GPs’ strategies in exploring the preschool child’s wellbeing in the paediatric consultation

Background: Although General Practitioners (GPs) are uniquely placed to identify children with emotional, social, and behavioural problems, they succeed in identifying only a small number of them. The aim of this article is to explore the strategies, methods, and tools employed by GPs in the assessment of the preschool child’s emotional, mental, social, and behavioural health. We look at how GPs address parental care of the child in general and in situations where GPs have a particular awareness of the child. Method: Twenty-eight Danish GPs were purposively selected to take part in a qualitative study which combined focus-group discussions, observation of child consultations, and individual interviews with GPs. Results: Analysis of the data suggests that GPs have developed a set of methods, and strategies to assess the preschool child and parental care of the child. They look beyond paying narrow attention to the physical health of the child and they have expanded their practice to include the relations and interactions in the consultation room. The physical examination of the child continues to play a central role in doctor-child communication. Conclusion: The participating GPs’ strategies helped them to assess the wellbeing of the preschool child but they often find it difficult to share their impressions with parents

Genetic diversity of Actinobacillus lignieresii isolates from different hosts

Genetic diversity detected by analysis of amplified fragment length polymorphisms (AFLPs) of 54 Actinobacilus lignieresii isolates from different hosts and geographic localities is described. On the basis of variances in AFLP profiles, the strains were grouped in two major clusters; one comprising strains isolated from horses and infected wounds of humans bitten by horses and another consisting of strains isolated from bovine and ovine hosts. The present data indicate a comparatively higher degree of genetic diversity among strains isolated from equine hosts and confirm the existence of a separate genomospecies for A. lignieresi-like isolates from horses. Among the isolates from bovine and ovine hosts some clonal lines appear to be genetically stable over time and could be detected at very distant geographic localities. Although all ovine strains investigated grouped in a single cluster, the existence of distinct genetic lineages that have evolved specificity for ovine hosts is not obvious and needs to be confirmed in other studies

Recreational soccer is an effective health-promoting activity for untrained men

Copyright BMJ publishing GroupTo examine the effects of regular participation in recreational soccer on health profile, 36 healthy untrained Danish men aged 20-43 years were randomised into a soccer group (SO; n=13), a running group (RU; n=12) and a control group (CO; n=11). Training was performed for 1 h two or three times per week for 12 weeks; at an average heart rate of 82% (SEM 2%) and 82% (1%) of HRmax for SO and RU, respectively. During the 12 week period, maximal oxygen uptake increased (p < 0.05) by 13% (3%) and 8% (3%) in SO and RU, respectively. In SO, systolic and diastolic blood pressure were reduced (p < 0.05) from 130 (2) to 122 (2) mm Hg and from 77 (2) to 72 (2) mm Hg, respectively, after 12 weeks, with similar decreases observed for RU. After the 12 weeks of training, fat mass was 3.0% (2.7 (0.6) kg) and 1.8% (1.8 (0.4) kg) lower (p < 0.05) for SO and RU, respectively. Only SO had an increase in lean body mass (1.7 (0.4) kg, p < 0.05), an increase in lower extremity bone mass (41 (8) g, p < 0.05), a decrease in LDL-cholesterol (2.7 (0.2) to 2.3 (0.2) mmol/l; p < 0.05) and an increase (p < 0.05) in fat oxidation during running at 9.5 km/h. The number of capillaries per muscle fibre was 23% (4%) and 16% (7%) higher (p < 0.05) in SO and RU, respectively, after 12 weeks. No changes in any of the measured variables were observed for CO. In conclusion, participation in regular recreational soccer training, organised as small-sided drills, has significant beneficial effects on health profile and physical capacity for untrained men, and in some aspects it is superior to frequent moderate-intensity running

Entanglement generation outside a Schwarzschild black hole and the Hawking effect

We examine the Hawking effect by studying the asymptotic entanglement of two mutually independent two-level atoms placed at a fixed radial distance outside a Schwarzschild black hole in the framework of open quantum systems. We treat the two-atom system as an open quantum system in a bath of fluctuating quantized massless scalar fields in vacuum and calculate the concurrence, a measurement of entanglement, of the equilibrium state of the system at large times, for the Unruh, Hartle-Hawking and Boulware vacua respectively. We find, for all three vacuum cases, that the atoms turn out to be entangled even if they are initially in a separable state as long as the system is not placed right at the even horizon. Remarkably, only in the Unruh vacuum, will the asymptotic entanglement be affected by the backscattering of the thermal radiation off the space-time curvature. The effect of the back scatterings on the asymptotic entanglement cancels in the Hartle-Hawking vacuum case.Comment: 15 pages, no figures, Revte

A unified model for age-velocity dispersion relations in Local Group galaxies: Disentangling ISM turbulence and latent dynamical heating

We analyze age-velocity dispersion relations (AVRs) from kinematics of individual stars in eight Local Group galaxies ranging in mass from Carina ($M_{*} \sim 10^{6}$) to M31 ($M_{*} \sim 10^{11}$). Observationally the $\sigma$ vs. stellar age trends can be interpreted as dynamical heating of the stars by GMCs, bars/spiral arms, or merging subhalos; alternatively the stars could have simply been born out of a more turbulent ISM at high redshift and retain that larger velocity dispersion till present day - consistent with recent IFU studies. To ascertain the dominant mechanism and better understand the impact of instabilities and feedback, we develop models based on observed SFHs of these Local Group galaxies in order to create an evolutionary formalism which describes the ISM velocity dispersion due to a galaxy's evolving gas fraction. These empirical models relax the common assumption that the stars are born from gas which has constant velocity dispersion at all redshifts. Using only the observed SFHs as input, the ISM velocity dispersion and a mid-plane scattering model fits the observed AVRs of low mass galaxies without fine tuning. Higher mass galaxies above $M_{vir} > 10^{11}$ need a larger contribution from latent dynamical heating processes (for example minor mergers), in excess of the ISM model. Using the SFHs we also find that supernovae feedback does not appear to be a dominant driver of the gas velocity dispersion compared to gravitational instabilities - at least for dispersions $\sigma \gtrsim 25$ km/s. Together our results point to stars being born with a velocity dispersion close to that of the gas at the time of their formation, with latent dynamical heating operating with a galaxy mass-dependent efficiency. These semi-empirical relations may help constrain the efficiency of feedback and its impact on the physics of disk settling in galaxy formation simulations

Upper- and mid-mantle interaction between the Samoan plume and the Tonga-Kermadec slabs

Mantle plumes are thought to play a key role in transferring heat from the core\u2013mantle boundary to the lithosphere, where it can significantly influence plate tectonics. On impinging on the lithosphere at spreading ridges or in intra-plate settings, mantle plumes may generate hotspots, large igneous provinces and hence considerable dynamic topography. However, the active role of mantle plumes on subducting slabs remains poorly understood. Here we show that the stagnation at 660 km and fastest trench retreat of the Tonga slab in Southwestern Pacific are consistent with an interaction with the Samoan plume and the Hikurangi plateau. Our findings are based on comparisons between 3D anisotropic tomography images and 3D petrological-thermo-mechanical models, which self-consistently explain several unique features of the Fiji\u2013Tonga region. We identify four possible slip systems of bridgmanite in the lower mantle that reconcile the observed seismic anisotropy beneath the Tonga slab (VSH4VSV) with thermo-mechanical calculations

Consensus review of best practice of transanal irrigation in adults

Study design: Review article. Objectives: To provide a consensus expert review of the treatment modality for transanal irrigation (TAI). Methods: A consensus group of specialists from a range of nations and disciplines who have experience in prescribing and monitoring patients using TAI worked together assimilating both the emerging literature and rapidly accruing clinical expertise. Consensus was reached by a round table discussion process, with individual members leading the article write-up in the sections where they had particular expertise. Results: Detailed trouble-shooting tips and an algorithm of care to assist professionals with patient selection, management and follow-up was developed. Conclusion: This expert review provides a practical adjunct to training for the emerging therapeutic area of TAI. Careful patient selection, directly supervised training and sustained follow-up are key to optimise outcomes with the technique. Adopting a tailored, stepped approach to care is important in the heterogeneous patient groups to whom TAI may be applied. Sponsorship: The review was financially supported by Coloplast A/S. Spinal Cord (2013) 51, 732–738; doi:10.1038/sc.2013.86; published online 20 August 201

Kinetic Characterisation of a Single Chain Antibody against the Hormone Abscisic Acid: Comparison with Its Parental Monoclonal

A single-chain Fv fragment antibody (scFv) specific for the plant hormone abscisic acid (ABA) has been expressed in the bacterium Escherichia coli as a fusion protein. The kinetics of ABA binding have been measured using surface plasmon resonance spectrometry (BIAcore 2000) using surface and solution assays. Care was taken to calculate the concentration of active protein in each sample using initial rate measurements under conditions of partial mass transport limitation. The fusion product, parental monoclonal antibody and the free scFv all have low nanomolar affinity constants, but there is a lower dissociation rate constant for the parental monoclonal resulting in a three-fold greater affinity. Analogue specificity was tested and structure-activity binding preferences measured. The biologically-active (+)-ABA enantiomer is recognised with an affinity three orders of magnitude higher than the inactive (-)-ABA. Metabolites of ABA including phaseic acid, dihydrophaseic acid and deoxy-ABA have affinities over 100-fold lower than that for (+)-ABA. These properties of the scFv make it suitable as a sensor domain in bioreporters specific for the naturally occurring form of ABA

THE RHYTHM OF FAIRALL 9. I. OBSERVING THE SPECTRAL VARIABILITY WITH XMM-NEWTON AND NuSTAR

© 2016. The American Astronomical Society. All rights reserved. We present a multi-epoch X-ray spectral analysis of the Seyfert 1 galaxy Fairall 9. Our analysis shows that Fairall 9 displays unique spectral variability in that its ratio residuals to a simple absorbed power law in the 0.5-10 keV band remain constant with time in spite of large variations in flux. This behavior implies an unchanging source geometry and the same emission processes continuously at work at the timescale probed. With the constraints from NuSTAR on the broad-band spectral shape, it is clear that the soft excess in this source is a superposition of two different processes, one being blurred ionized reflection in the innermost parts of the accretion disk, and the other a continuum component such as a spatially distinct Comptonizing region. Alternatively, a more complex primary Comptonization component together with blurred ionized reflection could be responsible