The contribution of Primary Health Care Research, Evaluation and Development-supported research to primary health care policy and practice

The importance of primary health care (PHC) research is well understood yet conducting this research can be challenging. Barriers include a lack of funding, support and opportunity. In 2000 the Australian government introduced the Primary Health Care Research, Evaluation and Development (PHCRED) Strategy to address the gap in high-quality research. One component of the strategy, the Research Capacity Building Initiative, provided funding to university departments of general practice and rural health, allowing them to expand their pool of researchers and produce more research relevant to policy and practice. This study investigates the impact of phase two of the PHCRED Strategy by analysing peer-reviewed publications from PHCRED-supported departments. Research output was recorded from 2006 to 2010 incorporating 661 publications in 212 journals. Rural departments often had fewer resources than urban departments yet demonstrated steady research contributions focusing on issues relevant to their community. Since its inception the PHCRED Strategy has enabled development of research capacity and contributed to the body of PHC knowledge. While PHC is a diverse field, reflected in the publications produced, the themes underlying much of this work were representative of current health reform and the priority areas and building blocks of the National PHC Strategy

Are liver function tests required for patients taking isoniazid for latent TB?

Routine liver function test monitoring is not required for all patients on isoniazid therapy for latent tuberculosis (TB) infection (strength of recommendation: B, based on case series). No clinical trials have studied the potential risks and benefits of routinely monitoring liver function tests for all patients taking isoniazid for latent TB infection. Data from 2 case series suggest that routine liver function test monitoring leads to withdrawal of isoniazid prophylaxis from about 6% of patients because of abnormal lab results. This is 10 to 60 times the hepatitis rate found in case series using a symptom-based monitoring strategy. Data are insufficient, however, to conclude that routine liver function test monitoring leads to a lower rate of fatal isoniazid hepatitis compared with a strategy of symptom-based screening. Given that complete recovery from nonfatal hepatitis is the rule, and that patients withdrawn from isoniazid prophylaxis remain at risk for developing active tuberculosis, current evidence does not support routine liver function test monitoring for all patients

Estimating Counterfactual Risk Under Hypothetical Interventions in the Presence of Competing Events: Crystalline Silica Exposure and Mortality From 2 Causes of Death.

Exposure to silica has been linked to excess risk of lung cancer and nonmalignant respiratory disease mortality. In this study we estimated risk for both these outcomes in relation to occupational silica exposure as well as the reduction in risk that would result from hypothetical interventions on exposure in a cohort of exposed workers. Analyses were carried out using data from an all-male study population consisting of 2,342 California diatomaceous earth workers regularly exposed to crystalline silica and followed between 1942 and 2011. We estimated subdistribution risk for each event under the natural course and interventions of interest using the parametric g-formula to adjust for healthy-worker survivor bias. The risk ratio for lung cancer mortality, comparing an intervention in which a theoretical maximum exposure limit was set at 0.05 mg/m3 (the current US regulatory limit) with the observed exposure concentrations, was 0.86 (95% confidence interval: 0.63, 1.22). The corresponding risk ratio for nonmalignant respiratory disease mortality was 0.69 (95% confidence interval: 0.52, 0.93). Our findings suggest that risks from both outcomes would have been considerably lower if historical silica exposures in this cohort had not exceeded current regulatory limits

Energy Conservation and Gravity Waves in Sound-proof Treatments of Stellar Interiors: Part I Anelastic Approximations

Typical flows in stellar interiors are much slower than the speed of sound. To follow the slow evolution of subsonic motions, various sound-proof equations are in wide use, particularly in stellar astrophysical fluid dynamics. These low-Mach number equations include the anelastic equations. Generally, these equations are valid in nearly adiabatically stratified regions like stellar convection zones, but may not be valid in the sub-adiabatic, stably stratified stellar radiative interiors. Understanding the coupling between the convection zone and the radiative interior is a problem of crucial interest and may have strong implications for solar and stellar dynamo theories as the interface between the two, called the tachocline in the Sun, plays a crucial role in many solar dynamo theories. Here we study the properties of gravity waves in stably-stratified atmospheres. In particular, we explore how gravity waves are handled in various sound-proof equations. We find that some anelastic treatments fail to conserve energy in stably-stratified atmospheres, instead conserving pseudo-energies that depend on the stratification, and we demonstrate this numerically. One anelastic equation set does conserve energy in all atmospheres and we provide recommendations for converting low-Mach number anelastic codes to this set of equations.Comment: Accepted for publication in ApJ. 20 pages emulateapj format, 7 figure

Looking Under the Hood : Tools for Diagnosing your Question Answering Engine

In this paper we analyze two question answering tasks : the TREC-8 question answering task and a set of reading comprehension exams. First, we show that Q/A systems perform better when there are multiple answer opportunities per question. Next, we analyze common approaches to two subproblems: term overlap for answer sentence identification, and answer typing for short answer extraction. We present general tools for analyzing the strengths and limitations of techniques for these subproblems. Our results quantify the limitations of both term overlap and answer typing to distinguish between competing answer candidates.Comment: Revision of paper appearing in the Proceedings of the Workshop on Open-Domain Question Answerin

Fact Sheet: Mentoring matters

Mentoring is a process involving communication and relationships. It is the basis for the informal exchange of knowledge, information and support between a person who has these attributes and a person who needs them. This fact sheet lists key information about mentoring matters

Examination of 4He droplets and droplets containing impurities at zero Kelvin using a density functional approach

Abstract Detailed in this manuscript is a methodology to model ground state properties of 4He droplets at zero pressure and zero Kelvin using a density functional theory of liquid helium. The density functional approach examined here consists of two noted functionals from the literature and corresponding mean field definitions. A mean field and trial density are defined for each system and optimized to self-consistency using a matrix diagonalization technique. Initial calculations of planar slabs are performed and demonstrate reasonable agreement with experiment and with prior studies using density functional theory. Quantum properties of droplets and droplets containing atomic dopants are calculated. Three different He-dopant potentials are examined to test the limits of the functional methods. For each impurity interaction, an average of 12 atoms were found to reside in the first solvation shell with an atomic dopant placed at the droplet center. Maximum densities in the first solvation shell reached those of solid helium as predicted by DF methods