A new U.S. record for a secondary fruit infester, Neosilba baresi (Curran) (Diptera: Lonchaeidae)

A lonchaeid fly, Neosilba batesi, first described by Curran in 1932 from Guatemala, is here reported in Florida as of September 1994, a new U.S. record

Utredning av hjärtlungräddning vid HNS sjukhus : organisation, skolning och insamling av resultat

Undersökningens syfte var att utreda hur återupplivningsverksamheten ser ut på de fyra kretssjukhus som tillhör HNS men inte HUCS. Sjukhusen har alla operativ verksamhet och ett sammanlagt befolkningsunderlag på över 400000 invånare. Målet var att utreda hur återupplivningen är organiserad, hur återupplivningsskolning genomförs samt hur återupplivningsresultat samlas in. Liknande studier har inte tidigare gjorts på regionalnivå. Svarsprocenten på den elektroniska enkät som skickades till sjukhusens återupplivningsansvariga läkare och sköterska med ansvar återupplivningsskolning steg till 100 %. Resultaten visar att man idag följer Gängse vård-instruktionerna bättre än tidigare. Idag finns det skötare med ansvar för återupplivningsskolning och läkare med återupplivningsansvar på alla sjukhus. Frekvensen av återupplivningsskolning är fortfarande lägre än rekommenderat, men högre än tidigare. 75 % av sjukhusen har en MET-grupp. Alla sjukhus använder inte HNS officiella återupplivningsblankett och rapporteringen görs inte enligt Utstein-modellen. Undersökningen lyfter fram så väl brister som styrkor i återupplivningsverksamheten. Men med denna kunskap möjliggörs skräddarsydd utveckling av återupplivningsverksamheten på sjukhusen

Two new species of Euxesta Loew (Diptera; Otitidae)

Two new species of the genus Euxesta Loew are described and illustrated: E. pacifica from California and E. atlantica from Florida, in the Quaternaria subgroup of the Notata group. A key is presented to the two new species, as well as E. calligyna (Bigot 1857), E. quaternaria Loew (1868), E. luteocesta Foote (1960), and E. nigricans Wulp (1903) of the quaternaria subgroup

How Do We Evaluate Health in All Policies? Comment on “Developing a Framework for a Program Theory-Based Approach to Evaluating Policy Processes and Outcomes: Health in All Policies in South Australia”

Abstract It is well-established that population health is influenced by a multitude of factors, many of which lie outside the scope of the health sector. In the public health literature it is often assumed that intersectoral engagement with nonhealth sectors will be instrumental in addressing these social determinants of health. Due to the expected desirable outcomes in population health, several countries have introduced Health in All Policies (HiAP). However, whether this systematic, top-down approach to whole-of-government action (which HiAP entails) is efficient in changing government policies remains unclear. A systematic evaluation of HiAP is therefore much needed. Lawless and colleagues present an evaluation framework for HiAP in their article: “Developing a Framework for a Program Theory-Based Approach to Evaluating Policy Processes and Outcomes: Health in All Policies in South Australia.” This work is an important endeavor in addressing this problem (of uncertainty as to whether HiAP is effective) and represents an essential contribution to the HiAP literature. Nonetheless, in the spirit of encouraging ongoing reflection on this topic, we wish to highlight some challenges in the presented framework, which may pose difficulties in operationalization. We find that the evaluation framework faces two main limitations: its unclear causal logic and its level of complexity. We argue that in order to function as a tool for evaluation, the framework should be explicit about the mechanisms of change and enable us to trace whether the assumed causal relations resulted in changes in practice. Developing manageable evaluation frameworks, albeit simplified, may then be an important part of cumulating the theoretical insights aspired in theory-based evaluation. On this basis, we highlight how HiAP processes and healthy public policies respectively involve different mechanisms, and thus argue that different program theories are needed

Adverse Effects of Methylmercury: Environmental Health Research Implications

Background: The scientific discoveries of health risks resulting from methylmercury exposure began in 1865 describing ataxia, dysarthria, constriction of visual fields, impaired hearing, and sensory disturbance as symptoms of fatal methylmercury poisoning. Objective: Our aim was to examine how knowledge and consensus on methylmercury toxicity have developed in order to identify problems of wider concern in research. Data sources and extraction: We tracked key publications that reflected new insights into human methylmercury toxicity. From this evidence, we identified possible caveats of potential significance for environmental health research in general. Synthesis: At first, methylmercury research was impaired by inappropriate attention to narrow case definitions and uncertain chemical speciation. It also ignored the link between ecotoxicity and human toxicity. As a result, serious delays affected the recognition of methylmercury as a cause of serious human poisonings in Minamata, Japan. Developmental neurotoxicity was first reported in 1952, but despite accumulating evidence, the vulnerability of the developing nervous system was not taken into account in risk assessment internationally until approximately 50 years later. Imprecision in exposure assessment and other forms of uncertainty tended to cause an underestimation of methylmercury toxicity and repeatedly led to calls for more research rather than prevention. Conclusions: Coupled with legal and political rigidity that demanded convincing documentation before considering prevention and compensation, types of uncertainty that are common in environmental research delayed the scientific consensus and were used as an excuse for deferring corrective action. Symptoms of methylmercury toxicity, such as tunnel vision, forgetfulness, and lack of coordination, also seemed to affect environmental health research and its interpretation

Adverse Effects of Methylmercury: Environmental Health Research Implications

Background: The scientific discoveries of health risks resulting from methylmercury exposure began in 1865 describing ataxia, dysarthria, constriction of visual fields, impaired hearing, and sensory disturbance as symptoms of fatal methylmercury poisoning. Objective: Our aim was to examine how knowledge and consensus on methylmercury toxicity have developed in order to identify problems of wider concern in research. Data sources and extraction: We tracked key publications that reflected new insights into human methylmercury toxicity. From this evidence, we identified possible caveats of potential significance for environmental health research in general. Synthesis: At first, methylmercury research was impaired by inappropriate attention to narrow case definitions and uncertain chemical speciation. It also ignored the link between ecotoxicity and human toxicity. As a result, serious delays affected the recognition of methylmercury as a cause of serious human poisonings in Minamata, Japan. Developmental neurotoxicity was first reported in 1952, but despite accumulating evidence, the vulnerability of the developing nervous system was not taken into account in risk assessment internationally until approximately 50 years later. Imprecision in exposure assessment and other forms of uncertainty tended to cause an underestimation of methylmercury toxicity and repeatedly led to calls for more research rather than prevention. Conclusions: Coupled with legal and political rigidity that demanded convincing documentation before considering prevention and compensation, types of uncertainty that are common in environmental research delayed the scientific consensus and were used as an excuse for deferring corrective action. Symptoms of methylmercury toxicity, such as tunnel vision, forgetfulness, and lack of coordination, also seemed to affect environmental health research and its interpretation

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)