The effects of environmental heat, with special reference to anhidrotic heat exhaustion

Following a review of the physiological principles involved in the regulation of body temperature and of the various ways in which the body is known to react when it is exposed to abnormal degrees of environmental heat, a "working" classification has been proposed in an attempt to clarify these heat effects syndromes. The terminology used was based on names hallowed by tradition, but modified in such a way as to illustrate the aetiology and principal clinical features of the syndromes. It was not claimed that the classification should be the definitive one, because of certain deficiencies in knowledge.Then, following a consideration of the different types of climate in which heat effects syndromes are known to occur, the expected distribution of thes syndromes according to climatic conditions was deduced. This hypothesis was shown to be correct by personal experience and a shady of the reports of the experience of other observers.A detailed study of the syndromes illustrated the importance of the different factors contributing to "climate ", but also demonstrated the difficulty in assessing their relative contribution. This was sometimes increased by the fact that environmental conditions cannot always be accessed from observations made by conventional methods, since these may be very remote from actual living and working conditions. Whilst the relationship between dry bulb temperature and heat stroke is fairly obvious it has been clearly demonstrated that the minilLuIL dry bulb and the wet bulb temperatures are also very important factors in the aetiology of some heat effects syndromes, although their exact contribution in particular syndromes has been difficult to assess from the data available. This was well illustrated in the discussion on anhidrotic heat exhaustion (Chapter 11), and in particular in the interpretation of the significance of the changes in the minimum dry bulb and wet bulb temperatures associated with the abrupt cessation of the epidemic of this syndrome at Karachi in 1946 (figure 6). There is no doubt, however, that the wet -bulb temperature, long known to nave a great influence on comfort sensation and ability to work in hot environments, makes a definite contribution to the aetiology of some heat effects syndromes.It has also been shown that certain climatic factors, including the wet -bulb temperatures, are important in the aetiology not only of prickly heat (a condition of much greater importance than has hitherto been appreciated) but also of other skin diseases.Important deficiences in knowledge have also been revealed and suggestions made for their remedy, but it has been pointed out that experiments conducted in artificial environments have a limited application, and that further studies in the field are also necessary to clarify the outstanding problems

Influence of Health Status on the Association Between Diabetes and Depression Among Adults in Europe: Findings From the SHARE International Survey.

The association between diabetes and depression, a common health comorbidity in people with diabetes, has been recognized but not well understood. The purpose of this study was to explore the association between diabetes and depression in a large international sample of adults, adjusting for demographics, socioeconomic status, behavioral risks, and current health status. The association between diabetes and depression was assessed in a sample of 57,004 Europeans ≥50 years of age from 15 European countries using data from the fifth wave of SHARE (the Survey of Health, Ageing, and Retirement in Europe). Multiple logistic regression models of the association between diabetes and depression were conducted, adjusting for potential confounders. Analyses showed that, despite diabetes being associated with depression in crude and partially adjusted models, further adjustment for self-perceived health made the association between diabetes and depression no longer statistically significant (odds ratio 1.0, 95% CI 0.9-1.0). Adjustment for a variety of demographic, socioeconomic, behavioral risk, and health status variables reduced the estimated association between diabetes and depression until it was no longer significant. Further research should explore the specific symptoms of distress characterized in people with diabetes

Quantification of complementarity in multi-qubit systems

Complementarity was originally introduced as a qualitative concept for the discussion of properties of quantum mechanical objects that are classically incompatible. More recently, complementarity has become a \emph{quantitative} relation between classically incompatible properties, such as visibility of interference fringes and "which-way" information, but also between purely quantum mechanical properties, such as measures of entanglement. We discuss different complementarity relations for systems of 2-, 3-, or \textit{n} qubits. Using nuclear magnetic resonance techniques, we have experimentally verified some of these complementarity relations in a two-qubit system.Comment: 12 pages, 10 figures (A display error about the figures in the previous version

Unstable Identities: The European Court of Human Rights and the Margin of Appreciation

All legal systems work under a master narrative – the self-conception of most actors of the system itself. A master narrative is a short and simple story and it is the underlying premise upon which any legal system is based. It is a simple story because it paints the system in quick broad brushstrokes and at (most) times is oblivious to the paradoxes within it. Furthermore, a master narrative is important for legitimization purposes because the actors’ legitimacy will depend on their (perceived) conformity with the system’s master narrative. Therefore, legitimacy is self-referential; the yardsticks for a legitimate action are contained within the system’s master narrative, not outside of it. When talking about different international courts it is important to remember that they are embedded within a master narrative that is contextual and contingent and, at different points, more or less contested. This paper explores the question of what happens when the master-narrative is in a period of transition (from a state cantered to a post-national world order) and when the actors’ legitimacy, their interpretative endeavours the very fundamentals are in a state of flux. I use the margin of appreciation discussion as a focal point of describing the conflicting narratives under which the European Court of Human Rights works, narratives in which the different actors (judges, attorneys, NGO activists, government agents) and their consequences in terms of the interpretation of the European Convention on Human Rights

Nonstorm time dynamics of electron radiation belts observed by the Van Allen Probes

Abstract Storm time electron radiation belt dynamics have been widely investigated for many years. Here we present a rarely reported nonstorm time event of electron radiation belt evolution observed by the Van Allen Probes during 21-24 February 2013. Within 2 days, a new belt centering around L=5.8 formed and gradually merged with the original outer belt, with the enhancement of relativistic electron fluxes by a factor of up to 50. Strong chorus waves (with power spectral density up to 10-4nT2/Hz) occurred in the region L\u3e5. Taking into account the local acceleration driven by these chorus waves, the two-dimensional STEERB can approximately reproduce the observed energy spectrums at the center of the new belt. These results clearly illustrate the complexity of electron radiation belt behaviors and the importance of chorus-driven local acceleration even during the nonstorm times

A Systematic Review of Genetic Testing and Lifestyle Behaviour Change: Are We Using High-Quality Genetic Interventions and Considering Behaviour Change Theory?

Background: Studying the impact of genetic testing interventions on lifestyle behaviour change has been a priority area of research in recent years. Substantial heterogeneity exists in the results and conclusions of this literature, which has yet to be explained using validated behaviour change theory and an assessment of the quality of genetic interventions. The theory of planned behaviour (TPB) helps to explain key contributors to behaviour change. It has been hypothesized that personalization could be added to this theory to help predict changes in health behaviours. Purpose: This systematic review provides a detailed, comprehensive identification, assessment, and summary of primary research articles pertaining to lifestyle behaviour change (nutrition, physical activity, sleep, and smoking) resulting from genetic testing interventions. The present review further aims to provide in-depth analyses of studies conducted to date within the context of the TPB and the quality of genetic interventions provided to participants while aiming to determine whether or not genetic testing facilitates changes in lifestyle habits. This review is timely in light of a recently published “call-to-action” paper, highlighting the need to incorporate the TPB into personalized healthcare behaviour change research. Methods: Three bibliographic databases, one key website, and article reference lists were searched for relevant primary research articles. The PRISMA Flow Diagram and PRISMA Checklist were used to guide the search strategy and manuscript preparation. Out of 32,783 titles retrieved, 26 studies met the inclusion criteria. Three quality assessments were conducted and included: (1) risk of bias, (2) quality of genetic interventions, and (3) consideration of theoretical underpinnings – primarily the TPB. Results: Risk of bias in studies was overall rated to be “fair.” Consideration of the TPB was “poor,” with no study making reference to this validated theory. While some studies (n = 11; 42%) made reference to other behaviour change theories, these theories were generally mentioned briefly, and were not thoroughly incorporated into the study design or analyses. The genetic interventions provided to participants were overall of “poor” quality. However, a separate analysis of studies using controlled intervention research methods demonstrated the use of higher-quality genetic interventions (overall rated to be “fair”). The provision of actionable recommendations informed by genetic testing was more likely to facilitate behaviour change than the provision of genetic information without actionable lifestyle recommendations. Several studies of good quality demonstrated changes in lifestyle habits arising from the provision of genetic interventions. The most promising lifestyle changes were changes in nutrition. Conclusions: It is possible to facilitate behaviour change using genetic testing as the catalyst. Future research should ensure that high-quality genetic interventions are provided to participants, and should consider validated theories such as the TPB in their study design and analyses. Further recommendations for future research are provided

Western Australian Radiology Departments’ Views on Australian Personally Controlled Electronic Health Record

Introduction: Since the last decade, many countries have started developing a national electronic health record (EHR). The national EHR in Australia is called Personally Controlled Electronic Health Record (PCEHR). It has been available for use since 1 July 2012. A federal government’s review of its implementation was conducted in late 2013 because it failed to meet the set targets. The purpose of this study was to investigate Western Australian radiology departments’ views on the PCEHR complementary to the government’s review report. Methods: Chief medical imaging technologists (n=18) and picture archiving and communication system (PACS) administrators (n=18) from public and private hospitals in Western Australian were invited to participate in this study in May 2014. The response rate for participation was 22.2 percent (8/36). Semi-structured interviews were conducted with the participants to obtain their perceptions of PCEHR. The interviews were analysed inductively and thematically. Results: There were eight people (n=8) who agreed to participate. They believed the PCEHR would enhance efficiency and effectiveness of healthcare services if barriers to its implementation were addressed. The major barriers identified were concern of individual privacy, increase of staff workload, inadequate system functionalities and training, lack of involvement of stakeholders and money. The use of Medicare to provide both positive and negative incentives to the stakeholders was suggested as a viable solution to address the current barriers. Conclusion: This study investigated four Western Australian radiology departments’ perceptions of PCEHR. Although their perceptions were similar to the ideas in the government’s review report in general, new insights were also provided by the participants. These findings could potentially complement the government’s review