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Introduction: Patients with chronic diseases are known to benefit from exercise. Such patients often visit the emergency department (ED). There are few studies examining prescribing exercise in the ED. We wished to study if exercise prescription in the ED is feasible and effective. Methods: In this pilot prospective block randomized trial, patients in the control group received routine care, whereas the intervention group received a combined written and verbal prescription for moderate exercise (150 minutes/week). Both groups were followed up by phone at 2 months. The primary outcome was achieving 150 min of exercise per week. Secondary outcomes included change in exercise, and differences in reported median weekly exercise. Comparisons were made by Mann-Whitney and Fishers tests (GraphPad). Results: Follow-up was completed for 22 patients (11 Control; 11 Intervention). Baseline reported median (with IQR) weekly exercise was similar between groups; Control 0(0-0)min; Intervention 0(0-45)min. There was no difference between groups for the primary outcome of 150 min/week at 2 months (Control 3/11; Intervention 4/11, RR 1.33 (95%CI 0.38-4.6;p=1.0). There was a significant increase in median exercise from baseline in both groups, but no difference between the groups (Control 75(10-225)min; Intervention 120(52.5-150)min;NS). 3 control patients actually received exercise prescription as part of routine care. A post-hoc comparison of patients receiving intervention vs. no intervention, revealed an increase in patients meeting the primary target of 150min/week (No intervention 0/8; Intervention 7/14, RR 2.0 (95%CI 1.2-3.4);p=0.023). Conclusion: Recruitment was feasible, however our study was underpowered to quantify an estimated effect size. As a significant proportion of the control group received the intervention (as part of standard care), any potential measurable effect was diluted. The improvement seen in patients receiving intervention and the increase in reported exercise in both groups (possible Hawthorne effect) suggests that exercise prescription for ED patients may be beneficial.
Introduction: The positive health outcomes of exercise have been well-studied, and exercise prescription has been shown to reduce morbidity in several chronic health conditions. However, patient attitudes around the prescription of exercise in the emergency department (ED) have not been explored. The aim of our pilot study is to explore patients’ willingness and perceptions of exercise being discussed and prescribed in the ED. Methods: This study is a survey of patients who had been previously selected for exercise prescription in a pilot study conducted at a tertiary care ED. This intervention group were given a standardized provincial written prescription to perform moderate exercise for 150 minutes per week. Participants answered a discharge questionnaire and were followed up by a telephone interview 2 months later. A structured interview of opinions around exercise prescription was conducted. Questions included a combination of non-closed style interview questions and Likert scale. Patients rated prescription detail, helpfulness and likelihood on a Likert scale from 1-5 (1 being strongly disagree and 5 being strongly agree). Median values (+/-IQRs) are presented, along with dominant themes. Results: 17 people consented to exercise prescription and follow up surveys. 2 were excluded due to hospital admission. 15 participants were enrolled and completed the discharge survey. Two-month follow up survey response rate was 80%. Patients rated the detail given in their prescription as 5 (+/-1). Helpfulness of prescription was rated as 4 (+/-2). Likelihood to continue exercising based on the prescription was rated as 4 (+/-2). 11/12 participants felt that exercise should be discussed in the Emergency Department either routinely or on a case-by-case basis.1 participant felt it should not be discussed at all. Conclusion: Our study demonstrates that most patients are open to exercise being discussed during their Emergency Department visit, and that the prescription format was well-received by study participants.
Acinetobacter is a well-recognized nosocomial pathogen. Previous reports of community-associated Acinetobacter infections have lacked clear case definitions and assessment of healthcare-associated (HCA) risk factors. We identified Acinetobacter bacteraemia cases from blood cultures obtained <3 days after hospitalization in rural Thailand and performed medical record reviews to assess HCA risk factors in the previous year and compare clinical and microbiological characteristics between cases with and without HCA risk factors. Of 72 Acinetobacter cases, 32 (44%) had no HCA risk factors. Compared to HCA infections, non-HCA infections were more often caused by Acinetobacter species other than calcoaceticus–baumannii complex species and by antibiotic-susceptible organisms. Despite similar symptoms, the case-fatality proportion was lower in non-HCA than HCA cases (9% vs. 45%, P < 0·01). Clinicians should be aware of Acinetobacter as a potential cause of community-associated infections in Thailand; prospective studies are needed to improve understanding of associated risk factors and disease burden.
Strain field distribution in a naval platform under dry-dock conditions is complex and represents the cumulative response from residual stress (“locked in” during fabrication of materials and formation of the structure) and static loading stress (e.g., dry-dock loading). The magnitude and distribution of stress fields are a significant concern for the Canadian Navy, where the superposition of applied stresses on residual stresses may adversely affect the performance, safe operational envelope, and service life of naval platforms. Stress analysis was conducted on Canada’s VICTORIA Class submarines using a portable miniature X-ray diffractometer (mXRD) under dry-dock conditions. This paper introduces the concept of “residential stress” as it applies to submarine platforms and discusses the methodology for performing stress analysis with a portable mXRD. The evolution of residential stress during routine pressure hull repairs to Canada’s VICTORIA Class submarines is discussed. In particular, the recent replacement of the diesel exhaust hull and back-up valves on one of the submarines, as well as a pressure hull plate extraction-insertion-weld procedure on another, is discussed.
Restriction endonuclease analysis of molluscum contagiosum virus DNA revealed two subtypes. In a study of 46 isolates from 41 patients, some with no other disorder and some with atopic dermatitis, the ratio of MCV I isolates to MCV II was 34:12. Multiple clustered lesions removed at the same time from an individual patient yielded only one type of MCV. Lesions induced by MCV I or MCV II were indistinguishable on the basis of size and form. Neither subtype was associated exclusively with lesions at certain sites or with other clinical features. Heterogeneity of DNA restriction endonuclease cleavage patterns amongst isolates of the same subtype was observed, this being greatest for MCV II.
A collaborative exercise, supervised by the World Health Organisation, was set up to compare ELISAs used for the serological detection of Salmonella enteritica serotype Enteritidis in chickens. The aim was to ascertain how far agreement could be reached on the interpretation of optical density readings for high titre, intermediate titre and low titre sera. Two sets of sera were sent to 14 participants. The first set compared high, medium and low titre sera raised in specified-pathogen-free and commercial broiler breeder chickens. The second set comprised 20 sera of different antibody titres raised in commercial birds reared under laboratory conditions and sent blind. Both indirect and double-antibody sandwich blocking ELISAs were used with a number of different detecting antigens. With a few exceptions good agreement was reached on the interpretation of results obtained from high and low titre sera from the optical density obtained with a single serum dilution. Differences were observed in the interpretation of medium titre sera. The results suggested that most ELISAs produce reasonably comparable results and that practical problems may arise from interpretation of the results mainly as a result of the choice of the criteria used for differentiating sera obtained from infected and uninfected chickens. These problems are discussed.
The meeting of the Working Group on Active B-type Stars consisted of a business meeting followed by a scientific meeting containing invited and contributed talks. The titles of the talks and their presenters are listed below. We plan to publish a series of articles containing summaries of these talks in Issue No. 39 of the Be Star Newsletter.
Pulsed Electron Beam Deposition (PEBD) and Pulsed Laser Deposition (PLD) were used to grow Gallium Oxide (Ga2O3) thin films on double sided polished sapphire substrates. At 850°C substrate temperature, smooth single crystal β-Ga2O3 films were obtained, which were confirmed with measurements by AFM of RMS surface roughness of about 1 nm. When characterized under electron beam excitation, the films exhibited different responses. For example: Europium doped films emitted intense red emission from 5D0 to 7Fj transitions while exhibiting weak broad emission from 300 to 500 nm. In contrast, Erbium doped films emitted strong emission from 300 to 500 nm peaked at 360 nm that was attributed to defects in the host matrix. Green emission from the Erbium transitions was observed at 528 and 550 nm. Films with different rare earth compositions varying from 0.1 % to 0.4 % were also prepared.
High quality natural waveguides were formed with the deposited Ga2O3 films on the lower refractive index substrate sapphire. This was confirmed by measuring the refractive index by prism coupling and sharp coupling spectra.
A multi-faceted, multi-institutional laboratory astrophysics program is carried out at the Livermore electron beam ion trap facility, which is a mature spectroscopic source with unsurpassed controls and capabilities, and an unparalleled assortment of spectroscopic equipment, including a full complement of grating and crystal spectrometers and a 6x6 micro-calorimeter array. Recent results range from the calibration of x-ray diagnostics, including the Fe XVII and Fe XXV emission lines, extensive lists of L-shell ions, the first laboratory simulation and fit of a cometary x-ray emission spectrum, and the discovery of new spectral diagnostics for measuring magnetic field strengths.
This review details the current literature on relevant aspects of biofilm formation and microbial control in dental practice. To date, there is no published evidence of a serious public health risk from biofilm-contaminated dental waterlines. However, there remain few effective methods of decontamination of such waterlines.
The Feed into Milk (FIM) project in the United Kingdom has developed a Mitscherlich equation from calorimetric data for energy rationing of dairy cattle (Agnew et al., 2004). The objective of the present study was to evaluate this equation using independent data sets obtained in both calorimetric and production studies.
One of the cornerstones in the development of a new feed rationing system for dairy cows must involve a reappraisal of both the concepts and ‘numbers’ adopted in defining the energy requirements for dairy cows. This is particularly important in the present scenario where increasingly high levels of animal output are being achieved from very different animal genotypes to those used in UK dairying 20 - 30 years ago. One of the tasks within the Feed Into Milk (FIM) project was to develop a new system to predict the energy requirements of todays dairy cow. The objective of the present study was to collate all available energy metabolism data with dairy cows in the UK and to develop relationships for describing metabolisable energy (ME) requirement for maintenance (MEm) and efficiency of ME use for lactation (kl) using both existing and new methodologies.
Seroconversion illness is known to be associated with more rapid HIV disease progression. However, symptoms are often subjective and prone to recall bias. We describe symptoms reported as seroconversion illness and examine the relationship between illness, HIV test interval (time between antibody-negative and anibody-positive test dates) and the effect of both on time to AIDS from seroconversion. We used a Cox model, adjusting for age, sex, exposure group and year of estimated seroconversion. Of 1820 individuals, information on seroconversion illness was available for 1244 of whom 423 (34%) reported symptomatic seroconversion. Persons with a short test interval ([les ]2 months) were significantly more likely to report an illness than people with a longer interval (OR 6·76, 95% CI 4·75–9·62). Time to AIDS was significantly faster (P=0·01) in those with a short test interval. The HIV test interval is a useful replacement for information on seroconversion illness in studies of HIV disease progression.