254 research outputs found
Passive Smoking Litigation in Australia and America: How an Employee\u27s Health Hazard May become an Employer\u27s Wealth Hazard
Spatially Resolved Stellar Populations of Eight GOODS-South AGN at z~1
We present a pilot study of the stellar populations of 8 AGN hosts at z~1 and
compare to (1) lower redshift samples and (2) a sample of nonactive galaxies of
similar redshift. We utilize K' images in the GOODS South field obtained with
the laser guide star adaptive optics (LGSAO) system at Keck Observatory. We
combine this K' data with B, V, i, and z imaging from the ACS on HST to give
multi-color photometry at a matched spatial resolution better than 100 mas in
all bands. The hosts harbor AGN as inferred from their high X-ray luminosities
(L_X > 10^42 ergs/s) or mid-IR colors. We find a correlation between the
presence of younger stellar populations and the strength of the AGN, as
measured with [OIII] line luminosity or X-ray (2-10 keV) luminosity. This
finding is consistent with similar studies at lower redshift. Of the three Type
II galaxies, two are disk galaxies and one is of irregular type, while in the
Type I sample there only one disk-like source and four sources with smooth,
elliptical/spheroidal morphologies. In addition, the mid-IR SEDs of the strong
Type II AGN indicate that they are excited to LIRG (Luminous InfraRed Galaxy)
status via galactic starbursting, while the strong Type I AGN are excited to
LIRG status via hot dust surrounding the central AGN. This supports the notion
that the obscured nature of Type II AGN at z~1 is connected with global
starbursting and that they may be extincted by kpc-scale dusty features that
are byproducts of this starbursting.Comment: 56 pages, 39 figures, accepted to A
Harm reduction: A missing piece to the holistic care of patients who inject drugs
BACKGROUND: The rise in injection drug use (IDU) has led to an increase in drug-related infections. Harm reduction is an important strategy for preventing infections among people who inject drugs (PWID). We attempted to evaluate the harm reduction counseling that infectious diseases physicians provide to PWID presenting with infections.
METHODS: An electronic survey was distributed to physician members of the Emerging Infections Network to inquire about practices used when caring for patients with IDU-related infections.
RESULTS: In total, 534 ID physicians responded to the survey. Of those, 375 (70%) reported routinely caring for PWID. Most respondents report screening for human immunodeficiency virus (HIV) and viral hepatitis (98%) and discussing the risk of these infections (87%); 63% prescribe immunization against viral hepatitis, and 45% discuss HIV preexposure prophylaxis (PrEP). However, 55% of respondents (n = 205) reported not counseling patients on safer injection strategies. Common reasons for not counseling included limited time and a desire to emphasize antibiotic therapy/medical issues (62%), lack of training (55%), and believing that it would be better addressed by other services (47%). Among respondents who reported counseling PWID, most recommended abstinence from IDU (72%), handwashing and skin cleansing before injection (62%), and safe disposal of needles/drug equipment used before admission (54%).
CONCLUSIONS: Almost all ID physicians report screening PWID for HIV and viral hepatitis and discussing the risks of these infections. Despite frequently encountering PWID, fewer than half of ID physicians provide safer injection advice. Opportunities exist to standardize harm reduction education, emphasizing safer injection practices in conjunction with other strategies to prevent infections (eg, HIV PrEP or hepatitis A virus/hepatitis B virus vaccination)
Curriculum Guidelines for Undergraduate Programs in Data Science
The Park City Math Institute (PCMI) 2016 Summer Undergraduate Faculty Program
met for the purpose of composing guidelines for undergraduate programs in Data
Science. The group consisted of 25 undergraduate faculty from a variety of
institutions in the U.S., primarily from the disciplines of mathematics,
statistics and computer science. These guidelines are meant to provide some
structure for institutions planning for or revising a major in Data Science
Speech rhythm: a metaphor?
Is speech rhythmic? In the absence of evidence for a traditional view that languages strive to coordinate either syllables or stress-feet with regular time intervals, we consider the alternative that languages exhibit contrastive rhythm subsisting merely in the alternation of stronger and weaker elements. This is initially plausible, particularly for languages with a steep âprominence gradientâ, i.e. a large disparity between stronger and weaker elements; but we point out that alternation is poorly achieved even by a âstress-timedâ language such as English, and, historically, languages have conspicuously failed to adopt simple phonological remedies that would ensure alternation. Languages seem more concerned to allow âsyntagmatic contrastâ between successive units and to use durational effects to support linguistic functions than to facilitate rhythm. Furthermore, some languages (e.g. Tamil, Korean) lack the lexical prominence which would most straightforwardly underpin prominence alternation. We conclude that speech is not incontestibly rhythmic, and may even be antirhythmic. However, its linguistic structure and patterning allow the metaphorical extension of rhythm in varying degrees and in different ways depending on the language, and that it is this analogical process which allows speech to be matched to external rhythms
Sickle cell trait and priapism: a case report and review of the literature
Background
A 32 year-old African-American man presented to our institution after attempting suicide via ingestion with quetiapine. He had reported a history of several days of substance abuse with alcohol, cocaine and marijuana related to a partying binge. Following this, his partner removed him from his residence resulting in a suicide attempt. During hospitalization the patient developed priapism, a condition he had not experienced before.
Case presentation
Given this was his first time with priapism, an extensive work-up revealed the patient had previously undiagnosed sickle cell trait, which we postulate to have been a significant factor in his development of acute priapism. Sickle cell trait is considered to be a generally benign condition except for a few rare complications under more demanding physical conditions. However, upon reviewing the literature on the association of sickle cell trait with priapism, we believe this may not be the case. Case reports and small series that appeared in the 1960s and 1970s indicated an association between priapism and sickle trait. Little has been reported recently, and the general teaching regarding sickle cell trait does not include this information. However, one case was reported with the use of phosphodiesterase-5 (PDE-5) inhibitors and the development of priapism in a patient with sickle cell trait. These medications are now first line treatment in erectile dysfunction. They act by enhancing nitric oxide (NO) production leading to relaxation of smooth muscle in the corpora cavernosa and penile arteries.
Conclusion
Priapism was not reported in the initial studies of these medications. Further review of the literature indicates this may be a complex relationship. Interestingly, PDE5 inhibitors also have been postulated to be protective in sickle cell disease and perhaps also sickle cell trait because priapism might be caused by reduced NO availability. In this article, we examine the evidence linking sickle cell trait to priapism, explore the implications of PDE5 use, particularly in the setting of sickle cell trait, and propose that teaching about sickle cell trait include a discussion of priapism risk
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What helps or hinders the transformation from a major tertiary center to a major trauma center? Identifying barriers and enablers using the Theoretical Domains Framework
BACKGROUND: Major Trauma Centers (MTCs), as part of a trauma system, improve survival and functional outcomes from injury. Developing such centers from current teaching hospitals is likely to generate diverse beliefs amongst staff. These may act as barriers or enablers. Prior identification of these may make the service development process more efficient. The importance of applying theory to systematically identify barriers and enablers to changing clinical practice in emergency medicine has been emphasized. This study systematically explored theory-based barriers and enablers towards implementing the transformation of a tertiary hospital into a MTC. Our goal was to demonstrate the use of a replicable method to identify targets that could be addressed to achieve a successful transformation from an organization evolved to provide a particular type of clinical care into a clinical system with different demands, requirements and expectations.
METHODS: The Theoretical Domains Framework (TDF) is a tool designed to elicit and analyze beliefs affecting behavior. Semi-structured interviews based around the TDF were conducted in a major tertiary hospital in Scotland due to become a MTC with a purposive sample of major stakeholders including clinicians and nurses from specialties involved in trauma care, clinical managers and administration. Belief statements were identified through qualitative analysis, and assessed for importance according to prevalence, discordance and evidence base.
RESULTS AND DISCUSSION: 1728 utterances were recorded and coded into 91 belief statements. 58 were classified as important barriers/enablers. There were major concerns about resource demands, with optimism conditional on these being met. Distracting priorities abound within the Emergency Department. Better communication is needed. Staff motivation is high and they should be engaged in skills development and developing performance improvement processes.
CONCLUSIONS: This study presents a systematic and replicable method of identifying theory-based barriers and enablers towards complex service development. It identifies multiple barriers/enablers that may serve as a basis for developing an implementation intervention to enhance the development of MTCs. This method can be used to address similar challenges in developing specialist centers or implementing clinical practice change in emergency care across both developing and developed countries
Standard operating procedure changed pre-hospital critical care anaesthesiologistsâ behaviour: a quality control study
Curriculum Guidelines for Undergraduate Programs in Data Science
The Park City Math Institute 2016 Summer Undergraduate Faculty Program met for the purpose of composing guidelines for undergraduate programs in data science. The group consisted of 25 undergraduate faculty from a variety of institutions in the United States, primarily from the disciplines of mathematics, statistics, and computer science. These guidelines are meant to provide some structure for institutions planning for or revising a major in data science
Optimising care for patients with cognitive impairment and dementia following hip fracture
The global shift in demographics towards aging populations is leading to a commensurate increase in age-related disease and frailty. It is essential to optimise health services to meet current needs and prepare for anticipated future demands. This paper explores issues impacting on people living with cognitive impairment and/or dementia who experience a hip fracture and are cared for in acute settings. This is important given the high mortality and morbidity associated with this population. Given the current insufficiency of clear evidence on optimum rehabilitation of this patient group, this paper explored three key themes namely: recognition of cognitive impairment, response by way of training and education of staff to optimise care for this patient group and review of the importance of outcomes measures. Whilst there is currently insufficient evidence to draw conclusions about the optimal ways of caring for patients living with dementia following hip fracture, this paper concludes that future research should improve understanding of healthcare staff education to improve the outcomes for this important group of patients
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