1,193 research outputs found
Comparison of predictive scores of symptomatic intracerebral haemorrhage after stroke thrombolysis in a single centre
Peer reviewedPublisher PD
Altered Patterns of Fungal Keratitis at a London Ophthalmic Referral Hospital: An Eight-Year Retrospective Observational Study
PURPOSE: In previous studies of fungal keratitis (FK)
from temperate countries, yeasts were the predominant
isolates, with ocular surface disease (OSD) being the
leading risk factor. Since the 2005–2006 outbreak of
contact lens (CL)-associated Fusarium keratitis, there
may have been a rise in CL-associated filamentary FK in
the United Kingdom. This retrospective case series investigated the patterns of FK from 2007 to 2014.
We compared these to 1994–2006 data from the same
hospital.
DESIGN: Retrospective observational study.
METHODS: All cases of FK presenting to Moorfields
Eye Hospital between 2007 and 2014 were identified.
The definition of FK was either a fungal organism isolated
by culture or fungal structures identified by light microscopy
(LM) of scrape material, histopathology, or
in vivo corneal confocal microscopy (IVCM). Main
outcome measure was cases of FK per year.
RESULTS: A total of 112 patients had confirmed FK.
Median age was 47.2 years. Between 2007 and 2014,
there was an increase in annual numbers of FK (Poisson
regression, P [ .0001). FK was confirmed using various
modalities: 79 (70.5%) by positive culture, 16 (14.3%)
by LM, and 61 (54.5%) by IVCM. Seventy-eight patients
(69.6%) were diagnosed with filamentary fungus alone,
28 (25%) with yeast alone, and 6 (5.4%) with mixed filamentary
and yeast infections. This represents an increase
in the proportion of filamentary fungal infections from
the pre-2007 data. Filamentary fungal and yeast infections
were associated with CL use and OSD, respectively.
CONCLUSIONS: The number of FK cases has increased.
This increase is due to CL-associated filamentary FK.
Clinicians should be aware of these changes, which
warrant epidemiologic investigations to identify modifiable
risk factors
Family Caregivers Who Would Be Unwilling to Provide Care at the End of Life Again: Findings from the Health Survey for England Population Survey
BACKGROUND: Family caregivers provide significant care at the end of life. We aimed to describe caregiver characteristics, and of those unwilling to repeat this role under the same circumstances.METHODS: Observational study of adults in private households (Health Survey for England [HSE]). Caregiving questions included: whether someone close to them died within past 5 years; relationship to the deceased; provision, intensity and duration of care; supportive/palliative care services used; willingness to care again; able to carry on with life. Comparison between those willing to care again or not used univariable analyses and an exploratory multiple logistic regression. A descriptive comparison with Health Omnibus Survey (Australia) data was conducted.FINDINGS: HSE response was 64%. 2167/8861 (25%) respondents had someone close to them die in the previous 5 years. Some level of personal care was provided by 645/8861 (7.3%). 57/632 (9%) former caregivers would be unwilling to provide care again irrespective of time since the death, duration of care, education and income. Younger age (≤65; odds ratio [OR] 2.79; 95% CI 136, 5.74) and use of palliative care services (odds ratio: 1.95, 95% CI: 1.09, 3.48) showed greater willingness to provide care again. Apart from use of palliative care services, findings were remarkably similar to the Australian data.CONCLUSIONS: A significant group of caregivers would be unwilling to provide care again. Older people and those who had not used palliative care services were more likely to be unwilling to care again. Barriers preventing access for disadvantaged groups need to be overcome
Egg shape changes at the theropod–bird transition, and a morphometric study of amniote eggs
The eggs of amniotes exhibit a remarkable variety of shapes,
from spherical to elongate and from symmetrical to asymmetrical.
We examine eggshell geometry in a diverse sample of fossil
and living amniotes using geometric morphometrics and linear
measurements. Our goal is to quantify patterns of morphospace
occupation and shape variation in the eggs of recent through to
Mesozoic birds (neornithe plus non-neornithe avialans), as well
as in eggs attributed to non-avialan theropods. In most amniotes,
eggs show significant deviation from sphericity, but departure
from symmetry around the equatorial axis is mostly confined
to theropods and birds. Mesozoic bird eggs differ significantly
from extant bird eggs, but extinct Cenozoic bird eggs do not. This
suggests that the range of egg shapes in extant birds had already
been attained in the Cenozoic. We conclude with a discussion
of possible biological factors imparting variation to egg shapes
during their formation in the oviduct
Cross sectional, qualitative thematic analysis of patient perspectives of disease impact in juvenile idiopathic arthritis-associated uveitis
BACKGROUND: Chronic health conditions in children can have a significant impact on their quality of life. The aim of this study was to explore the subjective experience of children and young people being treated for chronic, non-infectious uveitis associated with a systemic disease such as juvenile idiopathic arthritis. METHODS: A semi-structured interview was conducted with 10 children and young people aged between 6 and 18 years of age and their parents. RESULTS: Preliminary thematic analysis indicated that both the treatment and complications of the disorder have a significant impact on the quality of life and emotional well-being of patients, not only in terms of the discomfort experienced but also in perceptions of social isolation, anxiety and sense of injustice. CONCLUSION: This study shows that themes including "impact on school", "social factors" and "emotional reactions" are important domains influencing health-related quality of life (HRQoL) in children with chronic uveitis. Inclusion of questions relating to these domains should be considered in future uveitis-specific tools examining HRQoL in these patients
Epidemiology and reporting characteristics of preclinical systematic reviews
In an effort to better utilize published evidence obtained from animal experiments, systematic reviews of preclinical studies are increasingly more common-along with the methods and tools to appraise them (e.g., SYstematic Review Center for Laboratory animal Experimentation [SYRCLE's] risk of bias tool). We performed a cross-sectional study of a sample of recent preclinical systematic reviews (2015-2018) and examined a range of epidemiological characteristics and used a 46-item checklist to assess reporting details. We identified 442 reviews published across 43 countries in 23 different disease domains that used 26 animal species. Reporting of key details to ensure transparency and reproducibility was inconsistent across reviews and within article sections. Items were most completely reported in the title, introduction, and results sections of the reviews, while least reported in the methods and discussion sections. Less than half of reviews reported that a risk of bias assessment for internal and external validity was undertaken, and none reported methods for evaluating construct validity. Our results demonstrate that a considerable number of preclinical systematic reviews investigating diverse topics have been conducted; however, their quality of reporting is inconsistent. Our study provides the justification and evidence to inform the development of guidelines for conducting and reporting preclinical systematic reviews
Lack of trust in maternal support is associated with negative interpretations of ambiguous maternal behavior
Attachment theory assumes that children who lack trust in maternal availability for support are more inclined to interpret maternal behavior in congruence with their expectation that mother will remain unavailable for support. To provide the first test of this assumption, early adolescents (9-13 years old) were asked to assess whether ambiguous interactions with mother should be interpreted in a positive or a negative way. In our sample (n = 322), results showed that early adolescents' lack of trust in their mother's availability for support was related to more negative interpretations of maternal behavior. The associations remained significant after controlling for depressive mood. The importance of these findings for our understanding of attachment theory, attachment stability, and clinical practice are discussed
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