Liver transplantation: need, indications, patient selection and pre-transplant care

Chronic or acute liver failure and primary liver cancers can be effectively managed with liver transplantation. The range of indications for liver transplantation is increasing but there is a mismatch between the numbers of available donations and current needs. Specific criteria for listing patients exist but, at minimum, the predicted mortality without transplantation must exceed that with transplantation, coupled with a 50% predicted 5-year survival following liver transplantation. The risk posed by liver disease must be weighed against the risk of liver transplantation, considering the patient's comorbidities, age, nutritional status and behavioural factors in a complex assessment process. This article reviews current UK practice in the selection and care of patients being assessed for liver transplantation

USER STUDIES FOR DIGITAL LIBRARIES EVALUATION AND DEVELOPMENT

This tutorial - the only one in JCDL 2012 Conference - introduces a range of methods which can be applied to understand better user needs and expectations (surveys, questionnaires, interviews, deep log analysis, personas, eye tracking, ethnographic studies) and to give a practical feel how they work in real practice through a series of recent studies. It includes real life international case study which will help the participants to get a better understanding what studies could be particularly helpful according to the products and services they develop, how to involve user s in digital library evaluation, and how to engage better with users

CHARACTERIZATION OF POLYLACTIC ACID COLLOIDS FOR IN SITU BIOREMEDIATION

Groundwater contamination is a widespread problem. As human activities generate chemical wastes, we seek quick, yet not always environmentally friendly, ways to dispose of them. Often, chemicals are dumped into waste containers and buried. Unfortunately, these chemicals may spill or leak, seep deeper into the ground, and eventually reach groundwater. Chlorinated organic solvents such as trichloroethene, tetrachloroethane, and chloroform are common contaminants in groundwater [1]. These solvents originate from chemical spills, tank leaks, and waste disposal practices [2]. Such contaminants are harmful to humans, and need to be removed to restore clean groundwater. There are two types of methods to clean chemically contaminated soil and groundwater: ex situ and in situ. Both types have advantages and disadvantages. In situ remediation avoids the cost of removing the contaminated material and has a lower risk of worker exposure to the contaminants. One in situ technique that shows promise is remediation, which uses microorganisms to anaerobically degrade contaminants. In bioremediation in situ, the microorganisms that are already present in the ground utilize nutrients that are injected into the ground to metabolize the contaminants into nonhazardous materials. The nutrients serve as a carbon source for the microbes. Though this method has been used with some success, there have been problems with too rapid release of nutrients to the microbes. In these cases, the microbes multiplied too rapidly and caused biofouling. This can occur when the nutrient content of the bioremediation solution is too high, as when lactate or lactic acid is the nutrient. Lactic acid is typically produced in carbohydrate matter by fermentation, and is used mainly in the food and pharmaceutical industries [3]. Because it has been found difficult to uniformly distribute lactate solutions in a contaminated area due to biofouling, it was suggested that polylactic acid, in colloidal form, be used instead. Polylactic acid (PLA) is a polymer of lactic acid, C3H6O3 [3]. PLA is used in medicine and agriculture. In medicine, PLA is used in sutures because it degrades within the body after the incision has healed. In agriculture, PLA is used in combination with polyglycolic acid for the release of chemicals [4]. We expect PLA to degrade in the ground at a rate that allows bioremediation to occur as intended. Currently, bioremediation of chlorinated solvents involves injecting nutrient containing solvents into the ground to induce the expected activity of the microbes. The solution must have a proper amount of nutrients for the microbes to metabolize so that they can continue to degrade the contaminants. If too much nutrient is available, and the microbes multiply too fast and clog the injection point, the solution may not reach the area where the contaminants are. One way to slowly release the nutrients for bioremediation is to package them as colloids. Colloids are particles that are less than one micrometer in size, with surface chemical properties that allow them to remain suspended in water and, therefore, to travel with water. Our research addresses the problem of packaging nutrients as colloids to support bioremediation

Changes in nurses’ work associated with computerised information systems: Opportunities for international comparative studies using the revised Work Observation Method by Activity Timing (WOMBAT)

An important step in advancing global health through informatics is to understand how systems support health professionals to deliver improved services to patients. Studies in several countries have highlighted the potential for clinical information systems to change patterns of work and communication, and in particular have raised concerns that they reduce nurses’ time in direct care. However measuring the effects of systems on work is challenging and comparisons across studies have been hindered by a lack of standardised definitions and measurement tools. This paper describes the Work Observation Method by Activity Time (WOMBAT) technique version 1.0 and the ways in which the data generated can describe different aspects of health professionals’ work. In 2011 a revised WOMBAT version 2.0 was developed specifically to facilitate its use by research teams in different countries. The new features provide opportunities for international comparative studies of nurses’ work to be conducted

Cognitive Effort Avoidance in Veterans with Suicide Attempt Histories

Suicide attempts (SA) are increasing in the United States, especially in veterans. Discovering individual cognitive features of the subset of suicide ideators who attempt suicide is critical. Cognitive theories attribute SA to facile schema-based negative interpretations of environmental events. Over-general autobiographical memory and facile solutions in problem solving tasks in SA survivors suggest that aversion to expending cognitive effort may be a neurobehavioral marker of SA risk. In veterans receiving care for mood disorder, we compared cognitive effort discounting and evidence-gathering in a beads task between veterans with (SAHx+; n = 26) versus without (SAHx-; n = 22) a history of SA. Groups did not differ in depressed mood or in a proxy metric of premorbid intelligence. Compared to SAHx- participants, SAHx+ participants self-reported significantly more severe cognitive problems in most domains, and also eschewed choice to earn higher monetary reward if earning it required a slightly increased working memory (WM) demand relative to an easy WM task. There was no group difference, however, in extent of evidence-gathering before declaring a conclusion in a beads task. These preliminary data suggest that aversion to expenditure of cognitive effort, potentially as a component of cognitive difficulties, may be a marker for SA risk

Resolved diffraction patterns from a reflection grating for atoms

We have studied atomic diffraction at normal incidence from an evanescent standing wave with a high resolution using velocity selective Raman transitions. We have observed up to 3 resolved orders of diffraction, which are well accounted for by a scalar diffraction theory. In our experiment the transverse coherence length of the source is greater than the period of the diffraction grating.Comment: 8 pages, 4 figure