Gender Equality, Drinking Cultures and Second-Hand Harms from Alcohol in the 50 US States.

BackgroundGender inequality and cultures of binge drinking may increase the risk of second-hand harms from alcohol.MethodsUsing the 2014-2015 National Alcohol Survey and 2015 National Alcohol's Harm to Others Survey (N = 7792), we examine associations of state-level gender equality measures (contraceptive access, abortion rights, women's economic equality) and binge drinking cultures (rates of men's and women's binge drinking) with individual-level indicators of second-hand harms by drinking strangers and partners/spouses.ResultsIn main effects models, only male binge drinking was associated with greater odds of harms from drinking strangers. There were significant interactions of gender equality with male binge drinking: High male binge drinking rates were more strongly associated with stranger-perpetrated harms in states low on contraceptive access or abortion rights compared to states high on these measures. Conversely, male binge drinking was more strongly associated with spouse/partner-perpetrated second-hand harms in states with more economic equality, compared to states lower on this measure.ConclusionsDetrimental effects of high male binge drinking rates may be modified by gender equality. Targeted interventions may reduce alcohol-related harms experienced by women in states with high rates of male binge drinking. Restrictions in access to contraception and abortion may exacerbate harms due to men's drinking

Clinician-targeted interventions to reduce antibiotic prescribing for acute respiratory infections in primary care:An overview of systematic reviews

This is the protocol for a review and there is no abstract. The objectives are as follows: To systematically review the literature and appraise the existing evidence from systematic reviews regarding the effects of interventions, aimed at changing clinician behaviour, to reduce antibiotic prescribing for ARIs in primary care

Neutrinos from Dark Matter annihilations at the Galactic Centre

We discuss the prospects for detection of high energy neutrinos from dark matter annihilation at the Galactic centre. Despite the large uncertainties associated with our poor knowledge of the distribution of dark matter in the innermost regions of the Galaxy, we determine an upper limit on the neutrino flux by requiring that the associated gamma-ray emission does not exceed the observed flux. We conclude that if dark matter is made of neutralinos, a neutrino flux from dark matter annihilations at the GC will not be observable by Antares. Conversely, the positive detection of such a flux would either require an alternative explanation, in terms of astrophysical processes, or the adoption of other \DM candidates, disfavouring the case for neutralinos.Comment: 8 pages, 7 figures, submitted to PR

Geographic Differences in Event Rates by Model for End-Stage Liver Disease Score

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72232/1/j.1600-6143.2006.01508.x.pd

Opportunistic screening for atrial fibrillation by clinical pharmacists in UK general practice during the influenza vaccination season: a cross-sectional feasibility study

Background: Growing prevalence of atrial fibrillation (AF) in the ageing population, and its associated life-changing health and resource implications, have led to a need to improve its early detection. Primary care is an ideal place to screen for AF, however this is limited by shortages in general practitioner (GP) resources. Recent increases in the number of clinical pharmacists within primary care, makes them ideally placed to conduct AF screening. This study aimed to determine the feasibility of GP practice-based clinical pharmacists to screen the over 65s for AF, using digital technology and pulse palpation during the influenza vaccination season. Methods and Findings: Screening was conducted over two influenza vaccination seasons, 2017-2018 and 2018-2019 in four GP practices in Kent, UK. Pharmacists were trained by a cardiologist to pulse palpate, record and interpret a single-lead ECG (SLECG). Eligible persons aged ≥65 years, attending an influenza vaccination clinic were offered a free heart rhythm check. 604 participants were screened (median age 73 years, 42.7% male). Total prevalence of AF was 4.3%. All participants with AF qualified for anticoagulation and were more likely to be male (57.7%); older; have an increased BMI and have a CHA2DS2-VASc (Congestive heart failure, Hypertension, Age ≥ 75, Diabetes, previous Stroke, Age 65-74 years, Sex category) score ≥ 3. The sensitivity and specificity of clinical pharmacists diagnosing AF using pulse palpation was 76.9% [95% CI: 56.4-91.0] and 92.2% [89.7-94.3], respectively. This rose to 88.5% (69.9-97.6) and 97.2% [95.5-98.4] with a SLECG. At follow-up, four participants (0.7%) were diagnosed with new AF and 3 (0.5%) were initiated on anticoagulation. Screening with SLECG also helped identify new non-AF cardiovascular diagnoses, such as left ventricular hypertrophy, in 28 participants (4.6%). The screening strategy was cost-effective in 71.8% and 64.3% of the estimates for SLECG or pulse palpation, respectively. Feedback from participants (422/604) was generally positive. Key limitations of the study were that the intervention did not reach individuals who did not attend the practice for an influenza vaccination and there was a limited representation of UK ethnic minority groups in the study cohort. Conclusions: This study demonstrates that AF screening performed by GP practice-based pharmacists was feasible, economically viable and positively endorsed by participants. Furthermore, diagnosis of AF by the clinical pharmacist using a SLECG was more sensitive and more specific than the use of pulse palpation alone. Future research should explore the key barriers preventing the adoption of national screening programmes

Atom--Molecule Coherence in a Bose-Einstein Condensate

Coherent coupling between atoms and molecules in a Bose-Einstein condensate (BEC) has been observed. Oscillations between atomic and molecular states were excited by sudden changes in the magnetic field near a Feshbach resonance and persisted for many periods of the oscillation. The oscillation frequency was measured over a large range of magnetic fields and is in excellent quantitative agreement with the energy difference between the colliding atom threshold energy and the energy of the bound molecular state. This agreement indicates that we have created a quantum superposition of atoms and diatomic molecules, which are chemically different species.Comment: 7 pages, 6 figure

Organometallic nucleoside analogues: effect of hydroxyalkyl linker length on cancer cell line toxicity

A new series of chiral ferrocene derivatives containing both a hydroxyalkyl group and a thyminyl group on one cyclopentadienyl ring have been synthesised to probe structure–activity relationships in cancer cell line cytotoxicities. The stereoisomers of enantiomeric pairs of these so-called ferronucleosides have been studied and characterised by a combination of chiral analytical HPLC and single-crystal X-ray diffraction. Biological activity studies revealed that changing the length of the hydroxyalkyl group had marked effects on IC50 values, with compounds having shorter arms that more closely resemble endogenous nucleosides exhibiting lower cytotoxicities. The lipophilicities and electrochemical properties of this compound series have been studied to rationalise these trends and indicate future directions of study

Pharmacists detecting atrial fibrillation (PDAF) in primary care during the influenza vaccination season: a multi-site, cross sectional feasibility pilot study

Reducing AF-related stroke risk is both clinically and economically important, with AF-related illness costing the NHS over £2 billion per annum. Despite this, there is no national screening programme for AF. Growing medical consensus backed by public health policy, agrees that there is an unmet need to improve diagnosis and that primary care is an appropriate setting. This model is likely to be convenient for patients and cost effective, but with the current shortage of GPs and nurses, and increasing GP workloads, it is unlikely to succeed. Huge investment by NHS England to introduce new work role models to GP practices, could mean, by 2021, that over 34 million patients will have access to the expertise of a clinical pharmacist, making clinical pharmacists a viable option for such screening initiatives. AIM: To determine whether clinical pharmacists based within GP practices, were able to accurately and effectively screen and diagnose patients for AF, using pulse palpation and a single-lead ECG device (AliveCor Kardia Mobile®) during the influenza vaccination season