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Introduction: One in nine (11.7%) people in Saskatchewan identifies as First Nations. In Canada, First Nations people experience a higher burden of cardiovascular disease when compared to the general population, but it is unknown whether they have different outcomes in out of hospital cardiac arrest (OHCA). Methods: We reviewed pre-hospital and inpatient records of patients sustaining an OHCA between January 1st, 2015 and December 31st, 2017. The population consisted of patients aged 18 years or older with OHCA of presumed cardiac origin occurring in the catchment area of Saskatoon's EMS service. Variables of interest included, age, gender, First Nations status (as identified by treaty number), EMS response times, bystander CPR, and shockable rhythm. Outcomes of interest included return of spontaneous circulation (ROSC), survival to hospital admission, and survival to hospital discharge. Results: In all, 372 patients sustained OHCA, of which 27 were identified as First Nations. First Nations patients with OHCA tended to be significantly younger (mean age 46 years vs. 65 years, p < 0.0001) and had shorter EMS response times (median times 5.3 minutes vs. 6.2 minutes, p = 0.01). There were no differences between First Nations and non-First Nations patients in terms of incidence of shockable rhythms (24% vs. 26%, p = 0.80), ROSC (42% vs. 41%, p = 0.87), survival to admission (27% vs 33%, p = 0.53), and survival to hospital discharge (15% vs. 12%, p = 0.54). Conclusion: In Saskatoon, First Nations patients sustaining OHCA appear to have similar survival rates when compared with non-First Nations patients, suggesting similar baseline care. Interestingly, First Nations patients sustaining OHCA were significantly younger than their non-First Nations counterparts. This may reflect a higher burden of cardiovascular disease, suggesting a need improved prevention strategies.
The Commensal Real-time Australian Square Kilometre Array Pathfinder Fast Transients survey is the first extensive astronomical survey using phased array feeds. Since January 2017, it has been searching for fast radio bursts in fly’s eye mode. Here, we present a calculation of the sensitivity and total exposure of the survey that detected the first 20 of these bursts, using the pulsars B1641-45 and B0833-45 as calibrators. The beamshape, antenna-dependent system noise, and the effects of radio-frequency interference and fluctuations during commissioning are quantified. Effective survey exposures and sensitivities are calculated as a function of the source counts distribution. Statistical ‘stat’ and systematics ‘sys’ effects are treated separately. The implied fast radio burst rate is significantly lower than the 37 sky−1 day−1 calculated using nominal exposures and sensitivities for this same sample by Shannon et al. (2018). At the Euclidean (best-fit) power-law index of −1.5 (−2.2), the rate is
(sys) ± 3.6 (stat) sky−1 day−1 (
(sys) ± 2.8 (stat) sky−1 day−1) above a threshold of 56.6 ± 6.6(sys) Jy ms (40.4 ± 1.2(sys) Jy ms). This strongly suggests that these calculations be performed for other FRB-hunting experiments, allowing meaningful comparisons to be made between them.
Important ear problems can affect the outer ear, the middle ear and the inner ear. Globally, the greatest burden of disease is due to ear conditions that are associated with otorrhoea and hearing loss.
This study reviewed the literature on the prevention and treatment of common ear conditions that are most relevant to settings with high rates of ear disease and limited resources. The grading of recommendations assessment, development and evaluation (‘GRADE’) approach was utilised to assess interventions.
Accurate diagnosis of ear disease is challenging. Much of the preventable burden of ear disease is associated with otitis media. Nine otitis media interventions for which there is moderate to high certainty of effect were identified. While most interventions only provide modest benefit, the impact of treatment is more substantial in children with acute otitis media with perforation and chronic suppurative otitis media.
Disease prevention through good hygiene practices, breastfeeding, reducing smoke exposure, immunisation and limiting noise exposure is recommended. Children with acute otitis media with perforation, chronic suppurative otitis media, complications of otitis media, and significant hearing loss should be prioritised for medical treatment.
It is no longer possible nor desirable to address the dual challenges of equity and sustainability separately. Instead, they require new thinking and approaches which recognize their interlinkages, as well as the multiple perspectives and dimensions involved. We illustrate how equity and sustainability are intertwined, and how a complex social–ecological systems lens brings together advances from across the social and natural sciences to show how (in)equity and (un)sustainability are produced by the interactions and dynamics of coupled social–ecological systems. This should help understand which possible pathways could lead to sustainable and fair futures.
The overall objective of a series of experiments to investigate ‘metabolic stress’ was to examine the relationships between ‘metabolic load’, disease and other parameters associated with the welfare of the dairy cow. In the main, these used several well controlled herd based studies complimented with more basic and strategic investigations. In this paper we compare and contrast practical aspects of health and welfare in two high genetic merit herds managed at the extremes of inputs and outputs for dairy farming in south-west Scotland. The hypothesis was that high output herds would have more health and welfare problems than low input herds. Two herds (70 Holstein-Friesian cows each) at SAC Acrehead Dumfries of a similar genetic background (overall in the top 5% of UK cows by PIN and ITEM), were housed in identical buildings and tended by the same herdsman. Both herds had autumn- and spring-calving cattle. The ‘low input’ herd (LI) was given a minimum of concentrate (approx. 0.5 t per cow per year) and milked twice a day and had a restricted quota of 385 000 l. The ‘high output’ herd (HO) was managed for high yields (unrestricted quota) and was given concentrates (2 t per cow per year) and forage ad libitum and milked three times daily. In 1995-96 the sole source of winter forage was grass/clover silage (LI) or grass silage (HO) but in 1996-1998 ensiled cereal and fodder beet were included in both diets. ‘Metabolic load’ could only be inferred from overall inputs, milk outputs, weight loss, body condition score and behaviour. There were significant differences in 305-day lactation yields between herds, and season of calving especially in 1995-96 (LI autumn; 5952 l at 30 g/kg protein (P); LI spring; 5741 l, 32.5 g/kg P; HO autumn; 9541 l at 32.8 g/kg P; HO spring; 8402 l, 32.6 g/kg P). LI weight and body condition-score losses were greatest in this year and behavioural studies showed substantial differences in feeding time (HO < LI, P < 0.05) and total lying time (LI < HO; P < 0.05). However these differences were much less marked in subsequent years. There was a significant difference in the prevalence and incidence of clinical lameness between herds (HO > LI; P < 0.05) and season (autumn > spring P < 0.05) but not for mastitis or metabolic disease. An in-depth study of subclinical claw horn lesion development in first calving heifers showed significant differences between herds in 1996-97 (LI > HO, P < 0.05) but none in 1995-96. There was a significant difference for season in both years (autumn > spring, P < 0.05). Analysis of blood biochemistry parameters of samples taken at approximately 1 month after calving showed some significant differences between LI and HO generally indicating a greater ‘metabolic load’ for LI. Although the full effects of ‘metabolic load’ on immune function and reproduction are dealt with elsewhere our preliminary data showed no significant differences between herds for the former but some significant differences for the latter, in particular there were differences in aspects of the progesterone profiles between herds and more importantly between seasons. However these latter differences were not clearly reflected in conception rates. It was concluded that the hypothesis was not fully sustained and that both systems had pitfalls in terms of welfare. The three major areas causing difficulties for both systems were the need first to ensure adequate intake of forage; secondly to limit the environmental challenge to the feet and udder and finally to marry these systems to the factors limiting reproduction, primarily calving season and ability of reproduction management.
To date, there has been no published textbook which takes into account changing sociolinguistic dynamics that have influenced South African society. Multilingualism and Intercultural Communication breaks new ground in this arena. The scope of this book ranges from macro-sociolinguistic questions pertaining to language policies and their implementation (or non-implementation) to micro-sociolinguistic observations of actual language-use in verbal interaction, mainly in multilingual contexts of Higher Education (HE). There is a gradual move for the study of language and culture to be taught in the context of (professional) disciplines in which they would be used, for example, Journalism and African languages, Education and African languages, etc. The book caters for this growing market. Because of its multilingual nature, it caters to English and Afrikaans language speakers, as well as the Sotho and Nguni language groups – the largest languages in South Africa [and also increasingly used in the context of South African Higher Education]. It brings together various inter-linked disciplines such as Sociolinguistics and Applied Language Studies, Media Studies and Journalism, History and Education, Social and Natural Sciences, Law, Human Language Technology, Music, Intercultural Communication and Literary Studies. The unique cross-cutting disciplinary features of the book will make it a must-have for twenty-first century South African students and scholars and those interested in applied language issues.
To review research addressing the polymicrobial aetiology of otitis media in Indigenous Australian children in order to identify research gaps and inform best practice in effective prevention strategies and therapeutic interventions.
Studies of aspirated middle-ear fluid represented a minor component of the literature reviewed. Most studies relied upon specimens from middle-ear discharge or the nasopharynx. Culture-based middle-ear discharge studies have found that non-typeable Haemophilus influenzae and Streptococcus pneumoniae predominate, with Moraxella catarrhalis, Staphylococcus aureus and Streptococcus pyogenes isolated in a lower proportion of samples. Alloiococcus otitidis was detected in a number of studies; however, its role in otitis media pathogenesis remains controversial. Nasopharyngeal colonisation is a risk factor for otitis media in Indigenous infants, and bacterial load of otopathogens in the nasopharynx can predict the ear state of Indigenous children.
Most studies have used culture-based methods and specimens from middle-ear discharge or the nasopharynx. Findings from these studies are consistent with international literature, but reliance on culture may incorrectly characterise the microbiology of this condition. Advances in genomic technologies are now providing microbiologists with the ability to analyse the entire mixed bacterial communities (‘microbiomes’) of samples obtained from Indigenous children with otitis media.