Responding to unexpected infant deaths : experience in one English region

New national procedures for responding to the unexpected death of a child in England require a joint agency approach to investigate each death and support the bereaved family. As part of a wider population-based study of sudden unexpected deaths in infancy (SUDI) we evaluated the implementation of this approach. Methods: A process evaluation using a population-based study of all unexpected deaths from birth to 2 years in the South West of England between January 2003 and December 2006. Local police and health professionals followed a standardised approach to the investigation of each death, supported by the research team set up to facilitate this joint approach as well as collect data for a wider research project. Results: We were notified of 155/157 SUDI, with a median time to notification of 2 hours. Initial multi-agency discussions took place in 93.5% of cases. A joint home visit by police officers with health professionals was carried out in 117 cases, 75% within 24 hours of the death. Time to notification and interview reduced during the 4 years of the study. Autopsies were conducted on all cases, the median time to autopsy being 3 days. At the conclusion of the investigation, a local multi-agency case discussion was held in 88% of cases. The median time for the whole process (including family support) was 5 months. Conclusions: This study has demonstrated that with appropriate protocols and support, the joint agency approach to the investigation of unexpected infant deaths can be successfully implemented

Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England

Objectives: To investigate the factors associated with sudden infant death syndrome (SIDS) from birth to age 2 years, whether recent advice has been followed, whether any new risk factors have emerged, and the specific circumstances in which SIDS occurs while cosleeping (infant sharing the same bed or sofa with an adult or child). Design: Four year population based case-control study. Parents were interviewed shortly after the death or after the reference sleep (within 24 hours) of the two control groups. Setting: South west region of England (population 4.9 million, 184 800 births). Participants: 80 SIDS infants and two control groups weighted for age and time of reference sleep: 87 randomly selected controls and 82 controls at high risk of SIDS (young, socially deprived, multiparous mothers who smoked). Results: The median age at death (66 days) was more than three weeks less than in a study in the same region a decade earlier. Of the SIDS infants, 54% died while cosleeping compared with 20% among both control groups. Much of this excess may be explained by a significant multivariable interaction between cosleeping and recent parental use of alcohol or drugs (31% v 3% random controls) and the increased proportion of SIDS infants who had coslept on a sofa (17% v 1%). One fifth of SIDS infants used a pillow for the last sleep (21% v 3%) and one quarter were swaddled (24% v 6%). More mothers of SIDS infants than random control infants smoked during pregnancy (60% v 14%), whereas one quarter of the SIDS infants were preterm (26% v 5%) or were in fair or poor health for the last sleep (28% v 6%). All of these differences were significant in the multivariable analysis regardless of which control group was used for comparison. The significance of covering the infant’s head, postnatal exposure to tobacco smoke, dummy use, and sleeping in the side position has diminished although a significant proportion of SIDS infants were still found prone (29% v 10%). Conclusions: Many of the SIDS infants had coslept in a hazardous environment. The major influences on risk, regardless of markers for socioeconomic deprivation, are amenable to change and specific advice needs to be given, particularly on use of alcohol or drugs before cosleeping and cosleeping on a sofa

Development and application of a self-referencing glucose microsensor for the measurement of glucose consumption by pancreatic ?-cells

Glucose gradients generated by an artificial source and ?-cells were measured using an enzyme-based glucose microsensor, 8-?m tip diameter, as a self-referencing electrode. The technique is based on a difference measurement between two locations in a gradient and thus allows us to obtain real-time flux values with minimal impact of sensor drift or noise. Flux values were derived by incorporation of the measured differential current into Fick's first equation. In an artificial glucose gradient, a flux detection limit of 8.2 ± 0.4 pmol·cm-2·s-1 (mean ± SEM, n = 7) with a sensor sensitivity of 7.0 ± 0.4 pA/mM (mean ± SEM, n = 16) was demonstrated. Under biological conditions, the glucose sensor showed no oxygen dependence with 5 mM glucose in the bulk medium. The addition of catalase to the bulk medium was shown to ameliorate surface-dependent flux distortion close to specimens, suggesting an underlying local accumulation of hydrogen peroxide. Glucose flux from ?-cell clusters, measured in the presence of 5 mM glucose, was 61.7 ± 9.5 fmol·nL-1·s-1 (mean ± SEM, n = 9) and could be pharmacologically modulated. Glucose consumption in response to FCCP (1 ?M) transiently increased, subsequently decreasing to below basal by 93 ± 16 and 56 ± 6%, respectively (mean ± SEM, n = 5). Consumption was decreased after the application of 10 ?M rotenone by 74 ± 5% (mean ± SEM, n = 4). These results demonstrate that an enzyme-based amperometric microsensor can be applied in the self-referencing mode. Further, in obtaining glucose flux measurements from small clusters of cells, these are the first recordings of the real-time dynamic of glucose movements in a biological microenvironment. <br/

Measuring sustainable intensification in smallholder agroecosystems: A review

In the sustainable intensification (SI) of smallholder agroecosystems, researchers and farmers collaborate to produce more food on land currently in cultivation, secure wellbeing in the present day, and bolster ecosystem services to sustain agricultural productivity into the future. In recent years there has been debate in the SI literature about the meaning and boundaries SI, accompanied by calls for clearly defined metrics to evaluate SI efforts. In this review, we present the current state of the literature in regards to SI metrics. We first survey the literature to identify key concepts and qualities associated with SI (referred to as SI indicators). We briefly discuss indicators that have been sources of contention in the SI literature, and highlight tradeoffs between certain SI indicators. The bulk of this review focuses on identifying measurable properties (referred to as SI metrics) associated with each SI indicator. We also identify metrics of broader system-level properties such as sustainability and intensification. We conclude by highlighting gaps in the current literature on SI metrics

Heralded Generation of Ultrafast Single Photons in Pure Quantum States

We present an experimental demonstration of heralded single photons prepared in pure quantum states from a parametric downconversion source. It is shown that, through controlling the modal structure of the photon pair emission, one can generate pairs in factorable states and thence eliminate the need for spectral filters in multiple-source interference schemes. Indistinguishable heralded photons were generated in two independent spectrally engineered sources, and, by performing a Hong-Ou-Mandel interference between them without spectral filters at a raw visibility of 94.4%, their purity was measured to be over 95%.Comment: 5 pages, 4 figure

Evolution of the Reverse Shock Emission from SNR 1987A

We present new (2004 July) G750L and G140L Space Telescope Imaging Spectrograph (STIS) data of the H-alpha and Ly-alpha emission from supernova remnant (SNR) 1987A. With the aid of earlier data, from Oct 1997 to Oct 2002, we track the local evolution of Ly-alpha emission and both the local and global evolution of H-alpha emission. In addition to emission which we can clearly attribute to the surface of the reverse shock, we also measure comparable emission, in both H-alpha and Ly-alpha, which appears to emerge from supernova debris interior to the surface. New observations taken through slits positioned slightly eastward and westward of a central slit show a departure from cylindrical symmetry in the H-alpha surface emission. Using a combination of old and new observations, we construct a light curve of the total H-alpha flux, F, from the reverse shock, which has increased by a factor ~ 4 over about 8 years. However, due to large systematic uncertainties, we are unable to discern between the two limiting behaviours of the flux - F ~ t (self-similar expansion) and F ~ t^5 (halting of the reverse shock). Such a determination is relevant to the question of whether the reverse shock emission will vanish in less than about 7 years (Smith et al. 2005). Future deep, low- or moderate-resolution spectra are essential for accomplishing this task.Comment: 28 pages, 12 figures. Accepted by Ap

Conditional preparation of single photons using parametric downconversion: A recipe for purity

In an experiment reported recently [Phys. Rev. Lett. 100, 133601 (2008)], we demonstrated that, through group velocity matched parametric downconversion, heralded single photons can be generated in pure quantum states without spectral filtering. The technique relies on factorable photon pair production, initially developed theoretically in the strict collinear regime; focusing - required in any experimental implementation - can ruin this factorability. Here we present the numerical model used to design our single photon sources and minimize spectral correlations in the light of such experimental considerations. Furthermore, we show that the results of our model are in good agreement with measurements made on the photon pairs and give a detailed description of the exact requirements for constructing this type of source.Comment: 27 pages, 14 figures, submitted to NJ

Unfolding dynamics of proteins under applied force

Understanding the mechanisms of protein folding is a major challenge that is being addressed effectively by collaboration between researchers in the physical and life sciences. Recently, it has become possible to mechanically unfold proteins by pulling on their two termini using local force probes such as the atomic force microscope. Here, we present data from experiments in which synthetic protein polymers designed to mimic naturally occurring polyproteins have been mechanically unfolded. For many years protein folding dynamics have been studied using chemical denaturation, and we therefore firstly discuss our mechanical unfolding data in the context of such experiments and show that the two unfolding mechanisms are not the same, at least for the proteins studied here. We also report unexpected observations that indicate a history effect in the observed unfolding forces of polymeric proteins and explain this in terms of the changing number of domains remaining to unfold and the increasing compliance of the lengthening unstructured polypeptide chain produced each time a domain unfolds

Confirmatory factor analysis of the Test of Performance Strategies (TOPS) among adolescent athletes

The aim of the present study was to examine the factorial validity of the Test of Performance Strategies (TOPS; Thomas et al., 1999) among adolescent athletes using confirmatory factor analysis. The TOPS was designed to assess eight psychological strategies used in competition (i.e. activation, automaticity, emotional control, goal-setting, imagery, negative thinking, relaxation and self-talk,) and eight used in practice (the same strategies except negative thinking is replaced by attentional control). National-level athletes (n = 584) completed the 64-item TOPS during training camps. Fit indices provided partial support for the overall measurement model for the competition items (robust comparative fit index = 0.92, Tucker-Lewis index = 0.88, root mean square error of approximation = 0.05) but minimal support for the training items (robust comparative fit index = 0.86, Tucker-Lewis index = 0.81, root mean square error of approximation = 0.06). For the competition items, the automaticity, goal-setting, relaxation and self-talk scales showed good fit, whereas the activation, emotional control, imagery and negative thinking scales did not. For the practice items, the attentional control, emotional control, goal-setting, imagery and self-talk scales showed good fit, whereas the activation, automaticity and relaxation scales did not. Overall, it appears that the factorial validity of the TOPS for use with adolescents is questionable at present and further development is required