Becoming (in)human. The search for an alternative present in Helen Macdonald's H Is for Hawk

The paper presents a reading of Helen Macdonald's non-fiction book H Is for Hawk, that focuses on the adoption of the temporal perspective of a predator (the instantaneousness of the attack and capture of the prey) instead of the typically human way of addressing the temporality spreading over a past, a present, and a future (memory, mourning, anxiety). Rethinking the inherited cultural practice of keeping and taming goshawks, the British writer narrates the process of mental merging with the female goshawk she trains. Through her engagement as an austringer (keeper of hawks), she also questions such categories as gender, class, and nationality. In parallel to her own experience, she reads the personal story of yet another transgressive austringer, the homosexual author T. H. White. This double line of vital/textual experience deconstructs the dominant cultural stance of heterosexual masculinity and sketches a peculiar queertopia.

Fluticasone/formoterol combination therapy is as effective as fluticasone/salmeterol in the treatment of asthma, but has a more rapid onset of action: an open-label, randomized study

<p>Abstract</p> <p>Background</p> <p>The inhaled corticosteroid (ICS) fluticasone propionate (fluticasone) and the long-acting β₂-agonist (LABA) formoterol fumarate (formoterol) are being made available as a combination product (fluticasone/formoterol, <b><it>flutiform</it></b>^®) in a single aerosol inhaler. This 12-week, open-label, randomized, active-controlled, parallel-group, multicentre, phase 3 study compared the efficacy and safety of fluticasone/formoterol with the commercially available combination product fluticasone/salmeterol.</p> <p>Methods</p> <p>Patients aged ≥ 18 years (N = 202) with mild-to-moderate–severe, persistent asthma for ≥ 6 months prior to screening were included in the study. After a screening phase (4–10 days), eligible patients were randomized 1:1 to receive fluticasone/formoterol or fluticasone/salmeterol during the 12-week treatment period. The primary objective was to demonstrate non-inferiority of fluticasone/formoterol versus fluticasone/salmeterol, measured by pre-dose forced expiratory volume in the first second (FEV₁), at week 12.</p> <p>Results</p> <p>Fluticasone/formoterol was comparable to fluticasone/salmeterol for the primary efficacy endpoint, mean pre-dose FEV₁at week 12. The new combination was also comparable to fluticasone/salmeterol for change from baseline to week 12 in pre-dose FEV₁, change from pre-dose FEV₁at baseline to 2-hour post-dose FEV₁at week 12 and discontinuations due to lack of efficacy. Importantly, fluticasone/formoterol was superior to fluticasone/salmeterol in time to onset of action throughout the duration of the study. The two treatments demonstrated similar results for various other secondary efficacy parameters, including other lung function tests, patient-reported outcomes, rescue medication use, asthma exacerbations and Asthma Quality of Life Questionnaire scores. Fluticasone/formoterol was well tolerated and had a good safety profile that was similar to fluticasone/salmeterol.</p> <p>Conclusions</p> <p>The results of this study indicate that fluticasone/formoterol is as effective as fluticasone/salmeterol, and has a more rapid onset of action, reflecting the faster bronchodilatory effects of formoterol compared with those of salmeterol. If patients perceive the benefits of therapy with fluticasone/formoterol more rapidly than with fluticasone/salmeterol, this could have a positive impact on preference and adherence.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT00476073">NCT00476073</a></p

Where to from here? A quality improvement project investigating burns treatment and rehabilitation practices in India

Abstract Objective To describe the capacity of the Indian healthcare system in providing appropriate and effective burns treatment and rehabilitation services. Results Health professionals involved in burns treatment or rehabilitation at seven hospitals from four states in India were invited to participate in consultative meetings. Existing treatment and rehabilitation strategies, barriers and enablers to patient flow across the continuum of care and details on inpatient and outpatient rehabilitation were discussed during the meetings. Seventeen health professionals from various clinical backgrounds were involved in the consultation process. Key themes highlighted (a) a lack of awareness on burn first aid at the community level, (b) a lack of human resource to treat burn injuries in hospital settings, (c) a gap in burn care training for medical staff, (d) poor hospital infrastructure and (e) a variation in treatment practices and rehabilitation services available between hospitals. A number of opportunities exist to improve burns treatment and rehabilitation in India. Improvements would most effectively be achieved through promoting multidisciplinary care across a number of facilities and service providers. Further research is required to develop context-specific burn care models, determining how these can be integrated into the Indian healthcare system

Performance of ionospheric maps in support of long baseline GNSS kinematic positioning at low latitudes

Ionospheric scintillation occurs mainly at high and low latitude regions of the Earth and may impose serious degradation on GNSS (Global Navigation Satellite System) functionality. The Brazilian territory sits on one of the most affected areas of the globe, where the ionosphere behaves very unpredictably, with strong scintillation frequently occurring in the local postsunset hours. The correlation between scintillation occurrence and sharp variations in the ionospheric total electron content (TEC) in Brazil is demonstrated in Spogli et al. (2013). The compounded effect of these associated ionospheric disturbances on long baseline GNSS kinematic positioning is studied in this paper, in particular when ionospheric maps are used to aid the positioning solution. The experiments have been conducted using data from GNSS reference stations in Brazil. The use of a regional TEC map generated under the CALIBRA (Countering GNSS high-Accuracy applications Limitations due to Ionospheric disturbances in BRAzil) project, referred to as CALIBRA TEC map (CTM), was compared to the use of the Global Ionosphere Map (GIM), provided by the International GNSS Service (IGS). Results show that the use of the CTM greatly improves the kinematic positioning solution as compared with that using the GIM, especially under disturbed ionospheric conditions. Additionally, different hypotheses were tested regarding the precision of the TEC values obtained from ionospheric maps, and its effect on the long baseline kinematic solution evaluated. Finally, this study compares two interpolation methods for ionospheric maps, namely, the Inverse Distance Weight and the Natural Neighbor

Validity of the Falls Risk for Older People in the Community (FROP‑Com) tool to predict falls and fall injuries for older people presenting to the emergency department after falling

The aims of this study were to (1) externally validate the accuracy of the Falls Risk for Older People in the Community (FROP-Com) falls risk assessment tool in predicting falls and (2) undertake initial validation of the accuracy of the FROPCom to predict injurious falls (requiring medical attention) in people aged ≥ 60 years presenting to emergency departments (EDs) after falling. Two hundred and thirteen participants (mean age = 72.4 years; 59.2% women) were recruited (control group of a randomised controlled trial). A FROP-Com assessment was completed at a home visit within 2 weeks of ED discharge. Data on falls and injurious falls requiring medical attention were collected via monthly falls calendars for the next 12 months. Predictive accuracy was evaluated using sensitivity and specificity of a high-risk FROP-Com classification (score ≥ 19) in predicting a fall and injurious falls requiring medical attention. Fifty per cent of participants fell, with 60.4% of falls requiring medical attention. Thirty-two per cent were classified as high, 49% as moderate and 19% low falls risk. Low sensitivity was achieved for the FROP-Com high-risk classification for predicting falls (43.4%) and injurious falls (34.4%), although specificity was high (79.4% and 78.6%, respectively). Despite the FROP-Com’s low predictive accuracy, the high fall rate and high falls risk of the sample suggest that older people who fall, present to ED and are discharged home are at high risk of future falls. In high-falls-risk populations such as in this study, the FROP-Com is not a valid tool for classifying risk of falls or injurious falls. Its potential value may instead be in identifying risk factors for falling to direct tailoring of falls prevention interventions to reduce future falls