3,795 research outputs found

    Describing and exchanging models of neurons and neuronal networks with NeuroML

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    Are food exposures obtained through commercial market panels representative of the general population? Implications for outbreak investigations

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    Current methods of control recruitment for case-control studies can be slow (a particular issue for outbreak investigations), resource-intensive and subject to a range of biases. Commercial market panels are a potential source of rapidly recruited controls. Our study evaluated food exposure data from these panel controls, compared with an established reference dataset. Market panel data were collected from two companies using retrospective internet-based surveys; these were compared with reference data from the National Diet and Nutrition Survey (NDNS). We used logistic regression to calculate adjusted odds ratios to compare exposure to each of the 71 food items between the market panel and NDNS participants. We compared 2103 panel controls with 2696 reference participants. Adjusted for socio-demographic factors, exposure to 90% of foods was statistically different between both panels and the reference data. However, these differences were likely to be of limited practical importance for 89% of Panel A foods and 79% of Panel B foods. Market panel food exposures were comparable with reference data for common food exposures but more likely to be different for uncommon exposures. This approach should be considered for outbreak investigation, in conjunction with other considerations such as population at risk, timeliness of response and study resources

    Popular Concepts of Justice and Hybrid Judicial Institutions in Ghana

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    The provision of effective, legitimate and accessible justice is one of the most fundamental public goods expected from a well?governed state. In this article, we compare the legitimacy of three state or state?supported Ghanaian dispute settlement institutions: the magistrate's courts, the Commission on Human Rights and Administrative Justice (CHRAJ) and the land dispute committees of the neo?traditional Customary Land Secretariats (CLSs). It was found that popular beliefs and expectations are predominantly focused on the notion that justice requires a ‘balanced process for establishing the truth’, and that the procedures, codes and remedies used by the magistrate's courts and the CHRAJ were more congruent with these beliefs than those of the CLSs. The findings challenge stereotypes of popular and traditional justice as being primarily about reconciliation or restoration of communal harmony, and suggest that state institutions should be supported in their current development of hybrid and informal kinds of dispute settlement

    On the Change in Archivability of Websites Over Time

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    As web technologies evolve, web archivists work to keep up so that our digital history is preserved. Recent advances in web technologies have introduced client-side executed scripts that load data without a referential identifier or that require user interaction (e.g., content loading when the page has scrolled). These advances have made automating methods for capturing web pages more difficult. Because of the evolving schemes of publishing web pages along with the progressive capability of web preservation tools, the archivability of pages on the web has varied over time. In this paper we show that the archivability of a web page can be deduced from the type of page being archived, which aligns with that page's accessibility in respect to dynamic content. We show concrete examples of when these technologies were introduced by referencing mementos of pages that have persisted through a long evolution of available technologies. Identifying these reasons for the inability of these web pages to be archived in the past in respect to accessibility serves as a guide for ensuring that content that has longevity is published using good practice methods that make it available for preservation.Comment: 12 pages, 8 figures, Theory and Practice of Digital Libraries (TPDL) 2013, Valletta, Malt

    Underuse of coronary revascularization procedures in patients considered appropriate candidates for revascularization.

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    Background: Ratings by an expert panel of the appropriateness of treatments may offer better guidance for clinical practice than the variable decisions of individual clinicians, yet there have been no prospective studies of clinical outcomes. We compared the clinical outcomes of patients treated medically after angiography with those of patients who underwent revascularization, within groups defined by ratings of the degree of appropriateness of revascularization in varying clinical circumstances.Methods: This was a prospective study of consecutive patients undergoing coronary angiography at three London hospitals. Before patients were recruited, a nine-member expert panel rated the appropriateness of percutaneous transluminal coronary angioplasty (PTCA) and coronary-artery bypass grafting (CABG) on a nine-point scale (with 1 denoting highly inappropriate and 9 denoting highly appropriate) for specific clinical indications. These ratings were then applied to a population of patients with coronary artery disease. However, the patients were treated without regard to the ratings. A total of 2552 patients were followed for a median of 30 months after angiography.Results: Of 908 patients with indications for which PTCA was rated appropriate (score, 7 to 9), 34 percent were treated medically; these patients were more likely to have angina at follow-up than those who underwent PTCA (odds ratio, 1.97; 95 percent confidence interval, 1.29 to 3.00). Of 1353 patients with indications for which CABG was considered appropriate, 26 percent were treated medically; they were more likely than those who underwent CABG to die or have a nonfatal myocardial infarction - the composite primary outcome (hazard ratio, 4.08; 95 percent confidence interval, 2.82 to 5.93) - and to have angina (odds ratio, 3.03; 95 percent confidence interval, 2.08 to 4.42). Furthermore, there was a graded relation between rating and outcome over the entire scale of appropriateness (P for linear trend = 0.002).Conclusions: On the basis of the ratings of the expert panel, we identified substantial underuse of coronary revascularization among patients who were considered appropriate candidates for these procedures. Underuse was associated with adverse clinical outcomes. (N Engl J Med 2001;344:645-54.) Copyright (C) 2001 Massachusetts Medical Society

    ‘VIOLET’: a fluorescence-based simulation exercise for training healthcare workers in the use of personal protective equipment

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    Background Healthcare workers caring for patients with high-consequence infectious diseases (HCIDs) require protection from pathogen exposure, for example by wearing personal protective equipment (PPE). Protection is acquired through the inherent safety of the PPE components, but also their safe and correct use, supported by adequate training and user familiarity. However, the evidence base for HCID PPE ensembles and any associated training is lacking, with subsequent variation between healthcare providers. Aim To develop an evidence-based assessment and training tool for evaluating PPE ensembles and doffing protocols, in the assessment of patients with suspected HCIDs. Methods VIOLET (Visualising Infection with Optimised Light for Education and Training) comprises a healthcare mannequin adapted to deliver simulated bodily fluids containing UV-fluorescent tracers. On demand and remotely operated, the mannequin projectile vomits (blue), coughs (red), has diarrhoea (yellow) and is covered in sweat (orange). Wearing PPE, healthcare staff participate in an HCID risk assessment and examination of the ‘patient’, thereby becoming exposed to these bodily fluids. Contamination of PPE is visualized and body-mapped under UV light before and after removal. Observational findings and participant feedback, around its use as a training exercise, is also recorded. Findings Significant contamination from different exposure events was seen, enabling evaluation of PPE and doffing procedures used. Observational data and participant feedback demonstrated its strengths and success as a training technique. Conclusion Simulation exercises using VIOLET provide evidence-based assessment of PPE ensembles, and are a valuable resource for training of healthcare staff in wearing and safe doffing of PPE

    Use of ultraviolet-fluorescence-based simulation in evaluation of personal protective equipment worn for first assessment and care of a patient with suspected high-consequence infectious disease

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    Background: Variations currently exist across the UK in the choice of personal protective equipment (PPE) used by healthcare workers when caring for patients with suspected high-consequence infectious diseases (HCIDs). Aim: To test the protection afforded to healthcare workers by current PPE ensembles during assessment of a suspected HCID case, and to provide an evidence base to justify proposal of a unified PPE ensemble for healthcare workers across the UK. Methods: One ‘basic level’ (enhanced precautions) PPE ensemble and five ‘suspected case’ PPE ensembles were evaluated in volunteer trials using ‘Violet’; an ultraviolet-fluorescence-based simulation exercise to visualize exposure/contamination events. Contamination was photographed and mapped. Findings: There were 147 post-simulation and 31 post-doffing contamination events, from a maximum of 980, when evaluating the basic level of PPE. Therefore, this PPE ensemble did not afford adequate protection, primarily due to direct contamination of exposed areas of the skin. For the five suspected case ensembles, 1584 post-simulation contamination events were recorded, from a maximum of 5110. Twelve post-doffing contamination events were also observed (face, two events; neck, one event; forearm, one event; lower legs, eight events). Conclusion: All suspected case PPE ensembles either had post-doffing contamination events or other significant disadvantages to their use. This identified the need to design a unified PPE ensemble and doffing procedure, incorporating the most protective PPE considered for each body area. This work has been presented to, and reviewed by, key stakeholders to decide on a proposed unified ensemble, subject to further evaluation
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