Retrospective analysis of suspicious non palpable breast lesions from : the initial years of the Breast Unit in Malta

Aim: The aim of this retrospective study was to analyse the false positive rate of suspicious non palpable breast lesions detected by ultrasonography and mommography. Method: the data was collected from the first seven years (2000-2007) since the set up of the Breast Unit in Malta. Results: The results showed that the false positive rate for suspicious breast lesions detected by ultrasound and mammography were 84% and 57.6% respectively. The overall false positive rate was 62.5%. Conclusion: The overall false positive rate for suspicious breast lesions detected by both radiographic modalities is high in our unit when compared to that of other countries. Suggestions for improvement are discussed.peer-reviewe

Dust particle charge in plasma with ion flow and electron depletion

The charge of micrometer-sized dust particles suspended in plasma above the powered electrode of radio-frequency (RF) discharges is studied. Using a self-consistent fluid model, the plasma profiles above the electrode are calculated and the electron depletion towards the electrode, as well as the increasing flow speed of ions towards the electrode, are considered in the calculation of the dust particle floating potential. The results are compared with those reported in literature and the importance of the spatial dust charge variation is investigated

Communicating About Routine Childhood Vaccines: Meta-Analysis of Parental Attitudes, Behaviors, & Vaccine Hesitancy

As scientific and medical communities research the next generation of vaccines, medical providers and parents observe the current routine vaccination schedules published for children today. And despite the fact protection is available from a number of preventable diseases through the use of safe, reliable, and accessible vaccines, Vaccine Hesitancy VH (delaying or refusing vaccination for reasons other than accessibility) is a growing issue. Using meta-analysis to examine existing research on communication about routine childhood vaccines, the study explores parental attitudes, behaviors, and demographics using the Protection Motivation Theory PMT. The study explores categories influencing VH such as: alternative medicine, safety, side effects, religion, and governmental/pharmaceutical conspiracies. Findings confirm parental attitudes, behaviors, and demographics influence VH and offer effect size information by study category. Implications of understanding effect size by category may include support for provider selection and prioritization of effective communication strategies for reducing VH

Glow and dust in plasma boundaries

The sheath region is probed in different complex plasma experiments using dust particles in addition to measurement of the optical emission originating from the plasma. The local maximum in optical emission coincides with the breaking of quasi-neutrality at the sheath boundary as indicated by the vertical force profile reconstructed from dust particle trajectories, as well as by the local onset of dust density waves in high density dust clouds suspended in a dielectric box

Falling in Acute Mental Health Settings for Older People : Who falls, where, when and why?

Copyright: © 2014 Dickinson A et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Falls, slips and trips are a major patient safety concern in hospital settings accounting for 26 per cent of all reported patient safety incidents in England. Mental health conditions and their treatments add further to fall risk but we have little information regarding who falls, where and when within mental health settings. Methods: This paper presents an overview of the pattern of falls by older patients within an in-patient mental health setting in the South of England using routine records completed by staff when a fall occurs. 920 fall reports over three years were analysed, and 7 focus groups were undertaken with ward staff to explore how staff understood falls and their experiences of using the falls reporting system. Results: In terms of diagnosis 40% of fallers had a primary functional diagnosis, 46% an organic mental health diagnosis (14% non-specific diagnosis), average age was 81.7 years (range 59 to 99 years; SD 8.3) and 57% were female. Approximately one quarter, 27%, of falls were observed by staff. Falls were not evenly distributed across either day of week or time of day, with peak times for falls on Tuesday and Saturday and morning (7-8 and 9-10am) and subsidiary peaks between noon and 1pm and early evening (5-6pm). Almost half of falls occurred in private spaces in the ward such as bedrooms, and 42% in public spaces such as sitting rooms. However 60% of falls in public spaces were unseen. Reporting in these settings was problematic for staff and patients were sometimes described as placing themselves on the floor as a consequence of their mental health condition. The average time to first fall was 5 weeks. Conclusions: Routine mapping of falls could be undertaken at ward and organization level and contribute to better understanding of the local factors contributing to falls. Exploring incident report data in focus groups with staff helped us and them to interpret the data and to understand some of the decision making staff engage in everyday when reporting falls.Peer reviewedFinal Published versio

Kenyan tea is made with heat and water: how will climate change influence its yield?

Tea is the most consumed beverage in the world apart from water. Climate change is anticipated to affect the tea industry, but quantified large-scale predictions of how temperature and water availability drive tea production is lacking in many regions. Here, we use satellite-derived observations to characterize the response of tea yield to water and heat stress from 2008 to 2016 across Kenya, the third largest producer of tea. We find that solar-induced fluorescence captures the interannual variability in tea yield remarkably well (Pearson’s correlation coefficient, r=0.93), and that these variations are largely driven by the daily dynamics of soil moisture and temperature. Considering rising temperature in isolation suggests that yields in 2040–2070 would decrease by 10% relative to 1990–2020 (ranging between −15% to −4% across 23 models), but most climate models also simulate an increase in soil moisture over this interval that would offset loss, such that yields decrease by only 5% (ranging between −12% to +1%). Our results suggest that adaptation strategies to better conserve soil moisture would help avert damage, but such changes require advanced planning due to the longevity of a tea plant, underscoring the importance of better predicting soil moisture over the coming decades

Determination of the levitation limits of dust particles within the sheath in complex plasma experiments

Experiments are performed in which dust particles are levitated at varying heights above the powered electrode in a RF plasma discharge by changing the discharge power. The trajectories of particles dropped from the top of the discharge chamber are used to reconstruct the vertical electric force acting on the particles. The resulting data, together with the results from a selfconsistent fluid model, are used to determine the lower levitation limit for dust particles in the discharge and the approximate height above the lower electrode where quasineutrality is attained, locating the sheath edge. These results are then compared with current sheath models. It is also shown that particles levitated within a few electron Debye lengths of the sheath edge are located outside the linearly increasing portion of the electric field

Physicochemical and microbiological characteristics of kitoza, a traditional salted/dried/smoked meat product of Madagascar

Kitoza samples collected from producers in Madagascar were analyzed for their physicochemical and microbial properties. Lactic acid bacteria and coagulase‐negative staphylococci were the two codominant populations with average counts of 6–7 log cfu/g. Good hygienic practices were sometimes lacking but samples were not contaminated with Salmonella, Clostridium perfringens, and Bacillus cereus and only once with Listeria monocytogenes. Staphylococcus aureus was found occasionally with higher counts in salted/dried products than in salted/smoked products. Moisture, protein, fat, and salt contents varied considerably and were on average 41.5, 43.5, 14.3, and 3.3 g/100 g, respectively, and water activity was 0.893 on average. Smoked kitoza showed higher moisture content compared to dried kitoza. Most of the smoked kitoza had a water activity higher than 0.9 which is not in accordance with their storage at ambient temperatures. Benzo(a)pyrene content was above 2 µg/kg in 11 out of 30 smoked samples (17 ± 16.5 µg/kg on average)

‘’It just happens’. Care home residents’ experiences and expectations of accessing GP care.

Background: Care homes provide personal care and support for older people who can no longer be supported in the community. As part of a larger study of integrated working between the NHS and care homes we asked older people how they accessed health care services. Our aim was to understand how older people resident in care homes access health services using the Andersen model of health care access. Methods: Case studies were conducted in six care homes with different socio-economic characteristics, size and ownership in three study sites. Residents in all care homes with capacity to participate were eligible for the study. Interviews explored how residents accessed NHS professionals. The Andersen model of health seeking behaviour was our analytic framework. Findings: Thirty-five participants were interviewed with an average of 4 different conditions. Expectations of their health and the effectiveness of services to mitigate their problems were low. Enabling factors were the use of intermediaries (usually staff, but also relatives) to seek access. Residents expected that care home staff would monitor changes in their health and seek appropriate help unprompted. Conclusions: Care home residents may normalise their health care needs and frame services as unable to remediate these which may combine to disincline older care home residents to seek care. Care access was enabled using intermediaries -either staff or relatives-and the expectation that staff would proactively seek care when they observed new/changed needs. Residents may over-estimate the health-related knowledge of care home staff and their ability to initiate referrals to NHS professionals.Peer reviewedFinal Accepted Versio

Free design approach in direct dental restorative therapy

Rezumat Disfuncţiile mușchilor masticatori reprezintă patologii clinice, caracterizate prin durere persistentă în mușchii masticatori. Incidenţa cea mai mare este între vârsta de 20 și 40 de ani, și se întâlnește preponderent la femei. Pe parcursul timpului, mai multe teorii etiologice au încercat să explice apariţia și dezvoltarea maladiei. Actualmente disfuncţia este privită prin prisma modelului integrat de adaptare la durere și a teoriei biopsihosociale. Sunt descriși numeroși factori și variabile, care își aduc aportul la apariţia, dezvoltarea și agravarea patologiei, printre care factori de mediu, psihologici, genetici, constituţionali, neurologici etc. Studierea pe larg a acestora va conduce la modificarea tratamentului acordat pacienţilor cu disfuncţii prin aplicarea abordărilor medicinii multidisciplinare, integrate și individualizate.Summary The masticatory muscles dysfunctions represent clinical pathologies, characterized by persistent pain in the masticatory muscles. The highest incidence is between the ages of 20 and 40, and is more prevalent in women. Over time, several etiological theories have tried to explain the occurrence and the development of the disease. Currently, the dysfunction is viewed through the integrated pain adaptation model and the biopsychosocial theory. Numerous factors and variables are described, which contribute to the onset, development and aggravation of the pathology, among which: environmental, psychological, genetic, constitutional, neurological factors etc. Their extensive study will lead to the modification of the treatment granted to patients with dysfunctions by applying the approaches of multidisciplinary, integrated and individualized medicine