Plasma exchange in severe leptospirosis with multi-organ failure: a case report

INTRODUCTION: Leptospirosis presents with disease of variable severity; multi-organ failure can occur. In this situation, plasma exchange has been used with positive results, although the mechanism of action has not been fully explained. CASE PRESENTATION: A 67-year-old Caucasian man developed severe leptospirosis with marked icterus, acute kidney injury and cardiorespiratory failure, after exposure to livestock. On the basis of previous reported cases, he was treated with plasma exchange. This led to a rapid improvement in his bilirubin level, cardiac and respiratory function, followed by renal function. CONCLUSION: We discuss the pathophysiology of the disease, and suggest that plasma exchange has a role in the treatment of severe sepsis caused by leptospirosis as well as immune complex-mediated organ injury

Legitimacy and procedural justice in prisons

All social situations are ‘ordered’ in some way, comprising a constantly changing set of relationships that establish the structure within which human action occurs. In many circumstances this order is hidden, even ephemeral; we are barely aware of its presence. But this is not the case in prisons. Social order in prison is in many ways highly visible: it is established and managed by the omnipresent rules that govern prison life. In large part these rules are oriented toward reproducing the extant regime. They lay down apparently strict criteria for what constitutes order and what is to be done if it is breached. But what is meant by order in prison? Most socia

Increasing Primary School Children’s Fruit and Vegetable Consumption: a Review of the Food Dudes Programme.

Purpose: To evaluate the evidence base of the Food Dudes healthy eating programme, specifically the short and long term effectiveness of the intervention for: a) consumption of fruit and vegetables both at school and at home and b) displacement of unhealthy snack consumption. Design/methodology/approach: Articles were identified using Academic Search Complete, PsycARTICLES, Medline and PubMed databases for the period January 1995 to August 2013. Articles were included if they reported an empirical evaluation of the Food Dudes programme aimed at children aged between 4-11 years. Articles were included regardless of geographical location and publication type (i.e. published and ‘grey’ literature). Findings: Six articles were included for review. Findings indicated that the programme was moderately effective in the short-term; however the long-term effectiveness of the programme is unknown. The ability of the programme to generalise to the home setting and to displace unhealthy snack foods also requires further investigation. Originality/value: This is the first independent review of the Food Dudes programme. In light of the extensive roll out of the Food Dudes programme, an appraisal of the evidence surrounding the programme is timely. The review highlights that sustaining fruit and vegetable intake cannot be achieved through behaviour-based interventions alone and the long term maintenance of fruit and vegetable consumption requires more than the implementation of an intervention found to be effective in a controlled research environment

The design, synthesis and application of 4,7-Diarylbenzo[c][1,2,5]thiadiazole photocatalysts

The debate surrounding climate change and global resource consumption has stimulated discussion within the chemical community about sustainable methods for enabling chemical transformations. Among the various avenues of research, photocatalysis has been identified as an attractive sustainable option as it would allow society to make use of light as an abundant resource that is not environmentally damaging. Current state of the art photocatalysts tend to be based on iridium and ruthenium polypyridyl complexes. However, the cost and low natural abundance of the metals they contain is not compatible with the long term environmental sustainability that modern photocatalysis is striving towards. Organophotocatalysts have been identified as a promising solution to this problem as they are derived from more abundant chemical feedstocks, making them far cheaper to synthesise and allowing for better long-term sustainability. In addition to natural pigments and organic dyes, various organic π-conjugated electron donor-acceptor (D-A) systems, comprising of electron-rich donor and electron-deficient acceptor groups connected through delocalised π-conjugated structures, have been investigated as organophotocatalysts. The benzo[c][1,2,5]thiadiazole (BTZ) group is an example of a strongly electron withdrawing group that has mainly been researched for photovoltaic systems although some promising photocatalysis has already been investigated with this moeity. Four different methods for utilising BTZ photocatalysts are presented in this thesis. The first of these was a conventional homogeneous approach to photocatalysis, whereby a series of structurally similar molecular BTZ photocatalysts were synthesised to optimise their photophysical and optoelectronic properties towards a test photoredox reaction. Secondly, photocatalysts were appended to the upper-rim of calix[4]arenes to investigate using their ability to form host-guest complexes to facilitate photocatalysis. The third and fourth regimes involve the use of two different polymer systems by either chemically incorporating the BTZ group into conjugated porous polymers or by trapping molecular photocatalysts within solution cast thin films of intrinsically microporous polymers

Family-based Childhood Obesity Interventions in the UK: a Systematic Review of Published Studies.

Family-based programmes that emphasise lifestyle and behaviour change using psychological principles have been shown to be effective in targeting childhood obesity. While there is some evidence that evaluates UK family-based obesity interventions at a local level, no review to date has addressed this nationally. This review presents the available evidence from UK family-based childhood obesity interventions. Ten articles that met the inclusion criteria were included for review. The majority of programmes reviewed lasted 12 weeks, with only three studies providing follow-up data at 12 months or longer. Change in adiposity may be a short-term benefit of participation in a child weight management programme, but there is insufficient robust evidence to indicate that this benefit is long lasting and many studies were methodologically weak with limited internal validity. There is insufficient evidence to suggest how the inclusion of parents and the wider family may impact on the effectiveness of UK community based weight management programme for children and young people