The Relationship Between Parental Income and a Child\u27s School Readiness Standard Composite Score as Measured by the Bracken Basic Concept Scale-Revised

The current study was designed to determine if children from families with higher income levels would be better prepared to enter kindergarten than children from families with lower income levels. For this study, 54 children attending childcare centers funded by the West Virginia Educare Initiative were administered the standard School Readiness Composite (SRC) of the Bracken Basic Concept Scale-Revised (BBCS-R) and the parental questionnaire of the study protocol. It was determined that there was no significant relationship between parental income level and a child\u27s SRC score on the BBCS-R

Psychological issues affecting patients living with a stoma

Stoma surgery, be it temporary or permanent, it is an intrusive operation, with outcomes that can impact seriously on daily life, not just in the immediate post-operative and recovery period, but for the rest of their lives. There are changes in bodily function, altered body image, physicality and personal care needs (ref). These changes require acceptance and adaptation and can necessitate a re-ordering of daily life, socially, emotionally and in terms of work. Assessing the patient’s needs through the trajectory of diagnosis, surgery and a stoma, is not just important during the treatment phase but needs to continue through the lifespan. Traditionally, patient outcome measures after bowel surgery have included overall self-efficacy, checking for stoma complications, clinical health status, function and psychological status. However, over the last three decades there has been increasing recognition that Quality of Life (QoL) which is now regarded as a key measurement, needs further consideration. Patients report difficulties when explaining to healthcare professionals the challenges they face, and their reactions as they try to make the adjustments to their new normal of life with a stoma. The transition process by professionals from active care to post care treatment using a long term health plan that not only takes the patient through the first five years (accepted time span if there has been a cancer) can be critical to wellbeing for the rest of their life. This article examines some of the previous research into QoL and looks at stoma patients perceptions of their outcomes from recent research

Effect of case management on neonatal mortality due to sepsis and pneumonia.

BACKGROUND: Each year almost one million newborns die from infections, mostly in low-income countries. Timely case management would save many lives but the relative mortality effect of varying strategies is unknown. We have estimated the effect of providing oral, or injectable antibiotics at home or in first-level facilities, and of in-patient hospital care on neonatal mortality from pneumonia and sepsis for use in the Lives Saved Tool (LiST). METHODS: We conducted systematic searches of multiple databases to identify relevant studies with mortality data. Standardized abstraction tables were used and study quality assessed by adapted GRADE criteria. Meta-analyses were undertaken where appropriate. For interventions with biological plausibility but low quality evidence, a Delphi process was undertaken to estimate effectiveness. RESULTS: Searches of 2876 titles identified 7 studies. Among these, 4 evaluated oral antibiotics for neonatal pneumonia in non-randomised, concurrently controlled designs. Meta-analysis suggested reductions in all-cause neonatal mortality (RR 0.75 95% CI 0.64- 0.89; 4 studies) and neonatal pneumonia-specific mortality (RR 0.58 95% CI 0.41- 0.82; 3 studies). Two studies (1 RCT, 1 observational study), evaluated community-based neonatal care packages including injectable antibiotics and reported mortality reductions of 44% (RR = 0.56, 95% CI 0.41-0.77) and 34% (RR = 0.66, 95% CI 0.47-0.93), but the interpretation of these results is complicated by co-interventions. A third, clinic-based, study reported a case-fatality ratio of 3.3% among neonates treated with injectable antibiotics as outpatients. No studies were identified evaluating injectable antibiotics alone for neonatal pneumonia. Delphi consensus (median from 20 respondents) effects on sepsis-specific mortality were 30% reduction for oral antibiotics, 65% for injectable antibiotics and 75% for injectable antibiotics on pneumonia-specific mortality. No trials were identified assessing effect of hospital management for neonatal infections and Delphi consensus suggested 80%, and 90% reductions for sepsis and pneumonia-specific mortality respectively. CONCLUSION: Oral antibiotics administered in the community are effective for neonatal pneumonia mortality reduction based on a meta-analysis, but expert opinion suggests much higher impact from injectable antibiotics in the community or primary care level and even higher for facility-based care. Despite feasibility and low cost, these interventions are not widely available in many low income countries. FUNDING: This work was supported by the Bill & Melinda Gates Foundation through a grant to the US Fund for UNICEF, and to Saving Newborn Lives Save the Children, through Save the Children US

Limiting factors in sub-10 nm scanning-electron-beam lithography

Achieving the highest possible resolution using scanning-electron-beam lithography (SEBL) has become an increasingly urgent problem in recent years, as advances in various nanotechnology applications [ F. S. Bates and G. H. Fredrickson, Annu. Rev. Phys. Chem. 41, 525 (1990) ; Black et al., IBM J. Res. Dev. 51, 605 (2007) ; Yang et al., J. Chem. Phys. 116, 5892 (2002) ] have driven demand for feature sizes well into the sub-10 nm domain, close to the resolution limit of the current generation of SEBL processes. In this work, the authors have used a combination of calculation, modeling, and experiment to investigate the relative effects of resist contrast, beam scattering, secondary electron generation, system spot size, and metrology limitations on SEBL process resolution. In the process of investigating all of these effects, they have also successfully yielded dense structures with a pitch of 12 nm at voltages as low as 10 keV

Supporting information for National, regional, and worldwide estimates of low birthweight rates in 2015, with trends from 2000: a systematic analysis

Data produced by the World Health Organization, UNICEF, LSHTM and Johns Hopkins University to estimate national low birthweight (LBW) and numbers for 195 countries. LBW data was collated through a systematic review of national routine/registration systems, nationally representative surveys, and other data sources, and subsequently modelled using restricted maximum likelihood estimation with country-level random effects. Data includes a list of 1447 rate data points used as an input to the modelled estimates, yearly national-level covariates for each of the 195 countries studied from 2000 to 2015, and information on estimated low birthweight rates from 2000 to 2015 for 148 countries with data. Stata code used to generate these estimates is provided

Alstrom syndrome (OMIM 203800): a case report and literature review

<p>Abstract</p> <p>Background</p> <p>Alstrom syndrome (AS) is a rare autosomal recessive disease characterized by multiorgan dysfunction. The key features are childhood obesity, blindness due to congenital retinal dystrophy, and sensorineural hearing loss. Associated endocrinologic features include hyperinsulinemia, early-onset type 2 diabetes, and hypertriglyceridemia. Thus, AS shares several features with the common metabolic syndrome, namely obesity, hyperinsulinemia, and hypertriglyceridemia. Mutations in the <it>ALMS1 </it>gene have been found to be causative for AS with a total of 79 disease-causing mutations having been described.</p> <p>Case presentation</p> <p>We describe the case of a 27-year old female from an English (Caucasian) kindred. She had been initially referred for hypertriglyceridemia, but demonstrated other features suggestive of AS, including blindness, obesity, type 2 diabetes, renal dysfunction, and hypertension. DNA analysis revealed that she is a compound heterozygote with two novel mutations in the <it>ALMS1 </it>gene – H3882Y and V424I. Examination of her family revealed that her phenotypically unaffected mother and younger sister also had heterozygous mutations in the <it>ALMS1 </it>gene. In addition to presenting these novel molecular findings for AS, we review the clinical and genetic features of AS in the context of our case.</p> <p>Conclusion</p> <p>Two novel mutations in the <it>ALMS1 </it>gene causative for AS have been reported here, thereby increasing the number of reported mutations to 81 and providing a wider basis for mutational screening among affected individuals.</p

Alma-Ata: Rebirth and revision 8 - Primary health care: making Alma-Ata a reality

The principles agreed at Alma-Ata 30 years ago apply just as much now as they did then. Health for all by the year 2000 was not achieved, and the Millennium Development Goals (MDGs) for 2015 will not be met in most low-income countries without substantial acceleration of primary health care. Factors have included insufficient political prioritisation of health, structural adjustment policies, poor governance, population growth, inadequate health systems, and scarce research and assessment on primary health care. We propose the following priorities for revitalising primary health care. Health-service infrastructure, including human resources and essential drugs, needs strengthening, and user fees should be removed for primary health-care services to improve use. A continuum of care for maternal, newborn, and child health services, including family planning, is needed. Evidence-based, integrated packages of community and primary curative and preventive care should be adapted to country contexts, assessed, and scaled up. Community participation and community health workers linked to strengthened primary-care facilities and first-referral services are needed. Furthermore, intersectoral action linking health and development is necessary, including that for better water, sanitation, nutrition, food security, and HIV control. Chronic diseases, mental health, and child development should be addressed. Progress should be measured and accountability assured. We prioritise research questions and suggest actions and measures for stakeholders both locally and globally, which are required to revitalise primary health care