditure on pensions and LTC.

Astronomy and Sodium Lighting,

DTIC Science & Technology

1984-02-01

55 REFERENCES...........................................................57 - ix - FIGURES 1. Wavelength response of the human...34 9. Retail Prices for the Specified Energy Consumption and Demand of Electricity in Selected Cities, February 1982, 0 1981 (Cents per Kilowatt Hour...555 nm and operate at approximately 2700 0K. In Fig. 1, we show the spectrum of a typical incandescent lamp, together with the human visual response

78 FR 67399 - Notice of Lodging of Proposed Consent Decree Under the Comprehensive Environmental Response...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-12

... EPA's past and future response costs and perform the remedial action that EPA selected for the.../Consent_Decrees.html . We will provide a paper copy of the proposed Consent Decree upon written request... $39.25 (25 cents per page reproduction cost) payable to the United States Treasury. For a paper copy...

The effect of yeast cell wall supplementation on the metabolic responses of crossbred heifers to endotoxin challenge

USDA-ARS?s Scientific Manuscript database

This study examined the effect of feeding yeast cell wall (YCW) products on the metabolic responses of newly-received heifers to endotoxin (lipopolysaccharide; LPS) challenge. Heifers (n=24; 218.9±2.4 kg) were obtained from commercial sale barns and transported to the Texas Tech University Beef Cent...

Determination of the rate constant for the NH2(X2B1) + NH2(X2B1) recombination reaction with collision partners He, Ne, Ar, and N2 at low pressures and 296 K. Part 1.

PubMed

Altinay, Gokhan; Macdonald, R Glen

2012-02-09

The recombination rate constant for the NH(2)(X(2)B(1)) + NH(2)(X(2)B(1)) → N(2)H(4)(X(1)A(1)) reaction in He, Ne, Ar, and N(2) was measured over the pressure range 1-20 Torr at a temperature of 296 K. The NH(2) radical was produced by 193 nm laser photolysis of NH(3) dilute in the third-body gas. The production of NH(2) and the loss of NH(3) were monitored by high-resolution continuous-wave absorption spectroscopy: NH(2) on the (1)2(21) ← (1)3(31) rotational transition of the (0,7,0)A(2)A(1) ← (0,0,0) X(2)B(1) vibronic band and NH(3) on either inversion doublet of the (q)Q(3)(3) rotational transition of the ν(1) fundamental. Both species were detected simultaneously following the photolysis laser pulse. The broader Doppler width of the NH(2) spectral transition allowed temporal concentration measurements to be extended up to 20 Torr before pressure broadening effects became significant. Fall-off behavior was identified and the bimolecular rate constants for each collision partner were fit to a simple Troe form defined by the parameters, k(0), k(inf), and F(cent). This work is the first part of a two part series in which part 2 will discuss the measurements with more efficient energy transfer collision partners CH(4), C(2)H(6), CO(2), CF(4), and SF(6). The pressure range was too limited to extract any new information on k(inf), and k(inf) was taken from the theoretical calculations of Klippenstein et al. (J. Phys. Chem A 2009, 113, 10241) as k(inf) = 7.9 × 10(-11) cm(3) molecule(-1) s(-1) at 296 K. The individual Troe parameters were: He, k(0) = 2.8 × 10(-29) and F(cent) = 0.47; Ne, k(0) = 2.7 × 10(-29) and F(cent) = 0.34; Ar, k(0) = 4.4 × 10(-29) and F(cent) = 0.41; N(2), k(0) = 5.7 × 10(-29) and F(cent) = 0.61, with units cm(6) molecule(-2) s(-1) for k(0). In the case of N(2) as the third body, it was possible to measure the recombination rate constant for the NH(2) + H reaction near 20 Torr total pressure. The pure three-body recombination rate constant was (2.3 ± 0.55) × 10(-30) cm(6) molecule(-2) s(-1), where the uncertainty is the total experimental uncertainty including systematic errors at the 2σ level of confidence.

Benchmarking welfare indicators in 73 free-stall dairy farms in north-western Spain

PubMed Central

Trillo, Yolanda; Quintela, Luis Angel; Barrio, Mónica; Becerra, Juan José; Peña, Ana Isabel; Vigo, Marcos; Garcia Herradon, Pedro

2017-01-01

The aim of this study was to describe the status of body condition score (BCS), hock injuries prevalence, locomotion and body hygiene score as animal welfare measures in 73 free-stall dairy cattle farms in Lugo (Spain). A benchmarking process was established across farms: (1) the animal-based indicators were ordered from low to high values; (2) The farms were classified into three categories based on the number of indicators within less than the 25th percentile, 25th to 75th percentile and above the 75th percentile. The median prevalence of unsuitable BCS, hock injuries and clinical lameness was (median (range)) 51.7 per cent (13.3 to 89.5 per cent), 40.0 per cent (7.0per cent to 100 per cent) and 9.0 per cent (0per cent to 60.0 per cent) respectively. The dirtiness of the cow’s coat had a high prevalence (73.0 per cent (37.5per cent to 100 per cent)). Most farms did not display consistently good or poor animal-based indicators and each farm had its own set of strong and weak points. Moreover, facilities design and management practices were described to understand source of the observations made of the cows. The incidence of overstocking was 31.5 per cent for stalls and 26.0 per cent for headlocks. The front lunge space was reduced (<90 cm) on most dairies (90.4 per cent). Signs of poor natural ventilation (cobwebs or humidity on the roof) and ammonia odour were observed on 32.8 per cent and 85.0 per cent of the barns totally closed or with a side openingless than 50 per cent of the wall height. The milking parlour was designed with two or more turns more than 90° (9.3 per cent), and failed to allow cows to see the parlour before entering (45.2 per cent). On 52.0 per cent of dairies, more than 15 per cent of the cows had to be forcefully moved into the milking parlour. In conclusion, there was a big variation in the animal welfare levels within and across farms and they could benefit from others by changing management practices related to facilities and herds. PMID:29018530

Subxiphoid pericardial window to exclude occult cardiac injury after penetrating thoracoabdominal trauma.

PubMed

Hommes, M; Nicol, A J; van der Stok, J; Kodde, I; Navsaria, P H

2013-10-01

An occult cardiac injury may be present in patients with an acute abdomen after penetrating thoracoabdominal trauma. This study assessed the use of a subxiphoid pericardial window (SPW) as a diagnostic manoeuvre in this setting. This was a retrospective review of a trauma database (2001-2009). Patients presenting with a penetrating thoracoabdominal injury with an acute abdomen, and in whom there was concern about a potential cardiac injury from the site or tract of the injury, were included. Fifty patients with an indication for emergency laparotomy underwent a SPW for a possible cardiac injury. An occult haemopericardium was present at SPW in 14 patients (28 per cent) mandating, median sternotomy. Nine cardiac injuries (18 per cent) were identified including five tangential injuries and four perforations. The specific complication rate relating to the SPW was 2 per cent. The SPW is a useful technique at laparotomy to identify cardiac injuries in patients with penetrating thoracoabdominal injuries. © 2013 British Journal of Surgery Society Ltd. Published by John Wiley & Sons Ltd.

Preliminary report of associated factors in wound infection after major head and neck neoplasm operations--does the duration of prophylactic antibiotic matter?

PubMed

Liu, S-A; Tung, K-C; Shiao, J-Y; Chiu, Y-T

2008-04-01

The aim of this study was to investigate whether an extended course of prophylactic antibiotic could reduce the wound infection rate in a subtropical country. Fifty-three consecutive cases scheduled to receive major head and neck operations were randomised into one-day or three-day prophylactic antibiotic groups. Thirteen cases (24.5 per cent) developed wound infections after operations. The duration of prophylactic antibiotic was not related to the surgical wound infection. However, pre-operative haemoglobulin less than 10.5 g/dl (odds ratio: 7.24, 95 per cent confidence interval: 1.28-41.0) and reconstruction with a free flap or pectoris major myocutaneous flap during the operation (odds ratio: 11.04, 95 per cent confidence interval: 1.17-104.7) were associated factors significantly influencing post-operative wound infection. Therefore, one day of prophylactic antibiotic was effective in major head and neck procedures but should not be substituted for proper aseptic and meticulous surgical techniques.

Photogrammetric registration of dental plaque accumulation in vivo.

PubMed

Bergström, J

1981-01-01

Using the labial surface of upper anterior laterals for determination, the accumulation of plaque was assessed by means of a stereo-photogrammetric method. The stereoimages were subjected to photogrammetric evaluation, the part of the surface area covered by plaque being given in per cent of the total surface area of the tooth. Plaque extension and plaque topography was studied in young adults with healthy periodontia during a 20 day period of no oral hygiene. At the end of the experimental period, on an average 75 per cent of the surface area was covered by plaque, corresponding to an extension rate of 3.75 per cent per day. The correlation between plaque values obtained by photogrammetry and various estimates obtained from clinical scoring ranged between r = 0.66 and r = 0.78. It is concluded that the method introduced is a sensitive means of determining small amounts of plaque and should prove useful for in vivo investigation of plaque growth and plaque suppression, where measurements of high quality is of importance.

Comparative effectiveness of individualised homeopathy and antibiotics in the treatment of bovine clinical mastitis: randomised controlled trial

PubMed Central

Keller, Diana; Sundrum, Albert

2018-01-01

Based on the widespread use of homeopathy in dairy farm practice when treating mastitis, a blind randomised controlled trial (RCT) was conducted to assess the effectiveness of homeopathic treatment of clinical mastitis on four dairy farms. The study considered specific guidelines for RCTs as well as the basic principles of individualised homeopathy and involved 180 lactating dairy cows. Evaluation of cure rates was based on clinical investigation of the udder and on laboratory analysis of milk samples. In culture-positive cases, the antibiotic treatment provided suboptimal bacteriological cures (60–81 per cent) but was more effective than individualised homeopathy (33–43 per cent) whose effects appeared little different to those of placebos (45–47 per cent) (P≤0.05). On the cytological cure level, all three treatment methods were similarly ineffective: antibiotic being 2–21 per cent, individualised homeopathy 0–8 per cent and placebo 3–13 per cent (P≤0.05; P=0.13). Antibiotics, individualised homeopathy and placebo had similar effects on bacteriological and cytological cure in cases of culture-negative milk samples (P>0.4) and Escherichia coli infections (P=1.0). The study results implied that the effectiveness of individualised homeopathy does not go beyond a placebo effect and successful treatment is highly dependent on the specific mastitis pathogen. Thus, antimicrobial or alternative remedies used should be based on the bacterial culture of the milk sample. Trial registration number NTP-ID: 00008011-1-9, Pre-results. PMID:29374099

Microbiological evaluation of female patients in STD clinics.

PubMed

Iyer, S V; Deodhar, L; Gogate, A

1991-03-01

A total of 215 women patients attending the STD clinic were evaluated in an attempt to isolate the different microorganisms in sexually transmitted diseases (STD). Mycoplasmas (30.22%), Candida species (20.00%), Trichomonas vaginalis (wet mount study; 15.81%), beta haemolytic streptococci (13.48%), Neisseria gonorrhoeae (9.30%), Staphylococcus aureus (13.95%), inclusion bodies of Chlamydia trachomatis (11.60%) and Gram negative organisms (9.30%) were isolated from these patients. Sera of all patients screened for HBsAg by ELISA showed a carrier rate of 12.5 per cent; 29.8 per cent sera were reactive in the VDRL test at the dilutions varying from 1:4 to 1:64.

Vocalization-Induced Enhancement of the Auditory Cortex Responsiveness during Voice F0 Feedback Perturbation

PubMed Central

Behroozmand, Roozbeh; Karvelis, Laura; Liu, Hanjun; Larson, Charles R.

2009-01-01

Objective The present study investigated whether self-vocalization enhances auditory neural responsiveness to voice pitch feedback perturbation and how this vocalization-induced neural modulation can be affected by the extent of the feedback deviation. Method Event related potentials (ERPs) were recorded in 15 subjects in response to +100, +200 and +500 cents pitch-shifted voice auditory feedback during active vocalization and passive listening to the playback of the self-produced vocalizations. Result The amplitude of the evoked P1 (latency: 73.51 ms) and P2 (latency: 199.55 ms) ERP components in response to feedback perturbation were significantly larger during vocalization than listening. The difference between P2 peak amplitudes during vocalization vs. listening was shown to be significantly larger for +100 than +500 cents stimulus. Conclusion Results indicate that the human auditory cortex is more responsive to voice F0 feedback perturbations during vocalization than passive listening. Greater vocalization-induced enhancement of the auditory responsiveness to smaller feedback perturbations may imply that the audio-vocal system detects and corrects for errors in vocal production that closely match the expected vocal output. Significance Findings of this study support previous suggestions regarding the enhanced auditory sensitivity to feedback alterations during self-vocalization, which may serve the purpose of feedback-based monitoring of one’s voice. PMID:19520602

16 CFR 305.17 - Television labeling.

Code of Federal Regulations, 2014 CFR

2014-01-01

... (sleep) mode per day, and an electricity cost rate of 11 cents per kWh. (5) The applicable ranges of... hours in sleep (standby) mode per day. (8) No marks or information other than that specified in this...

29 CFR 5.32 - Overtime payments.

Code of Federal Regulations, 2014 CFR

2014-07-01

....25 an hour to a mechanic as his basic cash wage plus 50 cents an hour as a contribution to a welfare... prevailing wage statutes. It is clear from the legislative history that in no event can the regular or basic... less than the amount determined by the Secretary of Labor as the basic hourly rate (i.e. cash rate...

29 CFR 5.32 - Overtime payments.

Code of Federal Regulations, 2013 CFR

2013-07-01

....25 an hour to a mechanic as his basic cash wage plus 50 cents an hour as a contribution to a welfare... prevailing wage statutes. It is clear from the legislative history that in no event can the regular or basic... less than the amount determined by the Secretary of Labor as the basic hourly rate (i.e. cash rate...

29 CFR 5.32 - Overtime payments.

Code of Federal Regulations, 2012 CFR

2012-07-01

....25 an hour to a mechanic as his basic cash wage plus 50 cents an hour as a contribution to a welfare... prevailing wage statutes. It is clear from the legislative history that in no event can the regular or basic... less than the amount determined by the Secretary of Labor as the basic hourly rate (i.e. cash rate...

Managerial attitude to the implementation of quality management systems in Lithuanian support treatment and nursing hospitals

PubMed Central

Buciuniene, Ilona; Malciankina, Sonata; Lydeka, Zigmas; Kazlauskaite, Ruta

2006-01-01

Background The regulations of the Quality Management System (QMS) implementation in health care organizations were approved by the Lithuanian Ministry of Health in 1998. Following the above regulations, general managers of health care organizations had to initiate the QMS implementation in hospitals. As no research on the QMS implementation has been carried out in Lithuanian support treatment and nursing hospitals since, the objective of this study is to assess its current stage from a managerial perspective. Methods A questionnaire survey of general managers of Lithuanian support treatment and nursing hospitals was carried out in the period of January through March 2005. Majority of the items included in the questionnaire were measured on a seven-point Likert scale. During the survey, a total of 72 questionnaires was distributed, out of which 58 filled-in ones were returned (response rate 80.6 per cent; standard sampling error 0.029 at 95 per cent level of confidence). Results Quality Management Systems were found operating in 39.7 per cent of support treatment and nursing hospitals and currently under implementation in 46.6 per cent of hospitals (13.7% still do not have it). The mean of the respondents' perceived QMS significance is 5.8 (on a seven-point scale). The most critical issues related to the QMS implementation include procedure development (5.5), lack of financial resources (5.4) and information (5.1), and development of work guidelines (4.6), while improved responsibility and power sharing (5.2), better service quality (5.1) and higher patient satisfaction (5.1) were perceived by the respondents as the key QMS benefits. The level of satisfaction with the QMS among the management of the surveyed hospitals is mediocre (3.6). However it was found to be higher among respondents who were more competent in quality management, were familiar with ISO 9000 standards, and had higher numbers of employees trained in quality management. Conclusion QMSs are perceived to be successfully running in one third of the Lithuanian support treatment and nursing hospitals. Its current implementation stage is dependent on the hospital size – the bigger the hospital the more success it meets in the QMS implementation. As to critical Quality Management (QM) issues, hospitals tend to encounter such major problems as lack of financial resources, information and training, as well as difficulties in procedure development. On the other hand, the key factors that assist to the success of the QMS implementation comprise managerial awareness of the QMS significance and the existence of employee training systems and audit groups in hospitals. PMID:16987416

The psychiatric patient at work.

PubMed Central

Robbins, D B; Kaminer, A J; Schussler, T; Pomper, I H

1976-01-01

Psychiatric consultations and job performance of 135 IBM employees were studied. Psychiatric referrals were made by management and the company medical department or were self-referred. The consulting psychiatrist conducted interviews, met with management, personnel representatives and other physicians to coordinate treatment with job requirements. Every effort was made to retain employees and improve performance. After a two-three year follow-up period, 82 employees (61.7 per cent) were with the company; ten were rated outstanding, 38 exceeded job requirements, 25 were meeting job requirements, and four were not. Performance data for five employees were not available. Forty-nine of 83 employees (59.0 per cent) rated unsatisfactory in job performance at the initial referral were performing satisfactorily at follow-up. The results support an optimistic attitude toward the working patient with psychiatric disease and highlight the value of a full-time medical department with consultation facilities leading to secondary and tertiary prevention. PMID:937612

Present and potential land use mapping in Mexico

NASA Technical Reports Server (NTRS)

Garduno, H.; Lagos, R. G.; Simo, F. G.

1975-01-01

The Mexican Water Plan (MWP) conducted studies of present and potential land use in Mexico using LANDSAT-1 satellite imagery. Present land use studies were carried out all over the country (197 million hectares); nine soil uses were mapped according to the first classification level recommended by the U.S. Geological Survey. Also 6.3 million hectares of land with advanced erosion were detected. Work was executed at a rate of 8 million hectares per month; reliability was 90% and the cost of only 0.1 cents/hectare. The potential land use study was performed in 45 million hectares at a rate of 4 million hectares per month and at a cost of 0.33 cents/hectare. Soil units according to FAO classification were delineated scale 1:1 million; interpretative maps were also prepared dealing with potential agricultural productivity carrying capacity for cattle, water, erosion risk, and slope ranges.

The personality and motivation of semen donors: a comparison with oocyte donors.

PubMed

Schover, L R; Rothmann, S A; Collins, R L

1992-04-01

Seventeen consecutively recruited candidates for semen donation were evaluated by a psychologist with testing and a structured interview. Most men (71%) were motivated by financial compensation. Only 29% would donate semen if records were open to potential offspring. Fifty-nine per cent of the men were rated as excellent candidates from a psychological perspective and 35% were rated as acceptable with slight reservations. One was excluded as a donor. Psychological testing revealed mildly abnormal subscale scores for 35% of donors. Forty-seven per cent had histories of minor depressive or anxiety episodes and 35% had had periods of heavy alcohol use. Compared to oocyte donors at the same institution, the men were less altruistic, more affluent, and more likely to have abused alcohol. Women had more traumatic family and reproductive histories. Psychological evaluation can be a valuable tool in gamete donor selection.

Patterns in hospitals' use of a regional poison information center.

PubMed Central

Chafee-Bahamon, C; Caplan, D L; Lovejoy, F H

1983-01-01

A statewide poison center undertook a study to identify types of hospitals which used its information services. Initial trends in calls from hospitals to the center over the center's first two years and percentages of hospitals' patient caseloads for which the center consulted were analyzed for 104 acute care hospitals by hospitals' location, size, and emergency room staffing. After the center's establishment as a regional resource, emergency room staff in urban teaching hospitals showed the greatest increase in calls within a year (88 per cent) and the highest consultation rates for poison patients seen (57 per cent). Private physician emergency room staff, and staff in distant and rural hospitals, showed lower or no increases in calls and lower consultation rates. Findings suggest that private physician emergency room staff and staff in distant and rural hospitals be considered for poison center outreach. Marketing of consultation services for non-pediatric overdoses is also indicated. PMID:6829822

[Epidemiological studies on Echinococcus multilocularis in red foxes in north-west Poland].

PubMed

Ramisz, A; Eckert, J; Balicka-Ramisz, A; Bieńko, R; Pilarczyk, B

1999-01-01

The studies were carried out in 15 provinces of North-West part of Poland in the years 1994 - 1997 under a regime of strict laboratory safety regulation. The intestine of 1909 red foxes were examined for the presence of Echinococcus multilocularis according to the method of Eckert et al (1991). The intestines were divided finto four to six sections and fifteen smears were prepared from each animal under study. Foxes infected with E. multilocularis were detected in 8 provinces. The average prevalence rate in these provinces was 1.20 per cent. Of special interest fis the finding in Slupsk and Gdafisk regions, where 9.6 per cent of foxes were infected with E. multilocularis. In comparison with some other European endemic regions the prevalence rates of E. multilocularis in Poland was low, except for the Stupsk-Gdańsk area.

A cross-sectional survey of optometrists and optometric practices in Ghana.

PubMed

Boadi-Kusi, Samuel Bert; Ntodie, Michael; Mashige, Khathutshelo Percy; Owusu-Ansah, Andrew; Antwi Osei, Kwaku

2015-09-01

The study was conducted to profile optometrists and optometric practices in Ghana. An online survey was conducted among 146 optometrists, who were registered with the Ghana Optometric Association (GOA). It included questions on their demographics, equipment, ophthalmic procedures routinely conducted and the barriers to providing a full scope of optometric services. Ninety registered optometrists (62 per cent) responded, their mean age being 28.97 ± 3.36 years. There were more males (68.9 per cent) than females and most had the Doctor of Optometry (OD) degree, the profession's highest degree in Ghana. There were more practitioners in urban centres (71.1 per cent) and most practices had basic optometric instruments, such as direct ophthalmoscopes, slitlamp biomicroscopes and retinoscopes. Many optometrists routinely conducted direct ophthalmoscopy (100 per cent), slitlamp biomicroscopy (87.5 per cent) and contact tonometry (55.7 per cent); however, few provided contact lens (10.2 per cent) and low vision (9.1 per cent) assessments, with 76 per cent stating that it was due to the unavailability of low vision devices, poor sources of contact lenses (27 per cent) and perceived insufficient training (11.2 per cent). Many practitioners (97 per cent) reported the use of diagnostic pharmaceutical agents and therapeutic pharmaceutical agents (96.6 per cent). Most practitioners (52.9 per cent) preferred conferences for the delivery of continuous professional development over publications (26.4 per cent) and internet resources (12.6 per cent). The data elicited in this study provide a basis for addressing the country's unmet eye-care needs and can be used to determine training and support guidelines for the profession. © 2015 The Authors. Clinical and Experimental Optometry © 2015 Optometry Australia.

Is 50 cent the price of the optimal copayment? - a qualitative study of patient opinions and attitudes in response to a 50 cent charge on prescription drugs in a publicly funded health system in Ireland

PubMed Central

2013-01-01

Background A 50 cent prescription levy was introduced in 2010 on the General Medical Services (GMS) scheme (Irish public health insurance). This study sought to examine patient attitudes and opinions surrounding the 50 cent copayment. Given the small momentary value of the prescription fee, these results are of interest to policymakers internationally who wish to reduce copayments rather than abolish them. Methods A qualitative research design was used; semi structured interviews were carried out. Twenty four GMS eligible participants were interviewed in 23 interviews. Fifteen females and 9 males took part. Ages varied from 31- >70 years. Patients were invited to be interviewed in both independent and chain community pharmacies in three types of setting; 1) a socially deprived urban area, 2) a suburban affluent area and 3) a rural area. The Framework method was used for data management and analysis using QSR International’s NVivo 9.2 qualitative data analysis software. The “Francis method” was used to test for data saturation. Results Results are of interest to the Irish context and also at a broader international level. Patients were mostly accepting of the prescription levy with some reservations concerning an increased price and the way in which generated revenue would be used by government. Participants identified waste of prescription drugs at the hand of patients (moral hazard), but there was discordant opinion on whether the 50 cent copayment would halt this moral hazard. Interviewees felt the levy was affordable, albeit some may suffer a financial impact more than others. Conclusions This qualitative study gives important insights into the experiences of GMS patients with regard to the prescription levy. Information regarding the appropriateness of a 50 cent copayment as a symbolic copayment needs to be confirmed by quantitative analysis. Further insight is required from a younger population. PMID:23305316

International practice survey on the management of brain metastases: Third International Consensus Workshop on Palliative Radiotherapy and Symptom Control.

PubMed

Tsao, M N; Rades, D; Wirth, A; Lo, S S; Danielson, B L; Vichare, A; Hahn, C; Chang, E L

2012-08-01

To evaluate international patterns of practice for the management of metastatic disease to the brain. An online international practice survey was conducted from April to June 2010. Most of the survey questions were based on common management issues for which optimal management using level 1 evidence was lacking. The survey consisted of three sections: respondent demographics, 13 general questions regarding surgery, whole brain radiotherapy (WBRT) and radiosurgery and 13 questions related to specific scenarios. In total, 445 individuals responded to the survey over a 3 month period. Ninety per cent of respondents worked in a hospital-based setting. Ninety-three per cent of respondents were radiation oncologists. Thirty-seven per cent worked in an academic setting. Only three of 26 survey questions generated at least 70% agreement for a favoured response. Eighty-eight per cent of respondents chose comfort measures only for patients with multiple brain metastases who have been previously treated with WBRT and who now present 6 months later with two to four brain metastases (all less than 4 cm in size) with uncontrolled extracranial disease and bedridden state. Seventy-eight per cent of respondents would use WBRT alone for initial treatment in patients with two to four brain metastases (all less than 4 cm in size), with active, uncontrolled extracranial disease and a Karnofsky performance status of 70. Seventy-eight per cent of respondents chose surgical resection for an enlarging single brain metastasis that has been previously treated with radiosurgery. The enlarging single brain metastasis is in a surgically accessible site and is now symptomatic. The patient has controlled extracranial disease, good performance status and magnetic resonance spectroscopy was not diagnostic. There is a lack of uniform agreement for many common management issues (not well answered by level 1 evidence) in patients with metastatic disease to the brain. Copyright © 2012 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

The retention of pit and fissure sealants placed in primary school children by Dental Health Services, Victoria.

PubMed

Messer, L B; Calache, H; Morgan, M V

1997-08-01

The benefit of a public sector sealant programme for children in Australia is yet to be established. This study evaluated sealants placed by therapists of the School Dental Service in Victoria, between 1989 and 1994, on permanent teeth of children in 15 primary schools in Melbourne. Seven hundred and seventy four children aged 6-12 years were examined in school dental clinics by six calibrated examiners. A total of 5363 sealants placed on 2875 permanent teeth (including 2616 first molars, 91 per cent of sample) up to four and a half years previously was examined. Values for complete and partial sealant retention were highest for premolars (86 per cent, 9 per cent respectively, total 95 per cent); similar for occlusal surfaces of maxillary and mandibular first molars (63 per cent, 30 per cent; 62 per cent, 32 per cent respectively) and buccal pits of mandibular molars (66 per cent); and low for pits/fissures of Carabelli's cusps of maxillary molars (44 per cent). Cross-sectional examination up to 24 months for both maxillary and mandibular first molars indicated average values of 67 per cent complete retention, 27 per cent partial retention, 6 per cent missing; thereafter complete retention decreased and partial retention increased. Sealant failures in the six months post-placement were attributed to technique failure. Regardless of sealant retention, caries experience was low under partially retained or missing sealants (4.5 per cent) and completely retained sealants (0.4 per cent). It is concluded that the SDS sealant programme is a sound preventive dental public health approach.

The prevalence of painful incidents among young recreational gymnasts

PubMed Central

Coates, Chrystal; McMurtry, C Meghan; Lingley-Pottie, Patricia; McGrath, Patrick J

2010-01-01

BACKGROUND: Although children experience pain during their daily life, research has generally focused on medical pain. Sport-related pain has not been widely studied in children and research has not examined the occurrence of painful incidents in gymnastics. The prevalence of painful incidents among children in recreational gymnastics classes and accompanying coach responses were recorded. METHODS: Sixty-one children between five and 10 years of age were observed at a gymnastics club. A checklist was used to record painful incidents as well as coach and child responses. RESULTS: The rate of painful incidents was 0.17 per child per hour observed. The floor apparatus was the most common site of incidents, while bumping into equipment was the most common incident. Based on observer ratings, most incidents were mild to moderate in severity and, on average, the child’s reaction to these mild to moderate incidents lasted for 8.5 s. Forty per cent of the children had a mild to moderate painful experience. Coaches reacted to more than 60% of the painful incidents, usually asking how the child was and what had happened. A significant difference was found between the mean severity ratings of painful incidents that were followed by coach response and incidents followed by no response. CONCLUSION: Most children who attend recreational gymnastics classes will likely experience at least one mild to moderate painful experience for every 6 h of class. Coaches are more inclined to react to a painful incident than not. Moreover, a difference was found that suggests coaches responded to more painful incidents. PMID:20577661

Three-dimensional hydrodynamical models of wind and outburst-related accretion in symbiotic systems

NASA Astrophysics Data System (ADS)

de Val-Borro, M.; Karovska, M.; Sasselov, D. D.; Stone, J. M.

2017-07-01

Gravitationally focused wind accretion in binary systems consisting of an evolved star with a gaseous envelope and a compact accreting companion is a possible mechanism to explain mass transfer in symbiotic binaries. We study the mass accretion around the secondary caused by the strong wind from the primary late-type component using global three-dimensional hydrodynamic numerical simulations during quiescence and outburst stages. In particular, the dependence of the mass accretion rate on the mass-loss rate, wind parameters and phases of wind outburst development is considered. For a typical wind from an asymptotic giant branch star with a mass-loss rate of 10-6 M⊙ yr-1 and wind speeds of 20-50 km s-1, the mass transfer through a focused wind results in efficient infall on to the secondary. Accretion rates on to the secondary of 5-20 per cent of the mass-loss from the primary are obtained during quiescence and outburst periods where the wind velocity and mass-loss rates are varied, about 20-50 per cent larger than in the standard Bondi-Hoyle-Lyttleton approximation. This mechanism could be an important method for explaining observed accretion luminosities and periodic modulations in the accretion rates for a broad range of interacting binary systems.

Galaxy And Mass Assembly: automatic morphological classification of galaxies using statistical learning

NASA Astrophysics Data System (ADS)

Sreejith, Sreevarsha; Pereverzyev, Sergiy, Jr.; Kelvin, Lee S.; Marleau, Francine R.; Haltmeier, Markus; Ebner, Judith; Bland-Hawthorn, Joss; Driver, Simon P.; Graham, Alister W.; Holwerda, Benne W.; Hopkins, Andrew M.; Liske, Jochen; Loveday, Jon; Moffett, Amanda J.; Pimbblet, Kevin A.; Taylor, Edward N.; Wang, Lingyu; Wright, Angus H.

2018-03-01

We apply four statistical learning methods to a sample of 7941 galaxies (z < 0.06) from the Galaxy And Mass Assembly survey to test the feasibility of using automated algorithms to classify galaxies. Using 10 features measured for each galaxy (sizes, colours, shape parameters, and stellar mass), we apply the techniques of Support Vector Machines, Classification Trees, Classification Trees with Random Forest (CTRF) and Neural Networks, and returning True Prediction Ratios (TPRs) of 75.8 per cent, 69.0 per cent, 76.2 per cent, and 76.0 per cent, respectively. Those occasions whereby all four algorithms agree with each other yet disagree with the visual classification (`unanimous disagreement') serves as a potential indicator of human error in classification, occurring in ˜ 9 per cent of ellipticals, ˜ 9 per cent of little blue spheroids, ˜ 14 per cent of early-type spirals, ˜ 21 per cent of intermediate-type spirals, and ˜ 4 per cent of late-type spirals and irregulars. We observe that the choice of parameters rather than that of algorithms is more crucial in determining classification accuracy. Due to its simplicity in formulation and implementation, we recommend the CTRF algorithm for classifying future galaxy data sets. Adopting the CTRF algorithm, the TPRs of the five galaxy types are : E, 70.1 per cent; LBS, 75.6 per cent; S0-Sa, 63.6 per cent; Sab-Scd, 56.4 per cent, and Sd-Irr, 88.9 per cent. Further, we train a binary classifier using this CTRF algorithm that divides galaxies into spheroid-dominated (E, LBS, and S0-Sa) and disc-dominated (Sab-Scd and Sd-Irr), achieving an overall accuracy of 89.8 per cent. This translates into an accuracy of 84.9 per cent for spheroid-dominated systems and 92.5 per cent for disc-dominated systems.

A survey of exercise professionals' barriers and facilitators to working with stroke survivors.

PubMed

Condon, Marie; Guidon, Marie

2018-03-01

Stroke survivors (SSs) are largely inactive despite the benefits of exercise. Exercise professionals (EPs), skilled in exercise prescription and motivation, may have a role in promoting exercise among SSs. However, the number of EPs working with SSs is estimated to be low. This study aimed to investigate EPs' opinions on working with SSs by rating their agreement of barriers and facilitators to working with SSs. The study also investigated EPs skills, interest and experience working with SSs and the relationship between EPs' barriers and facilitators with their training on stroke. A descriptive cross-sectional study was conducted using a researcher-designed online survey between October and December 2015. Purposive sampling was used to survey EPs on the Register of Exercise Professionals in Ireland (n = 277). The response rate was 31% (87/277). Only 22% (19/86) of EPs had experience working with SSs. The primary barriers rated by EPs included insufficient training on psychological problems post-stroke (84%; 61/73), unsuitable equipment for SSs (69%; 50/73) and the level of supervision SSs require (56%; 41/73). The primary facilitators rated included access to suitable equipment (97%; 69/71), practical (100%; 71/71) and theoretical training (93%; 66/71) on stroke. Respondents with no training on stroke were significantly more likely to agree that insufficient training on psychological problems post-stroke and lack of experience were barriers. Seventy-six per cent of EPs (58/76) were interested in one-to-one exercise sessions with SSs but only 53% (40/76) were interested in group sessions. Eighty-two per cent of EPs (62/76) rated their motivational skills as good or very good but 42% (32/76) indicated having only acceptable skills dealing with psychological problems. Results indicate that EPs are interested in working with SSs despite limited experience and practical barriers. Training opportunities on stroke need to be developed; taking into account EPs' barriers, facilitators and skills along with access to suitable equipment. © 2017 John Wiley & Sons Ltd.

78 FR 48192 - Notice of Lodging of Consent Decree Under the Comprehensive Environmental Response, Compensation...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-07

... and payment of reproduction costs. Please mail your request and payment to: Consent Decree Library, U....25 (.25 cents per page reproduction cost) payable to the United States Treasury. Robert Brook...

Skin injuries identified in cattle and water buffaloes at livestock markets in Bangladesh.

PubMed

Alam, M R; Gregory, N G; Jabbar, M A; Uddin, M S; Kibria, A S M G; Silva-Fletcher, A

2010-09-11

Skin injuries were assessed in 560 imported and local cattle and water buffaloes at two livestock markets in Bangladesh. The body of each animal was divided into 11 anatomical regions, and abrasions, lacerations, penetrations, ulcerations, bleeding, swelling, hyperkeratosis and scars were recorded for each region. Among the 560 animals studied, 501 were found to have at least one injury. The prevalence of skin injuries was 89 per cent, with 84 per cent of the cattle and 99 per cent of the water buffaloes having obvious skin injuries. The most common types of injury were abrasions that were found in 73 per cent of the animals, followed by scars (50 per cent), and lacerations (41 per cent). Buffaloes had more abrasions (95 per cent), lacerations (57 per cent), swelling (15 per cent) and hyperkeratosis (32 per cent) compared with cattle, whereas scars (60 per cent) were more common in cattle (P<0.001). Within the 11 different anatomical regions, all types of injuries were present but in different proportions. The buttock region had a higher proportion of abrasions (36 per cent) followed by the hip, hindlimb and back regions. Penetration, ulceration, bleeding and swelling were present at lower frequencies in all regions. Causes for these injuries included rubbing against the inside wall of vehicles used for transportation and stock-handler abuse (59 per cent and 13 per cent, respectively). Buffaloes sustained more transport injuries than cattle, and the number of injuries was higher in imported than local animals.

Comparison of indium-labeled-leukocyte imaging with sequential technetium-gallium scanning in the diagnosis of low-grade musculoskeletal sepsis. A prospective study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Merkel, K.D.; Brown, M.L.; Dewanjee, M.K.

We prospectively compared sequential technetium-gallium imaging with indium-labeled-leukocyte imaging in fifty patients with suspected low-grade musculoskeletal sepsis. Adequate images and follow-up examinations were obtained for forty-two patients. The presence or absence of low-grade sepsis was confirmed by histological and bacteriological examinations of tissue specimens taken at surgery in thirty of the forty-two patients. In these thirty patients, the sensitivity of sequential Tc-Ga imaging was 48 per cent, the specificity was 86 per cent, and the accuracy was 57 per cent, whereas the sensitivity of the indium-labeled-leukocyte technique was 83 per cent, the specificity was 86 per cent, and the accuracymore » was 83 per cent. When the additional twelve patients for whom surgery was deemed unnecessary were considered, the sensitivity of sequential Tc-Ga imaging was 50 per cent, the specificity was 78 per cent, and the accuracy was 62 per cent, as compared with a sensitivity of 83 per cent, a specificity of 94 per cent, and an accuracy of 88 per cent with the indium-labeled-leukocyte method. In patients with a prosthesis the indium-labeled-leukocyte image was 94 per cent accurate, compared with 75 per cent accuracy for sequential Tc-Ga imaging. Statistical analysis of these data demonstrated that the indium-labeled-leukocyte technique was superior to sequential Tc-Ga imaging in detecting areas of low-grade musculoskeletal sepsis.« less

Identification and characterization of functional centromeres of the common bean.

PubMed

Iwata, Aiko; Tek, Ahmet L; Richard, Manon M S; Abernathy, Brian; Fonsêca, Artur; Schmutz, Jeremy; Chen, Nicolas W G; Thareau, Vincent; Magdelenat, Ghislaine; Li, Yupeng; Murata, Minoru; Pedrosa-Harand, Andrea; Geffroy, Valérie; Nagaki, Kiyotaka; Jackson, Scott A

2013-10-01

In higher eukaryotes, centromeres are typically composed of megabase-sized arrays of satellite repeats that evolve rapidly and homogenize within a species' genome. Despite the importance of centromeres, our knowledge is limited to a few model species. We conducted a comprehensive analysis of common bean (Phaseolus vulgaris) centromeric satellite DNA using genomic data, fluorescence in situ hybridization (FISH), immunofluorescence and chromatin immunoprecipitation (ChIP). Two unrelated centromere-specific satellite repeats, CentPv1 and CentPv2, and the common bean centromere-specific histone H3 (PvCENH3) were identified. FISH showed that CentPv1 and CentPv2 are predominantly located at subsets of eight and three centromeres, respectively. Immunofluorescence- and ChIP-based assays demonstrated the functional significance of CentPv1 and CentPv2 at centromeres. Genomic analysis revealed several interesting features of CentPv1 and CentPv2: (i) CentPv1 is organized into an higher-order repeat structure, named Nazca, of 528 bp, whereas CentPv2 is composed of tandemly organized monomers; (ii) CentPv1 and CentPv2 have undergone chromosome-specific homogenization; and (iii) CentPv1 and CentPv2 are not likely to be commingled in the genome. These findings suggest that two distinct sets of centromere sequences have evolved independently within the common bean genome, and provide insight into centromere satellite evolution. © 2013 The Authors The Plant Journal © 2013 John Wiley & Sons Ltd.

A femoral component inserted without cement in total hip arthroplasty. A study of the Tri-Lock component with an average ten-year duration of follow-up.

PubMed

Burt, C F; Garvin, K L; Otterberg, E T; Jardon, O M

1998-07-01

Seventy-four total hip arthroplasties in sixty-six patients were performed, between 1983 and 1986, with use of a Tri-Lock femoral component inserted without cement. This tapered cobalt-chromium component has a fixed head and a circumferential proximal porous coating. Follow-up was conducted with use of a questionnaire, physical examination, and radiographic analysis. At the time of the latest follow-up, fifteen patients (eighteen hips) had died, three patients (four hips) had been lost to follow-up, and one patient (one hip) had refused to participate in the follow-up study; however, the status of fifteen hips at the time of death could be verified. Thus, clinical follow-up data were available for sixty-six of the original seventy-four hips. The average age at the time of the operation was sixty-two years (range, seventeen to eighty-four years), and the average interval between the operation and the latest follow-up evaluation was 10.0 years (range, 8.3 to 11.6 years). The Harris hip score was determined for forty-three hips (forty-one patients) in which the prosthesis was in situ at the time of the latest follow-up. The score was good for thirteen hips and excellent for twenty-eight, so the rate of clinical success was 95 per cent. Two patients had a fair result. One of them had persistent pain and the other had limited motion, but neither had radiographic evidence of loosening of the femoral or acetabular component. All forty-one patients were satisfied with the result. The probability (with standard error) of survival of the femoral component at ten years, with revision as the end point, was 0.95 +/- 0.03. The rate of revision of the femoral component because of aseptic loosening was one (2 per cent) of sixty-six. The overall rate of aseptic loosening of the femoral component in the hips that were followed radiographically was two (4 per cent) of forty-seven. Only one (2 per cent) of the forty-seven acetabular cups had evidence of aseptic loosening. There was no radiographic evidence of distal osteolysis around the prostheses that were well fixed. Proximal osteolysis was present in five (11 per cent) of forty-seven hips, but none of the lesions compromised the stability of the prosthesis or the bone and there were no associated fractures. At an average of ten years postoperatively, the Tri-Lock femoral component functioned well overall and patient satisfaction was high.

Low dose naltrexone for induction of remission in Crohn's disease.

PubMed

Parker, Claire E; Nguyen, Tran M; Segal, Dan; MacDonald, John K; Chande, Nilesh

2018-04-01

Crohn's disease is a transmural, relapsing inflammatory condition afflicting the digestive tract. Opioid signalling, long known to affect secretion and motility in the gut, has been implicated in the inflammatory cascade of Crohn's disease. Low dose naltrexone, an opioid antagonist, has garnered interest as a potential therapy. The primary objective was to evaluate the efficacy and safety of low dose naltrexone for induction of remission in Crohn's disease. A systematic search of MEDLINE, Embase, PubMed, CENTRAL, and the Cochrane IBD Group Specialized Register was performed from inception to 15 January 2018 to identify relevant studies. Abstracts from major gastroenterology conferences including Digestive Disease Week and United European Gastroenterology Week and reference lists from retrieved articles were also screened. Randomized controlled trials of low dose naltrexone (LDN) for treatment of active Crohn's disease were included. Data were analyzed on an intention-to-treat basis using Review Manager (RevMan 5.3.5). The primary outcome was induction of clinical remission defined by a Crohn's disease activity index (CDAI) of < 150 or a pediatric Crohn's disease activity index (PCDAI) of < 10. Secondary outcomes included clinical response (70- or 100-point decrease in CDAI from baseline), endoscopic remission or response, quality of life, and adverse events as defined by the included studies. Risk ratios (RR) and 95% confidence intervals (CI) were calculated for dichotomous outcomes. The methodological quality of included studies was evaluated using the Cochrane risk of bias tool. The overall quality of the evidence supporting the primary outcome and selected secondary outcomes was assessed using the GRADE criteria. Two studies were identified (46 participants). One study assessed the efficacy and safety of 12 weeks of LDN (4.5 mg/day) treatment compared to placebo in adult patients (N = 34). The other study assessed eight weeks of LDN (0.1 mg/kg, maximum 4.5 mg/day) treatment compared to placebo in pediatric patients (N = 12). The primary purpose of the pediatric study was to assess safety and tolerability. Both studies were rated as having a low risk of bias. The study in adult patients reported that 30% (5/18) of LDN treated patients achieved clinical remission at 12 weeks compared to 18% (3/16) of placebo patients, a difference that was not statistically significant (RR 1.48, 95% CI 0.42 to 5.24). The study in children reported that 25% of LDN treated patients achieved clinical remission (PCDAI < 10) compared to none of the patients in the placebo group, although it was unclear if this result was for the randomized placebo-controlled trial or for the open label extension study. In the adult study 70-point clinical response rates were significantly higher in those treated with LDN than placebo. Eighty-three per cent (15/18) of LDN patients had a 70-point clinical response at week 12 compared to 38% (6/16) of placebo patients (RR 2.22, 95% CI 1.14 to 4.32). The effect of LDN on the proportion of adult patients who achieved a 100-point clinical response was uncertain. Sixty-one per cent (11/18) of LDN patients achieved a 100-point clinical response compared to 31% (5/16) of placebo patients (RR 1.96, 95% CI 0.87 to 4.42). The proportion of patients who achieved endoscopic response (CDEIS decline > 5 from baseline) was significantly higher in the LDN group compared to placebo. Seventy-two per cent (13/18) of LDN patients achieved an endoscopic response compared to 25% (4/16) of placebo patients (RR 2.89; 95% CI 1.18 to 7.08). However, there was no statistically significant difference in the proportion of patients who achieved endoscopic remission. Endoscopic remission (CDEIS < 3) was achieved in 22% (4/18) of the LDN group compared to 0% (0/16) of the placebo group (RR 8.05; 95% CI 0.47 to 138.87). Pooled data from both studies show no statistically significant differences in withdrawals due to adverse events or specific adverse events including sleep disturbance, unusual dreams, headache, decreased appetite, nausea and fatigue. No serious adverse events were reported in either study. GRADE analyses rated the overall quality of the evidence for the primary and secondary outcomes (i.e. clinical remission, clinical response, endoscopic response, and adverse events) as low due to serious imprecision (sparse data). Currently, there is insufficient evidence to allow any firm conclusions regarding the efficacy and safety of LDN used to treat patients with active Crohn's disease. Data from one small study suggests that LDN may provide a benefit in terms of clinical and endoscopic response in adult patients with active Crohn's disease. Data from two small studies suggest that LDN does not increase the rate of specific adverse events relative to placebo. However, these results need to be interpreted with caution as they are based on very small numbers of patients and the overall quality of the evidence was rated as low due to serious imprecision. Further randomized controlled trials are required to assess the efficacy and safety of LDN therapy in active Crohn's disease in both adults and children.

Implications of the (H2O)n + CO ↔ trans-HCOOH + (H2O)n-1 (n = 1, 2, and 3) reactions for primordial atmospheres of Venus and Earth

NASA Astrophysics Data System (ADS)

Vichietti, R. M.; Spada, R. F. K.; da Silva, A. B. F.; Machado, F. B. C.; Haiduke, R. L. A.

2018-04-01

The forward and backward (H2O)n + CO ↔ HCOOH + (H2O)n-1 (n = 1, 2, and 3) reactions were studied in order to furnish trustworthy thermochemical and kinetic data. Stationary point structures involved in these chemical processes were achieved at the B2PLYP/cc-pVTZ level so that the corresponding vibrational frequencies, zero-point energies, and thermal corrections were scaled to consider anharmonicity effects. A complete basis set extrapolation was also employed with the CCSD(T) method in order to improve electronic energy descriptions and providing therefore more accurate results for enthalpies, Gibbs energies, and rate constants. Forward and backward rate constants were encountered at the high-pressure limit between 200 and 4000 K. In turn, modified Arrhenius' equations were fitted from these rate constants (between 700 and 4000 K). Next, considering physical and chemical conditions that have supposedly prevailed on primitive atmospheres of Venus and Earth, our main results indicate that 85-88 per cent of all water forms on these atmospheres were monomers, whereas (H2O)2 and (H2O)3 complexes would represent 12-15 and ˜0 per cent, respectively. Besides, we estimate that Earth's and Venus' primitive atmospheres could have been composed by ˜0.001-0.003 per cent of HCOOH when their temperatures were around 1000-2000 K. Finally, the water loss process on Venus may have occurred by a mechanism that includes the formic acid as intermediate species.

Baseline survey of sun protection policies and practices in primary school settings in New Zealand.

PubMed

Reeder, A I; Jopson, J A; Gray, A

2009-10-01

The SunSmart Schools Accreditation Programme (SSAP) was launched as a national programme in October 2005 to help reduce the risk of excessive child exposure to ultraviolet radiation. As part of the need for evaluation, this paper reports the findings of a national survey of a randomly selected sample of approximately 12% of New Zealand primary schools prior to the national launch of the SSAP. Principals at 242 schools completed a mail survey (81% response rate) relating to school sun protection policies, practices, curriculum and environment. Survey responses were evaluated according to the 12 criteria of the SSAP, with schools assigned a score from 0 to 12. No school fully met all 12 accreditation criteria, although 2% of schools attained 11 criteria and another 2% attained 10. Nine per cent of schools attained three or fewer criteria. Overall, 7 was the most common score, achieved by 23%. School socio-economic decile rating and roll size were positively associated with higher scores (both P < 0.02). Continued support and resources are needed to encourage schools to address sun protection across the spectrum of curriculum, practices and environment and through commitment to written policy.

Tree stands, not guns, are the midwestern hunter's most dangerous weapon.

PubMed

Crockett, Andrew; Stawicki, Stanislaw P; Thomas, Yalaunda M; Jarvis, Amy M; Wang, Cecily F; Beery, Paul R; Whitmill, Melissa L; Lindsey, David E; Steinberg, Steven M; Cook, Charles H

2010-09-01

Although the prevailing stereotype is that most hunting injuries are gunshot wounds inflicted by intoxicated hunting buddies, our experience led us to hypothesize that falls comprise a significant proportion of hunting related injuries. Trauma databases of two Level I trauma centers in central Ohio were queried for all hunting related injuries during a 10-year period. One hundred and thirty patients were identified (90% male, mean age 41.0 years, range 17-76). Fifty per cent of injuries resulted from falls, whereas gunshot wounds accounted for 29 per cent. Most hunters were hunting deer and 92 per cent of falls were from tree stands. Alcohol was involved in only 2.3 per cent, and drugs of abuse in 4.6 per cent. Of gunshots, 58 per cent were self-inflicted, and 42 per cent were shot by another hunter. Tree stand falls were highly morbid, with 59 per cent of fall victims suffering spinal fractures, 47 per cent lower extremity fractures, 18 per cent upper extremity fractures, and 18 per cent closed head injuries. Surgery was required for 81 per cent of fall-related injuries, and 8.2 per cent of fall victims had permanent neurological deficits. In contrast to prevailing beliefs, in our geographic area tree-stand falls are the most common mechanism of hunting related injury requiring admission to a Level 1 trauma center.

An observational radiative constraint on hydrologic cycle intensification

DOE PAGES

DeAngelis, Anthony M.; Qu, Xin; Zelinka, Mark D.; ...

2015-12-09

We report that intensification of the hydrologic cycle is a key dimension of climate change, with substantial impacts on human and natural systems. A basic measure of hydrologic cycle intensification is the increase in global-mean precipitation per unit surface warming, which varies by a factor of three in current-generation climate models (about 1–3 per cent per kelvin). Part of the uncertainty may originate from atmosphere–radiation interactions. As the climate warms, increases in shortwave absorption from atmospheric moistening will suppress the precipitation increase. This occurs through a reduction of the latent heating increase required to maintain a balanced atmospheric energy budget.more » Using an ensemble of climate models, here we show that such models tend to underestimate the sensitivity of solar absorption to variations in atmospheric water vapour, leading to an underestimation in the shortwave absorption increase and an overestimation in the precipitation increase. This sensitivity also varies considerably among models due to differences in radiative transfer parameterizations, explaining a substantial portion of model spread in the precipitation response. Consequently, attaining accurate shortwave absorption responses through improvements to the radiative transfer schemes could reduce the spread in the predicted global precipitation increase per degree warming for the end of the twenty-first century by about 35 per cent, and reduce the estimated ensemble-mean increase in this quantity by almost 40 per cent.« less

An updated global earthquake catalogue for stable continental regions: Reassessing the correlation with ancient rifts

USGS Publications Warehouse

Schulte, S.M.; Mooney, W.D.

2005-01-01

We present an updated global earthquake catalogue for stable continental regions (SCRs; i.e. intraplate earthquakes) that is available on the Internet. Our database contains information on location, magnitude, seismic moment and focal mechanisms for over 1300 M (moment magnitude) ??? 4.5 historic and instrumentally recorded crustal events. Using this updated earthquake database in combination with a recently published global catalogue of rifts, we assess the correlation of intraplate seismicity with ancient rifts on a global scale. Each tectonic event is put into one of five categories based on location: (i) interior rifts/taphrogens, (ii) rifted continental margins, (iii) non-rifted crust, (iv) possible interior rifts and (v) possible rifted margins. We find that approximately 27 per cent of all events are classified as interior rifts (i), 25 per cent are rifted continental margins (ii), 36 per cent are within non-rifted crust (iii) and 12 per cent (iv and v) remain uncertain. Thus, over half (52 per cent) of all events are associated with rifted crust, although within the continental interiors (i.e. away from continental margins), non-rifted crust has experienced more earthquakes than interior rifts. No major change in distribution is found if only large (M ??? 6.0) earthquakes are considered. The largest events (M ??? 7.0) however, have occurred predominantly within rifts (50 per cent) and continental margins (43 per cent). Intraplate seismicity is not distributed evenly. Instead several zones of concentrated seismicity seem to exist. This is especially true for interior rifts/taphrogens, where a total of only 12 regions are responsible for 74 per cent of all events and as much as 98 per cent of all seismic moment released in that category. Of the four rifts/taphrogens that have experienced the largest earthquakes, seismicity within the Kutch rift, India, and the East China rift system, may be controlled by diffuse plate boundary deformation more than by the presence of the ancient rifts themselves. The St. Lawrence depression, Canada, besides being an ancient rift, is also the site of a major collisional suture. Thus only at the Reelfoot rift (New Madrid seismic zone, NMSZ, USA), is the presence of features associated with rifting itself the sole candidate for causing seismicity. Our results suggest that on a global scale, the correlation of seismicity within SCRs and ancient rifts has been overestimated in the past. Because the majority of models used to explain intraplate seismicity have focused on seismicity within rifts, we conclude that a shift in attention more towards non-rifted as well as rifted crust is in order. ?? 2005 RAS.

Feasibility randomized-controlled trial of online Acceptance and Commitment Therapy for patients with complex chronic pain in the United Kingdom.

PubMed

Scott, W; Chilcot, J; Guildford, B; Daly-Eichenhardt, A; McCracken, L M

2018-04-28

Acceptance and Commitment Therapy (ACT) has growing support for chronic pain. However, more accessible treatment delivery is needed. This study evaluated the feasibility of online ACT for patients with complex chronic pain in the United Kingdom to determine whether a larger trial is justified. Participants with chronic pain and clinically meaningful disability and distress were randomly assigned to ACT online plus specialty medical pain management, or specialty medical management alone. Participants completed questionnaires at baseline, and 3- and 9-month post-randomization. Primary feasibility outcomes included recruitment, retention and treatment completion rates. Secondary outcomes were between-groups effects on treatment outcomes and psychological flexibility. Of 139 potential participants, 63 were eligible and randomized (45% recruitment rate). Retention rates were 76-78% for follow-up assessments. Sixty-one per cent of ACT online participants completed treatment. ACT online was less often completed by employed (44%) compared to unemployed (80%) participants. Fifty-six per cent of ACT online participants rated themselves as 'much improved' or better on a global impression of change rating, compared to only 20 per cent of control participants. Three-month effects favouring ACT online were small for functioning, medication and healthcare use, committed action and decentring, medium for mood, and large for acceptance. Small-to-medium effects were maintained for functioning, healthcare use and committed action at 9 months. Online ACT for patients with chronic pain in the United Kingdom appears feasible to study in a larger efficacy trial. Some adjustments to treatment and trial procedures are warranted, particularly to enhance engagement among employed participants. This study supports the feasibility of online Acceptance and Commitment Therapy for chronic pain in the United Kingdom and a larger efficacy trial. Refinements to treatment delivery, particularly to better engage employed patients, may improve treatment completion and outcomes. © 2018 European Pain Federation - EFIC®.

The separation distribution and merger rate of double white dwarfs: improved constraints

NASA Astrophysics Data System (ADS)

Maoz, Dan; Hallakoun, Na'ama; Badenes, Carles

2018-05-01

We obtain new and precise information on the double white dwarf (DWD) population and on its gravitational-wave-driven merger rate by combining the constraints on the DWD population from two previous studies on radial velocity variation. One of the studies is based on a sample of white dwarfs (WDs) from the Sloan Digital Sky Survey (SDSS, which with its low spectral resolution probes systems at separations a < 0.05 au) and the other is based on the ESO-VLT Supernova-Ia Progenitor surveY (SPY, which with its high spectral resolution is sensitive to a < 4 au). From a joint likelihood analysis, the DWD fraction among WDs is fbin = 0.095 ± 0.020 (1σ, random) +0.010 (systematic) in the separation range ≲4 au. The index of a power-law distribution of initial WD separations (at the start of solely gravitational-wave-driven binary evolution), N(a)da ∝ aαda, is α = -1.30 ± 0.15 (1σ) +0.05 (systematic). The Galactic WD merger rate per WD is Rmerge = (9.7 ± 1.1) × 10-12 yr-1. Integrated over the Galaxy lifetime, this implies that 8.5-11 per cent of all WDs ever formed have merged with another WD. If most DWD mergers end as more-massive WDs, then some 10 per cent of WDs are DWD-merger products, consistent with the observed fraction of WDs in a `high-mass bump' in the WD mass function. The DWD merger rate is 4.5-7 times the Milky Way's specific Type Ia supernova (SN Ia) rate. If most SN Ia explosions stem from the mergers of some DWDs (say, those with massive-enough binary components) then ˜15 per cent of all WD mergers must lead to a SN Ia.

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Effect of tonal native language on voice fundamental frequency responses to pitch feedback perturbations during sustained vocalizations

PubMed Central

Liu, Hanjun; Wang, Emily Q.; Chen, Zhaocong; Liu, Peng; Larson, Charles R.; Huang, Dongfeng

2010-01-01

The purpose of this cross-language study was to examine whether the online control of voice fundamental frequency (F0) during vowel phonation is influenced by language experience. Native speakers of Cantonese and Mandarin, both tonal languages spoken in China, participated in the experiments. Subjects were asked to vocalize a vowel sound ∕u∕ at their comfortable habitual F0, during which their voice pitch was unexpectedly shifted (±50, ±100, ±200, or ±500 cents, 200 ms duration) and fed back instantaneously to them over headphones. The results showed that Cantonese speakers produced significantly smaller responses than Mandarin speakers when the stimulus magnitude varied from 200 to 500 cents. Further, response magnitudes decreased along with the increase in stimulus magnitude in Cantonese speakers, which was not observed in Mandarin speakers. These findings suggest that online control of voice F0 during vocalization is sensitive to language experience. Further, systematic modulations of vocal responses across stimulus magnitude were observed in Cantonese speakers but not in Mandarin speakers, which indicates that this highly automatic feedback mechanism is sensitive to the specific tonal system of each language. PMID:21218905

Cyclosporine use and male gender are independent determinants of avascular necrosis after kidney transplantation: a cohort study.

PubMed

Schachtner, Thomas; Otto, Natalie M; Reinke, Petra

2018-06-03

Kidney transplant recipients (KTRs) are at increased risk of avascular necrosis (AVN) due to bone disorder, steroid use and common comorbidities. However, knowledge on risk factors and outcomes of AVN among KTRs in the modern era of immunosuppression remains scarce. We analysed 765 KTRs between 2001 and 2013 for AVN. Cases of symptomatic AVN were diagnosed by hip X-ray, radioisotope bone scan or magnetic resonance imaging. We evaluated risk factors and clinical characteristics of AVN. KTRs showed a constant incidence rate of AVN of 4.1% at 10 years after transplantation. The use of cyclosporine compared with tacrolimus was identified as an independent risk factor, with a rate of 8.0% compared with 2.7% at 10 years (P < 0.01). In addition, male gender was independently associated with AVN (P = 0.047). Eighty-three per cent of AVN cases were of the femoral head and treated operatively. None of the operated KTRs experienced complications in the long term. Thirty-three per cent of KTRs had bilateral AVN. Ninety-two per cent of KTRs showed AVN at the allograft side. The decreasing incidence of AVN may be attributed to the replacement of cyclosporine by tacrolimus over the last decade. Our data raise the hypothesis of an ischaemic steal syndrome due to the allograft kidney impacting AVN at the allograft side.

Seasonal variations of infrasonic arrivals from long-term ground truth observations in Nevada and implication for event location

NASA Astrophysics Data System (ADS)

Negraru, Petru; Golden, Paul

2017-04-01

Long-term ground truth observations were collected at two infrasound arrays in Nevada to investigate how seasonal atmospheric variations affect the detection, traveltime and signal characteristics (azimuth, trace velocity, frequency content and amplitudes) of infrasonic arrivals at regional distances. The arrays were located in different azimuthal directions from a munition disposal facility in Nevada. FNIAR, located 154 km north of the source has a high detection rate throughout the year. Over 90 per cent of the detonations have traveltimes indicative of stratospheric arrivals, while tropospheric waveguides are observed from only 27 per cent of the detonations. The second array, DNIAR, located 293 km southeast of the source exhibits strong seasonal variations with high stratospheric detection rates in winter and the virtual absence of stratospheric arrivals in summer. Tropospheric waveguides and thermospheric arrivals are also observed for DNIAR. Modeling through the Naval Research Laboratory Ground to Space atmospheric sound speeds leads to mixed results: FNIAR arrivals are usually not predicted to be present at all (either stratospheric or tropospheric), while DNIAR arrivals are usually correctly predicted, but summer arrivals show a consistent traveltime bias. In the end, we show the possible improvement in location using empirically calibrated traveltime and azimuth observations. Using the Bayesian Infrasound Source Localization we show that we can decrease the area enclosed by the 90 per cent credibility contours by a factor of 2.5.

Gravitational wave sources from Pop III stars are preferentially located within the cores of their host Galaxies

NASA Astrophysics Data System (ADS)

Pacucci, Fabio; Loeb, Abraham; Salvadori, Stefania

2017-10-01

The detection of gravitational waves (GWs) generated by merging black holes has recently opened up a new observational window into the Universe. The mass of the black holes in the first and third Laser Interferometer Gravitational Wave Observatory (LIGO) detections (36-29 M⊙ and 32-19 M⊙) suggests low-metallicity stars as their most likely progenitors. Based on high-resolution N-body simulations, coupled with state-of-the-art metal enrichment models, we find that the remnants of Pop III stars are preferentially located within the cores of galaxies. The probability of a GW signal to be generated by Pop III stars reaches ∼90 per cent at ∼0.5 kpc from the galaxy centre, compared to a benchmark value of ∼5 per cent outside the core. The predicted merger rates inside bulges is ∼60 × βIII Gpc-3 yr-1 (βIII is the Pop III binarity fraction). To match the 90 per cent credible range of LIGO merger rates, we obtain: 0.03 < βIII < 0.88. Future advances in GW observatories and the discovery of possible electromagnetic counterparts could allow the localization of such sources within their host galaxies. The preferential concentration of GW events within the bulge of galaxies would then provide an indirect proof for the existence of Pop III stars.

Assessing primary care data quality.

PubMed

Lim, Yvonne Mei Fong; Yusof, Maryati; Sivasampu, Sheamini

2018-04-16

Purpose The purpose of this paper is to assess National Medical Care Survey data quality. Design/methodology/approach Data completeness and representativeness were computed for all observations while other data quality measures were assessed using a 10 per cent sample from the National Medical Care Survey database; i.e., 12,569 primary care records from 189 public and private practices were included in the analysis. Findings Data field completion ranged from 69 to 100 per cent. Error rates for data transfer from paper to web-based application varied between 0.5 and 6.1 per cent. Error rates arising from diagnosis and clinical process coding were higher than medication coding. Data fields that involved free text entry were more prone to errors than those involving selection from menus. The authors found that completeness, accuracy, coding reliability and representativeness were generally good, while data timeliness needs to be improved. Research limitations/implications Only data entered into a web-based application were examined. Data omissions and errors in the original questionnaires were not covered. Practical implications Results from this study provided informative and practicable approaches to improve primary health care data completeness and accuracy especially in developing nations where resources are limited. Originality/value Primary care data quality studies in developing nations are limited. Understanding errors and missing data enables researchers and health service administrators to prevent quality-related problems in primary care data.

Design and implementation of an automated email notification system for results of tests pending at discharge.

PubMed

Dalal, Anuj K; Schnipper, Jeffrey L; Poon, Eric G; Williams, Deborah H; Rossi-Roh, Kathleen; Macleay, Allison; Liang, Catherine L; Nolido, Nyryan; Budris, Jonas; Bates, David W; Roy, Christopher L

2012-01-01

Physicians are often unaware of the results of tests pending at discharge (TPADs). The authors designed and implemented an automated system to notify the responsible inpatient physician of the finalized results of TPADs using secure, network email. The system coordinates a series of electronic events triggered by the discharge time stamp and sends an email to the identified discharging attending physician once finalized results are available. A carbon copy is sent to the primary care physicians in order to facilitate communication and the subsequent transfer of responsibility. Logic was incorporated to suppress selected tests and to limit notification volume. The system was activated for patients with TPADs discharged by randomly selected inpatient-attending physicians during a 6-month pilot. They received approximately 1.6 email notifications per discharged patient with TPADs. Eighty-four per cent of inpatient-attending physicians receiving automated email notifications stated that they were satisfied with the system in a brief survey (59% survey response rate). Automated email notification is a useful strategy for managing results of TPADs.

Healthy workplace indicators in Thailand: phase 2 (a pilot study).

PubMed

Sithisarankul, Pornchai; Punpeng, Twisuk; Boonchoo, Sujitra; Baikrai, Udomlak

2003-06-01

This study was a result of the second phase of a two-phase research project. In the previous phase, the draft of healthy workplace indicators was developed by means of literature review and soliciting of expert opinion. There were 46 indicators divided into 6 different groups. This phase of the project was a quantitative cross-sectional descriptive study which aimed at exploring the opinion of employers and occupational health officers (OHOs) of the enterprises towards the pilot set of healthy workplace indicators. The field data collection was conducted by means of a postal survey. Questionnaires were sent to 180 workplaces in Samutprakarn province. The response rates of employers and OHOs were 66.7 per cent (n = 120) and 68.3 per cent (n = 123), respectively. It was found that the majority of the enterprises had a workplace health promotion policy (59.3%), had health promotion activities (60.2%), did not have designated personnel responsible for health promotion (69.1%), had a health promotion budget (53.7%), were large scale enterprises (61.0%), and did not have a mother enterprise in foreign country (81.3%). In general, the mean scores of the opinions of employers and OHOs toward indicators in the appropriateness aspect were high. For the achievability aspect, there were 9 indicators which less than half of the employers thought they could achieve, and 10 indicators that less than half of the OHOs thought they could achieve. The opinion of employers and OHOs differed significantly in 4 indicators in the appropriateness aspect and 1 indicator in the achievability aspect. In conclusion, both the employers and OHOs considered most of these indicators appropriate for the enterprises and most indicators were achievable and useful as a guideline and evaluation tool for workplace health promotion.

Duane's retraction syndrome: a retrospective review from Kathmandu, Nepal.

PubMed

Shrestha, Gauri Shankar; Sharma, Ananda Kumar

2012-01-01

  The aim was to study the clinical characteristics of Duane's retraction syndrome (DRS) in Nepalese patients.   Medical records from 52 cases of DRS from May 2003 to April 2010 were retrospectively reviewed for age, gender, laterality and clinical characteristics. Forty-one case records (78.8 per cent) that had complete clinical findings were considered for further evaluation. Examination included visual acuity by Snellen chart, refraction, associated horizontal and vertical strabismus in primary gaze, upshoot and downshoot on attempted adduction, binocular vision assessed with the Worth four-dot test on adopted gaze and stereopsis examined with the Titmus stereo test.   DRS type I was the most common type observed in 73.2 per cent of cases, followed by DRS type II (14.6 per cent) and DRS type III (12.2 per cent). It was more common in female patients (58.5 per cent) than male patients (χ(2) = 4.6, df = 1, p = 0.03). DRS was more common in the left eye (68.3 per cent) than the right eye and unilaterally present in 95.1 per cent of subjects. In primary gaze, orthotropia (41.5 per cent) was more common than exotropia (34.1 per cent) and esotropia (24.4 per cent) and vertical strabismus was present in 24.4 per cent of subjects. Upshoot and downshoot on attempted adduction was seen in 14.6 and 9.8 per cent, respectively. Binocular single vision was present in 68.3 per cent of subjects by Worth four-dot test at near. Stereopsis of 3,000 seconds of arc was present in 9.8 per cent, 100 to 200 seconds of arc in 14.6 per cent and 40 to 60 seconds of arc in 43.9 per cent with the Titmus stereo test.   DRS is more common in female patients and the left eye. DRS type I is the most common type. © 2011 The Authors. Clinical and Experimental Optometry © 2011 Optometrists Association Australia.

An evaluation of a leadership development coaching and mentoring programme.

PubMed

Le Comte, Lyndsay; McClelland, Beverley

2017-07-03

Purpose The purpose of this paper was to determine the value and impact of the Leadership Development - Coaching and Mentoring Programme at Counties Manukau Health and understand how the skills gained are applied. Design/methodology/approach Mixed-methods approach including surveys of programme participants and senior staff and semi-structured interviews with programme participants. Findings The survey response rate was 24.4 per cent for programme participants and 30 per cent for senior staff. Eight programme participants participated in semi-structured interviews. Of the 70 programme participants, 69 utilised their learning from the programme; 45 of 70 changed their approach to managing staff; and 40 of 68 programme participants reported that meeting with peers for triad group coaching was the most challenging aspect of the programme. Key themes identified through interviews included: working with others; not owning others' problems; professional support and development; coaching and mentoring; future participants. Practical implications The majority of participants changed their leadership behaviours as a result of the programme, which has resulted in improved communication, a more supportive culture and distributed leadership. These changes contribute to better patient care. Originality value There is a paucity of evidence in the literature about the impact of coaching and mentoring programme on leadership development and how the skills gained in such programmes are applied in practice in a healthcare context. This evaluation helps to address that gap.

Patient satisfaction with the management of infertility.

PubMed

Souter, V L; Penney, G; Hopton, J L; Templeton, A A

1998-07-01

The objective of this study was to assess patient satisfaction with the investigation and initial management of infertility. A postal questionnaire survey was carried out of 1366 women attending outpatient clinics for the investigation and initial management of infertility at 12 hospitals throughout Scotland. The response rate to the questionnaire was 59% (806/1366). Overall, 87% of responders were satisfied or very satisfied with their care but a number of deficiencies were identified. Thirty-nine per cent had never been asked to bring their partner to the clinic and 86% felt they had not been given enough help with the emotional aspects of infertility. Forty-seven per cent felt they were not given a clear plan for the future and 23% of those who had been given drug treatments reported receiving little or no information about the treatment or possible side-effects. Overall, only a third had been given any written information and 78% expressed a wish for more written information. Women ranked 'the information and explanation given' and the 'attitude of the doctor at the clinic' highly in comparison to other aspects of their care, including 'help with the emotional aspects of infertility'. In general women were satisfied with their care but improvements may be made by giving more explanation and written information and by adopting a more couple-centred approach. Where resources allow, clinics should take steps to address the emotional aspects of infertility.

Treatment of anal dysplasia in HIV-positive men who have sex with men in a large AIDS reference centre.

PubMed

Willems, Nathalie; Libois, Agnès; Nkuize, Marcel; Feoli, Francesco; Delforge, Marc; DeWit, Stéphane

2017-02-01

Over the last few decades, incidence of anal cancer among HIV-positive men has been on the rise. In this context, programmes of screening and treatment of anal dysplasia which is a precursor of anal cancer have been developed. The aim of our study was to describe the efficiency, side effects and outcome of anal dysplasia treatment in a population of HIV-positive men who have sex with men (MSM). We performed a retrospective study of HIV-positive MSM who received treatment for anal dysplasia between May 2010 and February 2014 in the Saint-Pierre University Hospital, Brussels. The different treatments used were electrocautery (ECA), infrared coagulation (IRC), surgical treatment and imiquimod. Seventy-three HIV-infected MSM were included in the study, counting 62% of HGAIN. Median age was 41 years. Eighty-one per cent were on HAART. Median CD4 cell count was 525 cell/mm³, and 65% had undetectable viral loads. A total of 139 therapeutic interventions were recorded during the study period, and two-thirds of the enrolled patients received more than one treatment. At 540 days of follow-up, the rate of treatment response was 62%. Fifty per cent of the persistent HGAIN were metachronous lesions. No severe adverse events were recorded but frequent treatment-associated discomfort was reported, such as pain, self-limited bleeding, infection and anal irritation. Treatment of anal dysplasia appears to be safe and to offer short-term efficiency. However, its long-term efficiency remains unknown, especially in the HIV-positive population in which spontaneous clearance is lower and rate of recurrence higher.

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29 CFR 5.31 - Meeting wage determination obligations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... obligations for the payment of both straight time wages and fringe benefits by paying in cash, making payments... “painters” will be met by the payment of a straight time hourly rate of not less than $3.90 and by... for pensions, and 20 cents an hour for vacations; or (2) By paying not less than the basic hourly rate...

The Effect of Increased Travel Reimbursement Rates on Health Care Utilization in the VA

ERIC Educational Resources Information Center

Nelson, Richard E.; Hicken, Bret; West, Alan; Rupper, Randall

2012-01-01

Purpose: The reimbursement rate that eligible veterans receive for travel to Department of Veterans Affairs (VA) facilities increased from 11 to 28.5 cents per mile on February 1, 2008. We examined the effect of this policy change on utilization of outpatient, inpatient, and pharmacy services, stratifying veterans based on distance from a VA…

The efficacy of exercise referral as an intervention for Irish male prisoners presenting with mental health symptoms.

PubMed

O'Toole, Shay; Maguire, Jim; Murphy, Pearse

2018-06-11

Purpose The use of exercise as an intervention to improve health in the general population is well documented. The purpose of this paper is to explore whether an exercise referral scheme can be an effective health promotion tool for male prisoners in Ireland, presenting with mental health symptoms. Design/methodology/approach This mixed methods study with a pre- and post-intervention design was conducted in Mountjoy Prison, Dublin, which has a capacity for approximately 790 prisoners. Reliable and validated symptom assessment scales were used to assess levels of depression, anxiety, stress, self-esteem and anger amongst a sample of 40 prisoners pre- and post-intervention. The scales used were the Depression, Anxiety and Stress scale or DASS-42 (Lovibond and Lovibond, 1995), the Novaco Anger Scale (Novaco, 1994), the Rosenberg Self-Esteem Scale ( Rosenberg, 1965 ) and the Zung Self-Rated Anxiety Scale (Zung, 1971). Semi-structured interviews were also conducted with a subset of the participants post-intervention to further test and contextualise the symptom ratings. The data gathered from the self-rating scales were imported into SPSS 22 for statistical testing for significance. Wilcoxon's signed-rank test was then used to measure significance of changes. Thematic analysis was performed on the qualitative data. Findings In the post-intervention, significant levels of improvement were achieved in the levels of depression, anxiety (DASS), anxiety (Zung), stress, anger, and self-esteem for 29 of the 30 prisoners who completed the study. The incidence of normal mood scores rose from 33 to 90 per cent after the intervention; the incidence of extremely severe scores for anxiety changed from 40 to 7 per cent, severe stress scores changed from 27 to 3 per cent, normal stress levels rose from 17 to 73 per cent, marked anger ratings reduced from 40 to 3 per cent and low self-esteem levels reduced from 20 per cent of participants pre-intervention to 7 per cent post-intervention. In the main, participants perceived the experiences and outcomes of the intervention positively. Research limitations/implications There are some limitations to the design of this study. Operational circumstances within the prison at the start of this study prevented the authors from accessing a larger sample. A control group would add greatly to the study but this was not possible within a single prison setting. The possible influence of extraneous variables such as increased attention and social contact, and more time out of one's cell may have contributed to improved symptom scores as much as the exercise intervention in this study. This possibility was recognised from the outset but the authors proceeded because the aim was to test if an exercise referral package (and all that inevitably goes with that) would make a difference for symptomatic prisoners. Practical implications The organisation and smooth running of the intervention and the positive results therein underpinned the practicality of this project. The significantly positive results contribute new knowledge to the profile of Irish male prisoners' mental health. Social implications This study could be the foundation for a larger study or set of studies which should include a control group and one or more female prisoner cohorts. The impact of positive changes in prisoners' mental health on the prison staff and environment could also be researched. This type of study could lead to important social implications in relation to its impact on prisoner rehabilitation. Originality/value This study was the first of its kind to explore the effectiveness of exercise referral as a health promotion intervention for Irish male prisoners presenting with mental health symptoms.

Diphtheria in the United States, 1971-81.

PubMed Central

Chen, R T; Broome, C V; Weinstein, R A; Weaver, R; Tsai, T F

1985-01-01

After a decade-long resurgence, including a large cutaneous diphtheria outbreak in Washington State, the diphtheria incidence rate in the United States reached its lowest recorded level ever in 1980--two patients (0.01 case per million). Mortality paralleled the decline in incidence rate. Only 143 of the 3,141 US counties reported noncutaneous diphtheria patients during 1971-81; most were located in the West. The highest attack rates were experienced by children less than 15 years old (0.8 case per million) and by American Indians (22.6 cases per million). Persons immunized with three or more doses of diphtheria toxoid had a lower death-to-case ratio (1.3 per cent) than totally unimmunized persons (13.4 per cent). The reasons for the dramatic decline in diphtheria incidence rates are unclear, although it has been postulated that the gene for producing diphtheria toxin may be lost from organisms in highly immunized populations. Significant proportions of the adult and elderly populations are susceptible to diphtheria. Continuation of primary immunization with increased emphasis on the routine use of tetanus and diphtheria toxoids (Td) boosters in adults should ensure that diphtheria will remain largely a scourge of the past. PMID:4061710

Preliminary design and economic investigations of Diffuser-Augmented Wind Turbines (DAWT). Executive summary

NASA Astrophysics Data System (ADS)

Foreman, K. M.

1981-12-01

A preferred design and configuration approach for the diffuser augmented wind turbine (DAWT) innovative wind energy conversion system is suggested. A preliminary economic assessment is made for limited production rates of units between 5 and 150 kW rated outputs. Nine point designs are used to arrive at the conclusions regarding best construction material for the diffuser and busbar cost of electricity (COE). It is estimated that for farm and cooperative end users, the COE can range between 2 and 3.5 cents pr kWh for sites with annual average wind speeds of 16 and 12 mph (25.7 and 19.3 km/h) respectively, and 150 kW rated units. No tax credits are included in these COE figures. For commercial end users of these 150 kW units, the COE ranges between 4.0 and 6.5 cents per kWh for 16 and 12 mph sites. These estimates in 1971 dollars are lower than department of energy goals set in 1978 for the rating size and end applications. Recommendations are made for future activities to maintain steady, systematic progress toward mature development of the DAWT.

[Prenatal care in Latin America].

PubMed

Buekens, P; Hernández, P; Infante, C

1990-01-01

Available data on the coverage of prenatal care in Latin America were reviewed. In recent years, only Bolivia had a coverage of prenatal care of less than 50 per cent. More than 90 per cent of pregnant women received prenatal care in Chile, Cuba, the Dominican Republic, and Puerto Rico. Prenatal care increased between the 1970 and 1980 in the Dominican Republic, Ecuador, Guatemala, Honduras, Mexico, and Peru. The coverage of prenatal care decreased in Bolivia and Colombia. The mean number of visits increased in Cuba and Puerto Rico. The increase of prenatal care in Guatemala and Honduras is due to increased care by traditional birth attendants, compared to the role of health care institutions. We compared the more recent data on tetanus immunization of pregnant women to the more recent data on prenatal care. The rates of tetanus immunization are always lower than the rates of prenatal care attendance, except in Costa Rica. The rates of tetanus immunization was less than half as compared to the rates of prenatal care in Bolivia, Guatemala, and Peru. To improve the content of prenatal care should be an objective complementary to the increase of the number of attending women.

Risk factors for vitamin A deficiency in rural areas of the Philippines.

PubMed

Rosen, D S; Sloan, N L; del Rosario, A; de la Paz, T C

1994-04-01

A survey of vitamin A deficiency was conducted in January and February 1991 on the island of Mindanao in the Philippines. Demographic, serum retinol, conjunctival impression cytology (CIC), anthropometric, and dietary data were collected from 248 preschool children in five randomly selected rural communities on the outskirts of Davao City. Twenty-nine per cent [95 per cent confidence interval (CI) 23-35 per cent] of preschool children had serum retinol levels below 20 micrograms/dl. Nearly 6 per cent (95 per cent CI 3-9 per cent) had serum retinol levels below 10 micrograms/dl. Thirty-two per cent (95 per cent CI 25-38 per cent) had abnormal CIC findings. The correlation between serum retinol and CIC results was poor. Recent history of diarrheal disease, reported night blindness, maternal education less than 9 years, and infrequent consumption of eggs, mangoes, and liver were associated with increased risk of vitamin A deficiency.

Comparison of two shampoos as sole treatment for canine bacterial overgrowth syndrome.

PubMed

Viaud, S; Maynard, L; Sanquer, A

2012-06-30

Two antibacterial shampoos for the treatment of canine bacterial overgrowth syndrome (BOGS) were compared in a prospective controlled clinical trial. Forty dogs with clinical signs (pruritus, erythema and excoriations without pustules and/or collarettes) and cytological findings compatible with bacterial overgrowth were treated twice weekly with 3 per cent chlorhexidine shampoo (3 per cent CHX) or 2.5 per cent benzoyl peroxide shampoo (2.5 per cent BPO) and evaluated every two weeks for up to six weeks until cytological cure. Pruritus, erythema, greasy seborrhoea, malodour, excoriations, secondary hair loss, lichenification, hyperpigmentation and lesion extent were each scored on a 0 to 3 severity scale and combined to calculate an aggregate score. Among the 34 dogs with good compliance to treatment, reduction of cocci counts of at least 90 per cent was recorded in 11 of 18 dogs after 3 per cent CHX and nine of 16 dogs after 2.5 per cent BPO, with no significant difference between the two products (P=0.98). Lesion score was significantly reduced in both groups (63.48 (34.45)) per cent with 3 per cent CHX v 54.45 (33.61) per cent with 2.5 per cent BPO, P=0.36) and time to cytological cure was not significantly different between groups (P=0.13), at the end of the treatment. In the present study, 3 per cent CHX and 2.5 per cent BPO were similarly effective in the treatment of canine BOGS.

Performance of high titre attenuated canine parvovirus vaccine in pups with maternally derived antibody.

PubMed

Burtonboy, S; Charlier, P; Hertoghs, J; Lobmann, M; Wiseman, A; Woods, S

1991-04-20

The performance of live, attenuated, homologous, canine parvovirus vaccines was studied in 140 puppies aged from four to 11 weeks. In the presence of maternally derived antibody the ability of the vaccines to elicit a serological response, as determined by the haemagglutination inhibition test and a standardised ELISA, was found to be dose (infectious titre) related. An experimental vaccine containing 10(7.0) TCID50 of virus induced seroconversion rates of 95, 89, 82 and 44 per cent in dogs with haemagglutination inhibition antibody titres of less than or equal to 8, 16, 32 and greater than 32, respectively. The standardised ELISA appeared to be better than the haemagglutination inhibition test with respect to variability and subjectivity, especially when titres were low.

Personal satisfaction and mentorship are critical factors for today's resident surgeons to seek surgical training.

PubMed

Lukish, Jeffrey; Cruess, David

2005-11-01

The specific aim of this study was to summarize the viewpoints of the Resident and Associate Society of the American College of Surgeons (RAS-ACS) membership regarding current training and quality of life-related issues prior to implementation of the new duty-hour guidelines. The goal was to gain insight of the members that may be useful to recruit and guide the future training of surgical residents. An Internet-based survey was developed to evaluate the viewpoints of RAS-ACS. The survey was administered by Esurveymaker.com via the ACS Web page from 2000 to 2003. RAS-ACS member participation was voluntary and anonymous. Analyses were performed to determine the frequency of response for each survey item. Two hundred thirty-five members completed the survey representing 5 per cent of RAS-ACS. Eighty-four per cent were general surgery residents. Personal satisfaction (64%) and mentorship (49%) were top factors for respondents to pursue surgical training; discussion with colleagues and future income was less important. Forty-five per cent reported that job performance was their most important concern during residency. A rewarding surgical career and family life were ranked as the most important expectations. Eighty-six per cent reported that they were satisfied with their residency, and 66 per cent reported that work hours should be limited. Personal satisfaction and mentorship were critical factors for members of the RAS-ACS to seek surgical training. Although most of the members report that work hours should be limited, an overwhelming majority reports satisfaction with surgical training prior to institution of the new duty-hour guidelines. Further emphasis on mentorship and work-hour reform may be beneficial in recruiting medical students into surgical residencies.

Development & validation of a quantitative anti-protective antigen IgG enzyme linked immunosorbent assay for serodiagnosis of cutaneous anthrax.

PubMed

Ghosh, N; Gunti, D; Lukka, H; Reddy, B R; Padmaja, Jyothi; Goel, A K

2015-08-01

Anthrax caused by Bacillus anthracis is primarily a disease of herbivorous animals, although several mammals are vulnerable to it. ELISA is the most widely accepted serodiagnostic assay for large scale surveillance of cutaneous anthrax. The aims of this study were to develop and evaluate a quantitative ELISA for determination of IgG antibodies against B. anthracis protective antigen (PA) in human cutaneous anthrax cases. Quantitative ELISA was developed using the recombinant PA for coating and standard reference serum AVR801 for quantification. A total of 116 human test and control serum samples were used in the study. The assay was evaluated for its precision, accuracy and linearity. The minimum detection limit and lower limit of quantification of the assay for anti-PA IgG were 3.2 and 4 µg/ml, respectively. The serum samples collected from the anthrax infected patients were found to have anti-PA IgG concentrations of 5.2 to 166.3 µg/ml. The intra-assay precision per cent CV within an assay and within an operator ranged from 0.99 to 7.4 per cent and 1.7 to 3.9 per cent, respectively. The accuracy of the assay was high with a per cent error of 6.5 - 24.1 per cent. The described assay was found to be linear between the range of 4 to 80 ng/ml (R [2] = 0.9982; slope = 0.9186; intercept = 0.1108). The results suggested that the developed assay could be a useful tool for quantification of anti-PA IgG response in human after anthrax infection or vaccination.

Long-term decline of global atmospheric ethane concentrations and implications for methane.

PubMed

Simpson, Isobel J; Sulbaek Andersen, Mads P; Meinardi, Simone; Bruhwiler, Lori; Blake, Nicola J; Helmig, Detlev; Rowland, F Sherwood; Blake, Donald R

2012-08-23

After methane, ethane is the most abundant hydrocarbon in the remote atmosphere. It is a precursor to tropospheric ozone and it influences the atmosphere's oxidative capacity through its reaction with the hydroxyl radical, ethane's primary atmospheric sink. Here we present the longest continuous record of global atmospheric ethane levels. We show that global ethane emission rates decreased from 14.3 to 11.3 teragrams per year, or by 21 per cent, from 1984 to 2010. We attribute this to decreasing fugitive emissions from ethane's fossil fuel source--most probably decreased venting and flaring of natural gas in oil fields--rather than a decline in its other major sources, biofuel use and biomass burning. Ethane's major emission sources are shared with methane, and recent studies have disagreed on whether reduced fossil fuel or microbial emissions have caused methane's atmospheric growth rate to slow. Our findings suggest that reduced fugitive fossil fuel emissions account for at least 10-21 teragrams per year (30-70 per cent) of the decrease in methane's global emissions, significantly contributing to methane's slowing atmospheric growth rate since the mid-1980s.

A survey of dental school applicants' career intentions and the balance with family life.

PubMed

Stewart, F M J; Drummond, J R; Carson, L; Hoad Reddick, G

2005-06-11

To investigate the career plans of prospective dental students and how they foresee their work life balance. Applicants to Dundee and Manchester dental schools completed anonymous questionnaires when they attended for interview. The useable response rate was 94% (n=436). The majority of the respondents (91.3%) intended working full time when they enter the workforce, with no significant variation detected between males and females. The cohort anticipated their mean salary to be just over 28,000 UK pounds, five years into their career, although the males felt they would be earning 5,000 UK pounds more than the females. Individuals of Pakistani and Indian origin thought they would earn most, and Asians least. Sixty-five per cent would enter general dental practice and, of these, only 2.8% expected to work exclusively within the NHS. Fifteen per cent intended to go into the hospital dental service, with orthodontics the most popular choice of subspecialty (43.7%), followed by oral surgery (31.1%). Significant variation was seen between ethnic groups, with the hospital and community dental services being more popular with those who identified themselves as of non-white ethnic origin, although the majority would still plan on entering general dental practice. Almost half (44.5%) would take time out of their career to concentrate on childcare when children were of pre-school age, with a further 11% taking longer. Ninety per cent of females and 70% of males anticipated taking time out, of a varying duration. Half of the respondents indicated that they felt a child would affect their career to a moderate extent. The dental profession will be severely affected if both males and females take time out of their careers in the future. As well as a work force shortage, the problems of accessibility to NHS dental services will be exacerbated if fewer dentists choose to provide NHS care.

Perceptions in health and medical research careers: the Australian Society for Medical Research Workforce Survey.

PubMed

Kavallaris, Maria; Meachem, Sarah J; Hulett, Mark D; West, Catherine M; Pitt, Rachael E; Chesters, Jennifer J; Laffan, Warren S; Boreham, Paul R; Khachigian, Levon M

2008-05-05

To report on the sentiments of the Australian health and medical research (HMR) workforce on issues related to employment and funding opportunities. In August 2006, the Australian Society for Medical Research (ASMR) invited all of its members to participate in an online survey. The survey took the form of a structured questionnaire that focused on career aspirations, career development and training opportunities, attitudes toward moving overseas to work, and employment conditions for medical researchers. Researchers' views on career opportunities, funding opportunities, salary and quality of the working environment; impact of these views on retaining a skilled medical research workforce in Australia. Of the 1258 ASMR members, 379 responded (30% response rate). Ninety-six per cent of respondents were currently based in Australia; 70% had a PhD or equivalent; and 58% were women. Most respondents worked at hospital research centres (37%), independent research institutes (28%) or university departments (24%). Sixty-nine per cent had funding from the National Health and Medical Research Council, with the remainder funded by other sources. Over the previous 5 years, 6% of respondents had left active research and 73% had considered leaving. Factors influencing decisions about whether to leave HMR included shortage of funding (91%), lack of career development opportunities (78%) and poor financial rewards (72%). Fifty-seven per cent of respondents were directly supported by grants or fellowships, with only 16% not reliant on grants for their continuing employment; 62% believed that funding had increased over the previous 5 years, yet only 30% perceived an increase in employment opportunities in HMR. Among the respondents, twice as many men as women held postgraduate qualifications and earned >or= dollars 100 000 a year. Employment insecurity and lack of funding are a cause of considerable anxiety among Australian health and medical researchers. This may have important implications for the recruitment and retention of researchers.

Lost in transition? An exploration of attempts to reduce energy consumption by UK households

NASA Astrophysics Data System (ADS)

Kukla, Christopher

As significant energy consumers, UK households need to reduce their energy use if the UK is to achieve its greenhouse gas reduction targets. Low levels of engagement and adoption rates of energy curtailment measures need to be overcome. Policies perceived as ‘fair’ can increase levels of engagement and acceptability. This thesis explores how households approach reducing their own energy use, the reductions they can achieve and any existing barriers. Households’ perception of what is ‘fair’ in the context of energy reductions is explored based on households' own experiences of energy reduction. Households recruited from the South East of England participated in a mixed-methods study attempting to reduce their energy use over a 12-month period. Provided with estimates of their carbon footprints and a comparison to the UK average, the participants discussed their energy use, reductions and perceptions of how reductions could be encouraged fairly. Participants’ energy use was something of an enigma, as were the associated GHG emissions. However, its use was protected and seen as ‘acceptable’ and ‘necessary’ for them to be comfortable in their day-to-day lives. Reducing their energy use was seen as possible and acceptable in areas of energy use viewed as ‘wasteful’ or ‘unnecessary’. While seen as possible, these targets were not necessarily achievable, with 50 per cent of the participants making measurable reductions, and 50 per cent unable to. Energy reductions of ten per cent were seen as possible, even by those unable to reduce, with little scope to move beyond this as participants did not know what they should or could do next. To move forward participants viewed fairness as important, citing energy reductions needing to be a valid, legitimate aim of society; with required reductions being achievable, supported by information, and placing the burden of responsibility on those who use the most.

Concentrating Solar Power Projects - DEWA CSP Trough Project |

Science.gov Websites

: Parabolic trough Turbine Capacity: Net: 600.0 MW Gross: 600.0 MW Status: Under development Start Year: 2020 Ground: 2018 Start Production: 2020 PPA/Tariff Rate: 7.3 US cents per kWh Participants Developer(s): ACWA

Viruses causing severe acute respiratory infections (SARI) in children ≤5 years of age at a tertiary care hospital in Rajasthan, India.

PubMed

Malhotra, Bharti; Swamy, M Anjaneya; Janardhan Reddy, P V; Gupta, M L

2016-12-01

Severe acute respiratory infection (SARI) is one of the leading causes of death among children worldwide. As different respiratory viruses exhibit similar symptoms, simultaneous detection of these viruses in a single reaction mixture can save time and cost. The present study was done in a tertiary care children's hospital for rapid identification of viruses causing SARI among children less than or equal to five years of age using multiplex real-time reverse transcription polymerase chain reaction (RT-PCR) kit. A total of 155 throat swabs were collected from equal number of children suspected to have SARI and processed for extraction of nucleic acids using automated extraction system. Multiplex real-time RT-PCR was done to identify the viruses in the samples. The overall positivity for viruses in the study was found to be 72.9 per cent with a co-infection rate of 19.5 per cent. Human metapneumovirus (HMPV) was the predominant virus detected in 25.7 per cent children followed by influenza A (H1N1)pdm09, human rhinovirus (HRV) and human adenovirus (HAdV) in 19.9, 11.0 and 8.8 per cent children, respectively. The HMPV was at its peak in February 2013, HAdV showed two peaks in March-April, 2012 and November 2012-March 2013 while HRV was detected throughout the year. Multiplex real-time PCR helped in rapid identification of viruses. Seventeen viruses were detected in SARI cases with overall positivity of 72.9 per cent. HMPV was the most predominant virus. However, for better clinico-virological correlation, studies are required with complete work up of all the aetiological agents, clinical profile of patients and treatment outcome.

Comparative effectiveness of individualised homeopathy and antibiotics in the treatment of bovine clinical mastitis: randomised controlled trial.

PubMed

Keller, Diana; Sundrum, Albert

2018-04-07

Based on the widespread use of homeopathy in dairy farm practice when treating mastitis, a blind randomised controlled trial (RCT) was conducted to assess the effectiveness of homeopathic treatment of clinical mastitis on four dairy farms. The study considered specific guidelines for RCTs as well as the basic principles of individualised homeopathy and involved 180 lactating dairy cows. Evaluation of cure rates was based on clinical investigation of the udder and on laboratory analysis of milk samples. In culture-positive cases, the antibiotic treatment provided suboptimal bacteriological cures (60-81 per cent) but was more effective than individualised homeopathy (33-43 per cent) whose effects appeared little different to those of placebos (45-47 per cent) (P≤0.05). On the cytological cure level, all three treatment methods were similarly ineffective: antibiotic being 2-21 per cent, individualised homeopathy 0-8 per cent and placebo 3-13 per cent (P≤0.05; P=0.13). Antibiotics, individualised homeopathy and placebo had similar effects on bacteriological and cytological cure in cases of culture-negative milk samples (P>0.4) and Escherichia coli infections (P=1.0). The study results implied that the effectiveness of individualised homeopathy does not go beyond a placebo effect and successful treatment is highly dependent on the specific mastitis pathogen. Thus, antimicrobial or alternative remedies used should be based on the bacterial culture of the milk sample. NTP-ID: 00008011-1-9, Pre-results. © British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Response to gravity by Zea mays seedlings. I. Time course of the response

NASA Technical Reports Server (NTRS)

Bandurski, R. S.; Schulze, A.; Dayanandan, P.; Kaufman, P. B.

1984-01-01

Gravistimulation induces an asymmetric distribution of free indole-3-acetic acid (IAA) in the cortex-epidermis of the Zea mays L. cv 'Stowells Evergreen' mesocotyl within 15 minutes, the shortest time tested. IAA was measured by an isotope dilution method as the pentaflurobenzyl ester. The per cent IAA in the lower half of the mescotyl cortex was 56 to 57% at 15, 30, and 90 minutes after stimulus initiation. Curvature is detectable in the mescotyl within 3 minutes after beginning gravitropic stimulation. The rate of curvature of the mesocotyl increases during the first 60 minutes to maximum of about 30 degrees per hour. Thus, the growth asymmetry continues to increase for 45 minutes after hormone asymmetry is established. Free IAA occurs predominantly in the stele of the mesocotyl whereas esterified IAA is mainly in the mesocotyl cortex-epidermis. This compartmentation may permit determining in which tissue the hormone asymmetry arises. Current data suggest the asymmetry originated in the stele.

The 25 parsec local white dwarf population

NASA Astrophysics Data System (ADS)

Holberg, J. B.; Oswalt, T. D.; Sion, E. M.; McCook, G. P.

2016-11-01

We have extended our detailed survey of the local white dwarf population from 20 to 25 pc, effectively doubling the sample volume, which now includes 232 stars. In the process, new stars within 20 pc have been added, a more uniform set of distance estimates as well as improved spectral and binary classifications are available. The present 25 pc sample is estimated to be about 68 per cent complete (the corresponding 20 pc sample is now 86 per cent complete). The space density of white dwarfs is unchanged at 4.8 ± 0.5 × 10-3 pc-3. This new study includes a white dwarf mass distribution and luminosity function based on the 232 stars in the 25 pc sample. We find a significant excess of single stars over systems containing one or more companions (74 per cent versus 26 per cent). This suggests mechanisms that result in the loss of companions during binary system evolution. In addition, this updated sample exhibits a pronounced deficiency of nearby `Sirius-like' systems. 11 such systems were found within the 20 pc volume versus only one additional system found in the volume between 20 and 25 pc. An estimate of white dwarf birth rates during the last ˜8 Gyr is derived from individual remnant cooling ages. A discussion of likely ways new members of the local sample may be found is provided.

The Star Formation Reference Survey - II. Activity demographics and host-galaxy properties for infrared-selected galaxies

NASA Astrophysics Data System (ADS)

Maragkoudakis, A.; Zezas, A.; Ashby, M. L. N.; Willner, S. P.

2018-04-01

We present activity demographics and host-galaxy properties of infrared-selected galaxies in the local Universe, using the representative Star Formation Reference Survey (SFRS). Our classification scheme is based on a combination of optical emission-line diagrams (BPT) and infrared (IR)-colour diagnostics. Using the weights assigned to the SFRS galaxies based on its parent sample, a far-IR-selected sample comprises 71 per cent H II galaxies, 13 per cent Seyferts, 3 per cent transition objects (TOs), and 13 per cent low-ionization nuclear emission-line regions (LINERs). For the SFRS H II galaxies, we derive nuclear star formation rates and gas-phase metallicities. We measure host-galaxy metallicities for all galaxies with available long-slit spectroscopy and abundance gradients for a subset of 12 face-on galaxies. The majority of H II galaxies show a narrow range of metallicities, close to solar, and flat metallicity profiles. Based on their host-galaxy and nuclear properties, the dominant ionizing source in the far-infrared selected TOs is star-forming activity. LINERs are found mostly in massive hosts (median of 1010.5 M⊙), median L(60 μm) = 109 L⊙, median dust temperatures of F60/F100 = 0.36, and median LH α surface density of 1040.2 erg s-1kpc-2, indicating older stellar populations as their main ionizing source rather than active galactic nucleus activity.

Carbon monoxide in clouds at low metallicity in the dwarf irregular galaxy WLM.

PubMed

Elmegreen, Bruce G; Rubio, Monica; Hunter, Deidre A; Verdugo, Celia; Brinks, Elias; Schruba, Andreas

2013-03-28

Carbon monoxide (CO) is the primary tracer for interstellar clouds where stars form, but it has never been detected in galaxies in which the oxygen abundance relative to hydrogen is less than 20 per cent of that of the Sun, even though such 'low-metallicity' galaxies often form stars. This raises the question of whether stars can form in dense gas without molecules, cooling to the required near-zero temperatures by atomic transitions and dust radiation rather than by molecular line emission; and it highlights uncertainties about star formation in the early Universe, when the metallicity was generally low. Here we report the detection of CO in two regions of a local dwarf irregular galaxy, WLM, where the metallicity is 13 per cent of the solar value. We use new submillimetre observations and archival far-infrared observations to estimate the cloud masses, which are both slightly greater than 100,000 solar masses. The clouds have produced stars at a rate per molecule equal to 10 per cent of that in the local Orion nebula cloud. The CO fraction of the molecular gas is also low, about 3 per cent of the Milky Way value. These results suggest that in small galaxies both star-forming cores and CO molecules become increasingly rare in molecular hydrogen clouds as the metallicity decreases.

Was Proxima captured by Alpha Centauri A and B?

NASA Astrophysics Data System (ADS)

Feng, F.; Jones, H. R. A.

2018-01-01

The nearest stellar system consists of the stars Proxima, Alpha Centauri A and B and at least one planet Proxima b. The habitability of Proxima b and any other planets are likely to be significantly influenced by the orbital evolution of the system. To study the dynamical evolution of the system, we simulate the motions of Proxima and Alpha Centauri A and B due to the perturbations from the Galactic tide and stellar encounters in a Monte Carlo fashion. From 100 clones, we find that 74 per cent orbits of Proxima Centauri are bound to Alpha Centauri A and B while 17 per cent and 9 per cent orbits become unbound in the simulations over the past and future 5 Gyr. If the system migrated outward in the Milky Way to its current location, more than 50 per cent of clones could become unstable in backward simulations. The ratio of unstable clones increases with the simulation time-scale and encounter rate. This provides some evidence for a capture scenario for the formation of the current triple system. Despite large uncertainties, the metallicity difference between Proxima and Alpha Centauri A and B is also suggestive of their different origin. None the less, further improvements in the available data and models will be necessary for a reliable assessment of the history of the Proxima-Alpha Centauri system and its impact on the habitability of Proxima b.

Prevalence of bovine milk pathogens in Azorean pastures: mobile versus fixed milking machines.

PubMed

Azevedo, C; Pacheco, D; Soares, L; Moitoso, M; Maldonado, J; Guix, R; Simões, J

2016-01-01

The aims of the present study were (1) to evaluate the influence of using mobile (n=47) or fixed (n=45) milking machines in Azorean herds on the apparent prevalence of several milk pathogens in bulk tank milk (BTM) and (2) to determine whether separated subclinical mastitic cows can serve, in real time, as predictors of milk pathogen prevalence for the remaining animals at the herd level. The use of a mobile or fixed milking machine influenced (P≤0.05) the prevalence of Staphylococcus aureus (72.3 per cent; n=34 v 51.1 per cent; n=23, respectively) and Klebsiella species (46.8 per cent; n=22 v 26.7 per cent; n=12, respectively). S aureus (95 per cent CI OR 1.1 to 6.0) and Klebsiella species (95 per cent CI OR 1.0 to 5.8) were 2.5 times more likely to increase in the BTM of herds using mobile milking machines. The prevalence of coagulase-negative staphylococci (100 per cent; n=92), Escherichia coli (75.0 per cent), Corynebacterium bovis (57.6 per cent), Enterococcus species (55.4 per cent), Streptococcus dysgalactiae (51.1 per cent), Streptococcus uberis (41.3 per cent), Actinomyces pyogenes or Peptostreptococcus indolicus (41.3 per cent) and Streptococcus agalactiae (32.6 per cent) in BTM remained similar among the herds. κ coefficients were always <0.70, indicating intra-herd disagreement of the prevalence of milk pathogens between BTM and separated milking cows. Milking hygiene should be improved in pastures, focusing specifically on herds that use a mobile milking machine. The segregated cows at milking time are not good predictors of milk pathogens in BTM.

Evaluation of dressings used with local anaesthetic cream and for peripheral venous cannulation.

PubMed

Needham, Rowan; Strehle, Eugen-Matthias

2008-10-01

To compare four polyurethane dressings manufactured by two different companies for use in children. Seventy-eight dressings were applied to secure either local anaesthetic creams (n = 62) or intravenous cannulae (n = 16). Each dressing was evaluated for ease of application, security and ease of removal, using a simple scoring system. 84 per cent of Opsite flexigrid and 90 per cent of Tegaderm local anaesthetic cream dressings were rated as easy or very easy to apply. Opsite flexigrid was felt to be more secure, whereas Tegaderm was easier to remove. The Tegaderm cannula dressing was easier to apply than the iv3000 dressing. There was little difference between the two brands, including costs.

Spring clip sterilization: one-year follow-up of 1,079 cases.

PubMed

Hulka, J F; Mercer, J P; Fishburne, J I; Kumarasamy, T; Omran, K F; Phillips, J M; Lefler, H T; Lieberman, B; Lean, T H; Pai, D N; Koetsawang, S; Castro, M V

1976-08-15

This is a report of 1,079 patients who underwent laparoscopic clip sterlization as of March, 1974. A one-year follow-up was obtained on 977 patients, or 90.5 per cent. Complications due to the clip technique appear limited to postoperative cramps for 24 to 48 hours in 26 per cent of patients. No ectopic pregnancies were detected. Pregnancies, when corrected for unsuspected existing pregnancies and surgical and manufacturing errors, occurred in 2 to 6 cases, for a method failure rate of 2 to 6/1,000. This report documents that experienced laparoscopists can perform this practice with local anesthesia, in combination with first-trimester abortion, and in hospital facilities other than an operating room.

Research and Development on Titanium Alloys

DTIC Science & Technology

1949-08-31

present contract was submitted in lieu of the first regular bimonthly progress report. The attached report contains an account of the following: 1 . A...and 5 to 11 per cent, respectively. l. Titanium - 5 per cent molybdenum base alloys with additions of 1 per cent copper, 2 per cent copper, 1 per...cent manganese, and 2 per cent iron, BATTELLE MEMORIAL INSTITUTE TABLE OF CONTENTS SUMMARY. ** * se0* .0. • • 0000 0 C 0, 00 1 INTRODUCTION. . . o

Suggestion, hypnosis and hypnotherapy: a survey of use, knowledge and attitudes of anaesthetists.

PubMed

Coldrey, J C; Cyna, A M

2004-10-01

Clinical hypnosis is a skill of using words and gestures (frequently called suggestions) in particular ways to achieve specific outcomes. It is being increasingly recognised as a useful intervention for managing a range of symptoms, especially pain and anxiety. We surveyed all 317 South Australian Fellows and trainees registered with ANZCA to determine their use, knowledge of, and attitudes towards positive suggestion, hypnosis and hypnotherapy in their anaesthesia practice. The response rate was 218 anaesthetists (69%). The majority of respondents (63%) rated their level of knowledge on this topic as below average. Forty-eight per cent of respondents indicated that there was a role for hypnotherapy in clinical anaesthesia, particularly in areas seen as traditional targets for the modality, i.e. pain and anxiety states. Nearly half of the anaesthetists supported the use of hypnotherapy and positive suggestions within clinical anaesthesia. Those respondents who had experience of clinical hypnotherapy were more likely to support hypnosis teaching at undergraduate or postgraduate level when compared with those with no experience.

Pre- and post-operative dizziness, tinnitus, and taste disturbances among cochlear implant recipients.

PubMed

Mikkelsen, K S; Ovesen, T; Swan, C Z

2017-04-01

To determine the pre- and post-operative prevalence of dizziness, tinnitus and taste disturbances in adult cochlear implant recipients. A questionnaire regarding pre- and post-operative dizziness, tinnitus and taste disturbances was sent to 170 cochlear implant recipients implanted between January 2003 and March 2009. Seventy-seven patients (41 per cent) responded. Pre-operatively, 20 per cent of the participants experienced dizziness, 52 per cent experienced tinnitus and 3 per cent experienced taste disturbances. Post-operative dizziness developed in 46 per cent of patients and resolved in the majority of these; however, 15 per cent reported dizziness more than six months after implantation. Tinnitus worsened in 25 per cent of patients, whereas 73 per cent reported attenuation or termination of tinnitus. Post-operatively, tinnitus developed in 12 per cent and taste disturbances developed in 17 per cent of the patients. The high prevalence of dizziness, tinnitus and taste disturbances reported by cochlear implant recipients necessitates that assessment of symptoms related to inner ear and chorda tympani damage are included when evaluating operative results.

Herpes simplex virus proctitis in homosexual men. Clinical, sigmoidoscopic, and histopathological features.

PubMed

Goodell, S E; Quinn, T C; Mkrtichian, E; Schuffler, M D; Holmes, K K; Corey, L

1983-04-14

Acute herpes simplex virus (HSV) infection was detected in 23 of 102 consecutively examined, sexually active male homosexuals who presented with anorectal pain, discharge, tenesmus, or hematochezia, as compared with 3 of 75 homosexual men without gastrointestinal symptoms (P less than 0.01). Findings that were significantly more frequent in men with HSV proctitis than in men with proctitis due to other infectious causes included fever (48 per cent), difficulty in urinating (48 per cent), sacral paresthesias (26 per cent), inguinal lymphadenopathy (57 per cent), severe anorectal pain (100 per cent), tenesmus (100 per cent), constipation (78 per cent), perianal ulcerations (70 per cent), and the presence of diffuse ulcerative or discrete vesicular or pustular lesions in the distal 5 cm of the rectum (50 per cent). Serologic evidence indicated that 85 per cent of the men with symptomatic HSV proctitis were having their first episode of HSV-2 infection. The diagnosis of HSV proctitis is suggested by the presence of severe anorectal pain, difficulty in urinating, sacral paresthesias or pain, and diffuse ulceration of the distal rectal mucosa.

Demographic and clinical characteristics of a paediatric low vision population in a low vision clinic in China.

PubMed

Gao, Guohong; Yu, Manrong; Dai, Jinhui; Xue, Feng; Wang, Xiaoying; Zou, Leilei; Chen, Minjie; Ma, Fei

2016-05-01

The aim was to describe the characteristics of the paediatric population attending the low vision clinic of the Eye and ENT Hospital, located in Shanghai, China. The clinical records of all the children attending the low vision clinic of Eye and ENT Hospital affiliated to Fudan University between January 1, 2009 and May 31, 2014 were retrospectively reviewed. The main data analysed were age, gender, education, visual demand, diagnosis, visual acuity and prescription of low vision aids. Of the 162 patients, 104 (64.20 per cent) were male. The age range of the study population was three to 20 years, with a mean of 10.73 ± 5.08 years. There were 43.21 per cent with moderate visual impairment, 26.54 per cent had severe visual impairment and 19.75 per cent were blind. The leading causes of visual impairment were congenital cataract (21.61 per cent), optic atrophy (14.20 per cent), macular dystrophy (11.73 per cent), nystagmus (9.88 per cent) and congenital glaucoma (9.26 per cent). The most frequently prescribed low vision devices for distant and near vision were binocular telescopes (23.57 per cent) and stand magnifiers (22.93 per cent), respectively. Young age (up to six years, 37.93 per cent), high cost (24.14 per cent), cosmetic reasons (17.24 per cent) and inconvenience (13.79 per cent) were the main reasons that children or parents refused to accept useful low vision aids. Congenital and hereditary diseases constituted the major causes of low vision in the study population. Strategies that make good-quality rehabilitation services available, affordable and accessible, especially in developing countries, will have the greatest impact on visual impairment. In China, both urban and rural, the coverage of low vision services should be strengthened. © 2016 The Authors. Clinical and Experimental Optometry © 2016 Optometry Australia.

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Impact of Schmallenberg virus on British sheep farms during the 2011/2012 lambing season.

PubMed

Harris, K A; Eglin, R D; Hayward, S; Milnes, A; Davies, I; Cook, A J C; Downs, S H

2014-08-16

British sheep farmers were invited to complete a questionnaire about the impact of Schmallenberg virus (SBV) on animal health, welfare and their own emotional wellbeing during the 2011-2012 lambing season, through Defra and Farming Industry websites, letters to farmers who had requested SBV laboratory tests and advertisement at Sheep 2012. The 494 responders included SBV confirmed (positive by RT-PCR) (n=76), SBV suspected by farmer (n=140) or SBV not suspected (n=278). Percentage of barren ewes was similar across SBV groups, however, lamb and ewe losses were higher on responder farms where SBV was confirmed or suspected. The median percentages of all lambs born (and lambs born deformed ) that died within one week of birth was 10.4 per cent (5.5 per cent), 7.0 per cent (2.9 per cent) and 5.3 per cent (0 per cent), respectively, on SBV confirmed, suspected and not suspected farms (P<0.001). Eight to 16 per cent of SBV confirmed or suspected farms reported lamb mortality of ≥40 per cent. Farmer perceived impact was greater where SBV was confirmed or suspected (P<0.001): 25 per cent reported a high impact on emotional wellbeing (4 per cent of SBV not suspected), 13 per cent reported a high impact on flock welfare and financial performance and 6 per cent were less likely to farm sheep next year because of SBV (<2 per cent in SBV not suspected). Overall, SBV impact has been large relative to reported sheep loss. British Veterinary Association.

Impact of Schmallenberg virus on British sheep farms during the 2011/2012 lambing season

PubMed Central

Harris, K. A.; Eglin, R. D.; Hayward, S.; Milnes, A.; Davies, I.; Cook, A. J. C.; Downs, S. H.

2014-01-01

British sheep farmers were invited to complete a questionnaire about the impact of Schmallenberg virus (SBV) on animal health, welfare and their own emotional wellbeing during the 2011–2012 lambing season, through Defra and Farming Industry websites, letters to farmers who had requested SBV laboratory tests and advertisement at Sheep 2012. The 494 responders included SBV confirmed (positive by RT-PCR) (n=76), SBV suspected by farmer (n=140) or SBV not suspected (n=278). Percentage of barren ewes was similar across SBV groups, however, lamb and ewe losses were higher on responder farms where SBV was confirmed or suspected. The median percentages of all lambs born (and lambs born deformed ) that died within one week of birth was 10.4 per cent (5.5 per cent), 7.0 per cent (2.9 per cent) and 5.3 per cent (0 per cent), respectively, on SBV confirmed, suspected and not suspected farms (P<0.001). Eight to 16 per cent of SBV confirmed or suspected farms reported lamb mortality of ≥40 per cent. Farmer perceived impact was greater where SBV was confirmed or suspected (P<0.001): 25 per cent reported a high impact on emotional wellbeing (4 per cent of SBV not suspected), 13 per cent reported a high impact on flock welfare and financial performance and 6 per cent were less likely to farm sheep next year because of SBV (<2 per cent in SBV not suspected). Overall, SBV impact has been large relative to reported sheep loss. PMID:24795165

Relationship between tuberculous otomastoiditis and tuberculous meningitis.

PubMed

Sonmez, G; Turhan, V; Senol, M G; Ozturk, E; Sildiroglu, H O; Mutlu, H

2008-09-01

The aim of this study was to determine the correlation between tuberculous meningitis and tuberculous otomastoiditis. Meningeal involvement sites were investigated by magnetic resonance imaging in 32 patients (21 males, 11 females) who had previously been diagnosed with tuberculous meningitis. Clinical and laboratory findings and responses to anti-tuberculous treatment were evaluated, and the presence of concomitant tuberculous otomastoiditis was also investigated. The meningeal involvement site was unilateral (in the sylvian fissure and the perimesencephalic cistern) in 28 patients (87.5 per cent), and bilateral and widespread in four patients (12.5 per cent). Tuberculous otomastoiditis was found in 11 of the patients with tuberculous meningitis (34.3 per cent). Otomastoiditis was on the same side as the meningeal involvement in nine of these 11 patients. Bilateral otomastoiditis with meningeal involvement was observed in two patients. Tuberculous meningitis is frequently accompanied by otomastoiditis, although the exact causal relationship between the two conditions is unclear. Since meningitis is a serious clinical condition, concomitant otomastoiditis generally remains unrecognised. Tuberculosis should be considered in the differential diagnosis of patients with otitis or otomastoiditis who do not respond to antibiotic therapy.

Wounds caused by firearms in El Salvador, 2003-2004: epidemiological issues.

PubMed

Paniagua, Ignacio; Crespin, Emperatriz; Guardado, Ademar; Mauricio, Ana

2005-01-01

This study presents data from hospital records in El Salvador describing the features of 100 patients admitted to a public hospital with firearm wounds. Wounds caused by Firearms (WFA) account for 70 per cent of homicides; 30 per cent of WFA homicides died in hospital. For every death in hospital there are five admissions who need treatment and survive. The typical victim is a young man with reasonable education but poor earning capacities and some family responsibilities, who lives in an urban setting where drugs, alcohol and firearms are commonplace. Extrapolating from this study, an estimated 2,580 people were treated in El Salvador hospitals during 2003; and of these 2,400 were treated in public hospitals at a cost to the state of 7.4 million USD, just over seven per cent of the health budget. Using further extrapolations, the total social costs for WFA morbidity would amount to around 34 million USD. There needs to be greater controls on firearms, public education on their risks and a more unified surveillance system.

Crisis management teams in health organisations.

PubMed

Canyon, Deon V

2012-01-01

Crisis management teams (CMT) are necessary to ensure adequate and appropriate crisis management planning and response to unforeseen, adverse events. This study investigated the existence of CMTs, the membership of CMTs, and the degree of training received by CMTs in Australian health and allied health organisations. This cross-sectional study draws on data provided by executive decision makers in a broad selection of health and allied health organisations. Crisis management teams were found in 44.2 per cent of the health-related organisations surveyed, which is ten per cent lower than the figure for business organisations. Membership of these CMTs was not ideal and did not conform to standard CMT membership profiles. Similarly, the extent of crisis management training in health-related organisations is 20 per cent lower than the figure for business organisations. If organisations do not become pro-active in their crisis management practices, the onus is on government to improve the situation through regulation and the provision of more physical, monetary and skill resources to ensure that the health services of Australia are sufficiently prepared to respond to adverse events.

Hypertension in Israeli adolescents: prevalence according to weight, sex and parental origin.

PubMed Central

Shohat, M; Shohat, T; Mimouni, M; Nitzan, M; Danon, Y L

1989-01-01

We studied the prevalence of hypertension in 57,499 male and 35,803 female Israeli military recruits and its relation with sex, weight, and parents' ethnic origin. The overall prevalence of systolic hypertension (greater than 140 mmHg) was 1.75 per cent for males and 0.32 per cent for females. The prevalence of diastolic hypertension (greater than 90 mmHg) was 0.41 per cent for males and 0.06 per cent for females. For males, the prevalence of systolic and diastolic hypertension increased with weight, exponentially. Males of Ashkenazi origin had a significantly higher prevalence of hypertension (systolic 2.52 per cent, diastolic 0.55 per cent) compared with those of Sephardi origin (systolic 1.12 per cent, diastolic 0.3 per cent). The prevalence of adolescents with systolic or diastolic blood pressure greater than the mean +2SD of each weight group ranged between 1.5-2.3 per cent. PMID:2705591

Field evaluation of the efficacy of fenbendazole in captive wild ruminants.

PubMed

Goossens, E; Dorny, P; Vercammen, F; Vercruysse, J

2005-11-05

The efficacy of in-feed fenbendazole at a dose rate of 7.5 mg/kg bodyweight for three consecutive days was assessed in five Arabian oryx (Oryx leucoryx), six scimitar-horned oryx (Oryx dammah), 14 slender-horned gazelles (Gazella leptoceros), eight Soay sheep (Ovis aries aries soay), 13 alpine ibex (Capra ibex ibex), six red deer (Cervus elaphus hippelaphus) and 11 Nelson's elk (Cervus elaphus nelsoni) kept in five herds in a zoo. The efficacy was assessed by means of repeated faecal egg count reduction (fecr) tests and in vitro egg hatch assays. Fenbendazole was highly effective against nematodes in five of the seven species, consistently reducing egg shedding by more than 90 per cent. In the egg hatch assays of the five herds, 50 per cent inhibition of hatching (ld50) was observed at a concentration of thiabendazole below 0.1 microg/ml. In the Arabian oryx and alpine ibex the efficacy of fenbendazole was less than 90 per cent, and the ld50 in the egg hatch assays was between 0.1 and 0.2 microg/ml thiabendazole.

Intraoperative colonic lavage and primary anastomosis in peritonitis and obstruction.

PubMed

Biondo, S; Jaurrieta, E; Jorba, R; Moreno, P; Farran, L; Borobia, F; Bettonica, C; Poves, I; Ramos, E; Alcobendas, F

1997-02-01

The surgical management of left colonic emergencies has evolved in the past few decades. Recently, there has been increasing interest in resection with primary anastomosis in selected cases. The aim of this study was to evaluate the differences in outcome in patients with peritonitis or obstruction treated by resection, on-table lavage and primary anastomosis of the left colon. Between January 1992 and August 1995, 212 patients underwent emergency operation for a distal colonic lesion: 97 presented with peritonitis, 113 with obstruction and two with other indications. Intraoperative colonic lavage was performed in 37 patients with obstruction and in 24 with an acute intra-abdominal inflammatory process. The postoperative mortality rate was 5 per cent. The incidence of clinical anastomotic leakage was 5 per cent. Wound infection was observed in ten patients (16 per cent), more often in those with peritonitis (P = 0.03). The overall mean(s.d.) hospital stay was 15(9) days. Resection, on-table lavage and primary anastomosis constitute the operation of choice for selected patients with left colonic emergency.

The tsunami's impact on mortality in a town severely damaged by the 2011 Great East Japan Earthquake.

PubMed

Nagata, Satoko; Teramoto, Chie; Okamoto, Reiko; Koide, Keiko; Nishida, Masumi; Suzuki, Ruriko; Nomura, Michie; Tada, Toshiko; Kishi, Emiko; Sakai, Yoko; Jojima, Noriko; Kusano, Emiko; Iwamoto, Saori; Saito, Miki; Murashima, Sachiyo

2014-07-01

This study identifies the relationship between tsunami damage and mortality through a demographic pyramid of a town severely damaged by the tsunami following the Great East Japan Earthquake of 11 March 2011. It uses cross-sectional data collection. Volunteers visited all households, including shelters, and asked residents about the whereabouts of family members and neighbours. The information was collated with lists of evacuees and the dead to confirm the whereabouts of all residents about 50 days after the disaster. Demographic pyramids for the whole population based on pre- and post-disaster data were drawn. In all, 1,412 (8.8 per cent) were dead or missing, 60.2 per cent of whom were aged 65 and over and 37.5 per cent aged 75 and over, suggesting that the very old should be located beyond the reach of tsunamis. The mortality rate of children was lower than that in other studies, which may indicate the efficacy of disaster evacuation drills. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

Finance salaries. Account the cost.

PubMed

Robling, Andy

2003-02-06

Post-qualification salaries have increased by 4-7 per cent, a slowdown on last year's figures when increases were often more than 10 per cent. The highest increases this year tended to be in medium-sized trusts where newly qualified accountants' salaries rose 8.2 per cent. Directors of finance in large trusts earn about 20 per cent more than in medium trusts and about 40 per cent more than in small ones. Newly qualified accountants in large trusts earn 5 per cent more than in medium-sized trusts and 13 per cent more than in small ones. The survey is based on an analysis of salaries from Hays' jobs database, and salaries of registered candidates.

An improved evaluation of the seismic/geodetic deformation-rate ratio for the Zagros Fold-and-Thrust collisional belt

NASA Astrophysics Data System (ADS)

Palano, Mimmo; Imprescia, Paola; Agnon, Amotz; Gresta, Stefano

2018-04-01

We present an improved picture of the ongoing crustal deformation field for the Zagros Fold-and-Thrust Belt continental collision zone by using an extensive combination of both novel and published GPS observations. The main results define the significant amount of oblique Arabia-Eurasia convergence currently being absorbed within the Zagros: right-lateral shear along the NW trending Main Recent fault in NW Zagros and accommodated between fold-and-thrust structures and NS right-lateral strike-slip faults on Southern Zagros. In addition, taking into account the 1909-2016 instrumental seismic catalogue, we provide a statistical evaluation of the seismic/geodetic deformation-rate ratio for the area. On Northern Zagros and on the Turkish-Iranian Plateau, a moderate to large fraction (˜49 and >60 per cent, respectively) of the crustal deformation occurs seismically. On the Sanandaj-Sirjan zone, the seismic/geodetic deformation-rate ratio suggests that a small to moderate fraction (<40 per cent) of crustal deformation occurs seismically; locally, the occurrence of large historic earthquakes (M ≥ 6) coupled with the high geodetic deformation, could indicate overdue M ≥ 6 earthquakes. On Southern Zagros, aseismic strain dominates crustal deformation (the ratio ranges in the 15-33 per cent interval). Such aseismic deformation is probably related to the presence of the weak evaporitic Hormuz Formation which allows the occurrence of large aseismic motion on both subhorizontal faults and surfaces of décollement. These results, framed into the seismotectonic framework of the investigated region, confirm that the fold-and-thrust-dominated deformation is driven by buoyancy forces; by contrast, the shear-dominated deformation is primary driven by plate stresses.

Modelling galaxy clustering on small scales to tighten constraints on dark energy and modified gravity

NASA Astrophysics Data System (ADS)

Wang, Yun

2017-01-01

We present a new approach to measuring cosmic expansion history and growth rate of large-scale structure using the anisotropic two-dimensional galaxy correlation function (2DCF) measured from data; it makes use of the empirical modelling of small-scale galaxy clustering derived from numerical simulations by Zheng et al. We validate this method using mock catalogues, before applying it to the analysis of the CMASS sample from the Sloan Digital Sky Survey Data Release 10 of the Baryon Oscillation Spectroscopic Survey. We find that this method enables accurate and precise measurements of cosmic expansion history and growth rate of large-scale structure. Modelling the 2DCF fully including non-linear effects and redshift space distortions in the scale range of 16-144 h-1 Mpc, we find H(0.57)rs(zd)/c = 0.0459 ± 0.0006, DA(0.57)/rs(zd) = 9.011 ± 0.073, and fg(0.57)σ8(0.57) = 0.476 ± 0.050, which correspond to precisions of 1.3 per cent, 0.8 per cent, and 10.5 per cent, respectively. We have defined rs(zd) to be the sound horizon at the drag epoch computed using a simple integral, fg(z) as the growth rate at redshift z, and σ8(z) as the matter power spectrum normalization on 8 h-1 Mpc scale at z. We find that neglecting the small-scale information significantly weakens the constraints on H(z) and DA(z), and leads to a biased estimate of fg(z). Our results indicate that we can significantly tighten constraints on dark energy and modified gravity by reliably modelling small-scale galaxy clustering.