A study of the social factors in patients with a diagnosis of multiple sclerosis referred to the social service department, Massachusetts General Hospital 1945-1949

Thesis (M.S.)--Boston Universit

When is going with the grain making the problem worse?

In order to realise change, development practitioners sometimes make compromises with groups that do not always share the same ideals. Following a recent workshop on social accountability, Tom Kirk and Annette JE Fisher reflect on the discussions held and ask when, and how, ‘going with the grain’ can make a problem worse

Using Economics for Sustainability, Efficient Management, and Conflict Resolution in Water

L’eau est généralement une ressource considérée uniquement en termes de quantité. Elle est estimée en termes de consummation et d’approvisionnement de manière à établir un équilibre. Lorsque cet équilibre est rompu ou lorsqu’apparaît une pénurie, les alarmes sont déclenchées et de l’ingénierie ou des solutions politiques sont recherchées en vue de trouver des sources supplémentaires. Les contentieux sur l’eau sont généralement pensés de cette manière. Deux ou plusieurs parties ayant des revendications aux mêmes sources d’eau sont considérées comme jouant un jeu à somme nulle. L’eau qu’obtient l’une des parties n’est tout simplement pas disponible pour les autres, de sorte que le gain d’une partie est considérée comme une perte pour l’autre. Mais il y a une autre façon de penser les problèmes d’eau et les conflits de l’eau qui prenne en compte les droits de propriété sur l’eau et les usages de l’eau, une façon qui peut conduire à la résolution des différends et au développement durable, à la gestion optimale de l’eau.Consumption amounts for water are projected, supplies estimated, and a balance struck. Where that balance shows a shortage, alarms are sounded and engineering or political solutions to secure additional sources are sought. Disputes over water are also generally thought of in this way. Two or more parties with claims to the same water sources are seen as playing a zero-sum game. The water that one party gets is simply not available to the others, so that one party’s gain is seen as the other parties’ loss. But there is another way of thinking about water problems and water disputes, both taking account of water ownership and water usage a way that can lead both to dispute resolution and to sustainable, optimal water management

Evidence of lasting impact of the Deepwater Horizon oil spill on a deep Gulf of Mexico coral community

A coral community 11 km southwest of the site of the Deepwater Horizon blowout at 1,370 m water depth was discovered 3.5 months after the well was capped on 3 November 2010. Gorgonian corals at the site were partially covered by a brown flocculent material (floc) that contained hydrocarbons fingerprinted to the oil spill. Here we quantify the visible changes to the corals at this site during five visits over 17 months by digitizing images of individual branches of each colony and categorizing their condition. Most of the floc visible in November 2010 was absent from the corals by the third visit in March 2011, and there was a decrease in the median proportions of the colonies showing obvious signs of impact after the first visit. During our second visit in 2010, about six weeks after the first, we documented the onset of hydroid colonization (a sign of coral deterioration) on impacted coral branches that increased over the remainder of the study. Hydroid colonization of impacted portions of coral colonies by the last visit in March 2012 correlated positively with the proportion of the colony covered by floc during the first two visits in late 2010. Similarly, apparent recovery of impacted portions of the coral by March 2012 correlated negatively with the proportion of the coral covered with floc in late 2010. A notable feature of the impact was its patchy nature, both within and among colonies, suggesting that the impacting agent was not homogeneously dispersed during initial contact with the corals. While the median level of obvious visible impact decreased over time, the onset of hydroid colonization and the probability of impacts that were not visually obvious suggest that future visits may reveal additional deterioration in the condition of these normally long-lived corals

Remarkably Few Sputum Cultures from People with Parkinson’s Disease during Hospital In-Patient Admission

Although respiratory tract infections can be a common complication in people with Parkinson’s disease (PD), there is little published data on the nature of such infections in this patient group. We wished to investigate whether sputum samples were being taken from PD patients in order to establish whether an infection was present and if so which bacteria were responsible for the infection. We recorded the number of positive sputum samples taken from admission to North Tyneside General Hospital in North-East England across a ten-year period from June 2001 to June 2011. Of 643 in-patient episodes involving people with PD, positive sputum samples were recorded for only 12 episodes (1.9%) in eight patients. All patients were in early stage disease. In all admissions to the NHS Trust running the hospital, there were 23,069 sputum cultures from 1,056,693 in-patient episodes (2.2%). Our findings may reflect the difficultly of expectorating in many people with PD, particularly in late-stage disease. Since people with PD are especially vulnerable to respiratory tract infections, clinicians need to ensure that, where possible, a sputum sample is obtained from people with PD when clinically indicated

What Predicts Hospital Admissions in Community-Dwelling People With Parkinsonism?

Objectives: Previous studies have looked at the reasons for hospital admission in people with parkinsonism (PwP), yet few have looked at factors that precipitate admission. Methods: People with parkinsonism with a diagnosis of idiopathic Parkinson disease of Hoehn and Yahr stage III-V and those with Parkinson plus syndromes were assessed for motor and nonmotor symptoms, quality of life, and functional performance. Logistic regression was used to investigate predictors of hospital admission over the subsequent 2 years. Results: Overall, 162 patients consented to be part of the study. Seventy-one PwP (43.8%) had at least 1 hospital admission, and 17 (10.5%) patients had 3 or more admissions to hospital. Poorer cognition, more nonmotor symptoms, poorer quality of life, slower timed-up-and-go test scores, and abnormal swallow predicted a subsequent hospital admission. Discussion: Our study emphasizes the importance of nonmotor symptoms in predicting admission. A cost–benefit analysis of early intervention to prevent admission should be considered

High frequency online data collection in an annual household panel study: some evidence on bias prevention and bias adjustment.

Understanding Society is the UK’s largest household panel survey. From April 2020, Understanding Society participants were invited to partake in a series of web surveys (the Understanding Society COVID-19 Study) designed to capture higher frequency information during the pandemic. To prevent bias, the COVID-19 Study invites the full range of Understanding Society participants – both those who regularly use the internet and those who do not – to take part and, furthermore, periodically invites a subset of non-respondents to a telephone follow-up. To adjust for bias, a weighting strategy is implemented that takes advantage of the rich background information available from past annual interviews. We examine the efficacy of these bias reduction and bias adjustment measures. We find that both the telephone follow-ups and weighting help to reduce bias, but that inviting those who do not regularly use the internet to the web survey appears to be of little benefit

Improving the relationships between Indigenous rights holders and researchers in the Arctic: an invitation for change in funding and collaboration

Truly transdisciplinary approaches are needed to tackle the complex problems that the Arctic is facing at the moment. Collaboration between Indigenous rights holders and researchers through co-creative research approaches can result in high-quality research outcomes, but crucially also address colonial legacies and power imbalances, enhance mutual trust, and respect the rights of Indigenous Peoples. However, to be successful, collaborative research projects have specific requirements regarding research designs, timeframes, and dissemination of results, which often do not fit into the frameworks of academic calendars and funding guidelines. Funding agencies in particular play an important role in enabling (or disabling) meaningful collaboration between Indigenous rights holders and researchers. There is an urgent need to re-think existing funding-structures. This article will propose a new paradigm for the financing of Arctic research, which centres around the inclusion of Indigenous partners, researchers, and institutions from the initial planning stages of funding programmes to the final stages of research projects. These findings and recommendations have been contextualized based on critical reflections of the co-authors, a group of Indigenous and non-Indigenous partners, who have practiced their own collaborative work process, the challenges encountered, and lessons learned

Clinical Practice Guidelines for the Management Candidiasis: 2009 Update by the Infectious Diseases Society of America

Guidelines for the management of patients with invasive candidiasis and mucosal candidiasis were prepared by an Expert Panel of the Infectious Diseases Society of America. These updated guidelines replace the previous guidelines published in the 15 January 2004 issue of Clinical Infectious Diseases and are intended for use by health care providers who care for patients who either have or are at risk of these infections. Since 2004, several new antifungal agents have become available, and several new studies have been published relating to the treatment of candidemia, other forms of invasive candidiasis, and mucosal disease, including oropharyngeal and esophageal candidiasis. There are also recent prospective data on the prevention of invasive candidiasis in high-risk neonates and adults and on the empiric treatment of suspected invasive candidiasis in adults. This new information is incorporated into this revised documen