Household decision-making about delivery in health facilities: evidence from Tanzania.

This study investigated how partners' perceptions of the healthcare system influence decisions about delivery-location in low-resource settings. A multistage population-representative sample was used in Kasulu district, Tanzania, to identify women who had given birth in the last five years and their partners. Of 826 couples in analysis, 506 (61.3%) of the women delivered in the home. In multivariate analysis, factors associated with delivery in a health facility were agreement of partners on the importance of delivering in a health facility and agreement that skills of doctors are better than those of traditional birth attendants. When partners disagreed, the opinion of the woman was more influential in determining delivery-location. Agreement of partners regarding perceptions about the healthcare system appeared to be an important driver of decisions about delivery-location. These findings suggest that both partners should be included in the decision-making process regarding delivery to raise rates of delivery at facility

Gas Purity effect on GEM Performance in He and Ne at Low Temperatures

The performance of Gas Electron Multipliers (GEMs) in gaseous He, Ne, He+H2 and Ne+H2 was studied at temperatures in the range of 3-293 K. This paper reports on previously published measurements and additional studies on the effects of the purity of the gases in which the GEM performance is evaluated. In He, at temperatures between 77 and 293 K, triple-GEM structures operate at rather high gains, exceeding 1000. There is an indication that this high gain is achieved through the Penning effect as a result of impurities in the gas. At lower temperatures the gain-voltage characteristics are significantly modified probably due to the freeze-out of these impurities. Double-GEM and single-GEM structures can operate down to 3 K at gains reaching only several tens at a gas density of about 0.5 g/l; at higher densities the maximum gain drops further. In Ne, the maximum gain also drops at cryogenic temperatures. The gain drop in Ne at low temperatures can be re-established in Penning mixtures of Ne+H2: very high gains, exceeding 104, have been obtained in these mixtures at 30-77 K, at a density of 9.2 g/l which corresponds to saturated Ne vapor density at 27 K. The addition of small amounts of H2 in He also re-establishes large GEM gains above 30 K but no gain was observed in He+H2 at 4 K and a density of 1.7 g/l (corresponding to roughly one-tenth of the saturated vapor density). These studies are, in part, being pursued in the development of two-phase He and Ne detectors for solar neutrino detection.Comment: 4 pages, 7 figure

Laterality Differences in Cerebellar-Motor Cortex Connectivity

Lateralization of function is an important organizational feature of the motor system. Each effector is predominantly controlled by the contralateral cerebral cortex and the ipsilateral cerebellum. Transcranial magnetic stimulation studies have revealed hemispheric differences in the stimulation strength required to evoke a muscle response from the primary motor cortex (M1), with the dominant hemisphere typically requiring less stimulation than the nondominant. The current study assessed whether the strength of the connection between the cerebellum and M1 (CB-M1), known to change in association with motor learning, have hemispheric differences and whether these differences have any behavioral correlate. We observed, in right-handed individuals, that the connection between the right cerebellum and left M1 is typically stronger than the contralateral network. Behaviorally, we detected no lateralized learning processes, though we did find a significant effect on the amplitude of reaching movements across hands. Furthermore, we observed that the strength of the CB-M1 connection is correlated with the amplitude variability of reaching movements, a measure of movement precision, where stronger connectivity was associated with better precision. These findings indicate that lateralization in the motor system is present beyond the primary motor cortex, and points to an association between cerebellar M1 connectivity and movement execution

Musbieħ il-Lejl

Ġabra ta’ poeżiji u proża li tinkludi: Il-Gwerra ta’ Ġużè Chetcuti – B’tifkira tas-Sur Fons M. Galea ta’ P. P. Saydon – Paċi u Gwerra ta’ Dun Karm – Ħobżna ta’ Kuljum ta’ Ġużè Galea – E. Boats ta’ Dun Karm – Il-Għarqa ta’ P. Pawl Tabone – L-Għolja ta’ Ġorġ Pisani – “Air Raid” bil-Lejl ta’ J. Delia – Missirijietna u aħna ta’ Brother Amedy – Ilħna ta’ Qniepen ta’ Ġużè Chetcuti – Għanjet in-nies b'ġieħ San Duminku ta’ Mag. – Musbieħ il-Lejl ta’ Ġużè Chetcuti.N/

Top Quark Physics at the Tevatron

We review the field of top-quark physics with an emphasis on experimental techniques. The role of the top quark in the Standard Model of particle physics is summarized and the basic phenomenology of top-quark production and decay is introduced. We discuss how contributions from physics beyond the Standard Model could affect top-quark properties or event samples. The many measurements made at the Fermilab Tevatron, which test the Standard Model predictions or probe for direct evidence of new physics using the top-quark event samples, are reviewed here.Comment: 50 pages, 17 figures, 2 tables; version accepted by Review of Modern Physic

Resultados a largo plazo del tratamiento de las fracturas de rótula mediante hemipatelectomia

Han sido revisadas retrospectivamente 48 fracturas de rótula tratadas mediante hemipatelectomía, con un seguimiento medio de 14,6 años. Para la valoración se han seguido criterios clínicos, radiológicos, subjetivos y de potencia del aparato extensor. El rango de movilidad de la extremidad intervenida es del 89%, la potencia del aparato extensor de 83% y la medición de la circunferencia del muslo del 97%, tomando como referencia la extremidad no intervenida. Encontramos un 45% de resultados excelentes, 39,58% de buenos resultados, 10,41% de resultados regulares y 4,16% de malos resultados. Existe una relación estadísticamente significativa entre el tipo de fractura, la edad de los pacientes, la existencia de patología previa en la rodilla, las lesiones asociadas a la fractura rotuliana por el traumatismo y el resultado final obtenido. A la vista de estos resultados podemos concluir que la hemipatelectomía es una técnica eficaz y segura para el tratamiento de algunos tipos de fracturas de rótula.A retrospective stydy was made of 48 patellar fractures who were threated with a hemipatellectomy. The mean time of follow-up was 14,6 years. The results were assessed with use of clinical, radiological, subjective and isokinetic quadriceps strength-testing criteria. The mean active range of motion was 89%, the strength of quadriceps was 83% and the circumference of the thigh was 97% of these measurements in the contralateral extremity. The over-all results was rated as excellent in 45,83%, dood in 39,58%, fair in 10,41% and poor in 4,16%. There was a significant statistical correlation between the type of fracture, the previous patology in the knee, the associated lesions caused by trauma and the outcome. The results of this study indicate that hemipatellectomy can be an effective and secure treatment for selected patellar fractures

Extracorporeal Shock Wave Therapy (ESWT) as a treatment for recurrent Neurogenic Heterotopic Ossification (NHO)

“This is an Accepted Manuscript of an article published by Taylor & Francis in Brain Injury on 5 Feb 2013, available online: http://www.tandfonline.com/10.3109/02699052.2012.729293." © 2013 Informa UK Ltd.Primary objective: To describe the effects of extracorporeal shock wave therapy (ESWT) on neurogenic heterotopic ossification (NHO). Research design: A single case study was considered the most appropriate methodology in this situation. Methods and procedures: The subject was a 43 year old female 10 years post-traumatic brain injury with recurring NHO around the hip joint. Baseline assessments of pain using a 10-point VAS, range of motion of the hip using a goniometer and walking ability (number of steps over a standard distance) were conducted. Four applications of ESWT using a Minispec™ Extracorporeal Shock Wave Lithotripsy machine (Medispec Int. USA) administered over 6 weeks to the anterolateral aspect of the right hip. Follow-up assessments were conducted weekly over the period of intervention and then monthly for 5 months. Main outcomes and results: Immediately following treatment, pain was reduced to 0 on the VAS scale; hip range of motion increased and the number of steps over a standard distance reduced, indicating increased step length. At 5-month follow-up, without further ESWT intervention, these results were maintained. Conclusion: This case study suggests that ESWT may be a non-invasive, low risk intervention for the management of NHO

Estudio prospectivo de profilaxis ambulatoria con sulodexida después de una artroplastia total de cadera o rodilla

La falta de continuidad en el tratamiento profiláctico ambulatorio se muestra como una de las causas determinantes en la aparición de complicaciones tromboembólicas en el primer mes tras el alta hospitalaria. La dificultad de administración por parte del paciente de las heparinas de bajo peso molecular y la diferencia de preocupación entre los médicos de Atención Primaria y los Servicios especializados por el problema tromboembólico son algunas de las causas de esta discontinuidad. Se realiza un estudio prospectivo sobre 221 pacientes intervenidos de prótesis total de cadera y rodilla con la finalidad de estudiar los resultados obtenidos con el tratamiento profiláctico mediante Sulodexida, un fármaco que une a sus propiedades antitrombóticas la comodidad de la administración vía oral. Se encontró una respuesta satisfactoria sin aparición de complicaciones tromboembólicas en el 98,8% del grupo que completó el tratamiento (n=164), frente al 21% de complicaciones que presentó el grupo que no completó el estudio.The discontinous thromboprophylaxis is a determinant cause in the presence of thromboembolic complications in the first month after hospital discharge. The difficult administration of the low -molecular- weight heparin by the patient and the different preoccupation for this problem between the Primary Care and the orthopedics specialists are the causes that incite to discontinous thromboprophylaxis. A prospective study was made of 221 patients who undergoing a total hip arthroplasty or a total knee arthroplasty and the objective was to investigate the incidence of venous thrombosis in the patients who were treated with oral sulodexide in the first month after hospital discharge. We analized the efficacy and the secondary effects of sulodexide. There were satisfactory results in 98,8% of patients who were treated with sulodexide (1,2% of venous complications), and 21% of venous complications in the group of patients who did not continue the thromboprophylactic treatment