Healthcare use for acute gastrointestinal illness in two Inuit communities: Rigolet and Iqaluit, Canada

Background. The incidence of self-reported acute gastrointestinal illness (AGI) in Rigolet, Nunatsiavut, and Iqaluit, Nunavut, is higher than reported elsewhere in Canada; as such, understanding AGI-related healthcare use is important for healthcare provision, public health practice and surveillance of AGI. Objectives: This study described symptoms, severity and duration of self-reported AGI in the general population and examined the incidence and factors associated with healthcare utilization for AGI in these 2 Inuit communities. Design: Cross-sectional survey data were analysed using multivariable exact logistic regression to examine factors associated with individuals’ self-reported healthcare and over-the-counter (OTC) medication utilization related to AGI symptoms. Results: In Rigolet, few AGI cases used healthcare services [4.8% (95% CI=1.5-14.4%)]; in Iqaluit, some cases used healthcare services [16.9% (95% CI=11.2-24.7%)]. Missing traditional activities due to AGI (OR=3.8; 95% CI=1.18-12.4) and taking OTC medication for AGI symptoms (OR=3.8; 95% CI=1.2-15.1) were associated with increased odds of using healthcare services in Iqaluit. In both communities, AGI severity and secondary symptoms (extreme tiredness, headache, muscle pains, chills) were significantly associated with increased odds of taking OTC medication. Conclusions: While rates of self-reported AGI were higher in Inuit communities compared to non-Inuit communities in Canada, there were lower rates of AGI-related healthcare use in Inuit communities compared to other regions in Canada. As such, the rates of healthcare use for a given disease can differ between Inuit and non-Inuit communities, and caution should be exercised in making comparisons between Inuit and non-Inuit health outcomes based solely on clinic records and healthcare use

Epidural lipomatosis and congenital small spinal canal in spinal anaesthesia: a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Complications after lumbar anaesthesia and epidural blood patch have been described in patients with congenital small spinal canal and increased epidural fat or epidural lipomatosis. These conditions, whether occurring separately or in combination, require magnetic resonance imaging for diagnosis and grading, but their clinical significance is still unclear.</p> <p>Case presentation</p> <p>A 35-year-old Caucasian woman who was undergoing a Caesarean section developed a longstanding L4-L5 unilateral neuropathy after the administration of spinal anaesthesia. There were several attempts to correctly position the needle, one of which resulted in paraesthesia. A magnetic resonance image revealed that the patient's bony spinal canal was congenitally small and had excess epidural fat. The cross-sectional area of the dural sac was then reduced, which left practically no free cerebrospinal fluid space.</p> <p>Conclusion</p> <p>The combination of epidural lipomatosis of varying degrees and congenital small spinal canal has not been previously discussed with spinal anaesthesia. Due to the low cerebrospinal fluid content of the small dural sac, the cauda equina becomes a firm system with a very limited possibility for the nerve roots to move away from the puncture needle when it is inserted into the dural sac. This constitutes risks of technical difficulties and neuropathies with spinal anaesthesia.</p

Aplicação de resinas sulfônicas como catalisadores em reações de transesterificação de óleos vegetais Evaluation of sulfonic resins as catalysts in transesterification of vegetable oils

Diferentes suportes poliméricos à base de estireno (S) e divinilbenzeno (DVB) foram sintetizados e suas morfologias caracterizadas por microscopia óptica e eletrônica de varredura. Foram preparados e caracterizados catalisadores sulfônicos a partir desses suportes e suas atividades catalíticas foram avaliadas na transesterificação de óleo vegetal com metanol. Os resultados obtidos com esses catalisadores foram comparados com os produzidos com uma resina sulfônica comercial. Verificou-se que os catalisadores sintetizados neste trabalho apresentaram desempenhos próximos ao da resina comercial.<br>Different polymer supports based on styrene (S) and divinylbenzene (DVB) were synthesized and their morphology was characterized by optical and scanning electron microscopy. Sulfonic catalysts were prepared from these supports, characterized and their activities were evaluated in vegetal oil transesterification with methanol and compared with the performance of a commercial sulfonic resin. The synthesized catalysts showed results close to the commercial resin

Energy consistency in homogenisation-based upscaling scheme for localisation in masonry shells

This paper presents an enhanced multi-scale framework for the failure of quasi-brittle thin shells as an improvement of the one proposed in Mercatoris and Massart (Int J Numer Methods Eng 85:1177-1206, 2011). The computational homogenisation-based multi-scale methodology is an attractive solution for heterogeneous materials when their characterisation becomes difficult because of complex evolving behaviour such as damage-induced anisotropy and localisation of degradation. An enhanced upscaling scheme for damage localisation in shell structures is proposed using a periodic computational homogenisation procedure and an energy equivalence between mesostructural material instabilities and aggregate macroscopic cracks. The structural cracking is treated by using embedded strong discontinuities incorporated in the shell formulation, the behaviour of which is deduced by an energetically consistent upscaling scheme. The effects of this energy equivalence are discussed based on results of multi-scale simulations of out-of-plane loaded masonry walls including flexural stair-case failure and compared to the results of direct numerical simulations. A good agreement is observed in terms of the load-bearing capacity and of associated energy dissipation. Based on the homogenisation procedure, the orientation of the structural-scale cracking is detected by means of an acoustic tensor-based failure detection adapted to shell kinematics. A multi-scale bifurcation analysis on a simple loading case is performed in order to discuss the selection of the cracking orientation based on energetic considerations. © 2012 Springer Science+Business Media B.V