Injury in Ireland

Injury mortality is the fourth commonest cause of death in Ireland. The treatment of injuries has a major impact on our hospitals and on our budget for health. Long term disability following accidents is a serious problem. The aim of this report is to examine the impact of accidents and injuries on the Irish population by analysing routine mortality and morbidity data, and to identify in turn those areas where preventive measures could have an impact. In Section One the literature review details the advantages and disadvantages of each type of routine data source used in this report. The interpretation of data should take account of the constraints of the available data collected. The usefulness of routine data collection is highlighted, while identifying areas for improvement. In Section Two the methodology employed in the study is detailed. In Section Three data on hospital admissions over a five-year period 1993-1997 are presented. An overview of injury admissions is presented, followed by further analysis of injury data by both cause and by age group. In Section Four data on all accident-related deaths over a 17-year period, 1980-1996, are presented, with overall mortality data and mortality data by age group and by major causes of injury death detailed. In Section Five comparisons are made between the eight health board regions for rates of admissions and deaths due to injury. In presenting the data we use a matrix format devised and recommended by the International Collaborative Effort on Injury Statistics to display injury simultaneously by cause and intent. The use of a common format will also facilitate regional and international comparisons. In Section Six the priority recommendations for injury prevention are outlined. The key findings are then discussed and further recommendations are presented with the aim of injury prevention, reduction of disability and improvement in injury surveillance

Field localization on a brane intersection in anti-de Sitter spacetime

We discuss the localization of scalar, fermion, and gauge field zero modes on a $3-$brane that resides at the intersection of two $4-$branes in six-dimensional anti-de Sitter space. This set-up has been introduced in the context of brane world models and, higher-dimensional versions of it, in string theory. In both six- and ten-dimensional cases, it has been shown that four-dimensional gravity can be reproduced at the intersection, due to the existence of a massless, localized graviton zero-mode. However, realistic scenarios require also the Standard Model to be localized on the $3-$brane. In this paper, we discuss under which conditions a higher-dimensional field theory, propagating on the above geometry, can have a zero-mode sector localized at the intersection and find that zero modes can be localized only if masses and couplings to the background curvature satisfy certain relations. We also consider the case when other 4-branes cut the bulk at some distance from the intersection and argue that, in the probe brane approximation, there is no significant effect on the localization properties at the $3-$brane. The case of bulk fermions is particularly interesting, since the properties of the geometry allow localization of chiral modes independently.Comment: 13 pages, 3 figures, the version to be published in PR

Lessons from crossing symmetry at large N

20 pages, v2: Assumptions stated more clearly, version published in JHEPWe consider the four-point correlator of the stress tensor multiplet in N=4 SYM. We construct all solutions consistent with crossing symmetry in the limit of large central charge c ~ N^2 and large g^2 N. While we find an infinite tower of solutions, we argue most of them are suppressed by an extra scale \Delta_{gap} and are consistent with the upper bounds for the scaling dimension of unprotected operators observed in the numerical superconformal bootstrap at large central charge. These solutions organize as a double expansion in 1/c and 1/\Delta_{gap}. Our solutions are valid to leading order in 1/c and to all orders in 1/\Delta_{gap} and reproduce, in particular, instanton corrections previously found. Furthermore, we find a connection between such upper bounds and positivity constraints arising from causality in flat space. Finally, we show that certain relations derived from causality constraints for scattering in AdS follow from crossing symmetry.Peer reviewe

Drinking speed using a Pat Saunders valved straw, wide-bore straw and a narrow-bore straw in a normal adult population

Background: Straw drinking is often recommended as a strategy for managing swallowing difficulties in adult clinical populations. This study presents a range of normal adult straw drinking speeds and discusses clinical applications. Method: Straw drinking speed in a normal healthy population of 70 adults from 18 to 95 years of age was measured. Three types of straws were used: a Pat Saunders valved straw (PSVS), a wide-bore straw and a narrow-bore straw (NBS). Participants drank 40 ml of water for each straw tested. All participants were asked to comment on the straws used. A mixed-method design was used wherein both quantitative and simple structured qualitative data were collected. Results: Drinking speed was quickest for the wide-bore straw, followed by the NBS and slowest for the PSVS. This was supported by qualitative comments from the adults who reported that the PSVS was the most difficult straw to use. There were no significant differences between straw flow or straw type and sex of the participants. There were significant changes with aging and a decrease in flow speed with the NBS. Weight and height had some effect on straw drinking speeds. There was a slight correlation between age and sex and age and height, but not between age and weight. Conclusion: This article presents data for a normal range of straw drinking speeds in a healthy adult population. It can be used in the assessment and monitoring of straw drinking in acquired disorders of swallowing

Integrated care and the working record

By default, many discussions and specifications of electronic health records or integrated care records often conceptualize the record as a passive information repository. This article presents data from a case study of work in a medical unit in a major metropolitan hospital. It shows how the clinicians tailored, re-presented and augmented clinical information to support their own roles in the delivery of care for individual patients. This is referred to as the working record: a set of complexly interrelated clinician-centred documents that are locally evolved, maintained and used to support delivery of care in conjunction with the more patient-centred chart that will be stored in the medical records department on the patient’s discharge. Implications are drawn for how an integrated care record could support the local tailorability and flexibility that underpin this working record and hence underpin practice

Evidence of recent interkingdom horizontal gene transfer between bacteria and Candida parapsilosis

<p>Abstract</p> <p>Background</p> <p>To date very few incidences of interdomain gene transfer into fungi have been identified. Here, we used the emerging genome sequences of <it>Candida albicans </it>WO-1, <it>Candida tropicalis, Candida parapsilosis, Clavispora lusitaniae, Pichia guilliermondii</it>, and <it>Lodderomyces elongisporus </it>to identify recent interdomain HGT events. We refer to these as CTG species because they translate the CTG codon as serine rather than leucine, and share a recent common ancestor.</p> <p>Results</p> <p>Phylogenetic and syntenic information infer that two <it>C. parapsilosis </it>genes originate from bacterial sources. One encodes a putative proline racemase (PR). Phylogenetic analysis also infers that there were independent transfers of bacterial PR enzymes into members of the Pezizomycotina, and protists. The second HGT gene in <it>C. parapsilosis </it>belongs to the phenazine F (PhzF) superfamily. Most CTG species also contain a fungal PhzF homolog. Our phylogeny suggests that the CTG homolog originated from an ancient HGT event, from a member of the proteobacteria. An analysis of synteny suggests that <it>C. parapsilosis </it>has lost the endogenous fungal form of PhzF, and subsequently reacquired it from a proteobacterial source. There is evidence that <it>Schizosaccharomyces pombe </it>and Basidiomycotina also obtained a PhzF homolog through HGT.</p> <p>Conclusion</p> <p>Our search revealed two instances of well-supported HGT from bacteria into the CTG clade, both specific to <it>C. parapsilosis</it>. Therefore, while recent interkingdom gene transfer has taken place in the CTG lineage, its occurrence is rare. However, our analysis will not detect ancient gene transfers, and we may have underestimated the global extent of HGT into CTG species.</p

The Distance to the Large Magellanic Cloud from the Eclipsing Binary HV2274

The distance to the Large Magellanic Cloud (LMC) is crucial for the calibration of the Cosmic Distance Scale. We derive a distance to the LMC based on an analysis of ground-based photometry and HST-based spectroscopy and spectrophotometry of the LMC eclipsing binary system HV2274. Analysis of the optical light curve and HST/GHRS radial velocity curve provides the masses and radii of the binary components. Analysis of the HST/FOS UV/optical spectrophotometry provides the temperatures of the component stars and the interstellar extinction of the system. When combined, these data yield a distance to the binary system. After correcting for the location of HV2274 with respect to the center of the LMC, we find d(LMC) = 45.7 +/- 1.6 kpc or DM(LMC) = 18.30 +/- 0.07 mag. This result, which is immune to the metallicity-induced zero point uncertainties that have plagued other techniques, lends strong support to the ``short'' LMC distance scale as derived from a number of independent methods.Comment: 6 pages, including 2 pages of figures. Newly available optical (B and V) photometry has revealed -- and allowed the elimination of -- a systematic error in the previously reported determination of E(B-V) for HV2274. The new result is E(B-V) = 0.12 mag (as compared to the value of 0.083 reported in the original submission) and produces a DECREASE in the distance modulus of HV2274 by 0.12 mag. ApJ Letters, in pres

The fundamental problem of command : plan and compliance in a partially centralised economy

When a principal gives an order to an agent and advances resources for its implementation, the temptations for the agent to shirk or steal from the principal rather than comply constitute the fundamental problem of command. Historically, partially centralised command economies enforced compliance in various ways, assisted by nesting the fundamental problem of exchange within that of command. The Soviet economy provides some relevant data. The Soviet command system combined several enforcement mechanisms in an equilibrium that shifted as agents learned and each mechanism's comparative costs and benefits changed. When the conditions for an equilibrium disappeared, the system collapsed.Comparative Economic Studies (2005) 47, 296–314. doi:10.1057/palgrave.ces.810011