Report of the Commission of Investigation into the Banking Sector in Ireland

Misjudging Risk: Causes of the Systemic Banking Crisis in Ireland -- Report of the Commission of Investigation into the Banking Sector In Irelan

Misjudging Risk: Causes Of The Systemic Banking Crisis In Ireland

Report of the Commission of Investigation into the Banking Sector in Irelan

Data Mining Methods Applied to a Digital Forensics Task for Supervised Machine Learning

Digital forensics research includes several stages. Once we have collected the data the last goal is to obtain a model in order to predict the output with unseen data. We focus on supervised machine learning techniques. This chapter performs an experimental study on a forensics data task for multi-class classification including several types of methods such as decision trees, bayes classifiers, based on rules, artificial neural networks and based on nearest neighbors. The classifiers have been evaluated with two performance measures: accuracy and Cohen’s kappa. The followed experimental design has been a 4-fold cross validation with thirty repetitions for non-deterministic algorithms in order to obtain reliable results, averaging the results from 120 runs. A statistical analysis has been conducted in order to compare each pair of algorithms by means of t-tests using both the accuracy and Cohen’s kappa metrics

Francisella tularensis Transmission by Solid Organ Transplantation, 20171.

In July 2017, fever and sepsis developed in 3 recipients of solid organs (1 heart and 2 kidneys) from a common donor in the United States; 1 of the kidney recipients died. Tularemia was suspected only after blood cultures from the surviving kidney recipient grew Francisella species. The organ donor, a middle-aged man from the southwestern United States, had been hospitalized for acute alcohol withdrawal syndrome, pneumonia, and multiorgan failure. F. tularensis subsp. tularensis (clade A2) was cultured from archived spleen tissue from the donor and blood from both kidney recipients. Whole-genome multilocus sequence typing indicated that the isolated strains were indistinguishable. The heart recipient remained seronegative with negative blood cultures but had been receiving antimicrobial drugs for a medical device infection before transplant. Two lagomorph carcasses collected near the donor's residence were positive by PCR for F. tularensis subsp. tularensis (clade A2). This investigation documents F. tularensis transmission by solid organ transplantation

Clinical characteristics of children with 2009 pandemic influenza A (H1N1) admitted in a single institution

PurposeThis study aims to investigate the clinical characteristics of children diagnosed with the novel influenza A (H1N1) in the winter of 2009 at a single medical institution.MethodsOut of 545 confirmed cases of influenza A (H1N1) in children, using the real time RT-PCR method at Kosin University Gospel Hospital from September to December of 2009, 149 patients and their medical records were reviewed in terms of symptoms, laboratory findings, complications and transmission within a family.ResultsMedian age of subjects was 7 years (range: 2 months-18 years). New cases increased rapidly from September to reach a peak in November, then declined rapidly. Most frequently observed symptoms were fever (96.7%), cough (73.2%), rhinorrhea (36.9%) and sore throat (31.5%). Average body temperatures on the 1st, 2nd and 3rd hospital day were 38.75±0.65℃, 38.08±0.87℃ and 37.51±0.76℃, respectively. Complete blood counts and biochemical tests performed on the first admission day showed within the reference values in most cases. Of the 82 patients with simple chest radiography, 18 (22%) had pneumonic lesions; multi-focal bronchopneumonia in eleven, single or multi-segmental lobar pneumonia in five, and diffuse interstitial pneumonia in two patients. All of the 149 patients improved from their symptoms and discharged within 9 days of admission without any late complication.ConclusionChildren with 2009 pandemic influenza A (H1N1) at our single institution displayed nonspecific symptoms and laboratory findings, resembling those of common viral respiratory illnesses, and did not appear to develop more severe disease

児童虐待防止のための医療機関と地域保健機関の看護職の支援と連携

本研究では,一地方都市を対象に,医療機関と地域保健機関看護職の児童虐待防止のための支援と連携の現状や課題について面接調査を行った。地域の実情に反映した医療機関と地域保健機関の看護職の連携システムのあり方を提言することが目的である。医療機関,地域保健機関が支援した事例は,乳幼児が多く,援助開始時の重症度は,虐待予備軍および軽症が多かった。医療機関看護師は,何らかの健康障害をもち受診・入院してくる子どもとその家族に対して,症状・障害・発達の程度を理解し,成長に応じて子どもとの生活の中で効果的に関われるよう必要な知識・技術の獲得を支援し,家族を地域の育児支援へつなげていた。地域保健機関保健師は,母親の支援者となり,子どもの心身の健康を見守り,家族全体を支援者であると捉え社会資源を活用し,地域に密着した支援を提供していた。双方共に,児童虐待防止のための支援を提供していたことが明らかになった。This study investigated the supports, linking systems and responsibilities for nurses in medical and community health institutions for preventing child abuse in a municipality. Our purpose was to propose a linking system for these nurses that deal with child abuse directly. There were many babies and infants that the medical institutions and community health institutions supported, and at the time of the start of the support system, there were many cases of abuse and mild illness. The nurses in the medical institution support and understand the signs of child abuse and child development, and they acquire the knowledge and technology necessary to help a child grow normally. They also provide consultation for the family of a child who is hospitalized with a health disorder. The nurse then connects the family with a local child support agency. The nurses in the community health institutions help to support the mother and follow the mental and physical health of the child. The author once arrested a whole family and utilized social resources to support them as necessary, which helped prevent child abuse by all those involved.報告Report国立情報学研究所で電子

Update on anti-coagulation in atrial fibrillation

Atrial fibrillation (AF), the most common clinically relevant arrhythmia, affects 2.2 million individuals in the USA and 4.5 million in Europe, resulting in significant morbidity and mortality. Pharmacotherapy aimed at controlling both heart rate and rhythm is employed to relieve AF symptoms, though debate continues about which approach is preferable. AF prevalence rises with age from 0.4% to 1% in the general population to 11% in those aged >70 years. AF is associated with a pro-thrombotic state and other comorbidities; age, hypertension, heart failure and diabetes mellitus all play a key role in AF pathogenesis. Anti-coagulation is essential for stroke prevention in patients with AF and is recommended for patients with one or more risk factors for stroke. Used within the recommended therapeutic range, warfarin and other vitamin K antagonists decrease the incidence of stroke and mortality in AF patients. Warfarin remains under-used, however, because of the perceived high risk of haemorrhage, narrow therapeutic window and need for regular monitoring. Several novel anti-coagulants show promise in AF-related stroke prevention. In particular, the novel, oral, direct thrombin inhibitor, dabigatran etexilate, recently licensed by the US Food and Drug Administration (FDA) and Health Canada has shown improved efficacy and safety compared with warfarin for stroke prevention in AF, and has the potential to replace warfarin in this indication. The increasing number of new therapeutic options, including improved anti-arrhythmic agents, novel anti-coagulants and more accessible ablation techniques, are likely to deliver better care for AF patients in the near future

Using surveillance data to estimate pandemic vaccine effectiveness against laboratory confirmed influenza A(H1N1)2009 infection : two case-control studies, Spain, season 2009-2010

Background: Physicians of the Spanish Influenza Sentinel Surveillance System report and systematically swab patients attended to their practices for influenza-like illness (ILI). Within the surveillance system, some Spanish regions also participated in an observational study aiming at estimating influenza vaccine effectiveness (cycEVA study). During the season 2009-2010, we estimated pandemic influenza vaccine effectiveness using both the influenza surveillance data and the cycEVA study. Methods: We conducted two case-control studies using the test-negative design, between weeks 48/2009 and 8/2010 of the pandemic season. The surveillance-based study included all swabbed patients in the sentinel surveillance system. The cycEVA study included swabbed patients from seven Spanish regions. Cases were laboratory-confirmed pandemic influenza A(H1N1)2009. Controls were ILI patients testing negative for any type of influenza. Variables collected in both studies included demographic data, vaccination status, laboratory results, chronic conditions, and pregnancy. Additionally, cycEVA questionnaire collected data on previous influenza vaccination, smoking, functional status, hospitalisations, visits to the general practitioners, and obesity. We used logistic regression to calculate adjusted odds ratios (OR), computing pandemic influenza vaccine effectiveness as (1-OR *100. Results: We included 331 cases and 995 controls in the surveillance-based study and 85 cases and 351 controls in the cycEVA study. We detected nine (2.7%) and two (2.4%) vaccine failures in the surveillance-based and cycEVA studies, respectively. Adjusting for variables collected in surveillance database and swabbing month, pandemic influenza vaccine effectiveness was 62% (95% confidence interval (CI): -5; 87). The cycEVA vaccine effectiveness was 64% (95%CI: -225; 96) when adjusting for common variables with the surveillance system and 75% (95%CI: -293; 98) adjusting for all variables collected. Conclusion: Point estimates of the pandemic influenza vaccine effectiveness suggested a protective effect of the pandemic vaccine against laboratory-confirmed influenza A(H1N1)2009 in the season 2009-2010. Both studies were limited by the low vaccine coverage and the late start of the vaccination campaign. Routine influenza surveillance provides reliable estimates and could be used for influenza vaccine effectiveness studies in future seasons taken into account the surveillance system limitations

Survey of women's experiences of care in a new freestanding midwifery unit in an inner city area of London, England - 1: Methods and women׳s overall ratings of care

Objective: To describe and compare women’s choices and experiences of maternity care before and after the opening of the Barkantine Birth Centre, a new freestanding midwifery unit in an inner city area. Design: Telephone surveys undertaken in late pregnancy and about six weeks after birth in two separate time periods, Phase 1 before the birth centre opened and Phase 2 after it had opened. Setting: Tower Hamlets, a deprived inner city borough in east London, England, 2007-2010. Participants: 620 women who were resident in Tower Hamlets and who satisfied the Barts and the London NHS Trust’s eligibility criteria for using the birth centre. Of these, 259 women were recruited to Phase 1 and 361 to Phase 2. Measurements and findings: Women who satisfied the criteria for birth centre care and who booked antenatally for care at the birth centre were significantly more likely to rate their care as good or very good overall than corresponding women who also satisfied these criteria but booked initially at the hospital. Women who started labour care in spontaneous labour at the birth centre were significantly more likely to be cared for by a midwife they had already met, have one to one care in labour and have the same midwife with them throughout their labour. They were also significantly more likely to report that the staff were kind and understanding, that they were treated with respect and dignity and that their privacy was respected. Key conclusions and implications for practice: This survey in an inner city area showed that women who chose the freestanding midwifery unit care had positive experiences to report. Taken together with the findings of the Birthplace Programme, It adds further weight to the evidence in support of freestanding midwifery unit care for women without obstetric complications