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This article examines responses to the terrorist attack on the Westgate Shopping Centre in Nairobi in September 2013 in order to investigate the role played by blood donation, as an expression of national dreams, in the political imaginary of contemporary Kenya. It considers the symbolic effectiveness of calls for blood donation made by political figures in the aftermath of the attacks. Such calls drew on a tradition of donation drives begun in the early years of independence, which emphasized the modernizing imperative of the new state and the importance of unity, hard work and self-sacrifice in building the nation. However, the reaction to Westgate, including calls for blood donation, also needs to be understood with reference to the response of American and other leaders to equivalent terrorist attacks in more recent years. These elite dreams found resonance among ordinary citizens and blood donation recruiters. But they were also subjected to trenchant critiques that sought to expose the reality of the transfusion system, as well as the inequality and injustice that mark the general healthcare system and Kenyan society as a whole. These shortcomings were also highlighted by mobilization drives organized by Kenya's Somali and Asian communities both before and during the Westgate crisis. The latter are presented by their organizers as a means of overcoming historic exclusion and discrimination.
To evaluate the association of airborne colony-forming units (CFU) at incision sites during implantation of prostheses with the incidence of either incisional or prosthesis-related surgical site infections.
Randomized, controlled trial.
Primary, public institution.
Three hundred patients undergoing total hip arthroplasty, instrumented spinal procedures, or vascular bypass graft implantation.
Patients were randomly assigned in a 1:1 ratio to either the intervention group or the control group. A novel device (Air Barrier System), previously shown to reduce airborne CFU at incision sites, was utilized in the intervention group. Procedures assigned to the control group were performed without the device, under routine operating room atmospheric conditions. Patients were followed up for 12 months to determine whether airborne CFU levels at the incision sites predicted the incidence of incisional or prosthesis-related infection.
Data were available for 294 patients, 148 in the intervention group and 146 in the control group. CFU density at the incision site was significantly lower in the intervention group than in the control group (P<.001). The density of airborne CFU at the incision site during the procedures was significantly related to the incidence of implant infection (P=.021). Airborne CFU densities were 4 times greater in procedures with implant infection versus no implant infection. All 4 of the observed prosthesis infections occurred in the control group.
Reduction of airborne CFU specifically at the incision site during operations may be an effective strategy to reduce prosthesis-related infections. Trial Registration: clinicaltrials.gov Identifier: NCT01610271
To examine the association between protective lifestyle behaviours (PLB) and depression in middle-aged Irish adults.
Secondary analysis of a cross-sectional study. PLB (non-smoker, moderate alcohol, physical activity, adequate fruit and vegetable intake) were assessed using a general health and lifestyle questionnaire and a validated FFQ. Depression was assessed using the Center for Epidemiologic Studies Depression Scale. A score of 15–21 indicates mild/moderate depression and a score of 22 or more indicates a possibility of major depression. Binary logistic regression was used to examine the association between PLB and depression.
Livinghealth Clinic, Mitchelstown, North Cork, Republic of Ireland.
Men and women aged 50–69 years were selected at random from a list of patients registered at the clinic (n 2047, 67 % response rate).
Over 8 % of participants engaged in zero or one PLB, 24 % and 39 % had two and three PLB respectively, while 28 % had four PLB. Those who practised three/four PLB were significantly more likely to be female, have a higher level of education and were categorised as having no depressive symptoms. Engaging in zero or one PLB was significantly associated with an increased odds of depression compared with four PLB. Results remained significant after adjusting for several confounders, including age, gender, education and BMI (OR=2·2; 95 % CI 1·2, 4·0; P for trend=0·001).
While causal inference cannot be established in a cross-sectional study, the findings suggest that healthy behaviours may play a vital role in the promotion of positive mental health or, at a minimum, are associated with lower levels of depression.
The Darwin region in northern Australia has experienced rapid population growth in recent years, and with it, an increased incidence of melioidosis. Previous studies in Darwin have associated the environmental presence of Burkholderia pseudomallei, the causative agent of melioidosis, with anthropogenic land usage and proximity to animals. In our study, we estimated the occurrence of B. pseudomallei and Burkholderia spp. relatives in faecal matter of wildlife, livestock and domestic animals in the Darwin region. A total of 357 faecal samples were collected and bacteria isolated through culture and direct DNA extraction after enrichment in selective media. Identification of B. pseudomallei, B. ubonensis, and other Burkholderia spp. was carried out using TTS1, Bu550, and recA BUR3–BUR4 quantitative PCR assays, respectively. B. pseudomallei was detected in seven faecal samples from wallabies and a chicken. B. cepacia complex spp. and Pandoraea spp. were cultured from wallaby faecal samples, and B. cenocepacia and B. cepacia were also isolated from livestock animals. Various bacteria isolated in this study represent opportunistic human pathogens, raising the possibility that faecal shedding contributes to the expanding geographical distribution of not just B. pseudomallei but other Burkholderiaceae that can cause human disease.
We have assembled a new sample of some of the most FIR-luminous galaxies in the Universe and have imaged them in 1.1 mm dust emission and measured their redshifts 1 < z < 4 via CO emission lines using the 32-m Large Millimeter Telescope / Gran Telescopio Milimétrico (LMT/GTM). Our sample of 31 submm galaxies (SMGs), culled from the Planck and Herschel all-sky surveys, includes 14 of the 21 most luminous galaxies known, with LFIR > 1014L⊙ and SFR > 104M⊙/yr. These extreme inferred luminosities – and multiple / extended 1.1 mm images – imply that most or all are strongly gravitationally lensed, with typical magnification μ ~ 10 × . The gravitational lensing provides two significant benefits: (1) it boosts the S/N, and (2) it allows investigation of star formation and gas processes on sub-kpc scales.
We describe two cases of infant botulism due to Clostridium butyricum producing botulinum type E neurotoxin (BoNT/E) and a previously unreported environmental source. The infants presented at age 11 days with poor feeding and lethargy, hypotonia, dilated pupils and absent reflexes. Faecal samples were positive for C. butyricum BoNT/E. The infants recovered after treatment including botulism immune globulin intravenous (BIG-IV). C. butyricum BoNT/E was isolated from water from tanks housing pet ‘yellow-bellied’ terrapins (Trachemys scripta scripta): in case A the terrapins were in the infant's home; in case B a relative fed the terrapin prior to holding and feeding the infant when both visited another relative. C. butyricum isolates from the infants and the respective terrapin tank waters were indistinguishable by molecular typing. Review of a case of C. butyricum BoNT/E botulism in the UK found that there was a pet terrapin where the infant was living. It is concluded that the C. butyricum-producing BoNT type E in these cases of infant botulism most likely originated from pet terrapins. These findings reinforce public health advice that reptiles, including terrapins, are not suitable pets for children aged <5 years, and highlight the importance of hand washing after handling these pets.
Data-driven approaches to dietary patterns are under-utilized; latent class analyses (LCA) are particularly rare. The present study used an LCA to identify subgroups of people with similar dietary patterns, explore changes in dietary patterns over a 10-year period and relate these dynamics to sociodemographic factors and health outcomes.
The 1998 baseline and 2008 follow-up of the Cork and Kerry Diabetes and Heart Disease Study. Diets were assessed with a standard FFQ. LCA, under the assumption of conditional independence, was used to identify mutually exclusive subgroups with different dietary patterns, based on food group consumption.
Republic of Ireland.
Men and women aged 50–69 years at baseline (n 923) and at 10-year follow-up (n 320).
Three dietary classes emerged: Western, Healthy and Low-Energy. Significant differences in demographic, lifestyle and health outcomes were associated with class membership. Between baseline and follow-up most people remained ‘stable’ in their dietary class. Most of those who changed class moved to the Healthy class. Higher education was associated with transition to a healthy diet; lower education was associated with stability in an unhealthy pattern. Transition to a healthy diet was associated with higher CVD risk factors at baseline: respondents were significantly more likely to be smokers, centrally obese and to have hypertension (non-significant).
LCA is useful for exploring dietary patterns transitions. Understanding the predictors of longitudinal stability/transitions in dietary patterns will help target public health initiatives by identifying subgroups most/least likely to change and most/least likely to sustain a change.
A new data analysis toolkit which is suitable for the analysis of large-scale, long-term datasets and the phenomenon/anomalies they represent is described. The toolkit aims to expose and quantify scientific information in a number of forms contained within a time-series based dataset in a quantitative and rigorous manner, reducing the subjectivity of observations made, thereby supporting the scientific observer. The features contained within the toolkit include the ability to handle non-uniform datasets, time-series component determination, frequency component determination, feature/event detection and characterization/parameterization of local behaviours. An application is presented of a case study dataset arising from the 'Lasgit' experiment.
In the Swedish KBS-3 repository concept, there is potential for gas to be generated from corrosion of ferrous materials under anoxic conditions, combined with the radioactive decay of the waste and radiolysis of water. A full understanding of the probable behaviour of this gas phase within the engineered barrier system (EBS) is therefore required for performance assessment. We demonstrate key features from gas transport experiments on pre-compacted Mx80 bentonite, under laboratory and field conditions, and discuss their implications in terms of a conceptual model for gas migration behaviour. On both scales, major gas entry is seen to occur close to the sum of the porewater and swelling pressures of the bentonite. In addition, gas pressure at breakthrough is profoundly sensitive to the number and location of available sinks for gas escape. Observations of breakthrough can be explained by the creation of dilatational pathways, resulting in localized changes in the monitored porewater pressures and total stresses. These pathways are highly unstable, evolving spatially and temporally, and must consequently influence the gas permeability as their distribution/geometry develops.
Such observations are poorly embodied by conventional concepts of two-phase flow, which do not fully represent the key processes involved. Although dilatancy based models provide a better description of these processes, the paucity of data limits further development and validation of these models at present.
The significance of the potential impacts of microbial activity on the transport properties of host rocks for geological repositories is an area of active research. Most recent work has focused on granitic environments. This paper describes pilot studies investigating changes in transport properties that are produced by microbial activity in sedimentary rock environments in northern Japan. For the first time, these short experiments (39 days maximum) have shown that the denitrifying bacteria, Pseudomonas denitrificans, can survive and thrive when injected into flow-through column experiments containing fractured diatomaceous mudstone and synthetic groundwater under pressurized conditions. Although there were few significant changes in the fluid chemistry, changes in the permeability of the biotic column, which can be explained by the observed biofilm formation, were quantitatively monitored. These same methodologies could also be adapted to obtain information from cores originating from a variety of geological environments including oil reservoirs, aquifers and toxic waste disposal sites to provide an understanding of the impact of microbial activity on the transport of a range of solutes, such as groundwater contaminants and gases (e.g. injected carbon dioxide).
Poor-quality diet, regarded as an important contributor to health inequalities, is linked to adverse health outcomes. We investigated sociodemographic and lifestyle predictors of poor-quality diet in a population sample.
A cross-sectional analysis of the Survey of Lifestyle, Attitudes and Nutrition (SLÁN). Diet was assessed using an FFQ (n 9223, response rate = 89 %), from which a dietary score (the DASH (Dietary Approaches to Stop Hypertension) score) was constructed.
General population of the Republic of Ireland.
The SLÁN survey is a two-stage clustered sample of 10 364 individuals aged 18 years.
Adjusting for age and gender, a number of sociodemographic, lifestyle and health-related variables were associated with poor-quality diet: social class, education, marital status, social support, food poverty (FP), smoking status, alcohol consumption, underweight and self-perceived general health. These associations persisted when adjusted for age, gender and social class. They were not significantly altered in the multivariate analysis, although the association with social support was attenuated and that with FP was borderline significant (OR = 1·2, 95 % CI 1·03, 1·45). A classical U-shaped relationship between alcohol consumption and dietary quality was observed. Dietary quality was associated with social class, educational attainment, FP and related core determinants of health.
The extent to which social inequalities in health can be explained by socially determined differences in dietary intake is probably underestimated. The use of composite dietary quality scores such as the DASH score to address the issue of confounding by diet in the relationship between alcohol consumption and health merits further study.
Insects are a key component of natural biodiversity, providing food for birds, mammals and other invertebrates, and pollinating many natural and cultivated plants. Despite this importance, there is a real lack of long-term data across Britain on the general abundance of most insect orders. An important source of information on aerial insect populations comes from the national network of 12.2 m high suction traps of the Rothamsted Insect Survey, which started operation with the first site in 1965. All aphids have been identified and counted from these samples and, of the 12 longest-running sites, seven show no trends, three increases and two overall declines in total aphid numbers. Recently a small sub-set of stored samples from these traps has been analysed for biomass and added to the aphid biomass to estimate total aerial biomass across all insect orders for four sites in southern Britain. At three of these sites there are no long-term trends, but the total biomass has declined severely at one site, Hereford. A more detailed analysis of the Hereford samples has been done, which indicated that the major component of the biomass decline is in the larger insects, particularly the Diptera (flies). Such declines may have been more widespread before the present sampling system was initiated, and may have had important conservation consequences, particularly for insectivorous birds and mammals.
Because marijuana use often precedes the use of other psychoactive substances, it has been characterized as a gateway to these other substances. The present study used data from both monozygotic (MZ) and dizygotic (DZ) twin pairs drawn from the National Longitudinal Study of Adolescent Youth (Add Health) to examine the “gateway effect” role of earlier marijuana on later hard drug use. Difference score analyses reveal that within-pair differences in earlier marijuana use, controlling for differences in earlier hard drug use, and peer marijuana use predicted later within-pair hard drug use differences for DZ twin pairs. In contrast, earlier differences in marijuana use among MZ twin pairs did not predict later hard drug use differences. Rather than supporting the interpretation that earlier marijuana use “triggers” later hard drug use, these results suggest that the longitudinal pattern of drug use that has been interpreted as the “gateway effect” might be better conceptualized as a genetically influenced developmental trajectory.
At the very end of the twentieth century, more precisely on 22 December 1999, the Mayor of Paris, Jean Tiberi, unveiled a plaque renaming a portion of l'avenue René Coty in the fourteenth arrondissement of Paris in honour of Samuel Beckett. The plaque reads:
Allée Samuel Beckett
Foxrock 1906 – Paris 1989
Prix Nobel de Littérature
'Samuel Beckett Alley' seems especially appropriate for the writer whose most memorable characters were tramps lacking middle-class values and fond of off-colour jokes. But it is even more appropriate that at the end of the century the French government would recognize and certify that a writer living in France and often writing in French could nevertheless remain an Irish writer. The Irish government essentially did the same much earlier by
establishing the Samuel Beckett Centre at his alma mater in Dublin, Trinity
College, in 1981. At the end of the twentieth century Samuel Beckett’s status
as an Irish writer seemed so clear that the Irish critic Anthony Roche, in
his study Contemporary Irish Drama, could state: ‘the presiding genius of
contemporary Irish drama, the ghostly founding father, is Samuel Beckett’.
This paper describes a long-term laboratory test designed to examine the sensitivity of gas flow in Mx80 buffer bentonite subject to a constant volume boundary condition. A constant volume and radial flow (CVRF) apparatus was designed to enable gas flow from a centrally located injection filter to be independently monitored at three sink-filter arrays mounted around the circumference of the clay specimen. Axial and radial total stresses and internal porewater pressure were continuously monitored. Gas entry, breakthrough and peak gas pressures were found to be systematically higher under constant volume boundary conditions than under previously reported constant stress and radially-constrained test conditions [6, 9, 10]. The observation that gas pressures are sensitive to test boundary conditions supports the hypothesis that gas entry is accompanied by dilation of the bentonite fabric. Gas penetration of the clay caused a substantial increase in total stress and internal porewater pressure. Abrupt drops in gas pressure, accompanied by similar drops in total stress, were interpreted as fracture propagation events. The outflow of gas was always non-uniformly distributed between the sinks. Furthermore, the distribution of flow between sinks often changed abruptly during the course of an experiment indicating that gas pathways were very unstable. When gas injection stopped, the gas pressure and rate of outflow spontaneously declined with time. Under constant volume conditions, the gas pressure at the asymptote exceeded the internal porewater pressure by an amount equal to the capillary pressure. In constant volume tests on clay with high water saturation, capillary pressure has a value close to the measured swelling pressure of the clay.