THE PSYCHOLOGY OF SCARS: A MINI-REVIEW

Scars can result from a range of causes: accidents, surgery, and even acne. The resultant change in appearance can negatively affect body image and self-confidence. Scarring is stigmatised in society because of the premium placed on beauty - disfigurement or unsightly features are still used to portray evil in horror films, comic strips, and fairy tales. Patients describe scars as living with the trauma and sufferers can feel devalued by society. Scars are inflexible and cause functional impairment which may prompt a change in career and have financial repercussions. Those with scars undergo a remodelling of their emotional state and are more prone to the development of depression and anxiety; feelings of shame and aggression can follow. This creates strain in social interactions, resulting in stunted communication, reduced intimacy, and avoidant behaviours. There is limited treatment available to address the psychological burden in this subset of patients. Additionally, doctors often lack training in recognition and management of psychosocial issues. Steps must be taken to relieve the physical, emotional, and psychological marks caused by scars

THE PSYCHOLOGY OF SCARS: A MINI-REVIEW

Scars can result from a range of causes: accidents, surgery, and even acne. The resultant change in appearance can negatively affect body image and self-confidence. Scarring is stigmatised in society because of the premium placed on beauty - disfigurement or unsightly features are still used to portray evil in horror films, comic strips, and fairy tales. Patients describe scars as living with the trauma and sufferers can feel devalued by society. Scars are inflexible and cause functional impairment which may prompt a change in career and have financial repercussions. Those with scars undergo a remodelling of their emotional state and are more prone to the development of depression and anxiety; feelings of shame and aggression can follow. This creates strain in social interactions, resulting in stunted communication, reduced intimacy, and avoidant behaviours. There is limited treatment available to address the psychological burden in this subset of patients. Additionally, doctors often lack training in recognition and management of psychosocial issues. Steps must be taken to relieve the physical, emotional, and psychological marks caused by scars

Cost-Effectiveness of Universal Prophylaxis in Pregnancy with Prior Group B Streptococci Colonization

Objective. To estimate the costs and outcomes of rescreening for group B streptococci (GBS) compared to universal treatment of term women with history of GBS colonization in a previous pregnancy. Study Design. A decision analysis model was used to compare costs and outcomes. Total cost included the costs of screening, intrapartum antibiotic prophylaxis (IAP), treatment for maternal anaphylaxis and death, evaluation of well infants whose mothers received IAP, and total costs for treatment of term neonatal early onset GBS sepsis. Results. When compared to screening and treating, universal treatment results in more women treated per GBS case prevented (155 versus 67) and prevents more cases of early onset GBS (1732 versus 1700) and neonatal deaths (52 versus 51) at a lower cost per case prevented ($8 805 versus$12 710). Conclusion. Universal treatment of term pregnancies with a history of previous GBS colonization is more cost-effective than the strategy of screening and treating based on positive culture results

Array Comparative Genomic Hybridisation (aCGH): An Analysis of the Current Technology and Its Future in Prenatal Diagnosis

Array comparative genomic hybridisation (aCGH) represents a major advance in the field of cytogenetics and offers tremendous promise in prenatal diagnosis for the detection of genetic alterations leading to serious genetic conditions. This technology, also sometimes known as molecular karyotyping, can detect differences in DNA copy number at hundreds or thousands of points in the genome simultaneously. At this stage of the development of aCGH technology, a number of recommendations can be made for clinical use. These recommendations should be revisited as information about its clinical validity and utility is obtained, and as the accuracy, resolution and cost of aCGH-based tests evolve

Environmental monitoring at St George’s Bay (Malta) in connection with beach replenishment works

This study was financed by the Malta Tourism Authority (MTA) through contract dated 14th April 2004 and tender MTA/104/2004 dated 26th November 2004, both awarded to Ecoserv.Adverse impacts of coastal beach replenishment projects on the marine environment are well documented. As a result, coastal managers have been seeking ways and techniques with which to implement beach replenishment projects without causing adverse changes to marine ecosystems. In May 2004, the Malta Tourism Authority undertook beach replenishment at St George’s Bay (St Julians, Malta) in which coarse sediment of terrestrial origin, having a mean grain size of 2 mm, was deposited at the head of the bay to create an artificial beach. An extensive 2-year (January 2004 to December 2005) environmental monitoring programme was commissioned by the MTA to monitor the potential impacts of the replenishment works on the marine environment. The programme included surveys of physico-chemical attributes (beach and seabed profile surveys, granulometric analysis and microscopic examination of sublittoral sediments, and water quality studies), and use of seagrass as a bioindicator of environmental quality. For most of the attributes surveyed, data was collected from stations located within the putatively ‘impacted’ inlet, and from control stations before initiation of the works and following the beach replenishment works. Data for mean sediment grain size, water quality attributes (salinity, dissolved oxygen, total suspended solids and nutrients) and seagrass morphometric parameters (shoot density, length and biomass of adult leaves, and shoot epiphyte biomass) were analysed using analysis of variance (ANOVA). Overall, the results of the various monitoring components indicated that (i) no major transport of sediment from the beach to the sublittoral had occurred, and (ii) the beach replenishment works did not result in any adverse impacts on the marine environment. Good project planning and management, the relatively sheltered location of the replenished beach, together with appropriate choice of grain size of the sand used for replenishment appear to have contributed to the success of the project.peer-reviewe

Profile: Agincourt health and socio-demographic surveillance system.

The Agincourt health and socio-demographic surveillance system (HDSS), located in rural northeast South Africa close to the Mozambique border, was established in 1992 to support district health systems development led by the post-apartheid ministry of health. The HDSS (90 000 people), based on an annual update of resident status and vital events, now supports multiple investigations into the causes and consequences of complex health, population and social transitions. Observational work includes cohorts focusing on different stages along the life course, evaluation of national policy at population, household and individual levels and examination of household responses to shocks and stresses and the resulting pathways influencing health and well-being. Trials target children and adolescents, including promoting psycho-social well-being, preventing HIV transmission and reducing metabolic disease risk. Efforts to enhance the research platform include using automated measurement techniques to estimate cause of death by verbal autopsy, full 'reconciliation' of in- and out-migrations, follow-up of migrants departing the study area, recording of extra-household social connections and linkage of individual HDSS records with those from sub-district clinics. Fostering effective collaborations (including INDEPTH multi-centre work in adult health and ageing and migration and urbanization), ensuring cross-site compatibility of common variables and optimizing public access to HDSS data are priorities

Mode of Delivery in Women with Antepartum Fetal Death and Prior Cesarean Delivery

We describe obstetric outcomes in a group of patients with prior cesarean delivery (CD) presenting with an intrauterine fetal demise (IUFD). A secondary analysis of an observational study of women with prior CD was performed. All antepartum singleton pregnancies with a prior CD and IUFD ≥ 20 weeks’ gestation or 500 grams were evaluated. Two hundred nine patients met inclusion criteria for analysis. The mean gestational age ± standard deviation at delivery was 31.3 ± 6.5 weeks. The trial of labor rate was 75.6% (158/209), and the vaginal birth after cesarean (VBAC) success rate was 86.7%. Labor induction or augmentation occurred in 83.3% of attempted VBAC. Uterine rupture occurred in five women (2.4%), and in 3.4% of those being induced but none of these required hysterectomy. Women with a history of previous CD and an IUFD often undergo trial of labor with a high VBAC success rate. Uterine rupture complicates 2.4% of such cases

Emphysema scores predict death from COPD and lung cancer

OBJECTIVE: Our objective was to assess the usefulness of emphysema scores in predicting death from COPD and lung cancer. METHODS: Emphysema was assessed with low-dose CT scans performed on 9,047 men and women for whom age and smoking history were documented. Each scan was scored according to the presence of emphysema as follows: none, mild, moderate, or marked. Follow-up time was calculated from time of CT scan to time of death or December 31, 2007, whichever came first. Cox regression analysis was used to calculate the hazard ratio (HR) of emphysema as a predictor of death. RESULTS: Median age was 65 years, 4,433 (49%) were men, and 4,133 (46%) were currently smoking or had quit within 5 years. Emphysema was identified in 2,637 (29%) and was a significant predictor of death from COPD (HR, 9.3; 95% CI, 4.3-20.2; P < .0001) and from lung cancer (HR, 1.7; 95% CI, 1.1-2.5; P = .013), even when adjusted for age and smoking history. CONCLUSIONS: Visual assessment of emphysema on CT scan is a significant predictor of death from COPD and lung cancer

Iconic dishes, culture and identity: the Christmas pudding and its hundred years’ journey in the USA, Australia, New Zealand and India

Asserting that recipes are textual evidences reflecting the society that produced them, this article explores the evolution of the recipes of the iconic Christmas pudding in the United States, Australia, New Zealand and India between the mid-nineteenth and the mid-twentieth centuries. Combining a micro-analysis of the recipes and the cookbook that provided them with contemporary testimonies, the article observes the dynamics revealed by the preparation and consumption of the pudding in these different societies. The findings demonstrate the relevance of national iconic dishes to the study of notions of home, migration and colonization, as well as the development of a new society and identity. They reveal how the preservation, transformation and even rejection of a traditional dish can be representative of the complex and sometimes conflicting relationships between colonists, migrants or new citizens and the places they live in