407 research outputs found
A randomised controlled trial on the effect of nurse-led educational intervention at the time of catheter ablation for atrial fibrillation on quality of life, symptom severity and rehospitalisation
No full textBackground: Atrial Fibrillation (AF) is a common condition associated with impaired quality of life (QOL) and recurrent hospitalisation. Catheter ablation for AF is a well-established treatment for symptomatic patients despite medical therapy. We sought to examine the effect of point specific nurse-led education on QOL, AF symptomatology and readmission rate post AF ablation. Methods: Forty-one patients undergoing AF ablation were randomised to Nurse Intervention (NI) versus Control (C), n=22 vs. 19. Both groups were well matched with respect to age, sex and AF subtype. All patients completed SF36 and AF Symptom Checklist, Frequency and Severity Scale questionnaires at baseline and six months post ablation. The NI group underwent nurse education on admission, prior to discharge, and with telephone contact. Results: Baseline SF-36 and AF Symptom Checklist, Frequency and Severity scores were similar. The NI group showed significant differences compared to Control with respect to higher QOL on the SF-36 score of Physical Functioning and Vitality at six months. There were significant improvements in seven components of the AF Symptom Checklist, Frequency and Severity at six months in the NI group with a trend in a further seven. There was no difference in AF related hospital readmissions at six months between C and NI groups (10.5% vs. 13.6%, p=ns). Conclusion: Nurse-led education at time of AF ablation is associated with improved QOL and reduced symptom frequency and severity compared to usual care.John L. Bowyer, Phillip J. Tully, Anand N. Ganesan, Fahd K. Chahadi, Cameron B. Singleton, Andrew D. McGaviga
Mutations in FRMD7, a newly identified member of the FERM family, cause X-linked idiopathic congenital nystagmus.
No full textIdiopathic congenital nystagmus is characterized by involuntary, periodic, predominantly horizontal oscillations of both eyes. We identified 22 mutations in FRMD7 in 26 families with X-linked idiopathic congenital nystagmus. Screening of 42 singleton cases of idiopathic congenital nystagmus (28 male, 14 females) yielded three mutations (7%). We found restricted expression of FRMD7 in human embryonic brain and developing neural retina, suggesting a specific role in the control of eye movement and gaze stability
Regional economic inequalities; migration and community response, with special reference to Yugoslavia
No full textYesAfter a general introduction to the problems of regional imbalance, this paper proceeds to an analysis of the background and causes of regional economic inequalities in Yugoslavia. Demographic factors are outlined with reference to Yugoslav statistical sources, and the policies being adopted for those areas defined as being in need of special assistance are examined. The author concludes by indicating some lessons to be drawn from Yugoslavia's experience of migration and especially of its workers abroad
Outcomes of external cephalic version and breech presentation at term, an audit of deliveries at a Sydney tertiary obstetric hospital, 1997-2004
No full textBackgroundProbabilistic information on outcomes of breech presentation is important for clinical decision-making. We aim to quantify adverse maternal and fetal outcomes of breech presentation at term.MethodsWe conducted an audit of 1,070 women with a term, singleton breech presentation who were classified as eligible or ineligible for external cephalic version or diagnosed in labor at a tertiary obstetric hospital in Australia, 1997-2004. Maternal, delivery and perinatal outcomes were assessed and frequency of events quantified.ResultsFive hundred and sixty (52%) women were eligible and 170 (16%) were ineligible for external cephalic version, 211 (20%) women were diagnosed in labor and 134 (12%) were unclassifiable. Seventy-one percent of eligible women had an external cephalic version, with a 39% success rate. Adverse outcomes of breech presentation at term were rare: immediate delivery for prelabor rupture of membranes (1.3%), nuchal cord (9.3%), cord prolapse (0.4%), and fetal death (0.3%); and did not differ by clinical classification. Women who had an external cephalic version had a reduced risk of onset-of-labor within 24 h (RR 0.25; 95%CI 0.08, 0.82) compared with women eligible for but who did not have an external cephalic version. Women diagnosed with breech in labor had the highest rates of emergency cesarean section (64%), cord prolapse (1.4%) and poorest infant outcomes.ConclusionsAdverse maternal and fetal outcomes of breech presentation at term are rare and there was no increased risk of complications after external cephalic version. Findings provide important data to quantify the frequency of adverse outcomes that will help facilitate informed decision-making and ensure optimal management of breech presentation.Natasha Nassar, Christine L. Roberts, Carolyn A. Cameron and Brian Pea
Potential health and well-being implications of autonomous vehicles
No full textTransportation's effects on health and well-being are widely recognized. In the near future, autonomous vehicles (AVs) are expected to revolutionize transportation options and ways of travel. Consequently, the effect of AVs on population health and well-being is a crucial topic of interest for transportation policymaking, one that has received comparatively little attention. This chapter discusses (and anticipates) potential AV impacts on health and well-being. First, we summarize knowledge surrounding effects of transportation on physical health (traffic safety, air and noise pollution, and physical activity) and well-being (travel satisfaction, access to activities, etc.). We then discuss how AVs may affect traveler behaviors, focusing on mode shifts toward private, shared, and/or pooled AVs, and how these shifts may lead to an overall increase in automobile travel, even if not necessarily in person-travel. Finally, we interpret the previous two sections to deduce potential positive, negative, and uncertain health/well-being effects of AVs. We expect benefits from improved safety, well-being, and access to opportunities; disadvantages from reduced physical activity; and uncertain impacts around land use changes and emissions. We conclude by discussing policy implications and research paths forward
The effect of advanced maternal age on perinatal outcomes in nulliparous singleton pregnancies
No full textPubMedID: 30134873Background: Pregnancy at advanced maternal age has become more common in both developed and developing countries over the last decades. The association between adverse perinatal outcomes and advanced maternal age has been a matter of controversy in several studies. The objective of this study is to investigate the impact of advanced maternal age on perinatal and neonatal outcomes of nulliparous singleton pregnancies. Methods: Records of patients admitted to the Department of Obstetrics and Gynecology, University of Cukurova School of Medicine, between January 2011 and July 2015 for routine mid-trimester fetal ultrasonography were retrospectively reviewed. The control (age: 18-34 years), advanced maternal age (35-39 years), and very advanced maternal age (> 40 years) groups included 471, 399, and 87 women, respectively. Results: Gestational diabetes, gestational hypertension, and cesarean delivery rates were more common in the very advanced maternal age group, with compared with the advanced maternal age and the younger age group. There were no significant differences in regarding rates of spontaneous preterm delivery before 34 weeks of gestation, prolonged rupture of membranes, large for gestational age infants, and operative vaginal delivery rates between the groups. Also, there were no significant differences regarding in APGAR scores, the rate of low birth weight infants, and neonatal morbidity rates between the groups. However, admission to the neonatal intensive care unit requirement was more common in the two advanced maternal age groups compared with the control group. Conclusion: Advanced maternal age is a risk factor for gestational diabetes mellitus, gestational hypertension, preeclampsia, small for gestational age infants, spontaneous late preterm delivery, and cesarean section, with significant potential clinical implications. © 2018 The Author(s)
Singletons and adjacencies of set partitions of type B
No full textAbstractWe show that the joint distribution of the number of singleton pairs and the number of adjacency pairs is symmetric over set partitions of type Bn without a zero block, in analogy with the result of Callan for ordinary partitions
Polyphony and the anxiety of influence in the fiction of Henry James
No full textJames's fiction, especially in the Middle Phase, centres
on the figure of the artist and is characterized by, the two
interrelated aspects which previous criticism has largely
overlooked: the Bakhtinian 'polyphonic' -creation of
'author-thinkers'; and the conflict between ephebes and
precursors, for which Harold-Bloom's concept of 'the-anxiety of
influence' is the most illuminating model. Polyphony is the
narrative mode, and influence is the intra-artistic, theme.
These, as the Introduction to the thesis makes clear, are
rehearsed in James's inaugural novel, Roderick Hudson. Rowland
Mallet is an author-thinker, and his failure is caused by
authorial limitations. His monologism -is impaired by his
mistaking empathy for the authorial sympathy. Likewise,
Hudson's failure does not arise from a mercurial temperament,
but from a polyphonic shortcoming: not possessing the power of
fiction to contain the fiction of power in, his mentor. And the
relationships among the three artists - Gloriani, Hudson and
Singleton - perfectly exemplify the Bloomian-theme. It is these
two concepts, polyphony and influence, which are the major
preoccupation in the Middle Phase; as, the works chosen
demonstrate. These are a novella, a novel, and a number of
short stories all of which have been unjustifiably neglected.
Chapter One, on The Aspern Papers, argues that Tina Bordereau,
far from being, the artless victim seen by many critics,
actually challenges and defeats the narrator by the very form
of her narrative. Her 'realist' discourse undermines his
language of 'romance', and shows up its internal unstability.
Chapter Two is an extensive study of the critical reception of
The Tragic Muse. The most common areas of critical attention
have been its contemporary topicality, its relation to previous
novels on similar themes, and the possible genealogy of Gabriel
Nash. Those have all missed the core of the work. - Chapter Three
demonstrates how polyphony and the anxiety of influence make
the novel what it really is. Influence arises from the
juxtaposition of, and the wrestling between, artistic ephebes
and their precursors (Nick and Nash,, Miriam and Madame Carre).
The dialogic quality defined by Bakhtin is crucial to the
proper, and even-handed, characterization of all, the conflicts
in the novel. And since most of James's tales in the eighties
and nineties -are about 'masters - and acolytes, the anxiety of
influence remains central. Chapter Four is a study of 'The
Author of Beltraffiol' and 'The Lesson of the Master'. Again the
characters' manipulations are a crucial focus in a way that
G6rard Genette's terminology helps to illuminate. The fact that
the ephebe is the author-thinker emphasizes the inextricability
of the Bakhtinian and the Bloomian in James. Just as
polyphony offers a different focus for explicating the poetics
of James's fiction; so the ephebal conflict provides the basis
for a fresh perception of James's own artistic struggle
Invasive Haemophilus influenzae Disease, Europe, 1996-2006
No full textEuropean Union Invasive Bacterial Infection Surveillance participants: Paula Lavado (Departamento de Doenças Infecciosas do INSA)An international collaboration was established in 1996 to monitor the impact of routine Haemophilus influenzae type b (Hib) vaccination on invasive H. influenzae disease; 14 countries routinely serotype all clinical isolates. Of the 10,081 invasive H. influenzae infections reported during 1996-2006, 4,466 (44%, incidence 0.28 infections/100,000 population) were due to noncapsulated H. influenzae (ncHi); 2,836 (28%, 0.15/100,000), to Hib; and 690 (7%, 0.036/100,000), to non-b encapsulated H. influenzae. Invasive ncHi infections occurred in older persons more often than Hib (median age 58 years vs. 5 years, p<0.0001) and were associated with higher case-fatality ratios (12% vs. 4%, p<0.0001), particularly in infants (17% vs. 3%, p<0.0001). Among non-b encapsulated H. influenzae, types f (72%) and e (21%) were responsible for almost all cases; the overall case-fatality rate was 9%. Thus, the incidence of invasive non-type b H. influenzae is now higher than that of Hib and is associated with higher case fatality.This study was funded by European Union Biomedicine and Health Research Programme II Reference BMH4960984(1996–1999
An Evolution of Land Use in Kent County, Maryland
No full textThe object of this study is to determine the land use changes that
have taken place in Kent County, located on the Eastern Shore of Maryland
(See Fig. 1) with emphasis on recent land use changes. The principal objectives
of this study will be to ascertain, analyze, and review the evolution of land utilization in Kent County.
A major trend within the past ten years has been toward a decreasing
number of farms and, at the same time, a decreasing number of people
gainfully employed in agriculture. This trend has resulted in the displacement
of agricultural earners by fa.rm machinery and farm consolidations.
An increase in the average size of farms is due to "outsiders" - business
men from out-of-state -- who have established themselves in the county by
buying and combining principally waterfront property. Thus large estates
are formed along with the restoration of Colonial homes. This type of
land tenure has been bringing about utilization of the land in the form
of large dairy and beef herds. Kent County has the smallest number of farms
of all the counties in Maryland but it has the largest average farm size
in the state. This is an area of predominantly large dairy farms with
highly mechanized machinery and equipment. The major trend in the last
25 years has been from cash grain to livestock raising which has resulted
from the growth of dairying. The pattern of field crops has also changed
from cash grains to feed grains for the large dairy herds.
This study has been accomplished through the use of field work
historical data, tables, maps, and photographs. The assumption can be
made that greater permanency and stability in land use may be assured by utilizing the land for what it is best suited to produce. In an
agricultural county, such as Kent, the retention of the soil, maintenance
of its fertility, and the productivity are fundamental and therefore, the
outstanding problems of optimum land utilization in the county. Land use
adjusted into a pattern set by man should be utilized according to its
capabilities. Optimum production and use of the land may be obtained by
utilizing it for purposes to which it is best adapted. This is essentially
a geographical problem in the final analysis and is manifested by a myriad
of socio-economic factors that compose the gamut of land use implications.
The author's interest in this area emanates from a field course
in Geography and a number of trips through parts of this county. Field
work was accomplished during the spring and summer of 1952 and constitutes
the primary source of data for this thesis. The initials of the
author appear where compilation of maps and graphs have been drawn from
research and field data. All photographs have been taken by the author
during his field work in the county
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