1,153 research outputs found
Evolution over a 15 year period of the epidemiological profile of 2884 newly diagnosed HCV patients in Belgium.
Recommended from our members
The collateral consequences of GPS-LED supervision in hot spots policing
Hot spots policing is popular, yet little is known about officer receptivity to the tactic and its impact on internal procedural justice, organizational commitment, and self-legitimacy. The nature of the tactic means that officers must relinquish their discretionary powers so that they can be directed to crime and disorder locations at specific times and for regimented durations. This loss of ‘spatiotemporal autonomy’ is exacerbated by technological tracking devices. We examined the receptivity of British officers to hot spots patrols, where the deployment was tracked with individual GPS trackers, compared to parallel patrols without hot spots policing or tracking. In contrast to the comparison group, officers in hot spots disliked the routinization of their shifts; regimented patrols were detrimental for internal procedural justice and organizational commitment. The ramifications of the introduction of GPS-enabled systems include certain tracking of officers and their compliance, such as a Taylorist time and motion study. While hot spots policing remains an effective tactic, questions about sustainability may be raised if officers’ expectations, attitudes and receptivity are not managed
Identification and characterisation of enteroaggregative Escherichia coli subtypes associated with human disease
Enteroaggregative E. coli (EAEC) are a major cause of diarrhoea worldwide. Due to their heterogeneity and carriage in healthy individuals, identification of diagnostic virulence markers for pathogenic strains has been difficult. In this study, we have determined phenotypic and genotypic differences between EAEC strains of sequence types (STs) epidemiologically associated with asymptomatic carriage (ST31) and diarrhoeal disease (ST40). ST40 strains demonstrated significantly enhanced intestinal adherence, biofilm formation, and pro-inflammatory interleukin-8 secretion compared with ST31 isolates. This was independent of whether strains were derived from diarrhoea patients or healthy controls. Whole genome sequencing revealed differences in putative virulence genes encoding aggregative adherence fimbriae, E. coli common pilus, flagellin and EAEC heat-stable enterotoxin 1. Our results indicate that ST40 strains have a higher intrinsic potential of human pathogenesis due to a specific combination of virulence-related factors which promote host cell colonization and inflammation. These findings may contribute to the development of genotypic and/or phenotypic markers for EAEC strains of high virulence
Lifelong learning and schools as community learning centres : key aspects of a national curriculum draft policy framework for Malta
The island of Malta has been engaged in policy document formulations for curriculum renewal in the country’s educational system (4-16 years of age) since 1988 when the first National Minimum Curriculum (henceforth NMC) was launched (Wain, 1991; Borg et al, 1995). In 1999 a revamped NMC (Ministry of Education, 1999) was developed following a long process of consultation involving various stages and stakeholders. It was a compromise document (Borg & Mayo, 2006) which emerged as a result of reactions to a more radical and coherent draft document produced in 1988.
Both curricular documents were subject to debates and critiques (Wain, 1991; Darmanin, 1993; Borg et al, 1995; Giordmaina, 2000; Borg and Mayo, 2006). More recently a series of volumes providing guidelines, key principles and aims for a national curriculum framework (henceforth NCF) have been produced (MEEF, 2011a,b,c,d) and are currently the target of debate and the focus of reactions by various stakeholders in education including teachers who were asked to read the volumes and provide reactions in the form of answers to a set questionnaire. In this paper, I will focus on one aspect of the documents, the first of its three aims: ‘Learners who are capable of successfully developing their full potential as lifelong learners.’ It is that aspect of the framework documents that falls within the purview of the title for this special issue. The use of this notion attests to the influence of the EU’s policy communications on member states, Malta having joined the Union in 2004 (Mayo, 2007).peer-reviewe
Are your covariates under control? How normalization can re-introduce covariate effects
Many statistical tests rely on the assumption that the residuals of a model are normally distributed. Rank-based inverse normal transformation (INT) of the dependent variable is one of the most popular approaches to satisfy the normality assumption. Studies regularly adjust for covariates and then normalize the residuals. This study investigated the effect of regressing covariates against the dependent variable and then applying rank-based INT to the residuals. The correlation between the dependent variable and covariates at each stage of processing was assessed. An alternative approach was tested of applying rank-based INT to the dependent variable before regressing covariates was tested. Analyses based on both simulated and real data examples demonstrated that applying rank-based INT to the dependent variable residuals after regressing out covariates re-introduces a linear correlation between the dependent variable and covariates in almost all situations. This will increase type-1 errors and reduce power. Our proposed alternative approach, where rank-based INT was applied prior to controlling for covariate effects, gave residuals that were normally distributed and linearly uncorrelated with covariates. This approach is therefore recommended
Omentum is highly effective in the management of complex cardiothoracic surgical problems
AbstractObjectives: Vascularized, pedicled tissue flaps are often used for cardiothoracic surgical problems complicated by factors that adversely affect healing, such as previous irradiation, established infection, or steroid use. We reviewed our experience with use of the omentum in these situations to provide a yardstick against which results with other vascularized flaps (specifically muscle flaps) could be compared. Methods: A retrospective review was undertaken of 85 consecutive patients in whom omentum was used in the chest. In 47 patients (group I), use of omentum was prophylactic to aid in the healing of closures or anastomoses considered to be at high risk for failure. In 32 patients (group II), omentum was used in the treatment of problems complicated by established infection. In 6 patients (group III), omentum was used for coverage of prosthetic chest wall replacements after extensive chest wall resection. Results: Overall, omental transposition was successful in its prophylactic or therapeutic purpose in 88% of these difficult cases (75/85). Success with omentum was achieved for 89% of patients (42/47) in group I, 91% of patients (29/32) in group II, and 67% of patients (4/6) in group III. Three patients (3.5%) had complications of omental mobilization. Four patients (4.7%) died after the operation as a result of failure of the omentum to manage the problem for which it was used. Conclusions: Results with omental transposition compare favorably with published series of similarly challenging cases managed with muscle transposition. Complications of omental mobilization are rare. We believe that its unique properties render the omentum an excellent choice of vascularized pedicle in the management of the most complex cardiothoracic surgical problems.J Thorac Cardiovasc Surg 2003;125:526-3
Hepatitis C of genotype 2: the role of medical invasive exams.
BACKGROUND AND AIM: Hepatitis C virus genotype 2 is the third in order of frequency in Belgium. The aim of this study was to better define the genotype 2 carriers' epidemiology characteristics. METHODS: In a database comprising 1726 viremic hepatitis C virus patient from the south part of Belgium, the files of 98 genotype 2 carriers were reviewed. RESULTS: There was a strong association between genotype 2 and the mode of transmission. The rate of contamination by invasive medical exams was very high (23%), and statistically different from the one of the others genotypes. Eligibility for antiviral therapies and the rate of sustained viral response were high. CONCLUSION: HCV genotype 2 was highly associated with transmission by invasive medical exams.Peer reviewe
Clinical and Serological Characterization of Orf-Induced Immunobullous Disease
Importance: Ecthyma contagiosum, or orf, is a viral zoonotic infection caused by Poxviridae. Although human orf infection is considered to follow a self-limited course, various immunological reactions may be triggered, including immunobullous diseases. In the majority of the latter cases, the antigenic target remained enigmatic. Objective: To characterize the predominant autoantigen in orf-induced immunobullous disease and further describe this clinical entity. Design, Setting, and Participants: This multicenter case series sought to provide detailed clinical, histopathological and immunological characteristics of a patient with orf-induced pemphigoid. Based on this index patient, serological analyses were conducted of 4 additional patients with previously reported orf-induced immunobullous disease. Immunoblotting with extracellular matrix and a recently established indirect immunofluorescence assay for detection of serum anti-laminin 332 IgG were performed. Exposures: The disease course and clinical characteristics of orf-induced immunobullous disease were observed. Main Outcomes and Measures: Orf-induced immunobullous disease is primarily characterized by anti-laminin 332 autoantibodies, predominant skin involvement, and a self-limiting course. The study provides further details on epidemiological, clinical, immunopathological, diagnostic, and therapeutic aspects of orf-induced immunobullous disease. Results: In all 5 patients, IgG1 and/or IgG3 autoantibodies against laminin 332 were identified. The α3, β3, and γ2 chains were recognized in 2, 4, and 1 patient(s), respectively. Conclusions and Relevance: In this case series, laminin 332, a well-known target antigen in mucous membrane pemphigoid, was a major autoantigen in orf-induced immunobullous disease, even though predominant mucosal lesions were lacking in this autoimmune blistering disease. Orf-induced anti-laminin 332 pemphigoid is proposed as distinct clinical entity
Searching for the elusive typhoid diagnostic
Typhoid (enteric) fever is still a common disease in many developing countries but current diagnostic tests are inadequate. Studies on pathogenesis and genomics have provided new insight into the organisms that cause enteric fever. Better understanding of the microorganisms explains, in part, why our current typhoid methodologies are limited in their diagnostic information and why developing new strategies may be a considerable challenge. Here we discuss the current position of typhoid diagnostics, highlight the need for technological improvements and suggest potential ways of advancing this area
- …