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Currently no national guidelines exist for the management of scabies outbreaks in residential or nursing care homes for the elderly in the United Kingdom. In this setting, diagnosis and treatment of scabies outbreaks is often delayed and optimal drug treatment, environmental control measures and even outcome measures are unclear. We undertook a systematic review to establish the efficacy of outbreak management interventions and determine evidence-based recommendations. Four electronic databases were searched for relevant studies, which were assessed using a quality assessment tool drawing on STROBE guidelines to describe the quality of observational data. Nineteen outbreak reports were identified, describing both drug treatment and environmental management measures. The quality of data was poor; none reported all outcome measures and only four described symptom relief measures. We were unable to make definitive evidence-based recommendations. We draw on the results to propose a framework for data collection in future observational studies of scabies outbreaks. While high-quality randomised controlled trials are needed to determine optimal drug treatment, evidence on environmental measures will need augmentation through other literature studies. The quality assessment tool designed is a useful resource for reporting of outcome measures including patient-reported measures in future outbreaks.
Space Infrared Telescope for Cosmology and Astrophysics (SPICA), the cryogenic infrared space telescope recently pre-selected for a ‘Phase A’ concept study as one of the three remaining candidates for European Space Agency (ESA's) fifth medium class (M5) mission, is foreseen to include a far-infrared polarimetric imager [SPICA-POL, now called B-fields with BOlometers and Polarizers (B-BOP)], which would offer a unique opportunity to resolve major issues in our understanding of the nearby, cold magnetised Universe. This paper presents an overview of the main science drivers for B-BOP, including high dynamic range polarimetric imaging of the cold interstellar medium (ISM) in both our Milky Way and nearby galaxies. Thanks to a cooled telescope, B-BOP will deliver wide-field 100–350
m images of linearly polarised dust emission in Stokes Q and U with a resolution, signal-to-noise ratio, and both intensity and spatial dynamic ranges comparable to those achieved by Herschel images of the cold ISM in total intensity (Stokes I). The B-BOP 200
m images will also have a factor
30 higher resolution than Planck polarisation data. This will make B-BOP a unique tool for characterising the statistical properties of the magnetised ISM and probing the role of magnetic fields in the formation and evolution of the interstellar web of dusty molecular filaments giving birth to most stars in our Galaxy. B-BOP will also be a powerful instrument for studying the magnetism of nearby galaxies and testing Galactic dynamo models, constraining the physics of dust grain alignment, informing the problem of the interaction of cosmic rays with molecular clouds, tracing magnetic fields in the inner layers of protoplanetary disks, and monitoring accretion bursts in embedded protostars.
In arguing that autistic people are socially motivated, Jaswal & Akhtar miss the opportunity to puncture the notion that social motivation is a prerequisite for humanity. Instead, we contend that some autistic people may indeed find social interactions to be unmotivating and that this doesn't have to be seen as a problem.
Giardiasis is one of the most important non-viral causes of human diarrhoea. Yet, little is known about the epidemiology of giardiasis in the context of developed countries such as Australia and there is a limited information about local sources of exposure to inform prevention strategies in New South Wales. This study aimed to (1) describe the epidemiology of giardiasis and (2) identify potential modifiable risk factors associated with giardiasis that are unique to south-western Sydney, Australia. A 1:2 matched case-control study of 190 confirmed giardiasis cases notified to the South-Western Local Health District Public Health Unit from January to December 2016 was employed to investigate the risk factors for giardiasis. Two groups of controls were selected to increase response rate; Pertussis cases and neighbourhood (NBH) controls. A matched analysis was carried out for both control groups separately. Variables with a significant odds ratio (OR) in the univariate analysis were placed into a multivariable regression for each matched group, respectively. In the regression model with the NBH controls, age and sex were controlled as potential confounders. Identified risk factors included being under 5 years of age (aOR = 7.08; 95% confidence intervals (CI) 1.02–49.36), having a household member diagnosed with a gastrointestinal illness (aOR = 15.89; 95% CI 1.53–164.60) and having contact with farm animals, domestic animals or wildlife (aOR = 3.03; 95% CI 1.08–8.54). Cases that travelled overseas were at increased risk of infection (aOR = 19.89; 95% CI 2.00–197.37) when compared with Pertussis cases. This study provides an update on the epidemiology and associated risk factors of a neglected tropical disease, which can inform enhanced surveillance and prevention strategies in the developed metropolitan areas.
Improving medical record keeping is a key part of the World Health Organization’s (WHO’s; Geneva, Switzerland) drive to standardize and evaluate emergency medical team (EMT) response to sudden onset disasters (SODs).
In response to the WHO initiative, the UK EMT is redeveloping its medical record template in line with the WHO minimum dataset (MDS) for daily reporting. When changing a medical record, it is important to understand how well it functions before it is implemented.
The redeveloped medical record was piloted at a UK EMT deployment course using simulated patients in order to examine ease of use by practitioners, and rates of data capture for key MDS variables.
Some parts of the form were consistently poorly filled in, and the way in which the form was completed suggested that the flow of the form did not align with the recorder’s natural thought processes when under pressure.
Piloting of a single-sheet triplicate medical record during an EMT deployment simulation led to significant modifications to improve data capture and function.
Jafar AJN, Fletcher RJ, Lecky F, Redmond AD. A pilot of a UK emergency medical team (EMT) medical record during a deployment training course. Prehosp Disaster Med. 2018;33(4):441–447.
The period of growth from parturition to weaning is a time of rapid fat deposition in many species. In the pig, body fat increases from about 10 g/kg at birth to 150 to 200 g/kg by 21 days of age (Wood and Groves 1965; Whittemore, Aumaitre and Williams, 1978). An adequate reserve of adipose tissue may be crucial to ensure health and survival, for example during the period of low food intake frequently observed after weaning.
It is likely that the nutrient composition of milk and the hormonal signals elicited by milk consumption play an important rôle in stimulating fat deposition. We have investigated the effects of milk ingestion on release of the gastrointestinal hormones GIP (gastric inhibitory peptide) and GLP-1 (glucagon-like peptide one). In addition, we have studied the effects of these hormones on fatty acid synthesis in vitro.
Explants (0.4 to 0.6 mg) of adipose tissue were obtained from three anatomical sites of an 18-day-old pig fasted for 12 h. The explants were pre-incubated for 90 min and then incubated in the presence of hormones and [14C] acetate (0.2μCi/ml). Triacylglycerols were extracted from the explants and following saponification, fatty acids were separated and radioactivity counted.
The colostrum of many species will stimulate the growth of cells in vitro and colostrum ingestion may play an important rôle in directly promoting the growth of the gastrointestinal tract in the newborn animal (Berseth, Lichtenberger and Morriss, 1984). Most studies have suggested however, that growth-promoting activity declines to zero, or to negligible levels in post-colostrum milk (Shing and Klagsbrun, 1984; Cera, Mahan and Simmen, 1987). We have investigated the ability of sow's milk, collected up to 21 days of lactation, to stimulate the growth of epithelial cells in vitro. For these studies we use cells derived from the mucosa of the small intestine: RIE-1 cells (Blay and Brown, 1984) and a lung-derived cell line: CHV79 cells.
Milk was collected from three sows at each of the following times: 0 (colostrum), 7, 14, and 21 days post partum. The samples were defatted by centrifugation (30 000 g for 40 min), filter sterilized and diluted in phosphate buffered saline (PBS, pH 6.8). RIE-1 cells (a generous gift from K. Brown, Brabaham) or CHV79 cells were grown to confluence in Dulbecco's modified Eagle's medium (DME) containing foetal calf serum (FCS, 10%). The cultures were quiesced in a medium containing 0.5% FCS for 24 h and milk samples added in serum-free PBS for a further 24 h. [3H]-thymidine was added for the final 4 h before cells were harvested. Growth-promoting activity of milk samples are expressed as a stimulation index (SI) i.e. in relation to the amount of label incorporated after incubation with an equivalent volume of PBS. Fractionation of the growth-promoting activity of a pooled post-colostrum milk sample was performed on sephacryl S-200sf and S-300sf columns.
Strategies to reduce the relatively high incidence of death and disease in young animals must be based on an understanding of the particular metabolic requirements in the period from birth to weaning. In this period, substrate availability and the pathways of substrate utilization differ from those of the foetus and of the adult. Metabolic requirements must be met from the energy stores laid down before birth and from the nutrients present in colostrum and milk. The young animal has a large glucose demand and after exhaustion of hepatic glycogen reserves this must be met by gluconeogenesis. Initiation of gluconeogenesis requires concomitant oxidation of fatty acids, either derived from adipose tissue or from the diet. The young animal is particularly susceptible to hypothermia. Non-shivering thermogenesis in brown adipose tissue uses fatty acids to uncouple oxidation from phosphorylation and also as the major oxidative substrate. In addition, non-shivering thermogenesis is dependent on a minimum concentration of circulating glucose. Shivering thermogenesis is initially fuelled by oxidation of intra-muscular glycogen and then primarily by dietary fat. Growth of white adipose tissue by deposition of dietary fatty acids is an important feature of the metabolism of many species before weaning and this may have several survival advantages.
Although natural weaning in the pig occurs at 6 to 8 weeks of age it is common commercial practice to wean at 3 to 4 weeks. This abrupt and early weaning is often associated with a more or less prolonged check in growth, frequent occurrence of gastrointestinal disease and a significant mortality. The transition from a milk diet to a solid diet in the post-weaning period necessitates complex digestive and metabolic adaptations in the piglet. Experiments in small animals have shown that some of the changes brought about by weaning are at least partially controlled by hormones from the adrenal cortex (Henning, 1981).
We have investigated the changes that occur in the mucosa of the small intestine and in the pancreas of pigs weaned at 21 days of age. In addition we have investigated the effects of an orally administered synthetic glucocorticoid (dexamethasone; DEX) given before weaning, on the development of the intestine and pancreas.
Two pigs from each of six litters were killed at 18 days of age, half of the remaining pigs were given DEX (0.4mg/kg ) suspended in agar (0.5%). This dose was divided into four equal aliquots and given by stomach tube on days 19 and 20. Controls received an equivalent volume of agar. Pigs were weaned at 21 days, two control and two DEX treated pigs were killed on the day of weaning and at 28, 35 and 42 days. After weaning pigs were allowed ad libitum access to a commercial starter diet.
Yellow hypergiant, HD 217476, (HR 8752) is known to have extensive circumstellar envelope. Its unusual spectrum makes it enigmatic object. On the H-R diagram this hypergiant lies among the most luminous stars known in six Local Group galaxies (Humphreys et al., 1984). We have observed it with the same equipment during last fifteen years at the Dominion Astrophysical Observatory. Our present results arg based upon several hundreds of high dispersion spectra (6 and 10 Å/mm).
A photoelectric radial velocity spectrometer has been in operation for several years at the coudé focus of the 1.2m telescope of the Dominion Astrophysical Observatory (DAO). The design of this instrument has been described by Fletcher et. al. (1982) and by McClure et al. (1984). These papers discuss the similarities and differences between this spectrometer and others of its type such as that constructed by Griffin and Gunn (1974) at Palomar. The spectrum mask in the present instrument consists of more than 700 transparent slots on an opaque background, representing the spectrum of a K giant star, plus a few slots to coincide with the argon lines in a cadmium-argon discharge tube for use in obtaining comparison arc velocities. By progressively tilting the slots an appropriate amount along the mask and scanning by moving the mask relative to the stellar spectrum at 45° to the dispersion it is possible to retain a spectral match at non-zero velocities. The masks are produced using a standard measuring engine modified with stepping motors controlled by a computer to position and tilt the slots. Since guiding errors are our major source of error we hope to make a significant improvement in this area in the following manner. By inserting an image rotating prism behind the slit a 180° rotation of the slit will occur when the prism is rotated. Although this has not yet been tested, it is hoped that by making this rotation every few scans the effects of guiding errors due to uneven illumination of the slit and collimator will be vastly reduced.
A plausible mechanism underlying flavonoid-associated cognitive effects is increased cerebral blood flow (CBF). However, behavioural and CBF effects following flavanone-rich juice consumption have not been explored. The aim of this study was to investigate whether consumption of flavanone-rich juice is associated with acute cognitive benefits and increased regional CBF in healthy, young adults. An acute, single-blind, randomised, cross-over design was applied with two 500-ml drink conditions – high-flavanone (HF; 70·5 mg) drink and an energy-, and vitamin C- matched, zero-flavanone control. A total of twenty-four healthy young adults aged 18–30 years underwent cognitive testing at baseline and 2-h after drink consumption. A further sixteen, healthy, young adults were recruited for functional MRI assessment, whereby CBF was measured with arterial spin labelling during conscious resting state at baseline as well as 2 and 5 h after drink consumption. The HF drink was associated with significantly increased regional perfusion in the inferior and middle right frontal gyrus at 2 h relative to baseline and the control drink. In addition, the HF drink was associated with significantly improved performance on the Digit Symbol Substitution Test at 2 h relative to baseline and the control drink, but no effects were observed on any other behavioural cognitive tests. These results demonstrate that consumption of flavanone-rich citrus juice in quantities commonly consumed can acutely enhance blood flow to the brain in healthy, young adults. However, further studies are required to establish a direct causal link between increased CBF and enhanced behavioural outcomes following citrus juice ingestion.
We have used the Dominion Astrophysical Observatory radial velocity spectrometer on the 3.6m Canada-France-Hawaii telescope to obtain radial velocities, accurate to ~0.8 km/s, for ~20 stars in each of nine globular clusters. The stars are generally within three core radii of the cluster center. The cluster names and metallicities (the latter are averages of values in Zinn and West (1984), Pilachowski (1984), and Webbink (1985)) are given in Table I. This sample includes two clusters with cusps in their surface brightness profiles: NGC 6624 and 6681.
Background: Research has suggested that female athletes have a higher incidence of concussion compared to their male counterparts. As such, programs designed to improve knowledge and attitudes of concussion should target this high-risk population. Previous work demonstrated the effect of a novel Concussion-U educational presentation on knowledge and attitudes of concussion amongst male Bantam and Midget AAA hockey players. The objective of this study was to determine if the same presentation was effective in improving the knowledge and attitudes of concussion in a cohort of elite female hockey players. Methods: 26 elite female high-school aged (14-17) hockey players from the province of New Brunswick consented to participate in the study. Each participant completed a modified version of Rosenbaum and Arnett’s Concussion Knowledge and Attitudes Survey questionnaire immediately before and after a Concussion-U educational presentation. Results were compared across the two time-points to assess the effectiveness of the presentation. Results: Concussion knowledge and attitude scores significantly (p<.001) increased from pre-presentation to post-presentation by 12.5% and 13.4%, respectively. Conclusions: A Concussion-U educational presentation resulted in increased knowledge and improved attitudes towards concussion in elite female hockey players. Future research should examine the long-term retention of these improvements.
Acceleration, propagation, and energy loss of particles energized in solar flares cannot be studied separately because their radiative signatures observed in the form of hard X-ray bremsstrahlung or radio gyrosynchrotron emission represent a convolution of all these processes. We analyze hard X-ray emission from solar flares using a kinematic model that includes free-streaming electrons (having an energy-dependent time-of-flight delay) as well as temporarily trapped electrons (which are pitch-angle scattered by Coulomb collisional scattering) to determine various physical parameters (trapping times, flux asymmetry, loss-cone angles, magnetic mirror ratios) in flare loops with asymmetric magnetic fields.