Effect of a new antenatal care programme on the attitudes of pregnant women and midwives towards antenatal care in Harare

A clinical study on the importance of women participation and co-operation,them being a key stakeholder of any Antenatal Care (ANC) programme that may be introduced in Zimbabwe's health delivery system.Health providers have 'only recently been paying attention to the attitudes of women towards antenatal care programmes. Previously, the benefits of antenatal care (ANC) were considered so self evident that the consumers could not question how the services were delivered. However, the success of any ANC programme depends to a greater or lesser degree on the co-operation of the women. One of the aims of increased satisfaction with ANC is to achieve better compliance with the advice given, which may lead to improved pregnancy outcome. Satisfaction with the services, rather than the mere improvement of pregnancy outcome is also: now considered a goal in its own right

Multimodal Chemical Imaging of Amyloid Plaque Polymorphism Reveals A beta Aggregation Dependent Anionic Lipid Accumulations and Metabolism

Amyloid plaque formation constitutes one of the main pathological hallmarks of Alzheimer’s disease (AD) and is suggested to be a critical factor driving disease pathogenesis. Interestingly, in patients that display amyloid pathology but remain cognitively normal, Aβ deposits are predominantly of diffuse morphology suggesting that cored plaque formation is primarily associated with cognitive deterioration and AD pathogenesis. Little is known about the molecular mechanism responsible for conversion of monomeric Aβ into neurotoxic aggregates and the predominantly cored deposits observed in AD. The structural diversity among Aβ plaques, including cored/compact- and diffuse, may be linked to their distinct Aβ profile and other chemical species including neuronal lipids. We developed a novel, chemical imaging paradigm combining matrix assisted laser desorption/ionization imaging mass spectrometry (MALDI IMS) and fluorescent amyloid staining. This multimodal imaging approach was used to probe the lipid chemistry associated with structural plaque heterogeneity in transgenic AD mice (tgAPPSwe) and was correlated to Aβ profiles determined by subsequent laser microdissection and immunoprecipitation-mass spectrometry. Multivariate image analysis revealed an inverse localization of ceramides and their matching metabolites to diffuse and cored structures within single plaques, respectively. Moreover, phosphatidylinositols implicated in AD pathogenesis, were found to localize to the diffuse Aβ structures and correlate with Aβ1–42. Further, lysophospholipids implicated in neuroinflammation were increased in all Aβ deposits. The results support previous clinical findings on the importance of lipid disturbances in AD pathophysiology and associated sphingolipid processing. These data highlight the potential of multimodal imaging as a powerful technology to probe neuropathological mechanisms

Randomised controlled trial of mammographic screening in women from age 40: results of screening in the first 10 years

Debate continues over the effectiveness of screening by mammography in women below age 50. We report here on results of screening in the first 10 years of a randomised trial to study the effect on breast cancer mortality of invitation to annual mammography from age 40 to 41 compared to first invitation to the 3-yearly UK national programme at age 50–52. The trial is taking place in 23 NHS breast screening centres. Between 1991 and 1997, 160 921 women were randomised in the ratio 1 : 2 to intervention and control arms. Screening is by two views at first screen and single view subsequently; data on screening up to and including round five are now complete. Uptake of invitation to screening is between 68 and 70% at all but the latest screening rounds. Rates of referral for assessment are 4.6% at first screen and 3.4% at subsequent screens. Invasive cancer detection rates are 0.09% at first screen, and similar at rescreens until the sixth and later screens. There is little evidence of regular mammography in the trial control arm. The setting of this trial within the NHS breast screening programme should ensure applicability of results to a national programme

Low-lying level structure of 56^{56}Cu and its implications on the rp process

The low-lying energy levels of proton-rich $^{56}$Cu have been extracted using in-beam $\gamma$-ray spectroscopy with the state-of-the-art $\gamma$-ray tracking array GRETINA in conjunction with the S800 spectrograph at the National Superconducting Cyclotron Laboratory at Michigan State University. Excited states in $^{56}$Cu serve as resonances in the $^{55}$Ni(p,$\gamma$)$^{56}$Cu reaction, which is a part of the rp-process in type I x-ray bursts. To resolve existing ambiguities in the reaction Q-value, a more localized IMME mass fit is used resulting in $Q=639\pm82$~keV. We derive the first experimentally-constrained thermonuclear reaction rate for $^{55}$Ni(p,$\gamma$)$^{56}$Cu. We find that, with this new rate, the rp-process may bypass the $^{56}$Ni waiting point via the $^{55}$Ni(p,$\gamma$) reaction for typical x-ray burst conditions with a branching of up to $\sim$40$\%$. We also identify additional nuclear physics uncertainties that need to be addressed before drawing final conclusions about the rp-process reaction flow in the $^{56}$Ni region.Comment: 8 pages, accepted for Phys. Rev.

Prognosis of screen-detected breast cancers: results of a population based study

BACKGROUND: The reduced mortality rate from breast carcinoma among women offered screening mammography is demonstrated after 15–20 years of follow-up. However, the assessment of 5-year overall and event-free survival could represent an earlier measure of the efficacy of mammography screening program (MSP). METHODS: All cases of breast cancer diagnosed in the Province of Modena between years 1996 and 2000 in women aged 50 to 69 years, were identified through the Modena Cancer Registry (MCR). Stage of disease and treatment information were obtained from clinical records. All the events occurring up to June 30, 2003 were retrieved by experienced monitors. Five-year overall and event-free survival were the principal end-points of the study. RESULTS: During a 5-year period, 587 primary breast cancers were detected by the MSP and 471 primary breast cancers were diagnosed out of the MSP. The screen-detected breast cancers were smaller, more likely node negative, with low histological grade, low proliferative activity and positive receptors status. Furthermore, the breast cancer diagnosed through the MSP more frequently received a conservative surgery. The 5-year survival rate was 94% in the screen-detected group, versus 84% in the other group (p = 0.0001). The rate of 5-year event-free survival was 89% and 75% for the MSP participants and not participants, respectively (p = 0.0001). CONCLUSIONS: Our data confirm a favourable outcome of screen-detected breast cancers in terms of five-year overall and event-free survival, which reflect the good quality assurance parameters of the MSP. Finally, a cancer registry should be implemented in every area covered by screening programs

First-principle based multi-channel integrated modelling in support to the design of the Divertor Tokamak Test facility

An intensive integrated modelling work of main scenarios of the new tokamak DTT (Divertor Tokamak Test facility) with the Single Null divertor configuration has been performed using first-principle quasi-linear transport models, in support to the design of the device and to the definition of its scientific work-programme. First results of this integrated modelling work on DTT (R0= 2.14 m, a= 0.65 m) are presented here along with outcome of the gyrokinetic simulations used to validate the reduced models in the DTT range of parameters. As a result of this work, the heating mix was defined, the size of device was increased to R0= 2.19 m and a= 0.70 m, the use of pellets for fuelling has been advised and reference profiles for diagnostic design, estimates of neutron yields and fast particle losses have become available.</p

Overcoming Public Resistance to Carbon Taxes

Carbon taxes represent a cost-effective way to steer the economy toward a greener future. In the real world, their application has however been limited. In this paper, we address one of the main obstacles to carbon taxes: public opposition. We identify drivers of and barriers to public support, and, under the form of stylized facts, provide general lessons on the acceptability of carbon taxes. We derive our lessons from a growing literature, as well as from a combination of policy “failures” and “successes.” Based on our stylized facts, we formulate a set of suggestions concerning the design of carbon taxes. We consider the use of trial periods, tax escalators, environmental earmarking, lump-sum transfers, tax rebates, and advanced communication strategies, among others. This paper contributes to the policy debate about carbon taxes, hopefully leading to more success stories and fewer policy failures

Prediction of higher mortality reduction for the UK Breast Screening Frequency Trial: A model-based approach on screening intervals

Background: The optimal interval between two consecutive mammograms is uncertain. The UK Frequency Trial did not show a significant difference in breast cancer mortality between screening every year (study group) and screening every 3 years (control group). In this study, the trial is simulated in order to gain insight into the results of the trial and to predict the effect of different screening intervals on breast cancer mortality. Methods: UK incidence, life tables and information from the trial were used in the microsimulation model MISCAN-Fadia to simulate the trial and predict the number of breast ca