Thermal analysis of anode and cathode regimes in an electric arc column quarterly progress report no. 9, jul. 1 - sep. 30, 1965

Heat transfer phenomena in electric arcs - design and testing of arc tunnel modificatio

Can screening and brief intervention lead to population-level reductions in alcohol-related harm?

A distinction is made between the clinical and public health justifications for screening and brief intervention (SBI) against hazardous and harmful alcohol consumption. Early claims for a public health benefit of SBI derived from research on general medical practitioners' (GPs') advice on smoking cessation, but these claims have not been realized, mainly because GPs have not incorporated SBI into their routine practice. A recent modeling exercise estimated that, if all GPs in England screened every patient at their next consultation, 96% of the general population would be screened over 10 years, with 70-79% of excessive drinkers receiving brief interventions (BI); assuming a 10% success rate, this would probably amount to a population-level effect of SBI. Thus, a public health benefit for SBI presupposes widespread screening; but recent government policy in England favors targeted versus universal screening, and in Scotland screening is based on new registrations and clinical presentation. A recent proposal for a national screening program was rejected by the UK National Health Service's National Screening Committee because 1) there was no good evidence that SBI led to reductions in mortality or morbidity, and 2) a safe, simple, precise, and validated screening test was not available. Even in countries like Sweden and Finland, where expensive national programs to disseminate SBI have been implemented, only a minority of the population has been asked about drinking during health-care visits, and a minority of excessive drinkers has been advised to cut down. Although there has been research on the relationship between treatment for alcohol problems and population-level effects, there has been no such research for SBI, nor have there been experimental investigations of its relationship with population-level measures of alcohol-related harm. These are strongly recommended. In this article, conditions that would allow a population-level effect of SBI to occur are reviewed, including their political acceptability. It is tentatively concluded that widespread dissemination of SBI, without the implementation of alcohol control measures, might have indirect influences on levels of consumption and harm but would be unlikely on its own to result in public health benefits. However, if and when alcohol control measures were introduced, SBI would still have an important role in the battle against alcohol-related harm

Hepatic mitochondrial dysfunction in Friedreich Ataxia

<p>Abstract</p> <p>Background</p> <p>Mitochondrial dysfunction due to respiratory chain impairment is a key feature in pathogenesis of Friedreich ataxia. Friedreich ataxia affects the nervous system, heart and pancreas.</p> <p>Methods</p> <p>We assessed hepatic mitochondrial function by ¹³C-methionine-breath-test in 16 Friedreich ataxia patients and matched healthy controls.</p> <p>Results</p> <p>Patients exhaled significantly smaller amounts of ¹³CO₂over 90 minutes. Maximal exhaled percentage dose of ¹³CO₂recovery was reduced compared to controls.</p> <p>Conclusions</p> <p>¹³C-methionine-breath-test indicates subclinical hepatic mitochondrial dysfunction in Friedreich ataxia but did not correlate with GAA repeat lengths, disease duration or disease severity.</p

Cost-Effectiveness of an Opportunistic Screening Programme and Brief Intervention for Excessive Alcohol Use in Primary Care

Effective prevention of excessive alcohol use has the potential to reduce the public burden of disease considerably. We investigated the cost-effectiveness of Screening and Brief Intervention (SBI) for excessive alcohol use in primary care in the Netherlands, which is targeted at early detection and treatment of ‘at-risk’ drinkers.We compared a SBI scenario (opportunistic screening and brief intervention for ‘at-risk’ drinkers) in general practices with the current practice scenario (no SBI) in the Netherlands. We used the RIVM Chronic Disease Model (CDM) to extrapolate from decreased alcohol consumption to effects on health care costs and Quality Adjusted Life Years (QALYs) gained. Probabilistic sensitivity analysis was employed to study the effect of uncertainty in the model parameters. In total, 56,000 QALYs were gained at an additional cost of €298,000,000 due to providing alcohol SBI in the target population, resulting in a cost-effectiveness ratio of €5,400 per QALY gained.Prevention of excessive alcohol use by implementing SBI for excessive alcohol use in primary care settings appears to be cost-effective

Bridging evidence-practice gaps: improving use of medicines in elderly Australian veterans

BACKGROUND The Australian Government Department of Veterans’ Affairs (DVA) funds an ongoing health promotion based program to improve use of medicines and related health services, which implements interventions that include audit and feedback in the form of patient-specific feedback generated from administrative claims records. We aimed to determine changes in medicine use as a result of the program. METHODS The program provides targeted patient-specific feedback to medical practitioners. The feedback is supported with educational material developed by a clinical panel, subject to peer review and overseen by a national editorial committee. Veterans who meet target criteria also receive educational brochures. The program is supported by a national call centre and ongoing national consultation. Segmented regression analyses (interrupted time series) were undertaken to assess changes in medication use in targeted veterans pre and post each intervention. RESULTS 12 interventions were included; three to increase medicine use, seven which aimed to reduce use, and two which had combination of messages to change use. All programs that aimed to increase medicine use were effective, with relative effect sizes at the time of the intervention ranging from 1% to 8%. Mixed results were seen with programs aiming to reduce inappropriate medicine use. Highly specific programs were effective, with relative effect sizes at the time of the intervention of 10% decline in use of NSAIDs in high risk groups and 14% decline in use of antipsychotics in dementia. Interventions targeting combinations of medicines, including medicine interactions and potentially inappropriate medicines in the elderly did not change practice significantly. Interventions with combinations of messages targeting multiple components of practice had an impact on one component, but not all components targeted. CONCLUSIONS The Veterans’ MATES program showed positive practice change over time, with interventions increasing use of appropriate medicines where under-use was evident and reduced use of inappropriate medicines when single medicines were targeted. Combinations of messages were less effective, suggesting specific messages focusing on single medicines are required to maximise effect. The program provides a model that could be replicated in other settings.Elizabeth E Roughead, Lisa M Kalisch Ellett, Emmae N Ramsay, Nicole L Pratt, John D Barratt, Vanessa T LeBlanc, Philip Ryan, Robert Peck, Graeme Killer and Andrew L Gilber

THE INFLUENCE OF REDUCED TEMPERATURE ON TORQUE PRODUCTION

S. Castro, T. Kitchel, L. Fortner, M. McCallum, J. Rivera Perez, C.J. Wutzke Gonzaga University, Spokane, WA Collegiate outdoor athletes tend to come from warmer climates compared to colder climates. This is due to the warmer climate athletes having the ability to practice year-round in their respective sports. Environmental conditions (increased temperature) have also shown to influence performance including torque production. In contrast, little is known regarding the influence of cooler temperatures and their influence on exercise performance. Previous literature has focused on how reduced temperature conditions can negatively influence the cardiovascular system and muscular physiology. PURPOSE: To determine if exercise in a reduced temperature influences peak and absolute max torque production of the biceps brachii and the semimembranosus. METHODS: This study examined 13 young, unimpaired adults (x=21.9±2.2 years) who were regularly active. Participants completed a standard stretching warm-up at room temperature (20°C) and in a reduced temperature (3.3°C) condition consisting of a two-and-a-half-minute walk (3mph) and a one-minute run (7mph). Following the warmup, participants completed five repetitions of bicep and hamstring curls respectively. Data analysis was conducted using repeated ANOVA to analyze dynamometer data between reduced and room temperature conditions with an alpha level of p≤0.05. RESULTS: Max torque in the reduced temperature of the biceps brachii (47.77 ± 19.68 Nm) showed no difference in comparison to that of the room temperature condition (45.18±18.57 Nm, p=0.08). Similarly, no difference was found in max torque in the semimembranosus (90.69±32.51 Nm reduced temperature; 94.02±34.67 Nm room temperature; p=0.68). Similarly, for peak torque of the biceps brachii, there was no difference between the reduced temperature condition (0.54±0.15) and the room temperature condition (0.51±0.14, p=0.18). A similar result was found for the peak torque of the semimembranosus. CONCLUSIONS: Our findings suggest that torque production for both the biceps brachii and semimembranosus does not differ during acute exposure to a reduced temperature condition. Additional study is necessary to determine the influence of repeated exposure to environmental conditions on torque production