Suchergebnisse

One of the findings of this study is that regional variations in the infant mortality rates of Sri Lanka are large, ranging from 26 per 1000 live births in Jaffna to 91 per 1000 in Nuwara Eliya, a tea estate district. These differences are more strongly associated with regional variations in environmental determinants of mortality than with regional variations in public health expenditure. The most significant environmental factor associated with interregional infant mortality rates was to be the nature of the water supply (r = -0.82, significant at the 99% level). Regional government expenditure on health had only a weak association with infant mortality rates (r = 0.08).

The multi-stakeholder approach is a valuable methodology for governance and policy development. In this paper we describe our use of the approach in the ongoing UnBias study, which seeks to identify opportunities for the effective governance of algorithmic online services. We use the multi-stakeholder methodology to bring together experts from relevant sectors including academia, education, government, regulation, law, civil society, media, and industry and commerce. This paper outlines how our work so far has facilitated open and constructive debate that can drive the development of meaningful policy recommendations. We also describe some challenges of this approach and our next steps towards producing actionable design and policy recommendations, including engagement with international industry standards development.1

In the United Kingdom there are plans to close most mental hospitals over the next 10 years. There is continuing uncertainty about the effectiveness of community psychiatric services that will be expected to cope with mental hospital inpatients after discharge, most of whom have schizophrenia. A survey was conducted to assess the severity of illness among such patients and implications for their future care. All 222 patients in non-psychogeriatric long stay wards of a mental hospital who met research diagnostic criteria for schizophrenia were interviewed by two psychiatrists with the comprehensive psychopathological rating scale to establish the prevalence of psychiatric symptomatology. A complete interview was not possible for 28 patients, mainly for reasons related to their schizophrenia. Despite energetic pharmacological and social treatments almost half of the 194 patients interviewed had enduring florid psychotic symptoms that presented as one or more delusions or auditory hallucinations, or both, and a sizable proportion showed behaviour that would set them apart in a community setting. The results illustrate a problem that is still imperfectly understood by policy makers and administrators in central and local government and in health authorities who are responsible for planning and implementing services for psychiatric care in the community.

Background. South Africa (SA) has a long history of goldmining that has resulted in locally high levels of environmental contamination from uranium and its decay products (radium-226 and radon-222) from the mine tailings. Populations living around mine tailings of the Witwatersrand goldfields may be exposed through various pathways, raising concern about potential health risks associated with haematological malignancies (HMs), for which evidence is inconclusive.Objectives. We designed a prospective case-series study of HMs at Chris Hani Baragwanath Academic Hospital (CHBAH), Johannesburg, the major public hospital in the area, to describe demographic and clinical characteristics, lifetime residential history and potential environmental uranium exposure pathways.Methods. All patients, male and female, aged ≥18 years and newly diagnosed with any form of leukaemia, lymphoma or myeloma at the CHBAH Haematology Unit in 2014 and 2015 were considered for inclusion in the study. Information on uranium exposure pathways and lifetime residential history was recorded from interviewer-administered questionnaires. These characteristics were described overall and according to subtypes of HM.Results. Of 556 patients with HMs diagnosed in 2014 and 2015 at CHBAH, 189 patients aged 18 - 90 years were interviewed, mainly with non-Hodgkin's lymphoma (NHL) (37.6%), leukaemia (32.8%) and Hodgkin's lymphoma (HL) (13.8%). HIV status was positive for 39.2% of the patients, mostly with NHL and HL. Potential environmental uranium exposure pathways were identified. Working on goldmines was reported by 12 patients (6.3%). Consumption of soil (geophagia) was a habit of 51 patients (27.0%), particularly during pregnancy. Drinking water was mainly piped water (76.6% in childhood and 97.9% in adulthood). Animal products and vegetables were most frequently obtained from stores (82.0% and 68.7%, respectively, in childhood and 96.3% and 83.6% in adulthood). Patients were referred to CHBAH by government clinic doctors (44.4%), referral hospitals (24.3%) and private doctors (20.1%). Most participants had been born and lived in Gauteng Province and Soweto (94.7% and 58.2%, respectively), and reported two lifetime places of residence on average and living at their current residence for ≥20 years (49.2%).Conclusions. We identified potential environmental uranium exposure pathways (occupational, lifestyle related and domestic) among patients with HMs that could have resulted in increased uranium exposure. HIV is common among patients with HMs. Together with the results from a previous retrospective case series of HMs at CHBAH (2004 - 2013), our findings suggest that further research on environmental uranium exposure in mining areas and HM risk in residents is warranted.

<p class="p1">The fabrication and characterisation of micro spark gap switch for single shot firing applications are given in detailed . A circular switch with triggering electrode is realised on alumina substrate and can be integratable easily with the electronics for ignition applications. Circular switch is realised on 25 mil alumina substrate within substrate diameter of 10 mm. The switch measurement shows having repeatable performance of pulse peak current of around 2000 A and less than 100 ns rise time. This article details the design, development including fabrication aspects of spark switch with trigger capabilities along with characterisation of switch on alumina substrates.<span class="Apple-converted-space"> </span></p>

Ross River virus, Barmah Forest virus, and Murray Valley encephalitis virus have been responsible for the majority of arbovirus infections in the Northern Territory over the past 12 years. Epidemic polyarthritis, caused by Ross River virus, was first recorded in the Northern Territory during the second World War, when troops were affected in military areas stretching from Darwin to Larrimah 400 kilometres south.[7s]. Sero prevalent surveys from 1957 [8s] to 1974 [9,10s] have suggested wide spread human exposure to Ross River virus in the Northern Territory (Doherty 1973,74). Each year from 1980 to 1989 there have been an increasing number of serologically confirmed cases of epidemic polyarthritis from widespread locations in the NT, but there has been little information on the probably vectors in the various areas. Isolations of Ross River virus from mosquitoes have been made in the Northern Territory from Darwin to Larrimah [Standfast et al 1984, Whelan and Shorthose 1982]. These isolations have been primarily from Culex annulirostris, Aedes vigilax and Aedes normanensis, with single isolation from Aedes normanensis, and Aedes vigilax. In the wet season of 1990-91, a record outbreak of epidemic polyarthritis occurred in the Northern Territory, especially in the Top End. This presented an opportunity to obtain epidemiological information, to indicate the probable vectors, and to assess the impact of mosquito control measures in various towns. Results of this outbreak are reported here.

Ross River virus, Barmah Forest virus, and Murray Valley encephalitis virus have been responsible for the majority of arbovirus infections in the Northern Territory over the past 12 years. Epidemic polyarthritis, caused by Ross River virus, was first recorded in the Northern Territory during the second World War, when troops were affected in military areas stretching from Darwin to Larrimah 400 kilometres south.[7s]. Sero prevalent surveys from 1957 [8s] to 1974 [9,10s] have suggested wide spread human exposure to Ross River virus in the Northern Territory (Doherty 1973,74). Each year from 1980 to 1989 there have been an increasing number of serologically confirmed cases of epidemic polyarthritis from widespread locations in the NT, but there has been little information on the probably vectors in the various areas. Isolations of Ross River virus from mosquitoes have been made in the Northern Territory from Darwin to Larrimah [Standfast et al 1984, Whelan and Shorthose 1982]. These isolations have been primarily from Culex annulirostris, Aedes vigilax and Aedes normanensis, with single isolation from Aedes normanensis, and Aedes vigilax. In the wet season of 1990-91, a record outbreak of epidemic polyarthritis occurred in the Northern Territory, especially in the Top End. This presented an opportunity to obtain epidemiological information, to indicate the probable vectors, and to assess the impact of mosquito control measures in various towns. Results of this outbreak are reported here.

Rationale: Specialized pro-resolving mediators (SPM—lipoxins, resolvins, protectins, and maresins) are produced via the enzymatic conversion of essential fatty acids, including the omega-3 fatty acids docosahexaenoic acid and n-3 docosapentaenoic acid. These mediators exert potent leukocyte directed actions and control vascular inflammation. Supplementation of animals and humans with essential fatty acids, in particular omega-3 fatty acids, exerts protective actions reducing vascular and systemic inflammation. Of note, the mechanism(s) activated by these supplements in exerting their protective actions remain poorly understood. Objective: Given that essential fatty acids are precursors in the biosynthesises of SPM, the aim of the present study was to establish the relationship between supplementation and peripheral SPM concentrations. We also investigated the relationship between changes in plasma SPM concentrations and peripheral blood platelet and leukocyte responses. Methods and Results: Healthy volunteers were enrolled in a double-blinded, placebo-controlled, crossover study, and peripheral blood was collected at baseline, 2, 4, 6, and 24 hours post administration of placebo or one of 3 doses of an enriched marine oil supplement. Assessment of plasma SPM concentrations using lipid mediator profiling demonstrated a time- and dose-dependent increase in peripheral blood SPM concentration. Supplementation also led to a regulation of peripheral blood cell responses. Here we found a dose-dependent increase in neutrophil and monocyte phagocytosis of bacteria and a decrease in the diurnal activation of leukocytes and platelets, as measured by a reduction in adhesion molecule expression. In addition, transcriptomic analysis of peripheral blood cells demonstrated a marked change in transcript levels of immune and metabolic genes 24 hours post supplementation when compared with placebo. Conclusions: Together, these findings demonstrate that supplementation with an enriched marine oil leads to an increase in peripheral blood SPM concentrations and reprograms peripheral blood cells, indicating a role for SPM in mediating the immune-directed actions of this supplement. ; This work was supported by funding from a Sir Henry Dale Fellowship jointly funded by the Wellcome Trust and the Royal Society (Grant 107613/Z/15/Z), funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme (grant number: 677542) and the Barts Charity (Grant MGU0343) to J. Dalli, as well as funding from Metagenics Inc.

Platelet Transfusion Does Not Improve Outcomes in Brain Injured Patients on Antiplatelet Therapy_ P. Maluso1 , C.L. Reynolds3 , M. Patel4 , S. Holland5 , N. Gamsky1 , H. Moore2 , E. Acquista6 , M. Carrick7 , R.L. Amdur1 , H. Hancock5 , J. Dunn9 , B. Sarani1 ; 1George Washington University School Of Medicine And Health Sciences, Surgery, Washington, DC, USA; 2Carle Foundation Hospital, Surgery, Urbana, IL, USA; 3East Carolina University Brody School Of Medicine, Surgery, Greenville, NC, USA; 4Vanderbilt University Medical Center, Surgery, Nashville, TN, USA; 5San Antonio Military Medical Center, Surgery, Fort Sam Houston, TX, USA; 6University Of North Carolina At Chapel Hill, Surgery, Chapel Hill, NC, USA; 7Medical Center At Plano, Surgery, Plano, TX, USA; 8Columbia University College Of Physicians And Surgeons, Surgery, New York, NY, USA; 9Medical Center Of The Rockies, Surgery, Loveland, CO, USA_x000D_ Introduction: Brain injury is the most common cause of death following trauma. Platelet dysfunction is associated with worsening hemorrhage following brain injury (TBI). Use of antiplatelet medications (APM) is common, especially in elderly patients but the efficacy of platelet transfusion remains unknown. Thrombelastography platelet mapping (TEG-PM) assesses platelet function. We hypothesize that platelet transfusion can reverse the effects of APM but does not improve clinical outcomes in TBI patients on APM. Methods: A 2 year prospective, observational study at 6 US trauma centers was performed. Patients over 17 years old on APM with CT evident TBI after blunt injury were enrolled. Patients underwent TEG-PM and brain CT on arrival and repeat imaging within 24 hours. Platelets were transfused and repeat TEG-PM was ordered at physician discretion. Demographics, platelet transfusion, brain CT and TEG-PM results, length of stay (LOS), and injury severity score (AIS) were abstracted. Groups were compared using student t-test. Results: 66 patients were enrolled (89% aspirin, 34% clopidogrel, 2% ticagrelor). 23 ...