Should health professionals screen women for domestic violence? : systematic review

Objective To assess the evidence for the acceptability and effectiveness of screening women for domestic violence in healthcare settings. Design Systematic review of published quantitative studies. Search strategy Three electronic databases (Medline, Embase, and CINAHL) were searched for articles published in the English language up to February 2001. Included studies Surveys that elicited the attitudes of women and health professionals on the screening of women in health settings; comparative studies conducted in healthcare settings that measured rates of identification of domestic violence in the presence and absence of screening; studies measuring outcomes of interventions for women identified in health settings who experience abuse from a male partner or ex­partner compared with abused women not receiving an intervention. Results 20 papers met the inclusion criteria. In four surveys, 43­85% of women respondents found screening in healthcare settings acceptable. Two surveys of health professionals' views found that two thirds of physicians and almost half of emergency department nurses were not in favour of screening. In nine studies of screening compared with no screening, most detected a greater proportion of abused women identified by healthcare professionals. Six studies of interventions used weak study designs and gave inconsistent results. Other than increased referral to outside agencies, little evidence exists for changes in important outcomes such as decreased exposure to violence. No studies measured quality of life, mental health outcomes, or potential harm to women from screening programmes. Conclusion Although domestic violence is a common problem with major health consequences for women, implementation of screening programmes in healthcare settings cannot be justified. Evidence of the benefit of specific interventions and lack of harm from screening is needed

Multi-Instantons and Exact Results II: Specific Cases, Higher-Order Effects, and Numerical Calculations

In this second part of the treatment of instantons in quantum mechanics, the focus is on specific calculations related to a number of quantum mechanical potentials with degenerate minima. We calculate the leading multi-instanton constributions to the partition function, using the formalism introduced in the first part of the treatise [J. Zinn-Justin and U. D. Jentschura, e-print quant-ph/0501136]. The following potentials are considered: (i) asymmetric potentials with degenerate minima, (ii) the periodic cosine potential, (iii) anharmonic oscillators with radial symmetry, and (iv) a specific potential which bears an analogy with the Fokker-Planck equation. The latter potential has the peculiar property that the perturbation series for the ground-state energy vanishes to all orders and is thus formally convergent (the ground-state energy, however, is nonzero and positive). For the potentials (ii), (iii), and (iv), we calculate the perturbative B-function as well as the instanton A-function to fourth order in g. We also consider the double-well potential in detail, and present some higher-order analytic as well as numerical calculations to verify explicitly the related conjectures up to the order of three instantons. Strategies analogous to those outlined here could result in new conjectures for problems where our present understanding is more limited.Comment: 55 pages, LaTeX; refs. to part I preprint update

Formes d'astéroïdes et formation de satellites : rôle de la réaccumulation gravitationnelle

International audienceAsteroid shapes and satellites: role of gravitational reaccumulation. Following current evidences, it is widely accepted that many asteroids would be "gravitational aggregates", i.e. bodies lacking internal cohesion. They could mainly be originated during the catastrophic disruption of some parent bodies, through the gravitational reaccumulation of the resulting fragments. The same events produced the dynamical families that we observe. In this work we address the problem of the origin of shapes of gravitational aggregates, that could contain signatures of their origin. We use a N-body code to simulate the collapse of a cloud of fragments, with a variety of initial velocity distributions and total angular momentum. The fragments are treated as inhelastic spheres, that rapidly accumulate to form rotating aggregates. The resulting shapes and rotational properties are compared with theoretical predictions. The results show that only a precise category of shapes (flattened spheroids) are created via this mechanism. This may provide interesting constraints on the evolution of asteroid shapes, in particular for those with one or more satellites

National research on the postgraduate student experience:Case presentation on postgraduate student diversity (Volume 2 of 3)

This is volume two of a set of three case studies that explore the postgraduate student experience. The theme of this case study is postgraduate student diversity and is based on experiences derived from student engagement breakfasts, interviews, and focus groups with 366 people across the stakeholder groups of postgraduate students, educators, and university executives from 26 institutions. The case studies constitute part of the output from the project, Engaging postgraduate students and supporting higher education to enhance the 21st century student experience

Systems intervention to promote colon cancer screening in safety net settings: Protocol for a community-based participatory randomized controlled trial

BACKGROUND: Colorectal cancer is a leading cause of cancer mortality. Screening can be effective but is underutilized. System- or multi-level interventions could be effective at increasing screening, but most have been implemented and evaluated in higher-resource settings such as health maintenance organizations. Given the disparities evident for colorectal cancer and the potential for screening to improve outcomes, there is a need to expand this work to include diverse settings, including those who treat economically disadvantaged patients. This paper describes the study protocol for a trial designed to increase colorectal cancer screening in those ‘safety-net’ health centers that serve underinsured and uninsured patients. This trial was designed and is being implemented using a community-based participatory approach. METHODS/DESIGN: We developed a practical clinical cluster-randomized controlled trial. We will recruit 16 community health centers to this trial. This systems-level intervention consists of a menu of evidence-based implementation strategies for increasing colorectal cancer screening. Health centers in the intervention arm then collaborate with the study team to tailor strategies to their own setting in order to maximize fit and acceptability. Data are collected at the organizational level through interviews, and at the provider and patient levels through surveys. Patients complete a survey about their healthcare and screening utilization at baseline, six months, and twelve months. OUTCOMES: The primary outcome is colorectal cancer screening by patient self-report, supplemented by a chart-audit in a subsample of patients. Implementation outcomes informed by the Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) conceptual framework will be measured at patient, provider, and practice levels. DISCUSSION: Our study is one of the first to integrate community participatory strategies to a randomized controlled trial in a healthcare setting. The multi-level approach will support the ability of the intervention to affect screening through multiple avenues. The participatory approach will strengthen the chance that implementation strategies will be maintained after study completion and, supports external validity by increasing health center interest and willingness to participate. TRIAL REGISTRATION: NCT0129949

Projections of Ebola outbreak size and duration with and without vaccine use in Équateur, Democratic Republic of Congo, as of May 27, 2018.

As of May 27, 2018, 6 suspected, 13 probable and 35 confirmed cases of Ebola virus disease (EVD) had been reported in Équateur Province, Democratic Republic of Congo. We used reported case counts and time series from prior outbreaks to estimate the total outbreak size and duration with and without vaccine use. We modeled Ebola virus transmission using a stochastic branching process model that included reproduction numbers from past Ebola outbreaks and a particle filtering method to generate a probabilistic projection of the outbreak size and duration conditioned on its reported trajectory to date; modeled using high (62%), low (44%), and zero (0%) estimates of vaccination coverage (after deployment). Additionally, we used the time series for 18 prior Ebola outbreaks from 1976 to 2016 to parameterize the Thiel-Sen regression model predicting the outbreak size from the number of observed cases from April 4 to May 27. We used these techniques on probable and confirmed case counts with and without inclusion of suspected cases. Probabilistic projections were scored against the actual outbreak size of 54 EVD cases, using a log-likelihood score. With the stochastic model, using high, low, and zero estimates of vaccination coverage, the median outbreak sizes for probable and confirmed cases were 82 cases (95% prediction interval [PI]: 55, 156), 104 cases (95% PI: 58, 271), and 213 cases (95% PI: 64, 1450), respectively. With the Thiel-Sen regression model, the median outbreak size was estimated to be 65.0 probable and confirmed cases (95% PI: 48.8, 119.7). Among our three mathematical models, the stochastic model with suspected cases and high vaccine coverage predicted total outbreak sizes closest to the true outcome. Relatively simple mathematical models updated in real time may inform outbreak response teams with projections of total outbreak size and duration

Low Friction Flows of Liquids at Nanopatterned Interfaces

With the recent important development of microfluidic systems, miniaturization of flow devices has become a real challenge. Microchannels, however, are characterized by a large surface to volume ratio, so that surface properties strongly affect flow resistance in submicrometric devices. We present here results showing that the concerted effect of wetting . properties and surface roughness may considerably reduce friction of the fluid past the boundaries. The slippage of the fluid at the channel boundaries is shown to be drastically increased by using surfaces that are patterned at the nanometer scale. This effect occurs in the regime where the surface pattern is partially dewetted, in the spirit of the 'superhydrophobic' effects that have been recently discovered at the macroscopic scales. Our results show for the first time that, in contrast to the common belief, surface friction may be reduced by surface roughness. They also open the possibility of a controlled realization of the 'nanobubbles' that have long been suspected to play a role in interfacial slippag

Growing apple (Malus domestica) under tropical mountain climate conditions in Northern Ethiopia

Lack of effective chilling during the dormant season is one of the major problems when apples are growing under a tropical climate. We evaluated the response of different apple cultivars (Golden Delicious, Gala, Fuji, Granny Smith and Jonagold) grown on M9 rootstock with different dormancy-management practices. The trials were carried out between 2004 and 2006 in a tropical mountain area (Tigray, Ethiopia), where chilling conditions are poor with the aim of improving and synchronizing the bud break and the blossoming period of these apple cultivars. Two-year-old well-feathered trees were planted in two experimental trial sites in it randomized complete block design. Trees were subjected to the following treatments in two sets of experiments: one defoliation per year only; two defoliations per year, one defoliation followed by 1% hydrogen cyanamide (Dormex) treatment; one defoliation followed by 2% Dormex treatment; one defoliation followed by 40% winter oil; one defoliation followed by 0.5% Dormex and 2% winter oil; and a control with no defoliation or dormancy breaking treatments. The result show positive effects of the dormancy breaking agents oil the productivity of the trees after defoliation, with comparable results for the effectiveness of both Dormex and winter oil. There were On statistically significant differences between the Dormex closes. The defoliation treatment alone Was not sufficient to break dormancy for the cultivars Golden Delicious, Granny Smith or Gala but showed promising results with dormancy breaking Jonagold. Yields increased as a result of better flowering time synchronization within a tree but even with the dormancy treatments the length of the flowering period was still spread over five weeks, where under it more temperate climate it lasted two to three weeks. The average fruit weight of Jonagold and Granny Smith can be considered as it good fruit quality while the fruit of other diploid cultivars like Golden, Gala and Fuji were rather small, which indicates chat fruit thinning by hand will be it necessity For these cultivars. Red colouration of the apples oil the cultivars Gala and Jonagold was excellent and meets the standards necessary for commercialization of these fruits. The sugar concentration of the fruits and the fruit firmness at harvest was high. The results of these first trials indicate that it is possible to develop new apple production in the mountain region of Tigray, Ethiopia