Summary care record early adopter programme: an independent evaluation by University College London.

Benefits The main potential benefit of the SCR is considered to be in emergency and unscheduled care settings, especially for people who are unconscious, confused, unsure of their medical details, or unable to communicate effectively in English. Other benefits may include improved efficiency of care and avoidance of hospital admission, but it is too early for potential benefits to be verified or quantified. Progress As of end April 2008, the SCR of 153,188 patients in the first two Early Adopter sites (Bolton and Bury) had been created. A total of 614,052 patients in four Early Adopter sites had been sent a letter informing them of the programme and their choices for opting out of having a SCR. Staff attitudes and usage The evaluation found that many NHS staff in Early Adopter sites (which had been selected partly for their keenness to innovate in ICT) were enthusiastic about the SCR and keen to see it up and running, but a significant minority of GPs had chosen not to participate in the programme and others had deferred participation until data quality improvement work was completed. Whilst 80 per cent of patients interviewed were either positive about the idea of having a SCR or ?did not mind?, others were strongly opposed ?on principle?. Staff who had attempted to use the SCR when caring for patients felt that the current version was technically immature (describing it as ?clunky? and ?complicated?), and were looking forward to a more definitive version of the technology. A comparable technology (the Emergency Care Summary) introduced in Scotland two years ago is now working well, and over a million records have been accessed in emergency and out-of-hours care. Patient attitudes and awareness Having a SCR is optional (people may opt out if they wish, though fewer than one per cent of people in Early Adopter sites have done so) and technical security is said to be high via a system of password protection and strict access controls. Nevertheless, the evaluation showed that recent stories about data loss by government and NHS organisations had raised concerns amongst both staff and patients that human fallibility could potentially jeopardise the operational security of the system. Despite an extensive information programme to inform the public in Early Adopter sites about the SCR, many patients interviewed by the UCL team were not aware of the programme at all. This raises important questions about the ethics of an ?implied consent? model for creating the SCR. The evaluation recommended that the developers of the SCR should consider a model in which the patient is asked for ?consent to view? whenever a member of staff wishes to access their record. Not a single patient interviewed in the evaluation was confident that the SCR would be 100 per cent secure, but they were philosophical about the risks of security breaches. Typically, people said that the potential benefit of a doctor having access to key medical details in an emergency outweighed the small but real risk of data loss due to human or technical error. Even patients whose medical record contained potentially sensitive data such as mental health problems, HIV or drug use were often (though not always) keen to have a SCR and generally trusted NHS staff to treat sensitive data appropriately. However, they and many other NHS patients wanted to be able to control which staff members were allowed to access their record at the point of care. Some doctors, nurses and receptionists, it seems, are trusted to view a person?s SCR, whereas others are not, and this is a decision which patients would like to make in real time

A Cross-sectional study to explore the challenges faced by Myanmar women in accessing antenatal care services

Background: Myanmar has one of the highest maternal mortality rates in the Southeast Asian region, with most maternal deaths occuring at the time of delivery. The aim of this research was to identify the relationship between socio-demographic characteristics of Myanmar women and utilisation of antenatal care services. Methods: This is a descriptive cross-sectional study utilising the Myanmar Demographic and Health Survey Data 2015-16. A total of 13,454 women agedbetween 15-49 years were surveyed. This study sampled married women only (n=7870). Results: The mean age of the respondents was 35 years and the majority of respondents (50.7%) belonged to the 35-49 age group. Approximately 46.3% of respondents reported more than four antenatal care service (ANC) visits and almost 54% respondents attended ANC during their second and third trimesters. This study found that women with no education, poorer socioeconomic status, less access to mass media, living in rural areas and with more children were not utilising ANC services adequately. Conclusion: Strategies should be introduced to encourage pregnant women to attend a minimum of four antenatal check-ups and there should be adequate monitoring in place of the timing of ANC visits during pregnancy

Joint Wavelet Transform Correlation with Separated Target and Reference Planes

In recent years, we realize the usefulness of feature extraction for optical correlator and hereby, we investigate the capability of Laplace operator in feature extraction of multiple targets. The first-order terms and the false alarm terms in the correlation output would be removed using electronic power spectrum subtraction technique. Most importantly, the entire magneto-optic SLM is completely utilized for displaying only targets in the input scene. A new cost efficient hardware implementation is proposed and aforementioned result of the proposed system is evaluated through computer simulation

Fine particulate matter pollution and risk of community-acquired sepsis

While air pollution has been associated with health complications, its effect on sepsis risk is unknown. We examined the association between fine particulate matter (PM2.5) air pollution and risk of sepsis hospitalization. We analyzed data from the 30,239 community-dwelling adults in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort linked with satellite-derived measures of PM2.5 data. We defined sepsis as a hospital admission for a serious infection with ≥2 systemic inflammatory response (SIRS) criteria. We performed incidence density sampling to match sepsis cases with 4 controls by age (±5 years), sex, and race. For each matched group we calculated mean daily PM2.5 exposures for short-term (30-day) and long-term (one-year) periods preceding the sepsis event. We used conditional logistic regression to evaluate the association between PM2.5 exposure and sepsis, adjusting for education, income, region, temperature, urbanicity, tobacco and alcohol use, and medical conditions. We matched 1386 sepsis cases with 5544 non-sepsis controls. Mean 30-day PM2.5 exposure levels (Cases 12.44 vs. Controls 12.34 µg/m3; p = 0.28) and mean one-year PM2.5 exposure levels (Cases 12.53 vs. Controls 12.50 µg/m3; p = 0.66) were similar between cases and controls. In adjusted models, there were no associations between 30-day PM2.5 exposure levels and sepsis (4th vs. 1st quartiles OR: 1.06, 95% CI: 0.85–1.32). Similarly, there were no associations between one-year PM2.5 exposure levels and sepsis risk (4th vs. 1st quartiles OR: 0.96, 95% CI: 0.78–1.18). In the REGARDS cohort, PM2.5 air pollution exposure was not associated with risk of sepsis

Future schistosome hybridizations: Will all Schistosoma haematobium hybrids please stand-up!

nterrogating the genetic make-up of schistosome larvae (i.e. eggs, miracidia and cercariae) originating from definitive or intermediate snail hosts with molecular DNA methods has, by noting unexpected inter-species hybrids, started a revolution in our appraisal of African schistosomiasis [1-4]. Here, two dominant species of human schistosome exist, Schistosoma haematobium and S. mansoni, which are transmitted by specific intermediate freshwater snails, Bulinus spp. for the former and Biomphalaria spp. for the latter. The two schistosomes cause either urogenital or intestinal schistosomiasis, respectively [5] and depending on local snail distributions, schistosome transmission zones in the aquatic habitat may or may not overlap [6]. Within the S. haematobium group, a further 8 sister species are described with S. intercalatum and S. guineensis of medical importance, causing intestinal schistosomiasis while others, such as S. bovis, S. curassoni and S. mattheei occur in livestock, with the remaining species infecting wildlife. Schistosoma mattheei is also of medical interest for occasional infection and associated disease [7]. In contrast, S. mansoni has a single sister species, S. rodhaini, typically found in small rodents which can hybridise with S. mansoni, if given sufficient opportunity [2]

Comparison of Near-Field Millimeter Wave Probes for Detecting Corrosion Pit under Paint

Corrosion pitting defection is a critical issue in the maintenance of aircraft. Near-field microwave nondestructive techniques have been successfully used for defection of corrosion under paint. In this paper a comparison between several different millimeter wave probes is made for the detection and evaluation of corrosion precursor pitting under paint at Ka-band and V-band. Since the pittings investigated here are very small in size, spatial resolution and sensitivity of the probes are critical issues. If is shown that modified open-ended rectangular probes namely, tapered waveguide and dielectric slab-loaded waveguide probes provide high resolution and sensitivity for the detection and evaluation of very small pittings under paint

Thermal tides in neutrally stratified atmospheres: Revisiting the Earth's Precambrian rotational equilibrium

Rotational dynamics of the Earth, over geological timescales, have profoundly affected local and global climatic evolution, probably contributing to the evolution of life. To better retrieve the Earth's rotational history, and motivated by the published hypothesis of a stabilized length of day during the Precambrian, we examine the effect of thermal tides on the evolution of planetary rotational motion. The hypothesized scenario is contingent upon encountering a resonance in atmospheric Lamb waves, whereby an amplified thermotidal torque cancels the opposing torque of the oceans and solid interior, driving the Earth into a rotational equilibrium. With this scenario in mind, we construct an ab initio model of thermal tides on rocky planets describing a neutrally stratified atmosphere. The model takes into account dissipative processes with Newtonian cooling and diffusive processes in the planetary boundary layer. We retrieve from this model a closed-form solution for the frequency-dependent tidal torque which captures the main spectral features previously computed using 3D general circulation models. In particular, under longwave heating, diffusive processes near the surface and the delayed thermal response of the ground prove to be responsible for attenuating, and possibly annihilating, the accelerating effect of the thermotidal torque at the resonance. When applied to the Earth, our model prediction suggests the occurrence of the Lamb resonance in the Phanerozoic, but with an amplitude that is insufficient for the rotational equilibrium. Interestingly, though our study was motivated by the Earth's history, the generic tidal solution can be straightforwardly and efficiently applied in exoplanetary settings.Comment: 20 pages (+14 for appendices), 6 figure

Comparison of Near-Field Millimeter-Wave Probes for Detecting Corrosion Precursor Pitting under Paint

Aircraft structural components such as wings and fuselages are constantly exposed to harsh environments, which make them susceptible to corrosion initiation and growth. To complicate matters, corrosion is normally hidden under paint and primer and cannot be visually detected until significant corrosion has occurred, causing the paint to blister. Corrosion of this type is usually preceded by the presence of corrosion precursor pitting. Hence, early detection of pitting is a critical issue in the maintenance of an aircraft and its structural components. Near-field microwave nondestructive testing techniques have been successfully used for detection of corrosion under paint, including very small laser machined pits. However, it is desirable to improve the spatial resolution associated with these techniques so that pits with dimensions in the range of a few hundreds of micrometers can be effectively detected. In this paper, a comparison between several different millimeter-wave open-ended rectangular waveguide-based probes is made for the detection and evaluation of corrosion precursor pitting at Ka-band (26.5-40 GHz) and V-band (50-75 GHz). A number of laser machined pits with dimensions varying between 150 to 500 μm were produced for this investigation. Using these probes, millimeter-wave images of these pits were produced, indicating that the modified open-ended rectangular waveguide probes, namely, single and double tapered and dielectric slab-loaded waveguide probes, were successful in detecting small pits. The results of this investigation, along with a complete discussion of the results, are presented

Exploring the relationship of Domestic violence on Health Seeking behavior and Empowerment of Women in Pakistan

Background: Violence against women is considered as a global problem and the trend for abusing domestically is very much up. This not only violates the human rights and it has got major implications on physical, mental, social and sexual health of a woman. Worldwide there is little research work on how domestic violence has affected women’s health and their decision-making power. This study aimed to explore the relationship between domestic violence on empowerment of women and their health seeking behavior in Pakistan. Methods: This research has used secondary data from Pakistan Demographic and Health Survey data 2012-13. About 3687 ever-married women were selected and interviewed for domestic violence from 248 urban and 252 rural areas of Pakistan. Results: Both chi-square and binary logistic regression analyses were performed. The results show that women with no education have suffered more (43%) from domestic violence. Almost 68% women reported that who have seen their parents beating their mothers have also experiences domestic violence. Logistic regression shown that women from rural areas are highly likely to be victims of domestic violence (OR=1.28, 95% CI 1.07-1.52, p-value<. 001). ANC visit is also found statistically significant with those who suffered violence at home. Conclusion: Policy makers and other stakeholders should take measures to control and stop violence against women and help them to live equally like a ma