Eye injuries: improving our practice.

Most eye health workers are involved in managing trauma. In fact, ocular injuries around the world make up a major part of daily ophthalmic clinical practice. Eye injuries range from mild, non sight-threatening, to extremely serious with blinding consequences

Ecological indicators of water quality in small rivers

At the present time hydrobiological indicators are widely used for the control of surface water quality. Results of the applying of methods suggested at the 1st Soviet-American seminar (1975), development of improved methods and estimation of their usefulness for various conditions are presented in this report. Among the criteria permitting an estimation of the degree and character of changes in water quality and their connection with the functioning of river ecosystems in general, the biological tests of natural waters appears to be the most universal one and is being carried out in two main directions — ecological and physiological. This study summarises approaches in both directions

Physician-Assisted Suicide Within a Kantian Framework

The highly polarized debate over the practice of physician-assisted suicide is relatively new to the realm of ethical issues. Physician-assisted suicide was first explicitly legalized in the United States in 1994, when Oregon passed its Death with Dignity Act. Although the Act stipulates that a doctor “may prescribe a lethal dose of medication to terminally ill people under certain conditions,” the term physician-assisted suicide also encompasses giving a patient information on how to commit suicide, or giving them the means to do so in a form other than a prescription. Physician-assisted suicide is different from euthanasia in that the patient, rather than the doctor, carries out the last step leading to the patient’s death. Exactly what “certain conditions” Oregon’s law entails are highly contested. The impetus behind it was to give rational, terminally ill people a chance to end their lives on their own terms, while preserving their dignity and avoiding incredible suffering from which there would be no relief, other than eventual death

Educational interventions for health professionals managing chronic obstructive pulmonary disease in primary care

© 2024 The Author(s). Published by Cambridge University Press. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/Peer reviewe

A comparison of the use of normal saline versus Ringer`s lactate in the fluid resuscitation of diabetic ketoacidosis

OBJECTIVE To determine whether there are differences in time to resolution of diabetic ketoacidosis (DKA) and in the occurrence of biochemical abnormalities in adult patients who received either normal saline or Ringer’s lactate as initial fluid resuscitation. RESEARCH DESIGN AND METHODS This prospective observational study compared outcomes in patients who received either normal saline (n=22) or Ringer’s lactate (n=18) as initial fluid therapy during the acute management of DKA. RESULTS Median time to resolution of DKA did not differ between the two groups [normal saline 18.5 hours (IQR 9-25) compared to Ringer’s lactate 17 hours (IQR 10-24); p=0.23]. There were also no significant differences in the incidence of hypernatraemia, hyperchloraemia or worsening acidosis between the groups. CONCLUSION Either normal saline or Ringer’s lactate may be used as initial fluid resuscitation in DKA as neither fluid conferred a benefit in time to resolution of DKA or in the occurrence of biochemical abnormalities

The concept of noise in medical visualisations perceived through a contemporary drawing practice

This research project explores how the concept of noise in medical visualisations is perceived through an analogue visual arts practice. Noise – which is the informational opposite to signal in science – is an unknown and visually ambiguous aspect of medical visualisations. A residency in a medical imaging institution was undertaken to investigate scientists’ perceptions of noise and to identify its key attributes. Conversations with contemporary artists and an examination of their work, explored how noise attributes are used as a strategy in their practices. Theories from art history and the neuropsychology of vision were used to interrogate how noise is implicated in visual perception. Critically, my on-going drawing exploration using instruments of vision, biosensor technologies and responding to unknown stimuli was a primary method of investigation used to understand how an analogue drawing practice perceives noise. My research identified that unknown movements and interactions are deeply implicated in the generation of noise and that the distinction between signal and noise is unstable. My practice-based investigations revealed that all my sensory perceptions become heightened in response to noise, so that vision becomes inseparable from them. This was an important difference between scientists’ and artists’ perceptions of noise, for scientists do not recognise the full sensorium in their practice. The writings of Jean-Luc Nancy and Michel Serres were used to elucidate this process. This research demonstrates the differences between artistic and scientific perceptual responses to ambiguity, the unknown and to noise. It evidences that artistic responses to noise can be a catalyst for change, generating new ways of perceiving, working and making. It contributes to an under-represented area of research: how an analogue arts practice perceives the digital concept of noise. Furthermore, my project indicates that analogue drawing could be used as a method in scientific training to explore visual ambiguity

How effective is community physical activity promotion in areas of deprivation for inactive adults? A pragmatic observational evaluation of the 'Active Herts' physical activity programme

Background There is a high prevalence of inactivity in UK adults and many suffer from comorbid conditions. These frequently co-exist in areas of higher socio-economic deprivation. There is a need to test the effectiveness, acceptability, and sustainability of physical activity programmes in this population. Method Active Herts recruited inactive adults (N=435) with one or more risk factors for cardiovascular disease and/or mild-to-moderate mental health conditions, and followed up at 3 and 6 months after baseline. In two areas programme-users received a behaviour change technique booklet, consultations, a booster phone call, motivational text messages, and signposting to 12 weeks of exercise classes (standard intervention). In another two areas programme-users also received 12 weeks of free tailored exercise classes, with optional exercise ‘buddies’ (enhanced intervention). Mixed ANOVAs analysed changes in physical activity, sporting participation, sitting (primary outcomes), mental wellbeing, health perception, and COM-B measures (secondary outcomes). Secondary analyses explored whether COM-B measures predicted moderate-to-vigorous physical activity (MVPA) at baseline, 3, and 6 months, and changes at 3 and 6 months using path analyses. Results At both timepoints, physical activity (3 months, η2 = .17; 6 months, η2 = .18), sporting participation (3 months, η2 = .22; 6 months, η2 = .17), sitting time (3 months, η2 = .08; 6 months, η2 = .06), and several secondary outcomes (e.g. wellbeing) improved regardless of group. COM-B related indicators explained MVPA performance better after 3 (R2=18%) and 6 (R2=15%) months than at baseline (R2=8%), but changes in MVPA were weakly predicted (3 months, R2=5%; 6 months, R2=7%). Self-monitoring was key in driving MVPA performance and change. Conclusions and Implications Active Herts improved activity levels at 3 and 6 months providing preliminary evidence that such interventions, delivered in real world settings, can change the behaviour and wellbeing of residents living in areas of deprivation.Peer reviewedFinal Published versio

Instruments for cataract surgery: results from our survey

For any operation, including cataract surgery, the appropriate instruments must be available and in good working order. If instruments are not available, or are blunt, or do not function properly, it may be necessary to delay or postpone surgery. Using such instruments in an operation can result in a poor outcome, or even pose a risk to surgeons and their assistants.The impact is therefore considerable, and can damage the reputation of the hospital in the community

A prospective study exploring the construct and predictive validity of the COM-B model for physical activity

The final, definitive version of this paper has been published in Journal of Health Psychology, November 2017, doi: https://doi.org/10.1177/1359105317739098, published by SAGE Publishing, All rights reserved.This study examined the constructs of Capability, Opportunity, and Motivation from the COM-B model and their influence on moderate-to-vigorous physical activity (MVPA). Using a prospective survey design, 186 healthy adults completed measures representing the Theoretical Domains Framework mapped to the COM-B, and MVPA one week later. The main indicators for the COM constructs were ‘habits’ (Capability), ‘subjective norms’ (Opportunity), and ‘exercise self-identity’ (Motivation). Motivation (77%) and MVPA (50%) were strongly predicted, with Capability and Motivation as key drivers of behaviour. Motivation was a strong mediator for Capability on behaviour. Future research should consider this approach for other populations and behaviours.Peer reviewe