Population prevalence, incidence, and predictors of atrial fibrillation in the Renfrew/Paisley study

<b>OBJECTIVES</b> Though atrial fibrillation (AF) is an important cause of cardiovascular morbidity, there are few large epidemiological studies of its prevalence, incidence, and risk factors. The epidemiological features of AF are described in one of the largest population cohorts ever studied. <b>METHODS</b> The prevalence and incidence of AF were studied in the Renfrew/Paisley population cohort of 15 406 men and women aged 45-64 years living in the west of Scotland. This cohort was initially screened between 1972 and 1976 and again between 1977 and 1979. Incident hospitalisations with AF in the 20 year period following initial screening were also studied. <b>RESULTS</b> The population prevalence of AF in this cohort was 6.5 cases/1000 examinations. Prevalence was higher in men and older subjects. In those who were rescreened, the four year incidence of AF was 0.54 cases/1000 person years. Radiological cardiomegaly was the most powerful predictor of new AF (adjusted odds ratio 14.0). During 20 year follow up, 3.5% of this cohort was discharged from hospital with a diagnosis of AF; the rate of incident hospitalisation for AF was 1.9 cases/1000 person years. Radiological cardiomegaly (adjusted odds ratio 1.46) and systolic blood pressure (adjusted odds ratio 2.1 for ≥ 169 mm Hg) were independent predictors of this outcome. <b>CONCLUSIONS</b> Data from one of the largest epidemiological studies ever undertaken confirm that AF has a large population prevalence and incidence, even in middle aged people. More important, it was shown that the long term incidence of hospitalisation related to AF is high and that two simple clinical measurements are highly predictive of incident AF. These findings have important implications for the prevention of AF

Les conséquences du sida dans la vie des hémophiles et de leurs soignants familiaux au Québec : stress, réponse au stress et soutien social

Le présent article présente les résultats de l'échantillon québécois d'une enquête nationale sur les besoins de soutien des hémophiles atteints du sida ou du VIH. Portant aussi sur les besoins des soignants et des proches (endeuillés ou non) de ces personnes, cette enquête se fondait sur une problématique qui considère le soutien social comme un moyen de faire face au stress. Les participants ont signalé avoir éprouvé plus de stress à cause de l'absence de soutien ou d'un soutien négatif que par suite de la détérioration physique due à la maladie. La question de la confidentialité a été fréquemment soulevée. En général, les participants se sont déclarés satisfaits du soutien reçu, surtout de la part des membres de leurs familles.The following article focuses on the Québec portion of a national survey on the care needed by hemophiliacs with AIDS or having contracted the HIV virus. The survey was based on an approach that considers social support as a means to face stress. It also examined the needs of dispensers of care and relatives (whether mourning or not) of these persons. Participants revealed having experienced more stress because of an absence of support or simply negative support, than because of the physical deterioration caused by the disease. In addition, the question of confidentiality was often raised. In general, participants said they were satisfied with the support they had received, especially on the part of members of their family

Capsules, secondary interactions and unusual multi-metallic complexes

Research into inorganic supramolecular chemistry is burgeoning, in particular that which focuses on the formation of capsular molecules and the effects that these unique environments have on catalytic reactions. With the aim of producing new ligand designs that could not only support reactive metals, but also partake in supramolecular aggregation to provide a capsular microenvironment, new tripodal ligands and wide span imines and amines have been synthesised. Furthermore, the exploitation of hydrogen-bonding motifs formed through pyrrole-imine tautomerisation upon metallation of these ligands has been explored, with the aim of enhancing reactivity and stabilising reactive intermediates. In Chapter one, the concept of covalent and non-covalent capsules is introduced, and includes the different aspects affecting the encapsulation of molecules and their use as nanoreactors. The use of secondary interactions, e.g. hydrogen-bonding in metal complexes of tetrapodal and tripodal ligands is discussed. Chapter two describes the synthesis of a tripodal pyrrole-imine ligand and the formation of its multi-metallic complexes of Group one metals, transition metal and the f-block elements. The complete and partial tautomerisation of this ligand upon metal complexation is also examined. In Chapter three, the formation of hangman complexes of the tripodal pyrrole-imine ligand is described and is extrapolated to the chemistry of a new pyrrole-amide ligand. The synthesis of this latter ligand and its properties with regards to anion binding are also explored. Chapter four describes the formation of wide span diamine and diimine ligands and their propensity to form adducts with cobalt and zinc chlorometallates and unusual multimetallic palladium complexes. The final conclusions of the work presented in this thesis are drawn in Chapter five. Chapter six presents experimental details and characterising data for all of the new compounds presented in this thesis

In vitro fertilization is associated with an increased risk of borderline ovarian tumours

Objectives: To compare the risk of borderline ovarian tumours in women having in vitro fertilization (IVF) with women diagnosed with infertility but not having IVF. Methods: This was a whole-population cohort study of women aged 20–44 years seeking hospital infertility treatment or investigation in Western Australia in 1982–2002. Using Cox regression, we examined the effects of IVF treatment and potential confounders on the rate of borderline ovarian tumours. Potential confounders included parity, age, calendar year, socio-economic status, infertility diagnoses including pelvic inflammatory disorders and endometriosis and surgical procedures including hysterectomy and tubal ligation. Results: Women undergoing IVF had an increased rate of borderline ovarian tumours with a hazard ratio (HR) of 2.46 (95% confidence interval [CI] 1.20–5.04). Unlike invasive epithelial ovarian cancer, neither birth (HR 0.89; 95% CI 0.43–1.88) nor hysterectomy (1.02; 0.24–4.37) nor sterilization (1.48; 0.63–3.48) appeared protective and the rate was not increased in women with a diagnosis of endometriosis (HR 0.31; 95% CI 0.04–2.29). Conclusions: Women undergoing IVF treatment are at increased risk of being diagnosed with borderline ovarian tumours. Risk factors for borderline ovarian tumours appear different from those for invasive ovarian cancer

Comparing and Contrasting a Program versus System Approach to Evaluation: The Example of a Cardiac Care System

This paper focuses on the application of systems thinking concepts to evaluate systems.  The terms systems and systems thinking concepts are first defined.  The use of systems thinking concepts in program and system evaluation are then highlighted.  It is noted that while there are methods available to assist evaluation practitioners in applying systems thinking concepts to program evaluation, there is a need for similar guidance in applying systems thinking concepts to evaluating systems.  System Evaluation Theory (SET) is then reviewed as one evaluation theory designed to apply systems thinking concepts to evaluating systems. A case illustration is presented to help teach practitioners how to apply SET’s three steps.  The discussion focuses on comparing the differences between evaluation questions answered by applying systems thinking concepts versus those using program logic models

Rod Fracture in Magnetically Controlled Growing Spine Rods

Background: The mechanisms of fracture in magnetically controlled growing rods (MCGRs) and the risk factors associated with this are poorly understood. This retrospective analysis of explanted MCGRs aimed to add understanding to this subject. / Methods: From our cohort of over 120 retrieved MCGRs, we identified 7 rods that had fractured; all were single-rod constructs, retrieved from 6 patients. These were examined and compared with 15 intact single-rod constructs. Retrieval and fractographic analyses were used to determine the failure mode at the fracture site and the implant's functionality. Cobb angle, degree of rod contouring, and the distance between anchoring points were computed on anteroposterior and lateral radiographs. / Results: 5/7 versus 3/15 rods had been inserted after the removal of a previously inserted rod, in the fractured versus control groups. All fractured rods failed due to bending fatigue. Fractured rods had greater rod contouring angles in the frontal plane (P = 0.0407) and lateral plane (P = 0.0306), and greater distances between anchoring points in both anteroposterior and lateral planes (P = 0.0061 and P = 0.0074, respectively). / Conclusions: We found all failed due to a fatigue fracture and were virtually all single rod configurations. Fracture initiation points corresponded with mechanical indentation marks induced by the intraoperative rod contouring tool. Fractured rods had undergone greater rod contouring and had greater distances between anchoring points, suggesting that it is preferable to implant double rod constructs in patients with sufficient spinal maturity to avoid this complication

Factors associated with statin treatment for the primary prevention of cardiovascular disease in people within 2 years following diagnosis of diabetes in Scotland, 2006-2008

© 2014 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK. Funded by Scottish Health Informatics Programme. Grant Number: WT086113 Scottish Government Scottish Diabetes Research NetworkPeer reviewedPublisher PD

Complete sequence and analysis of the ovine herpesvirus 2 genome

Ovine herpesvirus 2 (OvHV-2) is endemic in sheep populations worldwide and causes malignant catarrhal fever (MCF), a lymphoproliferative disease, in cattle, bison and deer. OvHV-2 has been placed in the gammaherpesvirus subfamily and is related closely to Alcelaphine herpesvirus 1 (AlHV-1). Here, the cloning, sequencing and analysis of the complete OvHV-2 genome derived from a lymphoblastoid cell line from an affected cow (BJ1035) are reported. The unique portion of the genome consists of 130 930 bp, with a mean G+C content of 52 mol%. The unique DNA is flanked by multiple copies of terminal repeat elements 4205 bp in length, with a mean G+C content of 72 mol%. Analysis revealed 73 open reading frames (ORFs), the majority (62) of which showed homology to other gammaherpesvirus genes. A further subset of nine ORFs is shared with only the related AlHV-1. Three ORFs are entirely unique to OvHV-2, including a spliced homologue of cellular interleukin-10 that retains the exon structure of the cellular gene. The sequence of OvHV-2 is a critical first step in the study of the pathogenesis and treatment of MCF