Perceptions of Growth Monitoring and Promotion Among an International Panel of District Medical Officers

The growth chart has been proposed as an educational tool to make the child's growth visible to both health workers and caregivers and to enhance communication between them. In the case of growth faltering, this would trigger timely corrective measures. Although the relevance of growth monitoring and promotion (GMP) has often been questioned in the literature, opinions of District Medical Officers responsible for local implementation of GMP are unknown. The aim of this qualitative research was to explore the perceptions and difficulties of an international panel of District Medical Officers regarding GMP. As an exploratory study, in-depth interviews of an international panel of District Medical Officers (n=19) were conducted. Data were coded using the QSR Nudist 5.0 software. A discrepancy between intended purposes and practice of GMP was detected at two levels. First, lack of participation of care-givers was reported. Second, the District Medical Officers expressed a restrictive interpretation of the concept of growth monitoring. The communication with parents was never reported as a means or a result of GMP, neither as an evaluation criterion of programme efficiency. The growth chart was mainly considered a tool intended to be used by health services for the purpose of diagnosis. This two-fold discrepancy between the intention of international policy-planners and practice of local programme implementers could be a crucial factor affecting the performance of GMP. More emphasis should be put on social communication and involvement of caregivers

Simple scoring system to predict in-hospital mortality after surgery for infective endocarditis

BACKGROUND: Aspecific scoring systems are used to predict the risk of death postsurgery in patients with infective endocarditis (IE). The purpose of the present study was both to analyze the risk factors for in-hospital death, which complicates surgery for IE, and to create a mortality risk score based on the results of this analysis. METHODS AND RESULTS: Outcomes of 361 consecutive patients (mean age, 59.1\ub115.4 years) who had undergone surgery for IE in 8 European centers of cardiac surgery were recorded prospectively, and a risk factor analysis (multivariable logistic regression) for in-hospital death was performed. The discriminatory power of a new predictive scoring system was assessed with the receiver operating characteristic curve analysis. Score validation procedures were carried out. Fifty-six (15.5%) patients died postsurgery. BMI >27 kg/m2 (odds ratio [OR], 1.79; P=0.049), estimated glomerular filtration rate 55 mm Hg (OR, 1.78; P=0.032), and critical state (OR, 2.37; P=0.017) were independent predictors of in-hospital death. A scoring system was devised to predict in-hospital death postsurgery for IE (area under the receiver operating characteristic curve, 0.780; 95% CI, 0.734-0.822). The score performed better than 5 of 6 scoring systems for in-hospital death after cardiac surgery that were considered. CONCLUSIONS: A simple scoring system based on risk factors for in-hospital death was specifically created to predict mortality risk postsurgery in patients with IE

Deep-Sea Bioluminescence Blooms after Dense Water Formation at the Ocean Surface

<p>The deep ocean is the largest and least known ecosystem on Earth. It hosts numerous pelagic organisms, most of which are able to emit light. Here we present a unique data set consisting of a 2.5-year long record of light emission by deep-sea pelagic organisms, measured from December 2007 to June 2010 at the ANTARES underwater neutrino telescope in the deep NW Mediterranean Sea, jointly with synchronous hydrological records. This is the longest continuous time-series of deep-sea bioluminescence ever recorded. Our record reveals several weeks long, seasonal bioluminescence blooms with light intensity up to two orders of magnitude higher than background values, which correlate to changes in the properties of deep waters. Such changes are triggered by the winter cooling and evaporation experienced by the upper ocean layer in the Gulf of Lion that leads to the formation and subsequent sinking of dense water through a process known as "open-sea convection". It episodically renews the deep water of the study area and conveys fresh organic matter that fuels the deep ecosystems. Luminous bacteria most likely are the main contributors to the observed deep-sea bioluminescence blooms. Our observations demonstrate a consistent and rapid connection between deep open-sea convection and bathypelagic biological activity, as expressed by bioluminescence. In a setting where dense water formation events are likely to decline under global warming scenarios enhancing ocean stratification, in situ observatories become essential as environmental sentinels for the monitoring and understanding of deep-sea ecosystem shifts.</p>

Expression of Interest for a Phase-II LHCb Upgrade: Opportunities in flavour physics, and beyond, in the HL-LHC era

https://cds.cern.ch/record/224431