Preparing for professional practice: how well does professional training equip health and social care practitioners to engage in evidence-based practice?

This paper reports on the findings of a study that aimed to explore how relevant initial training is in relation to evidence-based practice, and explore the perceptions of recently qualified practitioners about their confidence to engage in evidence-based practice. A cross-sectional postal survey was used to ascertain the views of nurses, social workers, occupational therapists and physiotherapists who had been qualified no longer than two years prior to the survey, and had qualified at one of three London Universities. Fifty questionnaires were sent out to each professional group (a sample of 200 overall) and there was a 43% response rate achieved. The results show a clear discrepancy between what are generally positive attitudes towards evidence-based practice and the value of research evidence and the infrequency with which they actually do make use of research resources and engage in evidence-based practice. A number of constraints to engagement in accessing and utilising evidence were identified

Characterization of lymphocyte subsets as a tool of assessment of histological disease activity pattern in ulcerative colitis

Background: In Ulcerative colitis (UC), the presence of a persistently elevated number of T cells in the inflamed area with respect to the activity of the disease suggesting bad prognosis. This study was done to evaluate cellular immune response in different disease activity patterns and its possible implication in evaluation of disease activity. Materials and methods: This study included Forty seven archived paraffin-embedded samples of ulcerative colitis; these samples diagnosed and graded for disease activity. Then dual immunofluorescence staining was used for phenotyping of lymphocytic infiltrate (CD3- CD19) and (CD4-CD8). A total and differential T cell as well as plasma cell count was recorded in these UC tissue samples. Non parametric Kruskal-Wallis test was used to compare the median cell counts among different study groups. Results: There is higher lymphocytic infiltrate for all types of cells when UC samples compared with control samples with highly statistical significant difference, T cells represents the major constituents of colonic mucosal infiltrate (86.89%) and about 75.79% were CD4 positive T cells. T-cell subsets and plasma cell have high statistical significant difference (p≤0.001) according to histological grade. Furthermore, with the histological grade the highest association found with T lymphocytes (r=0.944) followed by T helper (r=0.821), T cytotoxic (r=0.653) and B lymphocyte (r=0.237). Conclusions: Qualitative and semi quantitative characterization of lymphocytes subsets was useful in the assessment of different histological grades of UC disease activity

Ectopic Cushing's syndrome secondary to lung and mediastinal tumours - Report from a tertiary care centre in Iran

Introduction: Ectopic Cushing's syndrome (ECS) secondary to neuroendocrine tumours (NETs) of the lung and mediastinum are rarely encountered. In this study, we present our experience in Iran on 15 patients with ECS secondary to lung and mediastinal tumours over a period of 27 years. Material and methods: Since 1985, 15 patients with ECS secondary to lung and mediastinal tumours have been diagnosed and prospectively followed by the endocrinology team of Taleghani Hospital, Tehran, Iran. The clinical signs and symptoms, laboratory findings, radiological features, immunohistochemical characteristics, management strategies and outcome data are here presented. Results: There were six women and nine men, aged 26-70 years, all presenting with typical features of Cushing's syndrome. Based on histopathologic evaluations, four patients had small cell lung cancer (SCLC) and seven patients had pulmonary NETs, one patient had a thymic NET, and one case was diagnosed as a lung tumourlet. The mean ± SD serum cortisol, 24h urine free cortisol and plasma ACTH were 47.2 ± 20.5 μg/dL, 2,702 ± 5,439 μg/day, and 220 ± 147 pg/mL, respectively. Pulmonary lesions ranged in diameter from 1.1 to 4 cm (mean 1.9 ± 1.1 cm). One patient had a 10 cm mediastinal mass. The duration of follow up in these cases was between one month and seven years (mean 29.9 ± 27.5 months). The four patients with SCLC died within three months of diagnosis. Conclusion: Our data demonstrates the protean clinical and laboratory manifestations of ECS secondary to lung and mediastinal tumours, the problems encountered in diagnosis, and the need for a multidisciplinary approach. This study confirms other series from Western Europe and North America that, unlike the SCLC patients who show a poor outlook, ECS secondary to lung carcinoids has a more favourable prognosis

Large Scale Production of Spider Silk Protein in E. coli

Spider silks have long been a focus of research due to their remarkable mechanical properties including strength, toughness and elasticity. Moreover, biodegradability and biocompatibility of spider silks make them beneficial to use in biomedical applications. Spiders cannot be farmed because of their territorial and cannibalistic nature. Hence, production of recombinant spider silks is the only feasible solution for large scale production Large scale production is still challenging due to the small recombinant protein size, low yield and low water solubility of bio-synthetic spider silk. The current study reports our progress as well as evolution of effective protocol for large scale bio-synthetic production of spider silk protein in E. coli. Our main spidersilk protein we seek to produce and purify in a large scale is MaSp2. Spider dragline silk is primarily composed of proteins called major ampullate spidroins (MaSps) that consist of a large repeat array flanked by nonrepetitive N- and C- terminal domains. All MaSp genes are co-expressed in the major ampullate gland of Nephila Clavipes

3D Reservoir Study for Yamama Formation in Nasirya Oil field in Southern of Iraq

Nasriya oil field is located at the Southern part of Iraq, this field is a giant and prolific, so it take a special are from the Oil Exploration Company for development purposes by using 3D seismic reflection. The primary objective of this thesis is to obtain reservoir properties and enhance the method of getting precise information about subsurface reservoir characterizations by improving the estimation of petrophysical properties (effective porosity, P-wave, water saturation and poisson's ratio). There are five wells in the study area penetrated the required reservoirs within Yammam Formation. The Synthetic seismogram of Nasriya wells were created to conduct well tie with seismic data. These well tie was very good matching with seismic section using best average statistical wavelet. Five main horizons were picked from the reflectors by using synthetic seismogram for wells then converted to structural maps in depth domain by using average velocity of five wells. By using petrel program TWT maps have been constructed from the picked horizons, Average velocity maps calculated from the wells velocities survey data and the sonic log information and Depth maps construction was drawn using Direct time-depth conversion and the general trend of these map was NW-SE. The model of low frequency was created from the low frequency contents from well data and the five main horizons were picked. The seismic inversion technique was performed on post-stack three dimensions (3D) seismic data in Nasriya oil field

Quantum Reality Filters

An anhomomorphic logic \ascript ^* is the set of all possible realities for a quantum system. Our main goal is to find the "actual reality" \phi_a\in\ascript ^* for the system. Reality filters are employed to eliminate unwanted potential realities until only $\phi_a$ remains. In this paper, we consider three reality filters that are constructed by means of quantum integrals. A quantum measure $\mu$ can generate or actualize a \phi\in\ascript ^* if $\mu (A)$ is a quantum integral with respect to $\phi$ for a density function $f$ over events $A$. In this sense, $\mu$ is an "average" of the truth values of $\phi$ with weights given by $f$. We mainly discuss relations between these filters and their existence and uniqueness properties. For example, we show that a quadratic reality generated by a quantum measure is unique. In this case we obtain the unique actual quadratic reality.Comment: 25 page

The effect of interferon beta-1b treatment on MRI measures of cerebral atrophy in secondary progressive multiple sclerosis.

The recently completed European trial of interferon beta-1b (IFN beta -1b) in patients with secondary progressive multiple sclerosis (SP multiple sclerosis) has given an opportunity to assess the impact of treatment on cerebral atrophy using serial MRI. Unenhanced T-1-weighted brain imaging was acquired in a subgroup of 95 patients from five of the European centres; imaging was performed at 6-month intervals from month 0 to month 36. A blinded observer measured cerebral volume on four contiguous 5 mm cerebral hemisphere slices at each time point, using an algorithm with a high level of reproducibility and automation. There was a significant and progressive reduction in cerebral volume in both placebo and treated groups, with a mean reduction of 3.9 and 2.9%, respectively, by month 36 (P = 0.34 between groups). Exploratory subgroup analyses indicated that patients without gadolinium (Gd) enhancement at the baseline had a greater reduction of cerebral volume in the placebo group (mean reduction at month 36: placebo 5.1%, IFN beta -1b 1.8%, P < 0.05) whereas those with Gd-enhancing lesions showed a trend to greater reduction of cerebral volume if the patient was on IFN<beta>-1b (placebo 2.6%, IFN beta -1b, 3.7%; P > 0.05). These results are consistent with ongoing tissue loss in both arms of this study of secondary progressive multiple sclerosis. This finding is concordant with previous observations that disease progression, although delayed, is not halted by IFN beta. The different pattern seen in patients with and without baseline gadolinium enhancement suggests that part of the cerebral volume reduction observed in IFN beta -treated patients may be due to the anti-inflammatory/antioedematous effect of the drug. Longer periods of observation and larger groups of patients may be needed to detect the effects of treatment on cerebral atrophy in this population of patients with advanced disease

PRELIMINARY DESIGN OF OSCILLATORY FLOW BIODIESEL REACTOR FOR CONTINUOUS BIODIESEL PRODUCTION FROM JATROPHA TRIGLYCERIDES

The concept of a continuous process in producing biodiesel from jatropha oil by using an Oscillatory Flow Biodiesel Reactor (OFBR) is discussed in this paper. It has been recognized that the batch stirred reactor is a primary mode used in the synthesis of biodiesel. However, pulsatile flow has been extensively researcehed and the fundamental principles have been successfully developed upon which its hydrodynamics are based. Oscillatory flow biodiesel reactor offers precise control of mixing by means of the baffle geometry and pulsation which facilitates to continuous operation, giving plug flow residence time distribution with high turbulence and enhanced mass and heat transfer. In conjunction with the concept of reactor design, parameters such as reactor dimensions, the hydrodynamic studies and physical properties of reactants must be considered prior to the design work initiated recently. The OFBR reactor design involves the use of simulation software, ASPEN PLUS and the reactor design fundamentals. Following this, the design parameters shall be applied in fabricating the OFBR for laboratory scale biodiesel production