Screening for Torticollis and Plagiocephaly: The Role of the Pediatrician

The purpose of this study was to examine the effects of providing a standardized screening examination to a group of attending and resident physicians on the rate of torticollis and plagiocephaly diagnoses, the age at time of diagnosis, and the attitudes and practice patterns of the physicians. All subjects were given a standardized screening procedure by verbal instruction and handout, and also completed a pre-­‐ and post-­‐intervention questionnaire, which assessed the practice regarding the diagnosis and management of torticollis and plagiocephaly. A retrospective chart review was conducted to ascertain the changes in frequency and mean age of patients diagnosed by subjects over the 6-­‐month intervention period compared to the previous 3 years. Pediatric residents reported significant increases in their frequency of diagnosing torticollis and plagiocephaly, their comfort level in screening for these diagnoses, and their frequency of referral to physical therapy for torticollis. Attending pediatricians reported significant increases in their diagnosis of plagiocephaly only. There was a significant increase in the percent of patients diagnosed with plagiocephaly at one of the six clinics during the intervention year. There was a significant decrease in the age at the time of diagnosis of torticollis patients at one of the six clinics during the intervention year

Slices of the Kerr ergosurface

The intrinsic geometry of the Kerr ergosurface on constant Boyer-Lindquist (BL), Kerr, and Doran time slices is characterized. Unlike the BL slice, which had been previously studied, the other slices (i) do not have conical singularities at the poles (except the Doran slice in the extremal limit), (ii) have finite polar circumference in the extremal limit, and (iii) for sufficiently large spin parameter fail to be isometrically embeddable as a surface of revolution above some latitude. The Doran slice develops an embeddable polar cap for spin parameters greater than about 0.96.Comment: 13 pages, 6 figures; v.2: minor editing for clarification, references added, typos fixed, version published in Classical and Quantum Gravit

Insulin-like Growth Factor Binding Protein Expression in Human Retinal Pigment Epithelial Cells

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73426/1/j.1749-6632.1993.tb26229.x.pd

MILD-Net: Minimal Information Loss Dilated Network for Gland Instance Segmentation in Colon Histology Images

The analysis of glandular morphology within colon histopathology images is an important step in determining the grade of colon cancer. Despite the importance of this task, manual segmentation is laborious, time-consuming and can suffer from subjectivity among pathologists. The rise of computational pathology has led to the development of automated methods for gland segmentation that aim to overcome the challenges of manual segmentation. However, this task is non-trivial due to the large variability in glandular appearance and the difficulty in differentiating between certain glandular and non-glandular histological structures. Furthermore, a measure of uncertainty is essential for diagnostic decision making. To address these challenges, we propose a fully convolutional neural network that counters the loss of information caused by max-pooling by re-introducing the original image at multiple points within the network. We also use atrous spatial pyramid pooling with varying dilation rates for preserving the resolution and multi-level aggregation. To incorporate uncertainty, we introduce random transformations during test time for an enhanced segmentation result that simultaneously generates an uncertainty map, highlighting areas of ambiguity. We show that this map can be used to define a metric for disregarding predictions with high uncertainty. The proposed network achieves state-of-the-art performance on the GlaS challenge dataset and on a second independent colorectal adenocarcinoma dataset. In addition, we perform gland instance segmentation on whole-slide images from two further datasets to highlight the generalisability of our method. As an extension, we introduce MILD-Net+ for simultaneous gland and lumen segmentation, to increase the diagnostic power of the network.Comment: Initial version published at Medical Imaging with Deep Learning (MIDL) 201

The effect of human resource management (HRM) practices in service-oriented organizational citizenship behaviour (OCB): Case of telecommunications and internet service providers in Malaysia

In the human resource management-organizational performance research context, this paper is focusing on the effect of Human Resource Management (HRM) practices (pay practice, job security, training and development, supervisor support) on service-oriented Organizational Citizenship Behaviour (OCB) in Malaysian telecommunication and internet service providers. A quantitative study was conducted on 204 customer-contact employees who working in telecommunications and internet service providers in Malaysia. Correlation analysis and multiple regression analysis were applied to analyse the relationships between HRM practices and service-oriented OCB. The results indicate that, job security, training and development, supervisor support and overall perceptions of HRM practices have positive and significant effect on service-oriented OCB with the exception for pay practice

Global affordability of fluoride toothpaste

<p>Abstract</p> <p>Objective</p> <p>Dental caries remains the most common disease worldwide and the use of fluoride toothpaste is a most effective preventive public health measure to prevent it. Changes in diets following globalization contribute to the development of dental caries in emerging economies. The aim of this paper is to compare the cost and relative affordability of fluoride toothpaste in high-, middle- and low-income countries. The hypothesis is that fluoride toothpaste is not equally affordable in high-, middle- and low-income countries.</p> <p>Methods</p> <p>Data on consumer prices of fluoride toothpastes were obtained from a self-completion questionnaire from 48 countries. The cost of fluoride toothpaste in high-, middle- and low-income countries was compared and related to annual household expenditure as well as to days of work needed to purchase the average annual usage of toothpaste per head.</p> <p>Results</p> <p>The general trend seems to be that the proportion of household expenditure required to purchase the annual dosage of toothpaste increases as the country's per capita household expenditure decreases. While in the UK for the poorest 30% of the population only 0.037 days of household expenditure is needed to purchase the annual average dosage (182.5 g) of the lowest cost toothpaste, 10.75 days are needed in Kenya. The proportion of annual household expenditure ranged from 0.02% in the UK to 4% in Zambia to buy the annual average amount of lowest cost toothpaste per head.</p> <p>Conclusion</p> <p>Significant inequalities in the affordability of this essential preventive care product indicate the necessity for action to make it more affordable. Various measures to improve affordability based on experiences from essential pharmaceuticals are proposed.</p

Houses along fourth street

This thesis consists of four short stories and Chapter 1 of a novel in progress. Each of the four stories are thematically linked through a common protagonist, Nancy, and through a relatively chronological following of events in her life. I chose to tell Nancy's stories in an attempt to gain a better understanding of my own. While Chapter 1 of Hensley House is not thematically linked to the first four pieces, its inclusion as the last piece herein suggests a graduation from a largely autobiographical focus to a broader view of complex themes and multiple perspectives of those themes

Family history of prostate and colorectal cancer and risk of colorectal cancer in the Women's health initiative.

BackgroundEvidence suggests that risk of colorectal and prostate cancer is increased among those with a family history of the same disease, particularly among first-degree relatives. However, the aggregation of colorectal and prostate cancer within families has not been well investigated.MethodsAnalyses were conducted among participants of the Women's Health Initiative (WHI) observational cohort, free of cancer at the baseline examination. Subjects were followed for colorectal cancer through August 31st, 2009. A Cox-proportional hazards regression modeling approach was used to estimate risk of colorectal cancer associated with a family history of prostate cancer, colorectal cancer and both cancers among first-degree relatives of all participants and stratified by race (African American vs. White).ResultsOf 75,999 eligible participants, there were 1122 colorectal cancer cases diagnosed over the study period. A family history of prostate cancer alone was not associated with an increase in colorectal cancer risk after adjustment for confounders (aHR =0.94; 95% CI =0.76, 1.15). Separate analysis examining the joint impact, a family history of both colorectal and prostate cancer was associated with an almost 50% increase in colorectal cancer risk (aHR = 1.48; 95% CI = 1.04, 2.10), but similar to those with a family history of colorectal cancer only (95% CI = 1.31; 95% CI = 1.11, 1.54).ConclusionsOur findings suggest risk of colorectal cancer is increased similarly among women with colorectal cancer only and among those with both colorectal and prostate cancer diagnosed among first-degree family members. Future studies are needed to determine the relative contribution of genes and shared environment to the risk of both cancers

Preparing Students for Team-Based Care for Vulnerable Populations

Health professionals have an obligation to improve both the health of the individual and the public in a time of scarce resources. The Institute of Medicine (IOM), Healthy People Curriculum Task Force and professional education accreditation standards indicate the need for health care professionals to demonstrate competencies related to community engagement, basic health promotion skills and the ability to work effectively in interprofessional teams. An Interprofessional Course, IPE 413: Developing Care for a Vulnerable Population provides students the opportunity to collaborate to address health needs in cooperation with a community partner. Students work in teams to address the complex health care needs of an individual community member. The one hour elective course is open to students from nursing, occupational therapy, pharmacy, social work, and exercise science. Efforts are underway to explore the possibility of offering this course to medical students. Students are assessed on the knowledge and experience gained through this interprofessional experience using the Team Skills Scale and student reflections. Faculties from each of the disciplines utilize a collaborative model in the instructional design of the course. The content is co-taught and faculty not only role model interprofessional care, but also serve as mentors and resource personnel for the students as they work with their clients