The diagnosis and treatment of early pulmonary tuberculosis in children

Recent investigations, conducted both in. the post mortem room and by means of the various Tuberculin .tests on.the living make it apparent.that Tuberculosis in Children, is a much commoner form of disease, and occurs at an earlier age,.than was formerly. imagined.In conclusion we would urge the vital necessity for early diagnosis in this.insidious disease, and the need of utilising every possible means of establishing the same. When the signs are definite, the symptoms well marked, it is often too late for hope of any permanent cure, . the case is now no longer early, but advanced. It is in the early stages that we must look to combat the disease with any degree of success.Tuberculin as a means of diagnosis may be of use, but it is a. two edged sword, and the danger of lighting up quiescent fool is too real to be lightly disregarded. In.the words of Sir Clifford Allbutt: there is too much at stake; and even for, the expert the number of 'normals' (or persons practically normal) who react is embarrassing In the stage preceding the presence of physical signs, we must look for slight irregularity of temperature - a sub- normal temperature in the morning is suspicious, 98.5 at that hour is too high and even more suspicious (Clifford Allbutt and most characteristic, one with a swing from 97°-99° at night. A feeling of.tiredness, general malnutrition, poor chest development and expansion, with deficient air entry, all these go,towards establishing an affirmative diagnosis. A positive von Pirquet's reaction - with certain reservations -'and, on X raying, a restricted movement of the diaphragm on one or other side, or shadows round. the roots of the lungs are confirmatory; while a family history of phthisis or exposure to infection must give additional weight to the evidence. The opsofic Index in skilled hands may afford valuable information.The earliest physical sign of value is the continued presence of crepitations, brought out often only by coughing. When expectoration is present the presence of Tubercle bacilli makes the diagnosis certain.With regard to treatment, we shall increase the patient's resistance by an open air life, by a diet With a due proportion of proteid and fat, the latter added to by cod liver oil, and by.the exhibition of creosote. We shall regulate his auto-innoculation by rest, coupled with graduated exercises and labour, and in suitable cases by the use of Tuberculin. The exercises should aid in improving the general musculature,.the chest expansion and development and.the air entry.Preventitive treatment consists in removing the child from debilitating: conditions, and surroundings, in his avoidance of chills and colds, and in attending to his teeth, throat, bowels and other organs and functions, so that a high standard of health may be reached and maintained

Promoting positive communication environments: a service evaluation.

Purpose The purpose of this paper is to present an evaluation of a programme of training and support provided to staff, which aimed to encourage supported communication environments for people with learning disabilities. Design/methodology/approach Training, monitoring and support for communication, specifically augmentative and alternative communication (AAC) strategies, was provided by speech and language therapy staff to two residential services over 46 weeks. Staff and service user communications were observed pre- and post-intervention. Findings In one provision there was an increase in service user initiations and the use of some AAC strategies by support staff. In the other provision there was no change in service user initiations and a decrease in the range of AAC strategies used. It appears that some forms for AAC remain challenging for staff to implement. Originality/value This evaluation explores ways of using specialist support services to improve communication environments for people with learning difficulties. Possible reasons for differences in the outcome of the intervention are discussed. Future research into the types of communication interactions experienced by people with learning disabilities across the range of communication styles may be useful so that support staff can be better helped to provide sustained and enriched communication environments

Feminism, Abortion and Disability: irreconcilable differences?

There has been considerable discussion of the political allegiance between the feminist and disability movements, but the question of abortion remains a thorny one. Disability rights advocates have been keen to demonstrate that it is possible to believe in a woman's right to sovereignty over the body and, yet, be opposed to the selective abortion of an impaired foetus – describing the latter as a form of 'weak' eugenics. The aim of this paper is to show that whilst there may be some points of agreement between the feminist and disability movements on the question of abortion, there exist fundamental and irreconcilable differences

Stabilizing non-trivial solutions of the generalized Kuramoto-Sivashinsky equation using feedback and optimal control

The problem of controlling and stabilizing solutions to the Kuramoto–Sivashinsky (KS) equation is studied in this paper. We consider a generalized form of the equation in which the effects of an electric field and dispersion are included. Both the feedback and optimal control problems are studied. We prove that we can control arbitrary non-trivial steady states of the KS equation, including travelling wave solutions, using a finite number of point actuators. The number of point actuators needed is related to the number of unstable modes of the equation. Furthermore, the proposed control methodology is shown to be robust with respect to changing the parameters in the equation, e.g. the viscosity coefficient or the intensity of the electric field. We also study the problem of controlling solutions of coupled systems of KS equations. Possible applications to controlling thin film flows are discussed. Our rigorous results are supported by extensive numerical simulations

The North Atlantic subpolar circulation in an eddy-resolving global ocean model

The subpolar North Atlantic represents a key region for global climate, but most numerical models still have well-described limitations in correctly simulating the local circulation patterns. Here, we present the analysis of a 30-year run with a global eddy-resolving (1/12°) version of the NEMO ocean model. Compared to the 1° and 1/4° equivalent versions, this simulation more realistically represents the shape of the Subpolar Gyre, the position of the North Atlantic Current, and the Gulf Stream separation. Other key improvements are found in the representation of boundary currents, multi-year variability of temperature and depth of winter mixing in the Labrador Sea, and the transport of overflows at the Greenland–Scotland Ridge. However, the salinity, stratification and mean depth of winter mixing in the Labrador Sea, and the density and depth of overflow water south of the sill, still present challenges to the model. This simulation also provides further insight into the spatio-temporal development of the warming event observed in the Subpolar Gyre in the mid 1990s, which appears to coincide with a phase of increased eddy activity in the southernmost part of the gyre. This may have provided a gateway through which heat would have propagated into the gyre's interior

The Unseen Face of E-Business Project Development

The purpose of this paper is intent on identify and analyze the unseen factors of successful or failure of e-business project development. The IT managers must take into account both all costs involved in e-business development and all phases (analysis, design, testing, implementation, maintenance and operation) according to principle of project management for software/systems life cycle development. There are many solutions to exceed these factors of failure among could be counted outsourcing, a good project management, involvement of senior management, a real cost estimation etc.Zadanie pt. „Digitalizacja i udostępnienie w Cyfrowym Repozytorium Uniwersytetu Łódzkiego kolekcji czasopism naukowych wydawanych przez Uniwersytet Łódzki” nr 885/P-DUN/2014 zostało dofinansowane ze środków MNiSW w ramach działalności upowszechniającej nauk

Dopamine D_2-receptor activation elicits akinesia, rigidity, catalepsy, and tremor in mice expressing hypersensitive 4 nicotinic receptors via a cholinergic-dependent mechanism

Recent studies suggest that high-affinity neuronal nicotinic acetylcholine receptors (nAChRs) containing α4 and β2 subunits (α4β2*) functionally interact with G-protein-coupled dopamine (DA) D_2 receptors in basal ganglia. We hypothesized that if a functional interaction between these receptors exists, then mice expressing an M2 point mutation (Leu9'Ala) rendering 4 nAChRs hypersensitive to ACh may exhibit altered sensitivity to a D_2-receptor agonist. When challenged with the D_(2)R agonist, quinpirole (0.5–10 mg/kg), Leu9'Ala mice, but not wild-type (WT) littermates, developed severe, reversible motor impairment characterized by rigidity, catalepsy, akinesia, and tremor. While striatal DA tissue content, baseline release, and quinpirole-induced DA depletion did not differ between Leu9'Ala and WT mice, quinpirole dramatically increased activity of cholinergic striatal interneurons only in mutant animals, as measured by increased c-Fos expression in choline acetyltransferase (ChAT)-positive interneurons. Highlighting the importance of the cholinergic system in this mouse model, inhibiting the effects of ACh by blocking muscarinic receptors, or by selectively activating hypersensitive nAChRs with nicotine, rescued motor symptoms. This novel mouse model mimics the imbalance between striatal DA/ACh function associated with severe motor impairment in disorders such as Parkinson’s disease, and the data suggest that a D_(2)R–α4*-nAChR functional interaction regulates cholinergic interneuron activity.—Zhao-Shea, R., Cohen, B. N., Just, H., McClure-Begley, T., Whiteaker, P., Grady, S. R., Salminen, O., Gardner, P. D., Lester, H. A., Tapper, A. R. Dopamine D2-receptor activation elicits akinesia, rigidity, catalepsy, and tremor in mice expressing hypersensitive α4 nicotinic receptors via a cholinergic-dependent mechanism

NEMO-ICB (v1.0): interactive icebergs in the NEMO ocean model globally configured at eddy-permitting resolution

An established iceberg module, ICB, is used interactively with the Nucleus for European Modelling of the Ocean (NEMO) ocean model in a new implementation, NEMO–ICB (v1.0). A 30-year hindcast (1976–2005) simulation with an eddy-permitting (0.25°) global configuration of NEMO–ICB is undertaken to evaluate the influence of icebergs on sea ice, hydrography, mixed layer depths (MLDs), and ocean currents, through comparison with a control simulation in which the equivalent iceberg mass flux is applied as coastal runoff, a common forcing in ocean models. In the Southern Hemisphere (SH), drift and melting of icebergs are in balance after around 5 years, whereas the equilibration timescale for the Northern Hemisphere (NH) is 15–20 years. Iceberg drift patterns, and Southern Ocean iceberg mass, compare favourably with available observations. Freshwater forcing due to iceberg melting is most pronounced very locally, in the coastal zone around much of Antarctica, where it often exceeds in magnitude and opposes the negative freshwater fluxes associated with sea ice freezing. However, at most locations in the polar Southern Ocean, the annual-mean freshwater flux due to icebergs, if present, is typically an order of magnitude smaller than the contribution of sea ice melting and precipitation. A notable exception is the southwest Atlantic sector of the Southern Ocean, where iceberg melting reaches around 50% of net precipitation over a large area. Including icebergs in place of coastal runoff, sea ice concentration and thickness are notably decreased at most locations around Antarctica, by up to ~ 20% in the eastern Weddell Sea, with more limited increases, of up to ~ 10% in the Bellingshausen Sea. Antarctic sea ice mass decreases by 2.9%, overall. As a consequence of changes in net freshwater forcing and sea ice, salinity and temperature distributions are also substantially altered. Surface salinity increases by ~ 0.1 psu around much of Antarctica, due to suppressed coastal runoff, with extensive freshening at depth, extending to the greatest depths in the polar Southern Ocean where discernible effects on both salinity and temperature reach 2500 m in the Weddell Sea by the last pentad of the simulation. Substantial physical and dynamical responses to icebergs, throughout the global ocean, are explained by rapid propagation of density anomalies from high-to-low latitudes. Complementary to the baseline model used here, three prototype modifications to NEMO–ICB are also introduced and discussed

Detection methods for non-Gaussian gravitational wave stochastic backgrounds

We address the issue of finding an optimal detection method for a discontinuous or intermittent gravitational wave stochastic background. Such a signal might sound something like popcorn popping. We derive an appropriate version of the maximum likelihood detection statistic, and compare its performance to that of the standard cross-correlation statistic both analytically and with Monte Carlo simulations. The maximum likelihood statistic performs better than the cross-correlation statistic when the background is sufficiently non-Gaussian. For both ground and space based detectors, this results in a gain factor, ranging roughly from 1 to 3, in the minimum gravitational-wave energy density necessary for detection, depending on the duty cycle of the background. Our analysis is exploratory, as we assume that the time structure of the events cannot be resolved, and we assume white, Gaussian noise in two collocated, aligned detectors. Before this detection method can be used in practice with real detector data, further work is required to generalize our analysis to accommodate separated, misaligned detectors with realistic, colored, non-Gaussian noise.Comment: 25 pages, 12 figures, submitted to physical review D, added revisions in response to reviewers comment