Paraphilias: definition, diagnosis and treatment

There is a great deal of controversy concerning paraphilia, and defining what is normal versus deviant or disordered, given that this is to some degree dependent on cultural views of acceptability. In this article, we outline these issues and describe recent progress in diagnosing and treating paraphilias

Evaluation of the Womens Health Services Physical Activity Project to Encourage Women and Their Families to Become More Active

In 2008 the Womens Health Services in Northbridge, Western Australia, was the recipient of a Healthy Active Australia grant, funded by the Commonwealth Department of Health and Ageing. The aim of the funded project was to increase participation and physical activity levels of marginalised women by introducing them to a range of low cost, easily accessible exercise opportunities and by providing relevant health information. The program ran from late 2008 to early 2010. Program activities included the delivery of thirty three health information talks covering topics such as nutrition, healthy eating,relaxation, stress and the need for adequate levels of vitamin D, as well as forty two blocks of physical activity classes. Activities included swimming, yoga, pilates, gentle exercise and dancing. Other physical activities included three Come and Try days, four organised walks and six bike workshops.Five family activity sessions were also held over the funding period. A qualitative evaluation of the activities was conducted by Curtin University. Evaluation activities included eight focus groups with approximately sixty participants, eight one-on-one interviews with participants and fourinterviews with class instructors. Overall, participants were satisfied with the physical activity program they were participating in. Participants reported that the program had increased their levels of activity, in many cases by providing an opportunity to be active that they would not otherwise have. Barriers to engaging in physical activity included financial barriers such as a lack of money to pay for services andchildcare, a lack of affordable services and a lack of culturally appropriate facilities. Other barriersincluded personal factors such as a lack of confidence or a lack of motivation.Many women, especially those caring for children, did not have time to engage in physical activity outside of their sessions with the WHS. For these women, the sessions offered them 'time out' from the pressures of their everyday lives. Other women experienced mental health issues which affected their ability to engage in physical activity. In addition to providing women with the opportunity to be active, participants also reported experiencing physical and mental health benefits as a result of the program. The program gave participants the opportunity to mix with peers in a nonjudgmental environment, introduced them to new activities and provided the opportunity to learn new skills. This report presents the findings of an independent qualitative evaluation of participants' experiences with the program

Search Engine Optimisation in UK news production

This is an Author's Accepted Manuscript of an article published in Journalism Practice, 5(4), 462 - 477, 2011, copyright Taylor & Francis, available online at: http://www.tandfonline.com/10.1080/17512786.2010.551020.This paper represents an exploratory study into an emerging culture in UK online newsrooms—the practice of Search Engine Optimisation (SEO), which assesses its impact on news production. Comprising a short-term participant observational case study at a national online news publisher, and a series of semi-structured, in-depth interviews with SEO professionals at three further UK media organisations, the author sets out to establish how SEO is operationalised in the newsroom, and what consequences these practices have for online news production. SEO practice is found to be varied and application is not universal. Not all UK news organisations are making the most of SEO even though some publishers take a highly sophisticated approach. Efforts are constrained by time, resources and management support, as well as off-page technical issues. SEO policy is found, in some cases, to inform editorial policy, but there is resistance to the principal of SEO driving decision-making. Several themes are established which call for further research

Mass fluxes and isofluxes of methane (CH4) at a New Hampshire fen measured by a continuous wave quantum cascade laser spectrometer

We have developed a mid‐infrared continuous‐wave quantum cascade laser direct‐absorption spectrometer (QCLS) capable of high frequency (≥1 Hz) measurements of 12CH4 and 13CH4 isotopologues of methane (CH4) with in situ 1‐s RMS image precision of 1.5 ‰ and Allan‐minimum precision of 0.2 ‰. We deployed this QCLS in a well‐studied New Hampshire fen to compare measurements of CH4 isoflux by eddy covariance (EC) to Keeling regressions of data from automated flux chamber sampling. Mean CH4 fluxes of 6.5 ± 0.7 mg CH4 m−2 hr−1 over two days of EC sampling in July, 2009 were indistinguishable from mean autochamber CH4 fluxes (6.6 ± 0.8 mgCH4 m−2 hr−1) over the same period. Mean image composition of emitted CH4 calculated using EC isoflux methods was −71 ± 8 ‰ (95% C.I.) while Keeling regressions of 332 chamber closing events over 8 days yielded a corresponding value of −64.5 ± 0.8 ‰. Ebullitive fluxes, representing ∼10% of total CH4 fluxes at this site, were on average 1.2 ‰ enriched in 13C compared to diffusive fluxes. CH4 isoflux time series have the potential to improve process‐based understanding of methanogenesis, fully characterize source isotopic distributions, and serve as additional constraints for both regional and global CH4 modeling analysis

Inadvertent Lead Placement In The Left Ventricle: A Case Report And Brief Review

Inadvertent lead placement in the left ventricle (LV) is an uncommon and often under-diagnosed complication of cardiac device implantation. Thromboembolic (TE) events are common and usually secondary to fibrosis or thrombus formation on or around the lead. Anticoagulation can prevent TE events. Percutaneous and surgical LV lead extractions have been performed successfully, but the risks of percutaneous lead removal are not well-defined. In this report, we describe a case of inadvertent LV lead placement and briefly review the contemporary literature

Does changing examiner stations during UK postgraduate surgery objective structured clinical examinations influence examination reliability and candidates' scores?

Objective Objective structured clinical examinations (OSCE) are widely used for summative assessment in surgery. Despite standardizing these as much as possible, variation, including examiner scoring, can occur which may affect reliability. In study of a high-stakes UK postgraduate surgical OSCE, we investigated whether examiners changing stations once during a long examining day affected marking, reliability, and overall candidates’ scores compared with examiners who examined the same scenario all day. Design, Setting, and Participants An observational study of 18,262 examiner-candidate interactions from the UK Membership of the Royal College of Surgeons examination was carried at 3 Surgical Colleges across the United Kingdom. Scores between examiners were compared using analysis of variance. Examination reliability was assessed with Cronbach’s alpha, and the comparative distribution of total candidates’ scores for each day was evaluated using t-tests of unit-weighted z scores. Results A significant difference was found in absolute scores differences awarded in the morning and afternoon sessions between examiners who changed stations at lunchtime and those who did not (p < 0.001). No significant differences were found for the main effects of either broad content area (p = 0.290) or station content area (p = 0.450). The reliability of each day was not affected by examiner switching (p = 0.280). Overall, no difference was found in z-score distribution of total candidate scores and categories of examiner switching. Conclusions This large study has found that although the range of marks awarded varied when examiners change OSCE stations, examination reliability and the likely candidate outcome were not affected. These results may have implications for examination design and examiner experience in surgical OSCEs and beyond

Simultaneous Measurements of Atmospheric HONO and NO2 via Absorption Spectroscopy using Tunable Mid-Infrared Continuous-wave Quantum Cascade Lasers

Nitrous acid (HONO) is important as a significant source of hydroxyl radical (OH) in the troposphere and as a potent indoor air pollutant. It is thought to be generated in both environments via heterogeneous reactions involving nitrogen dioxide $(NO_2)$. In order to enable fast-response HONO detection suitable for eddy-covariance flux measurements and to provide a direct method that avoids interferences associated with derivatization, we have developed a 2-channel tunable infrared laser differential absorption spectrometer (TILDAS) capable of simultaneous high-frequency measurements of HONO and NO2. Beams from two mid-infrared continuous-wave mode quantum cascade lasers (cw-QCLs) traverse separate 210 m paths through a multi-pass astigmatic sampling cell at reduced pressure for the direct detection of HONO $(1660 cm^{−1})$ and $(NO_2)$ $(1604 cm^{−1})$. The resulting one-second detection limits (S/N=3) are 300 and 30 ppt (pmol/mol) for HONO and $(NO_2)$, respectively. Our HONO quantification is based on revised line-strengths and peak positions for cis-HONO in the 6-micron spectral region that were derived from laboratory measurements. An essential component of ambient HONO measurements is the inlet system and we demonstrate that heated surfaces and reduced pressure minimize sampling artifacts.Earth and Planetary SciencesEngineering and Applied Science

Accuracy of blood pressure monitors owned by patients with hypertension (ACCU-RATE study)

Background Home blood pressure (BP) monitoring is recommended in guidelines and increasingly popular with patients and health care professionals, but the accuracy of patients’ own monitors in real world use is not known. Aim To assess the accuracy of home BP monitors used by people with hypertension, and investigate factors affecting accuracy. Design and Setting Patients on the hypertension register at seven practices in central England were surveyed to ascertain if they owned a monitor and wanted it tested. Method Monitor accuracy was compared to a calibrated reference device, at 50 mmHg intervals between 0-280/300 mmHg (static pressure test), with a difference from the reference monitor of +/-3 mmHg at any interval considered a failure. Cuff performance was also assessed. Results were analysed by usage rates, length of time in service, make and model, monitor validation status, cost, and any previous testing. Results 251 (76%, 95% CI 71-80%) of 331 tested devices passed all tests (monitors and cuffs) and 86% passed the static pressure test, deficiencies primarily due to overestimation. 40% of testable monitors were unvalidated. Pass rate on the static pressure test was greater in validated monitors (96% [95% CI 94-98%] vs 64% [95% CI 58-69%]), those retailing for over £10, and those in use for less than four years.12% of cuffs failed. Conclusion Patients’ own BP monitor failure rate was similar to that in studies performed in professional settings, though cuff failure was more frequent. Clinicians can be confident of the accuracy of patients’ own BP monitors, if validated and less than five years old.This work represents independent research commissioned by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research funding scheme (RP-PG-1209-10051). The views expressed in this study are those of the authors and not necessarily of the NHS, the NIHR or the Department of Health. RJM was supported by an NIHR Professorship (NIHR-RP-02-12-015) and by the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Oxford at Oxford Health NHS Foundation Trust. FDRH is part funded as Director of the National Institute for Health Research (NIHR) School for Primary Care Research (SPCR), Theme Leader of the NIHR Oxford Biomedical Research Centre (BRC), and Director of the NIHR CLAHRC Oxford. JM is an NIHR Senior Investigator. No funding for this study was received from any monitor manufacturer

Determination of superconducting anisotropy from magnetization data on random powders as applied to LuNi2_2B2_2C, YNi2_2B2_2C and MgB2_2

The recently discovered intermetallic superconductor MgB2 appears to have a highly anisotopic upper critical field with Hc2(max)/Hc2(min} = \gamma > 5. In order to determine the temperature dependence of both Hc2(max) and Hc2(min) we propose a method of extracting the superconducting anisotropy from the magnetization M(H,T) of randomly oriented powder samples. The method is based on two features in dM/dT the onset of diamagnetism at Tc(max), that is commonly associated with Hc2, and a kink in dM/dT at a lower temperature Tc(min). Results for LuNi2B2C and YNi2B2C powders are in agreement with anisotropic Hc2 obtained from magneto-transport measurements on single crystals. Using this method on four different types of MgB2 powder samples we are able to determine Hc2(max)(T) and Hc2(min)(T) with \gamma \approx 6