Radiocarbon dating of deep-sea corals

Deep-sea corals are a promising new archive of paleoclimate. Coupled radiocarbon and U-series dates allow ^(14)C to be used as a tracer of ocean circulation rate in the same manner as it is used in the modern ocean. Diagnetic alteration of coral skeletons on the seafloor requires a thorough cleaning of contaminating phases of carbon. In addition, 10% of the coral must be chemically leached prior to dissolution to remove adsorbed modern CO_2. A survey of modern samples from the full Δ^(14)C gradient in the deep ocean demonstrates that the coralline CaCO_3 records the radiocarbon value of the dissolved inorganic carbon

V. problem presentation and advice-giving on a home birth helpline

The rate of home births in the UK is very low (around 2%) and many women who would like to give birth at home find it impossible to get midwifery cover or are advised of medical contraindications. The Home Birth Helpline offers support and expertise for women in this situation. Based on the analysis of 80 recorded calls, this article uses conversation analysis (CA) to explore how callers present their reason for calling the helpline, and what this shows about the culturally shared medicalized culture of birth. This research is an example of feminist CA in that it contributes both to the study of childbirth as a key women's health issue and to the study of helpline interaction from a conversation analytic perspectiv

Do callers of young children with fever follow the self-care recommendations given by a nursing triage line?

Introduction The management of fever can be a stressful situation for caregivers of young children. Accessing emergency departments and urgent care centres (ED/UCCs) due to concerns about fever and the potential consequences of child fever is common, despite fever rarely being considered a medical emergency. Objectives and Approach Determine the non-compliance rate with public health advice for self-care at home for young children (3-35 months) with a fever. Non-compliance was defined based on the presence of a record of healthcare use within 72 hours following a call to a nurse telephone triage line, Health Link (HL), and receiving a self-care recommendation. Callers between October 2015-March 2016 were identified and linked with four databases: registry files, National Ambulatory Care Reporting System; Inpatient-Discharge Abstract Database and Physician Claims (N = 879). Overall non-compliance rate and descriptive analysis by child age, caregiver age, geography, and call time were completed. Results The overall non-compliance rate with HL advice was 35.6%. Among callers, 17.5% visited an ED/UCC, 1.1% had an inpatient hospital admission, and 21.3% visited a physician’s office. Among the patients that utilized health care services after the HL call, 13.6% only visited ED/UCC, 18% only visited a physician’s office, and 4% utilized more than one type of health care service. Callers in rural and rural remote areas had lower odds of visiting a physician’s office compared to the urban areas (p-value <0.01). No significant differences were found by child age, caregiver age or time of call. Conclusion/Implications Findings of this study suggest that approximately one-third of callers are not following the telephone triage advice, potentially leading to unnecessary increased burden on the healthcare system. Further study is warranted to examine reasons for non-compliance. Strategies to increase compliance in caregivers should be explored

Implementing Shared Decision Making in the NHS: Lessons from the MAGIC Programme

Contains fulltext : 174279.pdf (publisher's version ) (Open Access

9.1 PERSONAL COMMUNICATIONS

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Non-participation during azithromycin mass treatment for trachoma in The Gambia: heterogeneity and risk factors.

BACKGROUND: There is concern that untreated individuals in mass drug administration (MDA) programs for neglected tropical diseases can reduce the impact of elimination efforts by maintaining a source of transmission and re-infection. METHODOLOGY/PRINCIPAL FINDINGS: Treatment receipt was recorded against the community census during three MDAs with azithromycin for trachoma in The Gambia, a hypo-endemic setting. Predictors of non-participation were investigated in 1-9 year olds using random effects logistic regression of cross-sectional data for each MDA. Two types of non-participators were identified: present during MDA but not treated (PNT) and eligible for treatment but absent during MDA (EBA). PNT and EBA children were compared to treated children separately. Multivariable models were developed using baseline data and validated using year one and two data, with a priori adjustment for previous treatment status. Analyses included approximately 10000 children at baseline and 5000 children subsequently. There was strong evidence of spatial heterogeneity, and persistent non-participation within households and individuals. By year two, non-participation increased significantly to 10.4% overall from 6.2% at baseline, with more, smaller geographical clusters of non-participating households. Multivariable models suggested household level predictors of non-participation (increased time to water and household head non-participation for both PNT and EBA; increased household size for PNT status only; non-inclusion in a previous trachoma examination survey and younger age for EBA only). Enhanced coverage efforts did not decrease non-participation. Few infected children were detected at year three and only one infected child was EBA previously. Infected children were in communities close to untreated endemic areas with higher rates of EBA non-participation during MDA. CONCLUSIONS/SIGNIFICANCE: In hypo-endemic settings, with good coverage and no association between non-participation and infection, efforts to improve participation during MDA may not be required. Further research could investigate spatial hotspots of infection and non-participation in other low and medium prevalence settings before allocating resources to increase participation

Outcomes of domestic violence screening at an acute London trust: are there missed opportunities for intervention?

Objectives: domestic violence screening is advocated in some healthcare settings. Evidence that it increases referral to support agencies or improves health outcomes is limited. This study aimed to (1) investigate the proportion of hospital patients reporting domestic violence, (2) describe characteristics and previous hospital attendances of affected patients and (3) assess referrals to an in-house domestic violence advisor from Camden Safety Net.Design: a series of observational studies.Setting: three outpatient clinics at the Royal Free London NHS Foundation Trust.Participants: 10?158 patients screened for domestic violence in community gynaecology, genitourinary medicine (GUM) and HIV medicine clinics between 1 October 2013 and 30 June 2014. Also 2253 Camden Safety Net referrals over the same period.Main outcome measures: (1) Percentage reporting domestic violence by age group gender, ethnicity and clinic. (2) Rates of hospital attendances in the past 3?years for those screening positive and negative. (3) Characteristics, uptake and risk assessment results for hospital in-house domestic violence referrals compared with Camden Safety Net referrals from other sources.Results: of the 10?158 patients screened, 57.4% were female with a median age of 30?years. Overall, 7.1% reported ever-experiencing domestic violence, ranging from 5.7% in GUM to 29.4% in HIV services. People screening positive for domestic violence had higher rates of previous emergency department attendances (rate ratio (RR) 1.63, 95% CI 1.09 to 2.48), emergency inpatient admissions (RR 2.27, 95% CI 1.37 to 3.84) and day-case admissions (RR 2.03, 95% CI 1.23 to 3.43) than those screening negative. The 77 hospital referrals to the hospital-based domestic violence advisor during the study period were more likely to be taken up and to be classified as high risk than referrals from elsewhere.Conclusions: selective screening for domestic violence in high-risk hospital clinic populations has the potential to identify affected patients and promote good uptake of referrals for in-house domestic violence suppor

Stromal senescence establishes an immunosuppressive microenvironment that drives tumorigenesis

Age is a significant risk factor for the development of cancer. However, the mechanisms that drive age-related increases in cancer remain poorly understood. To determine if senescent stromal cells influence tumorigenesis, we develop a mouse model that mimics the aged skin microenvironment. Using this model, here we find that senescent stromal cells are sufficient to drive localized increases in suppressive myeloid cells that contributed to tumour promotion. Further, we find that the stromal-derived senescence-associated secretory phenotype factor interleukin-6 orchestrates both increases in suppressive myeloid cells and their ability to inhibit anti-tumour T-cell responses. Significantly, in aged, cancer-free individuals, we find similar increases in immune cells that also localize near senescent stromal cells. This work provides evidence that the accumulation of senescent stromal cells is sufficient to establish a tumour-permissive, chronic inflammatory microenvironment that can shelter incipient tumour cells, thus allowing them to proliferate and progress unabated by the immune system

Low reservoir ages for the surface ocean from mid-Holocene Florida corals

Author Posting. © American Geophysical Union, 2008. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Paleoceanography 23 (2008): PA2209, doi:10.1029/2007PA001527.The 14C reservoir age of the surface ocean was determined for two Holocene periods (4908–4955 and 3008–3066 calendar (cal) B.P.) using U/Th-dated corals from Biscayne National Park, Florida, United States. We found that the average reservoir ages for these two time periods (294 ± 33 and 291 ± 27 years, respectively) were lower than the average value between A.D. 1600 and 1900 (390 ± 60 years) from corals. It appears that the surface ocean was closer to isotopic equilibrium with CO2 in the atmosphere during these two time periods than it was during recent times. Seasonal δ 18O measurements from the younger coral are similar to modern values, suggesting that mixing with open ocean waters was indeed occurring during this coral's lifetime. Likely explanations for the lower reservoir age include increased stratification of the surface ocean or increased Δ14C values of subsurface waters that mix into the surface. Our results imply that a more correct reservoir age correction for radiocarbon measurements of marine samples in this location from the time periods ∼3040 and ∼4930 cal years B.P. is ∼292 ± 30 years, less than the canonical value of 404 ± 20 years.NSF Chemical Oceanography program provided monetary support under grants OCE-9711326, OCE-0137207, and OCE-0551940 (to ERMD)