UK National Audit of Early Syphilis Management. Clinics audit: screening for and management of early syphilis

Data were provided by 131 clinics, and 56% of cases were managed in clinics in the London regions in 2003. Three clinics (2%) do not routinely screen new patients for syphilis, and 28 clinics (21%) do not routinely screen ‘rebook’ patients who have had a new partner. More than 80% of clinics routinely conduct cardiovascular and neurological examinations, although chest radiography is only performed by 50% of clinics and lumbar puncture by 13%. Only 19 (14%) clinics indicated not routinely using the recommended procaine penicillin G (PPG) regimen or one- or two-dose benzathine penicillin G (BPG) regimens for early syphilis, with 57% providing two doses of BPG 2.4 g, 40% providing PPG 750 mg for 10 days, and 15% providing one dose of BPG 2.4 g. Only seven clinics (5%) indicated that they provided treatment for early syphilis with PPG that is inferior to that recommended in the national guidelines. Only 18 clinics specified using the recommended dose and duration (or in excess of this) of PPG for neurosyphilis for cases with HIV infection. Provision for management of severe penicillin reaction is good, although few patients are desensitized. All clinics report that contact tracing for early syphilis is provided, and is mainly the responsibility of health advisers. Compared with auditing outcomes, audit of management policies overestimated performance in contact tracing and provision of dark ground microscopy

UK National Audit of Early Syphilis Management. Case notes audit: diagnosis and treatment

A national audit of 781 early syphilis cases presenting during 2002–03 in UK genitourinary medicine clinics was conducted in late 2004, organized through the Regional Audit Groups. Data were aggregated by region and National Health Service trust, allowing practice to be compared between regions, between trusts within regions, as well as to national averages and the UK National Guidelines. An enzyme immunoassay was used to diagnose 695 (89%) cases (regional range 18–100%). Use of a non-treponemal test was not recorded for 44 (6%) cases. Dark ground microscopy was used in the diagnosis of only 80 (29%) primary cases. Uptake of HIV testing was 77% (range 69–94%). Nationally, 527 (67%) treatments were parenteral, with almost equal use of benzathine penicillin G for 262 (50%, range 0–97%) cases and procaine penicillin G (PPG) for 260 cases (49%, range 3–100%). There were 14 (5%) treatments with less than the recommended 750 mg dose of PPG. One hundred and five (40%) PPG treatments were with greater than 750 mg and/or for longer than 10 days of which 76 (72%) were for early latent syphilis and/or cases with HIV infection. One hundred and ninety two (86%, range 0–100%) of all oral treatments were with doxycycline. The recommended regimen of 100 mg doxycycline twice daily for 14 days was used for 104 (53%) cases; the other 91 (47%) treatments were with a variety of regimens, mainly treatments with larger doses and/or longer treatment intervals and some combination treatments. Fourteen (2%) cases were not treated; treatment was not reported for seven (0.9%) and not known for 10 (1.3%) cases, who were treated at other centres

QAA subject benchmark statement architecture : version for consultation December 2019

The Statement is intended to guide lecturers and course leaders in the design of academic courses leading to qualifications in architecture, it will also be useful to those developing other related courses. Higher education providers may need to consider other reference points in addition to this Statement in designing, delivering and reviewing courses. These may include requirements set out by the Architects Registration Board (ARB), the Royal Institute of British Architects (RIBA) and the Institute for Apprenticeships and Technical Education (IfATE). Providers may also need to consider industry or employer expectations. Individual higher education providers will decide how they use this information. The broad subject of architecture is both academic and vocational. The bachelor's award for architecture is the first stage of the typical education of an architect. This is typically either a BSc or a BA degree. The second stage of academic qualification is a master's level degree, typically in the form of a two-year MArch, which is defined as an undergraduate master's award. Architecture qualifications typically require a total of 360 (Credit Accumulation and Transfer Scheme, or CATS) credits at bachelor's level and 240 (CATS) credits within a master's level degree. While this may equate to five years of 120 (CATS) credits each, higher education providers may construct alternatives to enable flexibility in student learning. This Statement seeks to encapsulate the nature of a rich and diverse academic discipline. It is not intended to prescribe a curriculum, but rather describes the broad intellectual territory within which individual higher education providers will locate their courses of study in architecture

A Systematic Review of the Acute Effects of Exercise on Immune and Inflammatory Indices in Untrained Adults

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of global mortality. Although the incidence may be reduced with regular exercise, the health benefits of a single bout of exercise on selected CVD risk factors are not well understood. The primary objective of this review is to consider the transient effects of exercise on immune (neutrophil count) and inflammatory (interleukin-6 [IL-6], C-reactive protein [CRP]) markers in untrained adults. METHODS: MEDLINE, EMBASE, CINAHL, Sports Discus and Cochrane were searched for relevant studies published from January 1946 to May 2013. Randomised controlled or crossover studies which measured any of these parameters in untrained but otherwise healthy participants in the 48 h following about of exercise, less than 1 h in duration were included. RESULTS: Ten studies met the inclusion criteria. The results indicate a single bout of aerobic or resistance exercise of moderate to high intensity promotes an increase in IL-6 (145 %) and neutrophil counts (51 %). It appears that 30–60 min of moderate to high intensity exercise is necessary to elicit such changes although variables such as the mode, intensity and pattern of exercise also affect the response. The acute response of CRP within the included studies is equivocal. CONCLUSIONS: Although responses to CRP are inconsistent, a single bout of exercise can increase the activity of both circulating IL-6 and neutrophil counts in untrained adults. These immune and inflammatory responses to a single bout of exercise may be linked to a range of health benefits

An Optimal UAV Deployment Algorithm for Bridging Communication

This is the author accepted manuscript. The final version is available from IEEE via the DOI in this record.In recent years, Unmanned Aerial Vehicles (UAVs) have attracted the attention of both the military and civilians because of their deployment in situations where part of the communication infrastructure is destroyed due to bomb blast, earthquake, flood, military operations or landslides. Also UAVs can be used in operations such as search and rescue, surveillance, forest fire monitoring, and border patrolling. Deployment of a UAV in a position where it can provide maximum coverage and high throughput is one of the vital problem that needs to be addressed. In this paper, we have proposed an optimal UAV deployment algorithm (OUDA) in order to bridge communication between two static nodes on the ground. In the proposed algorithm the UAV deploys to a position where it can provide the best communication facilities to both the nodes based on the received signal strength (RSS), and distance between nodes and UAV. Simulation results showed that the algorithm provides maximum throughput and low bit error rate (BER) once the UAV is fixed to an optimal position

Clinicopathological evaluation of chronic traumatic encephalopathy in players of American football

IMPORTANCE: Players of American football may be at increased risk of long-term neurological conditions, particularly chronic traumatic encephalopathy (CTE). OBJECTIVE: To determine the neuropathological and clinical features of deceased football players with CTE. DESIGN, SETTING, AND PARTICIPANTS: Case series of 202 football players whose brains were donated for research. Neuropathological evaluations and retrospective telephone clinical assessments (including head trauma history) with informants were performed blinded. Online questionnaires ascertained athletic and military history. EXPOSURES: Participation in American football at any level of play. MAIN OUTCOMES AND MEASURES: Neuropathological diagnoses of neurodegenerative diseases, including CTE, based on defined diagnostic criteria; CTE neuropathological severity (stages I to IV or dichotomized into mild [stages I and II] and severe [stages III and IV]); informant-reported athletic history and, for players who died in 2014 or later, clinical presentation, including behavior, mood, and cognitive symptoms and dementia. RESULTS: Among 202 deceased former football players (median age at death, 66 years [interquartile range, 47-76 years]), CTE was neuropathologically diagnosed in 177 players (87%; median age at death, 67 years [interquartile range, 52-77 years]; mean years of football participation, 15.1 [SD, 5.2]), including 0 of 2 pre–high school, 3 of 14 high school (21%), 48 of 53 college (91%), 9 of 14 semiprofessional (64%), 7 of 8 Canadian Football League (88%), and 110 of 111 National Football League (99%) players. Neuropathological severity of CTE was distributed across the highest level of play, with all 3 former high school players having mild pathology and the majority of former college (27 [56%]), semiprofessional (5 [56%]), and professional (101 [86%]) players having severe pathology. Among 27 participants with mild CTE pathology, 26 (96%) had behavioral or mood symptoms or both, 23 (85%) had cognitive symptoms, and 9 (33%) had signs of dementia. Among 84 participants with severe CTE pathology, 75 (89%) had behavioral or mood symptoms or both, 80 (95%) had cognitive symptoms, and 71 (85%) had signs of dementia. CONCLUSIONS AND RELEVANCE: In a convenience sample of deceased football players who donated their brains for research, a high proportion had neuropathological evidence of CTE, suggesting that CTE may be related to prior participation in football.This study received support from NINDS (grants U01 NS086659, R01 NS078337, R56 NS078337, U01 NS093334, and F32 NS096803), the National Institute on Aging (grants K23 AG046377, P30AG13846 and supplement 0572063345-5, R01 AG1649), the US Department of Defense (grant W81XWH-13-2-0064), the US Department of Veterans Affairs (I01 CX001038), the Veterans Affairs Biorepository (CSP 501), the Veterans Affairs Rehabilitation Research and Development Traumatic Brain Injury Center of Excellence (grant B6796-C), the Department of Defense Peer Reviewed Alzheimer’s Research Program (grant 13267017), the National Operating Committee on Standards for Athletic Equipment, the Alzheimer’s Association (grants NIRG-15-362697 and NIRG-305779), the Concussion Legacy Foundation, the Andlinger Family Foundation, the WWE, and the NFL

The Capaciousness of No: Affective Refusals as Literacy Practices

© 2020 The Authors. Reading Research Quarterly published by Wiley Periodicals, Inc. on behalf of International Literacy Association The authors considered the capacious feeling that emerges from saying no to literacy practices, and the affective potential of saying no as a literacy practice. The authors highlight the affective possibilities of saying no to normative understandings of literacy, thinking with a series of vignettes in which children, young people, and teachers refused literacy practices in different ways. The authors use the term capacious to signal possibilities that are as yet unthought: a sense of broadening and opening out through enacting no. The authors examined how attention to affect ruptures humanist logics that inform normative approaches to literacy. Through attention to nonconscious, noncognitive, and transindividual bodily forces and capacities, affect deprivileges the human as the sole agent in an interaction, thus disrupting measurements of who counts as a literate subject and what counts as a literacy event. No is an affective moment. It can signal a pushback, an absence, or a silence. As a theoretical and methodological way of thinking/feeling with literacy, affect proposes problems rather than solutions, countering solution-focused research in which the resistance is to be overcome, co-opted, or solved. Affect operates as a crack or a chink, a tiny ripple, a barely perceivable gesture, that can persist and, in doing so, hold open the possibility for alternative futures

Insecticide resistance and the future of malaria control in Zambia.

BACKGROUND: In line with the Global trend to improve malaria control efforts a major campaign of insecticide treated net distribution was initiated in 1999 and indoor residual spraying with DDT or pyrethroids was reintroduced in 2000 in Zambia. In 2006, these efforts were strengthened by the President's Malaria Initiative. This manuscript reports on the monitoring and evaluation of these activities and the potential impact of emerging insecticide resistance on disease transmission. METHODS: Mosquitoes were captured daily through a series of 108 window exit traps located at 18 sentinel sites. Specimens were identified to species and analyzed for sporozoites. Adult Anopheles mosquitoes were collected resting indoors and larva collected in breeding sites were reared to F1 and F0 generations in the lab and tested for insecticide resistance following the standard WHO susceptibility assay protocol. Annual cross sectional household parasite surveys were carried out to monitor the impact of the control programme on prevalence of Plasmodium falciparum in children aged 1 to 14 years. RESULTS: A total of 619 Anopheles gambiae s.l. and 228 Anopheles funestus s.l. were captured from window exit traps throughout the period, of which 203 were An. gambiae malaria vectors and 14 An. funestus s.s.. In 2010 resistance to DDT and the pyrethroids deltamethrin, lambda-cyhalothrin and permethrin was detected in both An. gambiae s.s. and An. funestus s.s.. No sporozoites were detected in either species. Prevalence of P. falciparum in the sentinel sites remained below 10% throughout the study period. CONCLUSION: Both An. gambiae s.s. and An. funestus s.s. were controlled effectively with the ITN and IRS programme in Zambia, maintaining a reduced disease transmission and burden. However, the discovery of DDT and pyrethroid resistance in the country threatens the sustainability of the vector control programme