Epidemiology

Epidemiology is a methodological, well grounded and versatile tool-kit to conduct evidence-based quantitative research in all health sciences. It integrates a wide spectrum of case studies and examples from the different disciplines thereby fostering the multi-disciplinary approach in the health sciences. It follows a two level 'methods based' approach differentiating between "basic" knowledge that all students of epidemiology should be familiar with and "beyond the basics" information for the interested or more advanced reader

Epidemiology

Epidemiology 2nd edition is a methodological and practical guide to conducting evidence-based quantitative research in all health sciences. With a multidisciplinary focus, it integrates a wealth of case studies and examples to demonstrate the application of theory to real-life research and draws from a broad spectrum of health disciplines. The book follows a two level 'methods based' approach which clearly differentiates between introductory knowledge that all students of epidemiology should be familiar with and 'beyond the basics' information for the interested or more advanced reader. Each chapter includes tips, key definitions and critical thinking exercises to help readers engage with key concepts and extend their knowledge of epidemiological methodologies

Strong Limit on a Variable Proton-to-Electron Mass Ratio from Molecules in the Distant Universe

The Standard Model of particle physics assumes that the so-called fundamental constants are universal and unchanging. Absorption lines arising in molecular clouds along quasar sightlines offer a precise test for variations in the proton-to-electron mass ratio, mu, over cosmological time and distance scales. The inversion transitions of ammonia are particularly sensitive to mu compared to molecular rotational transitions. Comparing the available ammonia spectra observed towards the quasar B0218+357 with new, high-quality rotational spectra, we present the first detailed measurement of mu with this technique, limiting relative deviations from the laboratory value to |dmu/mu| < 1.8x10^{-6} (95% confidence level) at approximately half the Universe's current age - the strongest astrophysical constraint to date. Higher-quality ammonia observations will reduce both the statistical and systematic uncertainties in these measurements.Comment: Science, 20th June 2008. 22 pages, 5 figures (12 EPS files), 2 tables, including Supporting Online Material; v2: Corrected reference for laboratory mu-variation bound

Incidence of middle ear barotrauma in staged versus linear chamber compression during hyperbaric oxygen therapy: a double blinded, randomized controlled trial

Context: Middle ear barotrauma (MEB) is common during chamber compression in hyperbaric oxygen therapy. However, little evidence exists on an optimal compression protocol to minimize the incidence and severity of MEB. Objective: To compare the incidence of MEB during hyperbaric oxygen therapy using two different chamber compression protocols. Design: Double-blinded, randomized controlled trial. Setting: Hyperbaric Medicine Unit, The Townsville Hospital, Queensland, Australia, September 2012 to December 2014.Patients: 100 participants undergoing their first hyperbaric oxygen therapy session. Intervention: Random assignment to a staged (n=50) or a linear (n=50) compression protocols. Photographs of tympanic membranes were taken pre- and post-treatment and then graded. Middle ear barotrauma was defined as an increase of at least one grade on a modified TEED scale. Results: The observed MEB incidence under the staged protocol was 48% compared to 62% using the linear protocol (P=0.12, exact one-sided binomial test),and thus the staged protocol did not show a significant improvement in MEB. However, the staged protocol resulted in significantly less severe deteriorations in MEB grades when compared to the linear protocol(P=0.028, exact one-sided Mann-Whitney type test). Conclusion: The use of the assessed staged compression protocol for the first hyperbaric oxygen treatment showed no significant effect on the overall incidence of MEB when compared to the gold standard linear protocol but resulted in a significant improvement in the severity of the experienced MEBs. Further studies are needed to elucidate an optimal compression protocol to minimize middle ear barotrauma

Community based, multicenter, double-blind, randomised controlled trial comparing the effectiveness of topical ciprofloxacin and Sofradex as treatments for chronic suppurative otitis media in Aboriginal children

Many Aboriginal conmmunities in rural and remote western Australia have rates of chronic suppurative otitis media (CSOM) 10 times the rate that the World Health Organization deemed as a massive public health problem in the child population. The recognition by Aboriginal leaders that the treatment of CSOM is a priority area has led to this issue being highlighted in Australia's National Aboriginal Health Strategy. In Aboriginal children, the disease usually commences in infancy within a few weeks of birth, causes hearing loss, is recurrent, can persist into adulthood, and may impact adversely on child development. Our trial aimed to compare the effectiveness of topical ciprofloxacin (0.3%) and framycetin (0.5%), gramicidin, dexamethasone (FGD, Sofradex) as treatments for CSOM in Aboriginal children. The trial was the first conmmunity controlled, multicenter, double-blind, randomized, controlled trial in Aboriginal children across the north of Australia

Community based, multicenter, double-blind, randomised controlled trial comparing the effectiveness of topical ciprofloxacin and Sofradex as treatments for chronic suppurative otitis media in Aboriginal children

Many Aboriginal conmmunities in rural and remote western Australia have rates of chronic suppurative otitis media (CSOM) 10 times the rate that the World Health Organization deemed as a massive public health problem in the child population. The recognition by Aboriginal leaders that the treatment of CSOM is a priority area has led to this issue being highlighted in Australia's National Aboriginal Health Strategy. In Aboriginal children, the disease usually commences in infancy within a few weeks of birth, causes hearing loss, is recurrent, can persist into adulthood, and may impact adversely on child development. Our trial aimed to compare the effectiveness of topical ciprofloxacin (0.3%) and framycetin (0.5%), gramicidin, dexamethasone (FGD, Sofradex) as treatments for CSOM in Aboriginal children. The trial was the first conmmunity controlled, multicenter, double-blind, randomized, controlled trial in Aboriginal children across the north of Australia

Suitability of current definitions of ambulatory care sensitive conditions for research in emergency department patients: a secondary health data analysis

Objective: The aim of this study was to investigate the suitability of existing definitions of ambulatory care sensitive conditions (ACSC) in the setting of an emergency department (ED) by assessing ACSC prevalence in patients admitted to hospital after their ED stay. The secondary aim was to identify ACSC suitable for specific application in the ED setting. Design: Observational clinical study with secondary health data. Setting: Two EDs of the Charite-Universitatsmedizin Berlin. Participants: All medical ED patients of the 'The Charite Emergency Medicine Study' (CHARITEM) study, who were admitted as inpatients during the 1-year study period (n=13 536). Outcome measures: Prevalence of ACSC. Results: Prevalence of ACSC in the study population differed significantly depending on the respective ACSC set used. Prevalence ranged between 19.1% (95% CI 18.4% to 19.8%; n=2586) using the definition by Albrecht et al and 36.6% (95% CI 35.8% to 37.5%; n=4960) using the definition of Naumann et al. (p<0.001). Overall ACSC prevalence (ie, when using all diagnoses used in any of the assessed ACSC-definitions) was 48.1% (95% CI 47.2% to 48.9%; n=6505). Some frequently observed diagnoses such as 'convulsion and epilepsy' (prevalence: 3.4%, 95% CI 3.1% to 3.7%; n=455), 'diseases of the urinary system' (prevalence: 1.4%; 95% CI 1.2% to 1.6%; n=191) or 'atrial fibrillation and flutter' (prevalence: 1.0%, 95% CI 0.8% to 1.2%, n=134) are not included in all of the current ACSC definitions. Conclusions: The results highlight the need for an optimised, ED-specific ACSC definition. Particular ACSC diagnoses (such as 'convulsion and epilepsy' or 'diseases of the urinary system' and others) seem to be of special relevance in an ED population but are not included in all available ACSC definitions. Further research towards the development of a suitable and specific ACSC definition for research in the ED setting seems warranted

Constraints on quintessence and new physics from fundamental constant

Changes in the values of the fundamental constants mu, the proton to electron mass ratio, and alpha, the fine structure constant due to rolling scalar fields have been discussed both in the context of cosmology and in new physics such as Super Symmetry (SUSY) models. This article examines the changes in these fundamental constants in a particular example of such fields, freezing and thawing slow roll quintessence. Constraints are placed on the product of a cosmological quantity, w, the equation of state parameter, and the square of the coupling constants for mu and alpha with the field, zeta_x, x = mu,alpha, using the existing observational limits on the values of Delta x/x. Various examples of slow rolling quintessence models are used to further quantify the constraints. Some of the examples appear to be rejected by the existing data which strongly suggests that conformation to the values of the fundamental constants in the early universe is a standard test that should be applied to any cosmological model or suggested new physics.Comment: Accepted for publication in the Monthly Notices of the Royal Astronomical Society Letter

Single Transfer-Excitation Resonance Observed Via the Two-Photon Decay in He-like Ge³⁰⁺

We measured the 2E1 decay of the 1s2s 1S0 →1s2 1S0 transition in He-like germanium for 12- to 19-MeV/u Ge31+ +H2 collisions. The resonant population of the 2s2p 1P1 state by transfer excitation was isolated due to its cascading to the 1s2s 1S0 state. The experimental cross sections compare well with calculations using dielectronic recombination rates. The method gives the unique possibility to populate selectively the 1S0 state in heavy He-like ions