A study of prevalence of tobacco use and related factors among medical students as per the Global Health Professions Student Survey protocol

Background: Physicians who smoke are less likely to ask patients about their smoking and initiate cessation interventions. Hence it is important to study the prevalence of tobacco use, attitude and training of health professional students. Objectives were to study prevalence and attitudes towards tobacco use and training related to tobacco cessation.Methods: Armed Forces Medical college-based cross-sectional survey by anonymous, self-administered questionnaire as per Global Health Professions Student Survey (GHPSS) was conducted. Data was compiled and analyzed for various variables as per the GHPSS questionnaire.Results: Forty-two percent of the students had ever smoked cigarettes and 24% were current smokers. Nearly one in five had tried their first cigarette before 20 years of age. Male gender was associated with smoking. There is a significant association between not smoking and support for smoking ban in public places. Almost all the respondents (98.1%) thought smoking should be banned in all enclosed public places. In light of 20.6% of all respondents who smoked in college buildings during past this year indicated a gap between their knowledge, attitude and behavior. There was a strong desire to quit smoking but only 42% reported receiving help/ advice to stop smoking. Only one in ten reported receiving formal training in smoking cessation techniques.Conclusions: The fight against tobacco can get a boost through interventions aimed at health care professional students. Active Interventions should be made to address smoking issues among medical students. Skill based medical school curriculum should incorporate and emphasize on acquiring effective smoking cessation skills

Hermitian quark mass matrices with four texture zeros

We provide a complete and systematic analysis of hermitian, hierarchical quark mass matrices with four texture zeros. Using triangular mass matrices, each pattern of texture zeros is readily shown to lead to a definite relation between the CKM parameters and the quark masses. Nineteen pairs are found to be consistent with present data, and one other is marginally acceptable. In particular, no parallel structure between the up and down mass matrices is found to be favorable with data.Comment: 18 pages, no figure, references [8] and [10] adde

Increasing the acceptability and rates of organ donation among minority ethnic groups: a programme of observational and evaluative research on Donation, Transplantation and Ethnicity (DonaTE)

Background: Black, Asian and minority ethnic (BAME) groups have a high need for organ transplantation but deceased donation is low. This restricts the availability of well-matched organs and results in relatively long waiting times for transplantation, with increased mortality risks. Objective: To identify barriers to organ donor registration and family consent among the BAME population, and to develop and evaluate a training intervention to enhance communication with ethnic minority families and identify impacts on family consent. Methods: Three-phase programme comprising (1) community-based research involving two systematic reviews examining attitudes and barriers to organ donation and effective interventions followed by 22 focus groups with minority ethnic groups; (2) hospital-based research examining staff practices and influences on family consent through ethics discussion groups (EDGs) with staff, a study on intensive care units (ICUs) and interviews with bereaved ethnic minority families; and (3) development and evaluation of a training package to enhance cultural competence among ICU staff. Setting: Community focus group study in eight London boroughs with high prevalence of ethnic minority populations. Hospital studies at five NHS hospital trusts (three in London and two in Midlands). Participants: (1) Community studies: 228 focus group participants; (2) hospital studies: 35 nurses, 28 clinicians, 19 hospital chaplains, 25 members of local Organ Donation Committees, 17 bereaved family members; and (3) evaluation: 66 health professionals. Data sources: Focus groups with community residents, systematic reviews, qualitative interviews and observation in ICUs, EDGs with ICU staff, bereaved family interviews and questionnaires for trial evaluation. Review methods: Systematic review and narrative synthesis. Results: (1) Community studies: Organ Donor Register – different ethnic/faith and age groups were at varying points on the ‘pathway’ to organ donor registration, with large numbers lacking knowledge and remaining at a pre-contemplation stage. Key attitudinal barriers were uncertainties regarding religious permissibility, bodily concerns, lack of trust in health professionals and little priority given to registration, with the varying significance of these factors varying by ethnicity/faith and age. National campaigns focusing on ethnic minorities have had limited impact, whereas characteristics of effective educational interventions are being conducted in a familiar environment; addressing the groups’ particular concerns; delivery by trained members of the lay community; and providing immediate access to registration. Interventions are also required to target those at specific stages of the donation pathway. (2) Hospital studies: family consent to donation – many ICU staff, especially junior nurses, described a lack of confidence in communication and supporting ethnic minority families, often reflecting differences in emotional expression, faith and cultural beliefs, and language difficulties. The continuing high proportion of family donation discussions that take place without the collaboration of a specialist nurse for organ donation (SNOD) reflected consultants’ views of their own role in family consent to donation, a lack of trust in SNODs and uncertainties surrounding controlled donations after circulatory (or cardiac) death. Hospital chaplains differed in their involvement in ICUs, reflecting their availability/employment status, personal interests and the practices of ICU staff. (3) Evaluation: professional development package – a digital versatile disk-based training package was developed to promote confidence and skills in cross-cultural communication (available at: www.youtube.com/watch?v=ueaR6XYkeVM&feature=youtu.be). Initial evaluation produced positive feedback and significant affirmative attitudinal change but no significant difference in consent rate over the short follow-up period with requirements for longer-term evaluation. Limitations: Participants in the focus group study were mainly first-generation migrants of manual socioeconomic groups. It was not permitted to identify non-consenting families for interview with data regarding the consent process were therefore limited to consenting families. Conclusions: The research presents guidance for the effective targeting of donation campaigns focusing on minority ethnic groups and provides the first training package in cultural competence in the NHS. Future work: Greater evaluation is required of community interventions in the UK to enhance knowledge of effective practice and analysis of the experiences of non-consenting ethnic minority families. Funding: The National Institute for Health Research Programme Grants for Applied Research programme

Anodic dissolution behaviour of tungsten carbide scraps in ammoniacal media

In the present paper, potentiodynamic studies of WC scrap have been carried out as these studies give better idea about the anodic dissolution behaviour of the scrap material for their recycling to recover metal values. However, it has been seen that anodic passivation retards the dissolution of the scrap and adversely affects the recovery of metals. To minimise the passivity and to increase the anodic dissolution, some chemicals are often used as additives. Two different electrolytes namely hydrochloric acid and aqueous ammonia at varying concentrations had been employed for the above studies. The additives citric acid and oxalic acid were added to the acidic electrolyte whereas ammonium chloride, ammonium carbonate, ammonium sulphate were added in different concentration to the ammoniacal electrolyte. The studies revealed that 2% citric acid in 1N HCl was the optimum to achieve maximum anodic dissolution (current) of WC scrap. On the other hand, 2% NH4Cl was found suitable to obtain maximum anodic dissolution (current) in the ammoniacal (1N) medium. The potentiodynamic studies were followed by the actual electrodissolution experiments in an electrolytic cell with the help of a rectifier. The W and Co were recovered as tungsten oxide and metallic chips, respectively

An exploration of the attitudes and views of general practitioners on the use of video consultations in a primary healthcare setting: a qualitative pilot study

BACKGROUND: In 2014, in the United Kingdom, the government made a commitment to spend £3.6 million on the introduction of Skype video calling consultations in general practice, however the efficacy of such technology has not yet been explored fully.AimThe study aimed to explore the views and attitudes of General Practitioners (GPs) towards video consultation in primary care; specifically, in three broad areas ∙The benefits of video consultations to patients and healthcare professionals.∙Potential problems with video consultation and its implementation.∙The cost-effectiveness of video consultation in this setting. METHOD: A convenience sample of the views of 12 general practitioners across two primary care centres in North London were identified using topic guide based semi-structured interviews. A thematic framework approach was used to analyse the data collected to isolate main and sub-themes.FindingsThree main themes were identified 1.Technology - GPs expressed concerns about the ability of patients to use technology, the availability of technology and the quality of technology available.2.Utility - encompassing GP's ideas about the usefulness of video consultations to patients, practitioners and the doctor-patient relationship. GPs presented mixed views on the extent to which video consultation would be useful.3.Practicality - covering the views of GPs on implementation and effects on workload. GPs unanimously felt that it was not a practical substitute for face-to-face consultation. There were mixed feelings about it being used as an alternative to telephone consultation. CONCLUSION: GPs did see potential benefits to using video consultations but also expressed concerns that need to be addressed if they are to have full confidence in the system. The views of those who are going to use video consultation as a means of increasing patient access are paramount if such tools are to be a core part of primary care

An overview on different processes for recovery of valuable metals from tungsten carbide scrap.

Cemented tungsten carbide material has been widely used in the hard metal industry for the manufacture of cutting tools, drilling tools, mining and machining tools and high wear resistant parts. When these tool bits and components are scrapped, they are collected and processed for recycling following appropriate methods. Tungsten and cobalt both are strategic rare metals and the cost of these metals entrapped in these scraps is estimated to be very high. Therefore, WC scraps have been considered as an important secondary resource of cobalt and tungsten metals. Recycling of hard materials like tungsten carbide scrap require specialised techniques. This paper presents a review of the different processes reported so far to recover valuable metals (W, Co) from cemented tungsten carbide scrap materials. Recycling techniques following either hydro or pyrometallurgical or a combination of them to recover the valuable metals (W, Co) are discussed. Thermal oxidation in presence of air/oxygen generates friable oxides of metals contained in tungsten carbide hard material, which is either leached in acid/alkali to produce tungsten oxide or subjected to reduction by hydrogen to produce tungsten powder. Direct leaching of tungsten scrap in concentrated acid/alkali solutions has also been investigated and different value added materials like ammonium para tungstate, tungstic acid etc are produced in the subsequent processing of leach liquor. The electrochemical route has emerged as an attractive method as it is a single step dissolution process consuming very low energy. However, passivation has been reported to slow down the dissolution rate and hence, some additives have also been tried for continuous dissolution. The environmental and economical aspects of some of the important processes have also been highlighted in this paper

Squamous cell carcinoma of tongue in a 19-year-old female

Squamous cell carcinoma is the most common malignant neoplasm of the Oral Cavity, usually affecting individuals over 50 years of age. It rarely occurs in patients who are less than 40 years old (0.4-5.5%). However, since it is so rare, when cases occur they are often misdiagnosed and inappropriately treated leading to delay in definitive treatment. This report describes a case of squamous cell carcinoma, involving the posterolateral border of the tongue of a 19-year-old female patient, with no deleterious habits usually associated with oral cancer. This report focuses on the etiological factors and prognosis related to the case. Additionally, a brief literature review regarding squamous cell carcinoma in young patients is also included

Squamous cell carcinoma of tongue in a 19-year-old female

Squamous cell carcinoma is the most common malignant neoplasm of the Oral Cavity, usually affecting individuals over 50 years of age. It rarely occurs in patients who are less than 40 years old (0.4-5.5%). However, since it is so rare, when cases occur they are often misdiagnosed and inappropriately treated leading to delay in definitive treatment. This report describes a case of squamous cell carcinoma, involving the posterolateral border of the tongue of a 19-year-old female patient, with no deleterious habits usually associated with oral cancer. This report focuses on the etiological factors and prognosis related to the case. Additionally, a brief literature review regarding squamous cell carcinoma in young patients is also included

A Novel Universal Primer-Multiplex-PCR Method with Sequencing Gel Electrophoresis Analysis

In this study, a novel universal primer-multiplex-PCR (UP-M-PCR) method adding a universal primer (UP) in the multiplex PCR reaction system was described. A universal adapter was designed in the 5′-end of each specific primer pairs which matched with the specific DNA sequences for each template and also used as the universal primer (UP). PCR products were analyzed on sequencing gel electrophoresis (SGE) which had the advantage of exhibiting extraordinary resolution. This method overcame the disadvantages rooted deeply in conventional multiplex PCR such as complex manipulation, lower sensitivity, self-inhibition and amplification disparity resulting from different primers, and it got a high specificity and had a low detection limit of 0.1 ng for single kind of crops when screening the presence of genetically modified (GM) crops in mixture samples. The novel developed multiplex PCR assay with sequencing gel electrophoresis analysis will be useful in many fields, such as verifying the GM status of a sample irrespective of the crop and GM trait and so on

Clinical features of acute reversible tacrolimus (FK 506) nephrotoxicity in kidney transplant recipients

This study was designed to (a) estimate the contribution of tacrolimus nephrotoxicity to episodes of renal allograft dysfunction investigated by needle biopsy, (b) describe the temporal evolution of nephrotoxicity and its response to therapy, and (c) ascertain how often renal dysfunction is associated with concurrent extra-renal toxicity. Patients were selected based on a rising serum creatinine, normal ultrasound, and biopsy findings leading to a reduction in the dose of tacrolimus and a fall in serum creatinine. Twenty two (17%) cases of nephrotoxicity were identified amongst 128 consecutive kidney transplant biopsies with sufficient clinical data for analysis. There were 13 males and 9 females, 17-75 yr in age. Tacrolimus was administered initially as a 0.075-0.1 mg/kg/d IV continuous infusion followed by an oral dose of 0.15 mg/kg twice daily. The onset of nephrotoxicity in this study occurred 1-156 wk post-operatively. The mean baseline creatinine was 212.2 ± 168.0 μmol/l (range 88.4-875.2) and rose 40.6% ± 14.2% (range 11-66) during episodes of nephrotoxicity (p 5.0 mequiv./l was recorded in 9/22 (41%) cases. Three or more elevations in blood glucose > 7.7 mmol/l (140 mg/dl) were recorded in 4/11 (36%) non-diabetic patients. Hand tremors were seen in two (9%) cases and elevated diastolic blood pressure > 90 mmHg in seven (32%) patients. In conclusion, tacrolimus nephrotoxicity accounted for 17% of graft dysfunction episodes investigated by biopsy. Concurrent hyperglycemia, hyperkalemia, or tremors were noted in several patients. Nephrotoxicity responded well to reduction in the drug dosage