1,928 research outputs found
A Cross-Sectional Survey of Anesthetic Airway Equipment and Airway Management Practices in Uganda.
BACKGROUND: Anesthesia-related causes contribute to a significant proportion of perioperative deaths, especially in low and middle-income countries (LMICs). There is evidence that complications related to failed airway management are a significant contributor to perioperative morbidity and mortality. While existing data have highlighted the magnitude of airway management complications in LMICs, there are inadequate data to understand their root causes. This study aimed to pilot an airway management capacity tool that evaluates airway management resources, provider practices, and experiences with difficult airways in an attempt to better understand potential contributing factors to airway management challenges. METHODS: We developed a novel airway management capacity assessment tool through a nonsystematic review of existing literature on anesthesia and airway management in LMICs, internationally recognized difficult airway algorithms, minimum standards for equipment, the safe practice of anesthesia, and the essential medicines and health supplies list of Uganda. We distributed the survey tool during conferences and workshops, to anesthesia care providers from across the spectrum of surgical care facilities in Uganda. The data were analyzed using descriptive methods. RESULTS: Between May 2017 and May 2018, 89 of 93 surveys were returned (17% of anesthesia providers in the country) from all levels of health facilities that provide surgical services in Uganda. Equipment for routine airway management was available to all anesthesia providers surveyed, but with a limited range of sizes. Pediatric airway equipment was always available 54% of the time. There was limited availability of capnography (15%), video laryngoscopes (4%), cricothyroidotomy kits (6%), and fiber-optic bronchoscopes (7%). Twenty-one percent (18/87) of respondents reported experiencing a "can't intubate, can't ventilate" (CICV) scenario in the 12 months preceding the survey, while 63% (54/86) reported experiencing at least 1 CICV during their career. Eighty-five percent (74/87) of respondents reported witnessing a severe airway management complication during their career, with 21% (19/89) witnessing a death as a result of a CICV scenario. CONCLUSIONS: We have developed and implemented an airway management capacity tool that describes airway management practices in Uganda. Using this tool, we have identified significant gaps in access to airway management resources. Gaps identified by the survey, along with advocacy by the Association of Anesthesiologists of Uganda, in partnership with the Ugandan Ministry of Health, have led to some progress in closing these gaps. Expanding the availability of airway management resources further, providing more airway management training, and identifying opportunities to support skilled workforce expansion have the potential to improve perioperative safety in Uganda
Estratégias para aumentar a sensibilidade da farmacovigilùncia em Portugal
OBJETIVO: Avaliar os resultados de intervenção para melhoria da quantidade e relevĂąncia das notificaçÔes de reacçÔes adversas a medicamentos. MĂTODOS: Foi implementado um estudo controlado aleatorizado, por agrupamentos em farmacĂȘuticos a exercer actividade profissional na regiĂŁo norte de Portugal, em 2007. ApĂłs aleatorização, 364 indivĂduos foram alocados ao grupo de intervenção (261 na intervenção telefĂłnica e 103 nos workshops); o grupo de controlo foi constituĂdo por 1.103 farmacĂȘuticos. Na intervenção educativa foram abordados a problemĂĄtica das reacçÔes adversas a medicamentos, o impacto na saĂșde pĂșblica e a notificação espontĂąnea. Quanto Ă relevĂąncia, as reaçÔes adversas foram classificadas em graves e inesperadas. A anĂĄlise estatĂstica foi efectuada com base no princĂpio intention-to-treat; aplicaram-se modelos lineares generalizados mistos, utilizando o mĂ©todo penalized quasi-likelihood. Os farmacĂȘuticos estudados foram seguidos durante um perĂodo de 20 meses. RESULTADOS: A intervenção aumentou trĂȘs vezes a taxa de notificação espontĂąnea das reaçÔes adversas (RR = 3,22; IC 95%: 1,33; 7,80) relativamente ao grupo de controlo. Houve incremento da relevĂąncia das notificaçÔes com aumento das reaçÔes adversas graves em cerca de quatro vezes (RR = 3,87; IC 95%: 1,29;11,61) e inesperadas em cinco vezes (RR = 5,02; IC 95%: 1,33;18,93), relativamente ao grupo de controlo. CONCLUSĂES: As intervençÔes educativas aumentam significativamente, por atĂ© quatro meses, a quantidade e a relevĂąncia das notificaçÔes espontĂąneas de reacçÔes adversas a medicamentos por parte dos farmacĂȘuticos da regiĂŁo norte de Portugal
R^4 counterterm and E7(7) symmetry in maximal supergravity
The coefficient of a potential R^4 counterterm in N=8 supergravity has been
shown previously to vanish in an explicit three-loop calculation. The R^4 term
respects N=8 supersymmetry; hence this result poses the question of whether
another symmetry could be responsible for the cancellation of the three-loop
divergence. In this article we investigate possible restrictions from the coset
symmetry E7(7)/SU(8), exploring the limits as a single scalar becomes soft, as
well as a double-soft scalar limit relation derived recently by Arkani-Hamed et
al. We implement these relations for the matrix elements of the R^4 term that
occurs in the low-energy expansion of closed-string tree-level amplitudes. We
find that the matrix elements of R^4 that we investigated all obey the
double-soft scalar limit relation, including certain
non-maximally-helicity-violating six-point amplitudes. However, the single-soft
limit does not vanish for this latter set of amplitudes, which suggests that
the E7(7) symmetry is broken by the R^4 term.Comment: 33 pages, typos corrected, published versio
Evidence for the Emergence of New Rice Types of Interspecific Hybrid Origin in West African Farmers' Fields
In West Africa two rice species (Oryza glaberrima Steud. and Oryza sativa L.) co-exist. Although originally it was thought that interspecific hybridization is impossible without biotechnological methods, progenies of hybridization appear to occur in farmer fields
Phylogenetic Position of a Copper Age Sheep (Ovis aries) Mitochondrial DNA
BACKGROUND: Sheep (Ovis aries) were domesticated in the Fertile Crescent region about 9,000-8,000 years ago. Currently, few mitochondrial (mt) DNA studies are available on archaeological sheep. In particular, no data on archaeological European sheep are available. METHODOLOGY/PRINCIPAL FINDINGS: Here we describe the first portion of mtDNA sequence of a Copper Age European sheep. DNA was extracted from hair shafts which were part of the clothes of the so-called Tyrolean Iceman or Ătzi (5,350-5,100 years before present). Mitochondrial DNA (a total of 2,429 base pairs, encompassing a portion of the control region, tRNA(Phe), a portion of the 12S rRNA gene, and the whole cytochrome B gene) was sequenced using a mixed sequencing procedure based on PCR amplification and 454 sequencing of pooled amplification products. We have compared the sequence with the corresponding sequence of 334 extant lineages. CONCLUSIONS/SIGNIFICANCE: A phylogenetic network based on a new cladistic notation for the mitochondrial diversity of domestic sheep shows that the Ătzi's sheep falls within haplogroup B, thus demonstrating that sheep belonging to this haplogroup were already present in the Alps more than 5,000 years ago. On the other hand, the lineage of the Ătzi's sheep is defined by two transitions (16147, and 16440) which, assembled together, define a motif that has not yet been identified in modern sheep populations
A telephone survey of cancer awareness among frontline staff: informing training needs
Background:
Studies have shown limited awareness about cancer risk factors among hospital-based staff. Less is known about general cancer awareness among community frontline National Health Service and social care staff.
Methods:
A cross-sectional computer-assisted telephone survey of 4664 frontline community-based health and social care staff in North West England.
Results:
A total of 671 out of 4664 (14.4%) potentially eligible subjects agreed to take part. Over 92% of staff recognised most warning signs, except an unexplained pain (88.8%, n=596), cough or hoarseness (86.9%, n=583) and a sore that does not heal (77.3%, n=519). The bowel cancer-screening programme was recognised by 61.8% (n=415) of staff. Most staff agreed that smoking and passive smoking âincreased the chance of getting cancer.â Fewer agreed about getting sunburnt more than once as a child (78.0%, n=523), being overweight (73.5%, n=493), drinking more than one unit of alcohol per day (50.2%, n=337) or doing less than 30âmin of moderate physical exercise five times a week (41.1%, n=276).
Conclusion:
Cancer awareness is generally good among frontline staff, but important gaps exist, which might be improved by targeted education and training and through developing clearer messages about cancer risk factors
Genes Suggest Ancestral Colour Polymorphisms Are Shared across Morphologically Cryptic Species in Arctic Bumblebees
email Suzanne orcd idCopyright: © 2015 Williams et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Soil water-holding capacity and monodominance in Southern Amazon tropical forests
Background and aims: We explored the hypothesis that low soil water-holding capacity is the main factor driving the monodominance of Brosimum rubescens in a monodominant forest in Southern Amazonia. Tropical monodominant forests are rare ecosystems with low diversity and high dominance of a single tree species. The causes of this atypical condition are still poorly understood. Some studies have shown a relationship between monodominance and waterlogging or soil attributes, while others have concluded that edaphic factors have little or no explanatory value, but none has accounted for soil-moisture variation other than waterlogging. This study is the first to explicitly explore how low soil water-holding capacity influences the monodominance of tropical forests.
Methods: We conducted in situ measurements of vertical soil moisture using electrical resistance collected over 1 year at 0â5; 35â40 and 75â80 cm depths in a B. rubescens monodominant forest and in an adjacent mixed-species forest in the Amazon-Cerrado transition zone, Brazil. Minimum leaf water potential (Κmin) of the seven most common species, including B. rubescens, and soil water-holding capacity for both forests were determined.
Results: The vertical soil moisture decay pattern was similar in both forests for all depths. However, the slightly higher water availability in the monodominant forest and Κmin similarity between B. rubescens and nearby mixed forest species indicate that low water-availability does not cause the monodominance.
Conclusions: We reject the hypothesis that monodominance of B. rubescens is primarily determined by low soil water-holding capacity, reinforcing the idea that monodominance in tropical forests is not determined by a single factor
The Rossiter-McLaughlin effect in Exoplanet Research
The Rossiter-McLaughlin effect occurs during a planet's transit. It provides
the main means of measuring the sky-projected spin-orbit angle between a
planet's orbital plane, and its host star's equatorial plane. Observing the
Rossiter-McLaughlin effect is now a near routine procedure. It is an important
element in the orbital characterisation of transiting exoplanets. Measurements
of the spin-orbit angle have revealed a surprising diversity, far from the
placid, Kantian and Laplacian ideals, whereby planets form, and remain, on
orbital planes coincident with their star's equator. This chapter will review a
short history of the Rossiter-McLaughlin effect, how it is modelled, and will
summarise the current state of the field before describing other uses for a
spectroscopic transit, and alternative methods of measuring the spin-orbit
angle.Comment: Review to appear as a chapter in the "Handbook of Exoplanets", ed. H.
Deeg & J.A. Belmont
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