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Medical equipment can transmit pathogenic bacteria to patients. This single-institution point prevalence study aimed to characterise the types and relative amount of bacteria found on surgical loupes, headlights and their battery packs.
Surgical loupes, headlights and battery packs of 16 otolaryngology staff and residents were sampled, cultured and quantified. Plate scores were summed for each equipment type, and the total was divided by the number of users to generate mean bacterial burden scores. Residents completed a questionnaire regarding their equipment cleaning practices.
The contamination rates of loupes, headlights and battery packs were 68.75 per cent, 100 per cent and 75 per cent, respectively. Battery packs cultured more bacteria (1.58 per swab ± 1.00) than loupes (0.75 per swab ± 0.66; p = 0.024). Headlights had non-significantly greater growth (1.50 per swab ± 0.71) than loupes (p = 0.052). Bacterial growth was significantly higher from inner surfaces of loupes (p = 0.035) and headlights (p = 0.037). Potentially pathogenic bacteria were cultured from the equipment of five participants, including: Pantoea agglomerans, Acinetobacter radioresistens, Staphylococcus aureus, Acinetobacter calcoaceticus baumannii complex and Moraxella osloensis.
This study demonstrates that surgical loupes and headlights used in otolaryngology harbour non-pathogenic skin flora and potentially pathogenic bacteria.
The Working Party has produced this report in order to prompt readers to engage at an early stage in InsurTech projects, through considering (i) the full range of risks associated with InsurTech developments, (ii) the lifecycle of an InsurTech venture and how any risk considerations may vary over this lifecycle and (iii) the extent to which InsurTech ventures align with risk strategy and risk appetite.
The report contains practical guidance for actuaries, risk professionals, insurance companies and their Boards on these considerations, and can be used to facilitate appropriate questioning, to help ensure that InsurTech-related business decisions are fully cognisant of the risk management issues and to help ensure the success of projects.
The Working Party developed this guidance having carried out an industry survey on a number of risk management topics relating to InsurTech, as well as having carried out interviews with a number of relevant senior stakeholders across the insurance industry, in order to better understand current sentiment and how risk management plays a part when considering opportunities in InsurTech. The Working Party views on the findings from these activities are summarised in the report.
Objectives: A rich body of literature has established the role of body image distortion and dissatisfaction in the development and maintenance of eating disorders. However, many of the currently used techniques require explicit comparison of the person’s body to an external stimulus. As the body schema is a largely unconscious construct, explicit comparison tasks may reflect a proxy, rather than the body schema itself. Methods: Here we use an implicit mental motor imagery (MMI) task to interrogate the body schema in healthy control participants (N=40) and participants at a residential eating disorder treatment center (N=42). By comparing the time it takes to imagine making a movement along a part of the body to the time it takes to actually make the same movement, we were able to assess participants’ mental image of their body (i.e., body schema). Results: We found that participants with eating disorders, but not healthy controls, exhibited distortions of the body schema such that they believed their abdomen, buttocks, and thighs to be larger than they really are. Additionally, the MMI task used here provided information above and beyond traditional self-report measures (i.e., Body Shape Questionnaire). Together the MMI task and traditional measures provide the most information. Conclusions: Findings using the novel MMI task are in line with the literature; participants with eating disorders consider themselves to be larger than they truly are. Taken together, results of this study suggest that MMI tasks provide complementary information to traditional self-report measures. (JINS, 2018, 22, 000–000)
We aimed to establish the treatment effect of physical activity for depression in young people through meta-analysis. Four databases were searched to September 2016 for randomised controlled trials of physical activity interventions for adolescents and young adults, 12–25 years, experiencing a diagnosis or threshold symptoms of depression. Random-effects meta-analysis was used to estimate the standardised mean difference (SMD) between physical activity and control conditions. Subgroup analysis and meta-regression investigated potential treatment effect modifiers. Acceptability was estimated using dropout. Trials were assessed against risk of bias domains and overall quality of evidence was assessed using GRADE criteria. Seventeen trials were eligible and 16 provided data from 771 participants showing a large effect of physical activity on depression symptoms compared to controls (SMD = −0.82, 95% CI = −1.02 to −0.61, p < 0.05, I2 = 38%). The effect remained robust in trials with clinical samples (k = 5, SMD = −0.72, 95% CI = −1.15 to −0.30), and in trials using attention/activity placebo controls (k = 7, SMD = −0.82, 95% CI = −1.05 to −0.59). Dropout was 11% across physical activity arms and equivalent in controls (k = 12, RD = −0.01, 95% CI = −0.04 to 0.03, p = 0.70). However, the quality of RCT-level evidence contributing to the primary analysis was downgraded two levels to LOW (trial-level risk of bias, suspected publication bias), suggesting uncertainty in the size of effect and caution in its interpretation. While physical activity appears to be a promising and acceptable intervention for adolescents and young adults experiencing depression, robust clinical effectiveness trials that minimise risk of bias are required to increase confidence in the current finding. The specific intervention characteristics required to improve depression remain unclear, however best candidates given current evidence may include, but are not limited to, supervised, aerobic-based activity of moderate-to-vigorous intensity, engaged in multiple times per week over eight or more weeks. Further research is needed. (Registration: PROSPERO-CRD 42015024388).
A global array of 20 radio observatories was used to measure the three-dimensional position and velocity of the two meteorological balloons that were injected into the equatorial region of the Venus atmosphere by the VEGA spacecraft.
The Naval Research Laboratory prepared three instruments for ATM and also a series of rocket payloads for purposes of calibration, under the overall direction of R. Tousey, the Principal Investigator. In this preliminary report a summary of results from operations during the first mission (SL/2) and sample results are presented.
We present a preliminary analysis of B- and I-band CCD images and Rutgers imaging Fabry–Perot Hα interferometry of the galaxy NGC 3081. We find that the outer R1 and inner ring are both intrinsically oval. We derive a bar pattern speed from the velocity field.
A comparison between XUV and Ca-K spectroheliograms for 9 dates from 1963 to 1967 showed an excellent correlation between plage intensities in Ca-K and He II 304 Å, except for plages near the limb and a few others. Around the limb all but the highest ionization XUV emission lines form a bright ring, usually weaker over the poles. This is an unresolved combination of the limb-brightened emission from the quiet corona and high chromosphere, and emission extending into the corona above plages located as much as several days from limb passage.
In Fe XV and XVI only the localized coronal emissions are observed; these vary in form and intensity from line to line. The 171–500 Å and white-light coronas, recorded on November 12, 1966, correlate well at low altitudes, but beyond 3′ the XUV corona becomes diffuse and without structure.
As a result of research carried out with rocket-borne grating spectrographs, the nature of the extreme ultraviolet spectrum of the Sun is now known to a short wavelength limit of 33.7 Å, the Lyman-alpha line of C VI. Most of the emission lines of wavelengths greater than 400 Å have been identified, as have those from 80 Å to 33.7 Å. Between 149 Å and 400 Å, however there are many intense emission lines whose identity has not as yet been established. Twenty or more have been proved to be from iron, since they appear in spectra obtained from high temperature plasmas into which iron has been introduced, but the stages of ionization have not yet been established. Lines from the elements most abundant in the Sun, H, He, O, N, O, Ne, Mg, Al, Si, S and Fe, in most of the stages of ionization requiring 500 eV or less for production have been found. The outstanding exceptions are the lines in the fluorine and neon sequences.
Spectroheliograms, photographed with normal incidence spectrographs, show that the emission lines Fe XV 284 Å, Fe XVI 335, 361 Å, originate principally from active regions, in contrast to He II 304 Å, which is emitted with great intensity from the disc also. Continuum emission, in the wavelength range 170–300 Å, has been recorded from intense centers of activity.
Massive stars are some of the most important objects in the Universe, shaping the evolution of galaxies, creating chemical elements, and hence shaping the evolution of the Universe. However, the processes by which they form, and how they shape their environment during their birth processes, are not well understood. We are using NH3 data from the “The H2O Southern Galactic Plane Survey” (HOPS) to define the positions of dense cores/clumps of gas in the southern Galactic plane that are likely to form stars. We did a comparative study with different methods for finding clumps and found Fellwalker to be the best for this dataset. We detected ~ 500 clumps with mean kinetic temperature ~ 20 K and virial mass ~ 680 solar masses.
On 30 May 2012, Surrey and Sussex Health Protection Unit was called by five nurseries reporting children and staff with sudden onset vomiting approximately an hour after finishing their lunch that day. Over the following 24 h 50 further nurseries supplied by the same company reported cases of vomiting (182 children, 18 staff affected). Epidemiological investigations were undertaken in order to identify the cause of the outbreak and prevent further cases. Investigations demonstrated a nursery-level attack rate of 55 out of 87 nurseries (63·2%, 95% confidence interval 52·2–73·3). Microbiological tests confirmed the presence of Bacillus cereus in food and environmental samples from the catering company and one nursery. This was considered microbiologically and epidemiologically consistent with toxin from this bacterium causing the outbreak. Laboratory investigations showed that the conditions used by the caterer for soaking of pearl haricot beans (known as navy bean in the USA) used in one of the foods supplied to the nurseries prior to cooking, was likely to have provided sufficient growth and toxin production of B. cereus to cause illness. This large outbreak demonstrates the need for careful temperature control in food preparation.
Upon my graduation from Denison University in May of 1990, I entered the Management Training Program at Huntington Bancshares Inc., based in Columbus, Ohio. The program was designed to develop numerous skills and abilities in the corporate, retail, and operational sectors of the corporation. The program entailed product and services training in trust, investments, credit analysis, and mortgage lending.
After spending almost two years as a management trainee, I obtained a position as a financial analyst in the Asset/Liability Management Department. I performed monthly forecasts of net interest income and analyses of Huntington's interest rate risk (a measurement of net interest income-at-risk to a directional change in interest rates). In all of my reporting to senior management, accuracy and precision were essential. I produced charts and graphs that were used as a means of communicating asset/liability issues to management. I was also a member of the Retail Deposit Pricing Committee, where I developed reports detailing rates, maturities, and risk characteristics of deposit products. These reports were used in weekly meetings to aid in determining product pricing for corporate-wide markets. For each of these responsibilities, my experience in mathematics allowed me to become more disciplined in my thinking and more attentive to details.
After spending more than two years as an analyst at Huntington, I moved on to a similar position for KeyCorp, a $65 billion bank located in Cleveland, Ohio. I am currently responsible for determining the interest rate risk exposure for affiliate banks in the Rocky Mountain Region.
The Millimetre Astronomy Legacy Team 90 GHz (MALT90) survey aims to characterise the physical and chemical evolution of high-mass star-forming clumps. Exploiting the unique broad frequency range and on-the-fly mapping capabilities of the Australia Telescope National Facility Mopra 22 m single-dish telescope1, MALT90 has obtained 3′ × 3′ maps towards ~2 000 dense molecular clumps identified in the ATLASGAL 870 μm Galactic plane survey. The clumps were selected to host the early stages of high-mass star formation and to span the complete range in their evolutionary states (from prestellar, to protostellar, and on to
regions and photodissociation regions). Because MALT90 mapped 16 lines simultaneously with excellent spatial (38 arcsec) and spectral (0.11 km s−1) resolution, the data reveal a wealth of information about the clumps’ morphologies, chemistry, and kinematics. In this paper we outline the survey strategy, observing mode, data reduction procedure, and highlight some early science results. All MALT90 raw and processed data products are available to the community. With its unprecedented large sample of clumps, MALT90 is the largest survey of its type ever conducted and an excellent resource for identifying interesting candidates for high-resolution studies with ALMA.
Performance measurement (PM) is central to the current Irish health service policy. However, PM within the Irish mental health services has not been fully implemented. These services lack a national comprehensive suite of performance indicators (PIs). Those indicators that are measured do not tend to reflect the objectives of the managers and staff measuring them. To overcome these challenges, this article suggests a suite of measures and aims to provide a practical guide to PM for managers and staff.
A narrative review of a range of policy documents and articles, relevant to PM in the Irish mental health services, was undertaken.
The search produced a number of themes illustrating the limitations of the current set of PIs for Irish mental health services, in particular the need for comprehensive PIs, including structure, process and outcome PIs. This informed the development of a suite of proposed PIs for mental health services. A number of additional themes highlighted the criticisms associated with the top-down approach used to implement PM. Drawing from these themes, a bottom-up approach to PM is proposed.
Although this review was selective in nature, it illustrates how the concerns of clinicians and service managers can be integrated with the priorities of the Health Service Executive and the Department of Health. This presented the suite of PIs and the practical guide that provide useful PM tools. While also applicable at a national level, this paper provides guidance for service managers as to the process of establishing and implementing a suite of PIs within their own service.
We describe observations with the Mopra radiotelescope designed to assess the feasibility of the H2O Maser Southern Galactic Plane Survey. We mapped two one-square-degree regions along the Galactic plane using the new 12-mm receiver and the UNSW Mopra spectrometer. We covered the entire spectrum between 19.5 and 27.5 GHz using this setup with the main aim of finding out which spectral lines can be detected with a quick mapping survey. We report on detected emission from H2O masers, NH3 inversion transitions (1,1), (2,2) and (3,3), HC3N (3–2), as well as several radio recombination lines.
We present the results of a programme of scanning and mapping observations of astronomical masers and Jupiter designed to characterise the performance of the Mopra Radio Telescope at frequencies between 16 and 50 GHz using the 12-mm and 7-mm receivers. We use these observations to determine the telescope beam size, beam shape, and overall telescope beam efficiency as a function of frequency. We find that the beam size is well fit by λ/D over the frequency range with a correlation coefficient of ∼90%. We determine the telescope main beam efficiencies are between ∼48 and 64% for the 12-mm receiver and reasonably flat at ∼50% for the 7-mm receiver. Beam maps of strong H2O (22 GHz) and SiO masers (43 GHz) provide a means to examine the radial beam pattern of the telescope. At both frequencies, the radial beam pattern reveals the presence of three components: a central ‘core’, which is well fit by a Gaussian and constitutes the telescopes main beam; and inner and outer error beams. At both frequencies, the inner and outer error beams extend out to ∼2 and ∼3.4 times the full-width half maximum of the main beam, respectively. Sources with angular sizes of a factor of two or more larger than the telescope main beam will couple to the main and error beams, and therefore the power contributed by the error beams needs to be considered. From measurements of the radial beam power pattern we estimate the amount of power contained in the inner and outer error beams is of order one-fifth at 22 GHz, rising slightly to one-third at 43 GHz.