Midazolam use for dental conscious sedation: how safe are we?

Aim: To explore the safety awareness of midazolam use amongst dentist in the UK. Materials and methods: A cross-sectional study on 203 dentists was undertaken, 146 of whom currently practice conscious sedation using intravenous midazolam. Use of high strength midazolam; awareness of the Rapid Response Report (RRR) and the National Reporting and Learning System (NRLS); and midazolam related incidents were explored. Results: Formal training in conscious sedation was variable with 35.6% holding a postgraduate sedation qualification. Flumazenil administration was common practice (63%) although used very selectively. Use to reverse respiratory depression was minimal (4%). Awareness of the RRR and the NRLS was generally low but higher among those working in general dental practice (p<0.05). Comparative analysis showed that high dose midazolam was administered more frequently in gastroenterology than in dentistry (p<0.001) with higher incidences of overdose (12.4% Vs 4.8%) and death (8.3% Vs 0%) within a 3 year period. Conclusions: High strength midazolam administration remains prevalent in dentistry, despite recommendations by the DoH. Use of flumazenil for reasons other than respiratory depression in dentistry should warrant little concern. The low incidence of reported harm is positive but may be due to a lack of uptake of national reporting systems

Food assessment: a discursive analysis of diet talk in interviews with older men who are obese

Objective: Obesity rates are increasing faster in men than in women, with particular concerns raised regarding older men. However, men are less likely than women to engage in weight-loss activities such as dieting, typically constructed as a feminine practice. Previous research has argued that men’s food consumption is notably different and unhealthier than women’s. The novel contribution of this article is an analysis of food assessments in order to explore how older men (mostly) undergoing weight management programmes make sense of changes in their nutritional intake. Design: Semi-structured interviews were conducted with 30 men who were obese, 27 of whom were engaged in weight loss programmes. Discursive psychology was employed to analyse the data. Results: In contrast to other research, participants constructed nutritional advice as enlightening. Participants worked up ‘ownership’ and pleasure assessments to certain food choices which they contrasted with new, less calorific, eating practices. Moreover, new diets were constructed as acceptable. Conclusion: Our study contributes new insights about how nutritional advice impacts upon preconceived (mis)understandings of healthy eating practices. During the interviews, men positioned themselves as educators – health promoters might usefully develop nutritional advice in collaboration with men who have successfully changed their diets for optimum effect

The bloodstream differentiation - division of Trypanosoma brucei studied using mitochondrial markers

In the bloodstream of its mammalian host, the African trypanosome Trypanosoma brucei undergoes a life cycle stage differentiation from a long, slender form to a short, stumpy form. This involves three known major events: exit from a proliferative cell cycle, morphological change and mitochondrial biogenesis. Previously, models have been proposed accounting for these events (Matthews & Gull 1994a). Refinement of, and discrimination between, these models has been hindered by a lack of stage-regulated antigens useful as markers at the single-cell level. We have now evaluated a variety of cytological markers and applied them to investigate the coordination of phenotypic differentiation and cell cycle arrest. Our studies have focused on the differential expression of the mitochondrial enzyme dihydrolipoamide dehydrogenase relative to the differentiation-division of bloodstream trypanosomes. The results implicate a temporal order of events: commitment, division, phenotypic differentiation

Choosing more mathematics : happiness through work?

This paper examines how A-level students construct relationships between work and happiness in their accounts of choosing mathematics and further mathematics A-level. I develop a theoretical framework that positions work and happiness as opposed, managed and working on the self and use this to examine students' dual engagement with individual practices of the self and institutional practices of school mathematics. Interviews with students acknowledge four imperatives that they use as discursive resources to position themselves as successful/unsuccessful students: you have to work, you have to not work, you have to be happy, you have to work at being happy. Tensions in these positions lead students to rework their identities or drop further mathematics. I then identify the practices of mathematics teaching that students use to explain un/happiness in work, and show how dependable mathematics and working together are constructed as 'happy objects' for students, who develop strategies for claiming control over these shapers of happiness. © 2010 British Society for Research into Learning Mathematics

On The Existence of Roton Excitations in Bose Einstein Condensates: Signature of Proximity to a Mott Insulating Phase

Within the last decade, artificially engineered Bose Einstein Condensation has been achieved in atomic systems. Bose Einstein Condensates are superfluids just like bosonic Helium is and all interacting bosonic fluids are expected to be at low enough temperatures. One difference between the two systems is that superfluid Helium exhibits roton excitations while Bose Einstein Condensates have never been observed to have such excitations. The reason for the roton minimum in Helium is its proximity to a solid phase. The roton minimum is a consequence of enhanced density fluctuations at the reciprocal lattice vector of the stillborn solid. Bose Einstein Condensates in atomic traps are not near a solid phase and therefore do not exhibit roton minimum. We conclude that if Bose Einstein Condensates in an optical lattice are tuned near a transition to a Mott insulating phase, a roton minimum will develop at a reciprocal lattice vector of the lattice. Equivalently, a peak in the structure factor will appear at such a wavevector. The smallness of the roton gap or the largeness of the structure factor peak are experimental signatures of the proximity to the Mott transition.Comment: 4 pages, 5 figure

The Compact Nucleus of the Deep Silicate Absorption Galaxy NGC 4418

High resolution, Hubble Space Telescope (HST) near-infrared and Keck mid-infrared images of the heavily extinguished, infrared luminous galaxy NGC 4418 are presented. These data make it possible to observe the imbedded near-infrared structure on scales of 10-20 pc, and to constrain the size of the mid-infrared emitting region. The 1.1-2.2 um data of NGC 4418 show no clear evidence of nuclear star clusters or of a reddened active galactic nucleus. Instead, the nucleus of the galaxy consists of a ~100-200 pc linear structure with fainter structures extending radially outward. The near-infrared colors of the linear feature are consistent with a 10-300 Myr starburst suffering moderate levels (few magnitudes) of visual extinction. At 7.9-24.5 um, NGC 4418 has estimated size upper limits in the range of 30-80 pc. These dimensions are consistent with the highest resolution radio observations obtained to date of NGC 4418, as well as the size of 50-70 pc expected for a blackbody with a temperature derived from the 25 um, 60 um, and 100 um flux densities of the galaxy. Further, a spectral energy distribution constructed from the multi-wavelength mid-infrared observations show the strong silicate absorption feature at 10 um, consistent with previous mid-infrared observations of NGC 4418. An infrared surface brightness of 2.1x10^13 L_sun kpc^-2 is derived for NGC 4418. Such a value, though consistent with the surface brightness of warm ultraluminous infrared galaxies (ULIGs: L_IR [8-1000 um] >~ 10^12 L_sun) such as IRAS 05189-2524 and IRAS 08572+3915, is not large enough to distinguish NGC 4418 as a galaxy powered by an Active Galactic Nucleus (AGN), as opposed to a lower surface brightness starburst.Comment: LaTex, 7 pages, including 2 jpg figures and 3 postscript figures, AJ, in press (May, 2003

Testing Magnetic Field Models for the Class 0 Protostar L1527

For the Class 0 protostar, L1527, we compare 131 polarization vectors from SCUPOL/JCMT, SHARP/CSO and TADPOL/CARMA observations with the corresponding model polarization vectors of four ideal-MHD, non-turbulent, cloud core collapse models. These four models differ by their initial magnetic fields before collapse; two initially have aligned fields (strong and weak) and two initially have orthogonal fields (strong and weak) with respect to the rotation axis of the L1527 core. Only the initial weak orthogonal field model produces the observed circumstellar disk within L1527. This is a characteristic of nearly all ideal-MHD, non-turbulent, core collapse models. In this paper we test whether this weak orthogonal model also has the best agreement between its magnetic field structure and that inferred from the polarimetry observations of L1527. We found that this is not the case; based on the polarimetry observations the most favored model of the four is the weak aligned model. However, this model does not produce a circumstellar disk, so our result implies that a non-turbulent, ideal-MHD global collapse model probably does not represent the core collapse that has occurred in L1527. Our study also illustrates the importance of using polarization vectors covering a large area of a cloud core to determine the initial magnetic field orientation before collapse; the inner core magnetic field structure can be highly altered by a collapse and so measurements from this region alone can give unreliable estimates of the initial field configuration before collapse.Comment: 43 pages, 9 figures, 4 tables. Accepted by the Astrophysical Journa

Experiments on Multidimensional Solitons

This article presents an overview of experimental efforts in recent years related to multidimensional solitons in Bose-Einstein condensates. We discuss the techniques used to generate and observe multidimensional nonlinear waves in Bose-Einstein condensates with repulsive interactions. We further summarize observations of planar soliton fronts undergoing the snake instability, the formation of vortex rings, and the emergence of hybrid structures.Comment: review paper, to appear as Chapter 5b in "Emergent Nonlinear Phenomena in Bose-Einstein Condensates: Theory and Experiment," edited by P. G. Kevrekidis, D. J. Frantzeskakis, and R. Carretero-Gonzalez (Springer-Verlag