Factors influencing adolescent girls' decision in initiation for human papillomavirus vaccination: A cross-sectional study in Hong Kong

Background: Cervical cancer is one of the common cancers among women worldwide. Despite HPV vaccination being one of the effective preventive measures, it is not included in government vaccination programme in Hong Kong. This study aimed to assess the knowledge of and attitude towards cervical cancer prevention among Chinese adolescent girls in Hong Kong, and to identify factors influencing the initiation of HPV vaccination. Methods: This was a cross-sectional study conducted in Hong Kong during the period of October 2010 to November 2010. A self-administered questionnaire was used, with 1,416 girls from 8 secondary schools completing the questionnaire. Knowledge scores were composited and initiation of HPV vaccination was staged based on stage of change. Analyses were conducted to identify the association of initiation of HPV vaccination with participant's personal and family factors as well as their knowledge and attitude towards cervical cancer prevention. Results: The uptake rate of HPV vaccination was low (7%) with 58% respondents in pre-contemplation and contemplation stage. The survey identified a significant gap in knowledge on cervical cancer prevention. The main channels of information were from media and very few from schools or parents. However, 70% expressed their wishes to have more information on cancer prevention, and 78% stated that they were willing to change their lifestyles if they knew the ways of prevention. Multivariate analysis identified three independent significant factors for initiation of vaccination (action and intention): perceived cancer as terrifying disease, school should provide more information on cancer prevention, and comments from relatives and friends having received the vaccine. The cost of vaccination and socio-economic background were not found to be significant. Conclusions: Public education on cervical cancer needs to be well penetrated into the community for more sharing among friends and relatives. School as setting to provide source of information would facilitate uptake rate of HPV vaccine as students have expressed their wishes that school should provide more information on prevention of cancer. School and community education on cancer prevention would help adolescents to have better understanding of the seriousness of cancer. © 2014 Lee et al.; licensee BioMed Central Ltd.link_to_subscribed_fulltex

Use of indigenous knowledge in the management of field and storage pests around Lake Victoria basin in Tanzania

Agriculture in Lake Victoria basin (LVB) in Tanzania is predominantly subsistence and is characterised by perennial food deficits, cyclic famines and poverty prompted largely by unreliable rainfall patterns, declining soil fertility and food grains pests and diseases. The pest problem is more pronounced as farmers are yet to fully integrate synthetic pesticides into their insect pest management systems due to subsistence nature of production and high poverty levels that make them rely on indigenous knowledge (IK) systems to meet their needs. The survey was conducted to document farmers’ IK on management of key field and storage insect pests in Magu and Misungwi districts in the LVB, Tanzania. Major crops grown were maize, rice, sorghum, finger millet, bean, groundnut, cowpea, green gram, brassicas, chicken pea, cassava, sweet potato, cotton and vegetables. Crops were mainly infested by Busseola fusca (Lepidoptera: Noctuidae), Spodoptera spp (Lepidoptera: Noctuidae), Agrotis spp (Lepidoptera: Noctuidae), Maruca vitrata (Lepidoptera: Crambidae), Rhopalosiphum maidis (Homoptera: Aphididae), Aphis fabae (Hemiptera: Aphididae), and grasshoppers in field and Stophilus spp (Coleoptera: Curculionidae), Prostephanus truncates (Coleoptera: Bostrichidae), Tribolium spp (Coleoptera: Tenebrionidae), Bruchus rufimanus (Coleoptera; Bruchidae), Rhyzopertha dominica (Coleoptera: Bostrichidae) and rodents on storage. IK based control methods used by farmers ranged from animal by-products (cow’s urine and dung), plant parts (Azadirachta indica (Meliaceae),Tephrosia vogelii (Fabaceae), Tamarindus indica (Fabaceae), Aloe spp (Asphodelaceae), red pepper, Capsicum spp (Solanaceae), Nicotiana tabasum (Solanaceae) to ash (general and specific) in the field. They also used neem, Chenopodium opulifolium (Chenopodiaceae), Ocimum suave (Labiatae), Senna siamea (Fabaceae or Caesalpinioideae), tobacco and Eucalyptus spp (Myrtaceae) and plant by-products (rice husks, ash from rice husks and red maize cobs and general ash) to control storage pests. Most of these products were used together with one or two others in different formulation mixtures. However, the formulations had variable amount taken during preparation, crop/ crop product treated, preparation times, modes and rates of application. Research is needed to unveil the amount for mixing, appropriate treatment, and application rate to ensure optimum concentration for specific pest. To ensure quality and safety, biosafety and quality studies are required for quality assessment of resulting product for human health. For understanding of active compounds in the formulations, chemical composition analysis of properly prepared solutions is required. Key words: Field and storage pests, indigenous knowledge, Tanzania, botanical formulation, Lake Victoria basin

Intracardiac anatomical relationships and potential for streaming in double inlet left ventricles.

The aim of this study was to gain better understanding of the variable anatomical features of double inlet left ventricle hearts without cavopulmonary connection that would potentially facilitate favorable streaming. Thirty-nine post-mortem specimens of double inlet left ventricle without cavopulmonary connection were investigated. The focus was on anatomical characteristics that could influence the flow and separation of deoxygenated and oxygenated blood in the ventricles. Elements of interest were the ventriculoarterial connection, the spatial relationship of the ventricles, the position and size of the great arteries, the ventricular septal defect, the presence of relative outflow tract stenosis and the relationship of the inflow and outflow tracts. The most common anatomy was a discordant ventriculoarterial connection with an anatomically left-sided morphologically right ventricle (n = 12, 31%). When looking at the pulmonary trunk/aorta ratio, 21 (72%) hearts showed no pulmonary stenosis relative to the aorta. The ventricular septal defect created a relative subpulmonary or subaortic stenosis in 13 (41%) cases. Sixteen (41%) hearts had a parallel relationship of the inflow and outflow tracts, facilitating separation of deoxygenated and oxygenated blood streams. On the other end of the spectrum were 10 (25%) hearts with a perpendicular relationship, which might lead to maximum mixing of the blood streams. The relationship of the inflow and outflow tracts as well as the presence of (sub-) pulmonary stenosis might play a crucial role in the distribution of blood in double inlet left ventricle hearts. Additional in vivo studies will be necessary to confirm this postulation

Comparative fitness analysis of D-cycloserine resistant mutants reveals both fitness-neutral and high-fitness cost genotypes

Drug resistant infections represent one of the most challenging medical problems of our time. D-cycloserine is an antibiotic used for six decades without significant appearance and dissemination of antibiotic resistant strains, making it an ideal model compound to understand what drives resistance evasion. We therefore investigated why Mycobacterium tuberculosis fails to become resistant to D-cycloserine. To address this question, we employed a combination of bacterial genetics, genomics, biochemistry and fitness analysis in vitro, in macrophages and in mice. Altogether, our results suggest that the ultra-low rate of emergence of D-cycloserine resistance mutations is the dominant biological factor delaying the appearance of clinical resistance to this antibiotic. Furthermore, we also identified potential compensatory mechanisms able to minimize the severe fitness costs of primary D-cycloserine resistance conferring mutations

The Role of Bile in the Regulation of Exocrine Pancreatic Secretion

As early as 1926 Mellanby (1) was able to show that introduction of bile into the duodenum of anesthetized cats produces a copious flow of pancreatic juice. In conscious dogs, Ivy & Lueth (2) reported, bile is only a weak stimulant of pancreatic secretion. Diversion of bile from the duodenum, however, did not influence pancreatic volume secretion stimulated by a meal (3,4). Moreover, Thomas & Crider (5) observed that bile not only failed to stimulate the secretion of pancreatic juice but also abolished the pancreatic response to intraduodenally administered peptone or soap

High density optical neuroimaging predicts surgeons's subjective experience and skill levels

Measuring cognitive load is important for surgical education and patient safety. Traditional approaches of measuring cognitive load of surgeons utilise behavioural metrics to measure performance and surveys and questionnaires to collect reports of subjective experience. These have disadvantages such as sporadic data, occasionally intrusive methodologies, subjective or misleading self-reporting. In addition, traditional approaches use subjective metrics that cannot distinguish between skill levels. Functional neuroimaging data was collected using a high density, wireless NIRS device from sixteen surgeons (11 attending surgeons and 5 surgery resident) and 17 students while they performed two laparoscopic tasks (Peg transfer and String pass). Participant’s subjective mental load was assessed using the NASA-TLX survey. Machine learning approaches were used for predicting the subjective experience and skill levels. The Prefrontal cortex (PFC) activations were greater in students who reported higher-than-median task load, as measured by the NASA-TLX survey. However in the case of attending surgeons the opposite tendency was observed, namely higher activations in the lower v higher task loaded subjects. We found that response was greater in the left PFC of students particularly near the dorso- and ventrolateral areas. We quantified the ability of PFC activation to predict the differences in skill and task load using machine learning while focussing on the effects of NIRS channel separation distance on the results. Our results showed that the classification of skill level and subjective task load could be predicted based on PFC activation with an accuracy of nearly 90%. Our finding shows that there is sufficient information available in the optical signals to make accurate predictions about the surgeons’ subjective experiences and skill levels. The high accuracy of results is encouraging and suggest the integration of the strategy developed in this study as a promising approach to design automated, more accurate and objective evaluation methods

Spatio-temporal simulation of future urban growth trends using an integrated CA-Markov model

Urban growth, a dynamic and demographic phenomenon, refers to the increased spatial value of urban areas, such as cities and towns, due to social and economic forces. Nowadays, urban lands are rapidly increasing, replacing non-urban lands such as agricultural, forest, water, rural, and open lands. In this study, a CA-Markov model was utilized to predict the growth of urban lands and their spatial trends in Seremban, Malaysia. The performance of the CA-Markov model was also assessed. The Markov chain model was applied to produce the quantitative values of transition probabilities for urban and non-urban lands. Subsequently, the CA model was used to predict the dynamic spatial trends of land changes. The change in urban and non-urban land use from 1984 to 2010 was modeled using the CA-Markov model for calibration purposes and to compute optimal CA transition rules, as well as to predict future urban growth. For accuracy assessment, the CA-Markov model was validated using a kappa coefficient. An 83% overall accuracy was observed for the kappa index statistics, which indicates the excellent performance of the proposed model. Finally, based on the CA transition rules and the transition area matrix produced from the Markov chain model-based calibration process, the future urban growth in Seremban for 2020 and 2030 was simulated

The clinical effectiveness of transurethral incision of the prostate : a systematic review of randomised controlled trials

The original publication is available at www.springerlink.com.Peer reviewedPostprin

Acupuncture reduces crying in infants with infantile colic: a randomised, controlled, blind clinical study

OBJECTIVE: To investigate whether acupuncture reduces the duration and intensity of crying in infants with colic. Patients and methods 90 otherwise healthy infants, 2-8 weeks old, with infantile colic were randomised in this controlled blind study. 81 completed a structured programme consisting of six visits during 3 weeks to an acupuncture clinic in Sweden. Parents blinded to the allocation of their children met a blinded nurse. The infant was subsequently given to another nurse in a separate room, who handled all infants similarly except that infants allocated to receive acupuncture were given minimal, standardised acupuncture for 2 s in LI4. RESULTS: There was a difference (p=0.034) favouring the acupuncture group in the time which passed from inclusion until the infant no longer met the criteria for colic. The duration of fussing was lower in the acupuncture group the first (74 vs 129 min; p=0.029) and second week (71 vs 102 min; p=0.047) as well as the duration of colicky crying in the second intervention week (9 vs 13 min; p=0.046) was lower in the acupuncture group. The total duration of fussing, crying and colicky crying (TC) was lower in the acupuncture group during the first (193 vs 225 min; p=0.025) and the second intervention week (164 vs 188 min; p=0.016). The relative difference from baseline throughout the intervention weeks showed differences between groups for fussing in the first week (22 vs 6 min; p=0.028), for colicky crying in the second week (92 vs 73 min; p=0.041) and for TC in the second week (44 vs 29 min; p=0.024), demonstrating favour towards the acupuncture group. CONCLUSIONS: Minimal acupuncture shortened the duration and reduced the intensity of crying in infants with colic. Further research using different acupuncture points, needle techniques and intervals between treatments is required

Influence of topography on tide propagation and amplification in semi-enclosed basins

An idealized model for tide propagation and amplification in semi-enclosed rectangular basins is presented, accounting for depth differences by a combination of longitudinal and lateral topographic steps. The basin geometry is formed by several adjacent compartments of identical width, each having either a uniform depth or two depths separated by a transverse topographic step. The problem is forced by an incoming Kelvin wave at the open end, while allowing waves to radiate outward. The solution in each compartment is written as the superposition of (semi)-analytical wave solutions in an infinite channel, individually satisfying the depth-averaged linear shallow water equations on the f plane, including bottom friction. A collocation technique is employed to satisfy continuity of elevation and flux across the longitudinal topographic steps between the compartments. The model results show that the tidal wave in shallow parts displays slower propagation, enhanced dissipation and amplified amplitudes. This reveals a resonance mechanism, occurring when\ud the length of the shallow end is roughly an odd multiple of the quarter Kelvin wavelength. Alternatively, for sufficiently wide basins, also Poincaré waves may become resonant. A transverse step implies different wavelengths of the incoming and reflected Kelvin wave, leading to increased amplitudes in shallow regions and a shift of amphidromic points in the direction of the deeper part. Including the shallow parts near the basin’s closed end (thus capturing the Kelvin resonance mechanism) is essential to reproduce semi-diurnal and diurnal\ud tide observations in the Gulf of California, the Adriatic Sea and the Persian Gulf