Concordance of gout management with European League against Rheumatism recommendations in hospital practice

Aim: To assess the concordance of gout management with the European League Against Rheumatism (EULAR) gout recommendations in hospital practice. Methods: This was a retrospective review of case notes of patients presenting to rheumatology outpatients between June and December 2009 under the care of 2 consultant rheumatologists. Data collected consisted of demographics, time lag to specialist referral, comorbidities, details about acute and recurrent attacks, lifestyle advice and use of urate lowering therapies. Documented management was assessed for concordance with the EULAR recommendations. Results: Thirty consecutive patients (27 males, 3 females) attending Rheumatology clinic at Mater Dei Hospital were recruited. Mean age at the time of survey was 59.4 ± 10.7 years, while mean age at diagnosis was 51.1 ± 14 years. Documentation of lifestyle advice was recorded for alcohol reduction (83%), weight loss (43%), diet (13%), and exercise (13%). Adequate control of comorbidities was attained in hyperlipidaemia (71%), diabetes mellitus (55%) and hypertension (30%). Advice about smoking cessation was given to 37%. Uric acid levels below target were achieved in 47%. The mean uric acid level at time of survey was 379 ± 146 μmol/l. This was significantly less than that at presentation (p=0.001). Conclusions: Current treatment of gout is poorly concordant with many of the EULAR recommendations. Documentation of lifestyle modifications advice is infrequent except for alcohol reduction. A significant number of patents on allopurinol still have hyperuricaemia implying that more aggressive management is required to improve standard of care. A proforma has been developed to make and help sustain the necessary improvements.peer-reviewe

Evaluation of the National Compact – Aspirations and Impact

Compacts are written agreements that articulate the vision for cooperation between governments and the not-for-profit sector, generally with the overall aim of improving social outcomes. This report documents an evaluation which assessed the implementation and impact of Australia’s National Compact, and the extent to which it has contributed to improved relationships between Federal government agencies and the not-for-profit sector. Findings from interviews, focus groups and surveys captured the perspectives of leaders in the not-for-profit sector and staff in government agencies about the relationship between the sectors, and the role the Compact has played in improving this relationship. Government and not-for-profit stakeholders strongly value the sector relationship and perceive it to be improving, with two thirds of the respondents in the government survey and almost fifty percent in the not-for-profit survey characterising the relationship as strong. The Compact has formalised the importance of the relationship, raised expectations within government agencies and the not-for-profit sector and provided an important symbol and foundation for mutual commitment to improving the relationship. However, awareness of the Compact remains inconsistent; there is limited understanding of the way the Compact has underpinned important elements of not-for-profit reform; and many perceive Compact implementation has lost momentum. As a result, there is limited attribution of improvements in the sector relationship to the Compact. Australia has a critical need for a constructive government-not-for-profit partnership working towards more effective and efficient delivery of social outcomes. In the context of its ageing population and socio-demographic challenges, there will be significantly increasing pressure to deliver stronger outcomes with fewer resources. In this context, the Compact has a vital role to play. The evidence in this report suggests that to build on the Compact’s solid foundation and ensure long term impact, a renewed commitment is needed from leaders of the not-for-profit sector as well as bipartisan support from government. Action is needed to continue to build awareness of the Compact, its aims, actions and outcomes, and its achievements in articulating the foundations for not-for-profit reform. A clearer logic framework linking Compact aspirations to actions and outcomes is needed, to inform continued implementation across both sectors. Establishment of a monitoring framework and an annual Relationship Scorecard would drive on-going refinement of the implementation as well as increased awareness of and commitment to the Compact and its intended outcomes

A nonlinear random walk approach to concentration-dependent contaminant transport in porous media

We propose a nonlinear random walk model to describe the dynamics of dense contaminant plumes in porous media. A coupling between concentration and velocity fields is found, so that transport displays non-Fickian features. The qualitative behavior of the pollutant spatial profiles and moments is explored with the help of Monte Carlo simulation, within a Continuous Time Random Walk approach. Model outcomes are then compared with experimental measurements of variable-density contaminant transport in homogeneous and saturated vertical columns.Comment: 8 pages, 9 figure

A pore-scale hydro-mechanical coupled model for geomaterials

We present a model for fluid-saturated granular media coupled flow and mechanical deformation. The fluid is assumed to be incompressible and the solid part is assumed to be a cohesive granular material. Forces exerted by the fluid in motion are determinated and applied to solid particles. We derive a finite volumes formulation of the flow problem and we couple it to a discrete element method (DEM) formulation of the solid deformation. The ability of the algorithm to solve transient problems is tested by simulating an oedometer test on a soil sample. The numerical solution of our model is in good agreement with Terzaghi’s analytical solution

Monte Carlo evaluation of FADE approach to anomalous kinetics

In this paper we propose a comparison between the CTRW (Monte Carlo) and Fractional Derivative approaches to the modelling of anomalous diffusion phenomena in the presence of an advection field. Galilei variant and invariant schemes are revised.Comment: 13 pages, 6 figure

Some Insights in Superdiffusive Transport

In this paper we deal with high-order corrections for the Fractional Derivative approach to anomalous diffusion, in super-diffusive regime, which become relevand whenever one attempts to describe the behavior of particles close to normal diffusion.Comment: 14 pages, 7 figure

Home is the new gym: Exergame as a potential tool to maintain adequate fitness levels also during quarantine

Purpose. With the coronavirus outbreak, the preventive measures include staying at home and isolation, increasing sedentary behaviours and risk for worsening of chronic diseases. To explore alternative forms of home-based physical activity, the study aim was to evaluate physiological (heart rate [HR], respiratory exchange ratio [RER], oxygen consumption [ O2], energy expenditure [EE], metabolic equivalent task [MET]) and psychological (session rating of perceived exertion [sRPE], enjoyment) parameters of real (Zumba® class [ZC]) and exergame (Zumba® Fitness Rush [ZFR]) activities in relation to sex. Methods. Overall, 12 female (age: 24.7 ± 0.9 years) and 8 male (age: 25.3 ± 2.1 years) college students randomly performed 2 experimental 60-min sessions, ZC and ZFR, during which HR (expressed as percentage of individual maximal HR [%HRmax]), O2, RER, MET and EE were measured. After each session, sRPE and Physical Activity Enjoyment Scale (PACES) were used to monitor exercise intensity and enjoyment, respectively. Results. Main effects for sex (p = 0.02) and modality (p < 0.0001) emerged for %HRmax, with women showing higher values than men and ZC showing higher values than ZFR. EE presented main effects for sex (p < 0.0001) and modality (p = 0.0002), with higher values in men and in ZC. Main effect (p = 0.0001) for modality emerged also for O2 and MET, with higher values in ZC regardless of sex. No significant differences were observed for RER, sRPE, or PACES. Conclusions. Although ZC elicited higher cardiovascular and metabolic responses, ZFR, classified as a moderate-to-vigorous activity, could be used to maintain regular physical activity in a safe home environment during the coronavirus crisis

Optical issues for the diagnostic stations for the ELI-NP compton gamma source

A high brightness electron Linac is being built in the Compton Gamma Source at the ELI Nuclear Physics facility in Romania. To achieve the design luminosity, a train of 32 bunches, 16 ns spaced, with a nominal charge of 250 pC will collide with the laser beam in the interaction point. Electron beam spot size is measured with optical transition radiation (OTR) profile monitors. In order to measure the beam properties, the optical radiation detecting system must have the necessary accuracy and resolution. This paper deals with the studies of different optic configurations to achieve the magnification, resolution and accuracy in order to measure very small beam (below 30 μm) or to study the angular distribution of the OTR and therefore the energy of the beam. Several configurations of the optical detection line will be studied both with simulation tools (e.g. Zemax) and experimentally. The paper will deal also with the sensibility of optic system (in terms of depth of field, magnification and resolution) to systematic error