138 research outputs found
How we managed to improve a professional attitude in the nursing team to deal with topics of sexuality, fertility and reproduction in relation to CF patients
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Final Report for the Arroyo Las Positas Maintenance Impact Study, Lawrence Livermore National Laboratory
In 2000, the Lawrence Livermore National Laboratory's (LLNL) Environmental Protection Department, in coordination with Plant Engineering (PE), began dredging sections of the Arroyo Las Positas (ALP) to alleviate concerns about flooding of sensitive facilities within the mainsite of Lawrence Livermore National Laboratory. In order to reduce potential impacts on the federally threatened California red-legged frog (Rana aurora draytonii), LLNL proposed to dredge sections of the ALP in a ''checkerboard pattern'', resulting in a mosaic of open water habitat and vegetated sections (Figure 1). The Arroyo Las Positas Management Plan (Plan) was coordinated with both state and federal agencies including the U.S. Fish and Wildlife Service (USFWS), California Department of Fish and Game (CDF&G), San Francisco Regional Water Quality Control Board (SFRWQCB), and the Army Corp of Engineers (ACOE). Water Discharge Requirements (WDRs) were issued for this project on December 30, 1999 (Order No. 99-086) by the SFRWQCB. Provision 19 of the WDRs outlined a five-year (2000 through 2004) Maintenance Impact Study (MIS) that LLNL began in coordination with dredging work that was conducted as part of the Arroyo Las Positas Management Plan. Provision 20 of these WDRs requires LLNL to submit a final report of the results of the Maintenance Impact Study for this project to the SFRWQCB. The purpose of this report is to present the results of the Maintenance Impact Study for Arroyo Las Positas and meet the requirements of Provision 20. A description of the annual monitoring included in this Maintenance Impact Study is included in the methods section of this report. Initially the Plan called for dredging the entire length of the Arroyo Las Positas (approximately 6,981 linear feet) over a 5-year period to minimize temporal impacts on the California red-legged frog. Dredging occurred in 2000 ({approx}1,300 ft.), 2001 ({approx}800 ft.), and 2002 ({approx}1,200 ft.), which constituted approximately 3,300 ft., or roughly half of the entire Plan (Figure 2). Logistical challenges and unanticipated cost influenced the decision to terminate the project prior to completion, and re-evaluate the long-term management goals for the ALP. No dredging was conducted in the final two years of the plan (2003 and 2004)
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Contaminant Uptake and Demography of the Loggerhead Shrike (Lanius ludovicianus) at the Lawrence Livermore National Laboratory, Site 300
Concentrations of eleven potential environmental contaminants (metals) in the blood and retrice feathers of fledged-Hatch Year and adult loggerhead shrikes (Lanius ludovicianus) were examined at Lawrence Livermore National Laboratory's Site 300 and a control site, in San Joaquin and Contra Costa Counties, California. The purpose of this pilot study was to determine, through non-lethal means, if loggerhead shrikes are exposed to metals at Site 300 and whether specific demographic variables (i.e., clutch size, fledgling success, etc.) are affected. Loggerhead shrikes at Site 300 had higher blood concentrations of metals, especially birds on the west side of the site, when compared to control site birds. Metal concentrations in the feathers of control site birds tended to be higher than Site 300 shrikes. Blood concentrations of metals in loggerhead shrikes from both Site 300 and the control site were well below the Most Tolerant Dietary Level (MTDL) for domestic birds for all metals except selenium. Clutch size was similar to other populations but one deformed embryo was discovered in a failed egg. The results of this pilot study suggest further work is needed to understand possible synergistic effects related to other contaminants of concern found at Site 300 and overall population variability
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Arroyo Mocho Boulder Removal Project: Lawrence Livermore National Laboratory Hetch Hetchy Pump Station
The purpose of this biological assessment is to review the proposed Arroyo Mocho Boulder Removal Project in sufficient detail to determine to what extent the proposed action may affect any of the threatened, endangered, proposed, or sensitive species and designated or proposed critical habitats listed below. In addition, the following information is provided to comply with statutory requirements to use the best scientific and commercial information available when assessing the risks posed to listed and/or proposed species and designated and/or proposed critical habitat by proposed federal actions. This biological assessment is prepared in accordance with legal requirements set forth under regulations implementing Section 7 of the Endangered Species Act (50 CFR 402; 16 U.S.C 1536 (c)). It is our desire for the Arroyo Mocho Boulder Removal Project to receive incidental take coverage for listed species and critical habitat within the greater project area by means of amending the previous formal Section 7 consultation (1-1-04-F-0086) conducted a few hundred meters downstream by Lawrence Livermore National Laboratory (LLNL) in 2002. All conservation measures, terms and conditions, and reporting requirements from the previous Biological Opinion (1-1-04-F-0086) have been adopted for this Biological Assessment and/or amendment
From the artificial atom to the Kondo-Anderson model: Orientation-dependent magnetophotoluminescence of charged excitons in InAs quantum dots
We present a magnetophotoluminescence study on neutral and charged excitons confined to InAs/GaAs quantum dots. Our investigation relies on a confocal microscope that allows arbitrary tuning of the angle between the applied magnetic field and the sample growth axis. First, from experiments on neutral excitons and trions, we extract the in-plane and on-axis components of the Landé tensor for electrons and holes in the s shell. Then, based on the doubly negatively charged exciton magnetophotoluminescence, we show that the p-electron wave function spreads significantly into the GaAs barriers. We also demonstrate that the p-electron g factor depends on the presence of a hole in the s shell. The magnetic field dependence of triply negatively charged excitons photoluminescence exhibits several anticrossings, as a result of coupling between the quantum dot electronic states and the wetting layer. Finally, we discuss how the system evolves from a Kondo-Anderson exciton description to the artificial atom model when the orientation of the magnetic field goes from Faraday to Voigt geometry.We acknowledge funding from the EPSRC. B.V.H. also thanks the Hitachi Cambridge Laboratory for additional fund- ing. P.C. acknowledges financial support from the European Union Seventh Framework Programme under Grant agreement No. 265073
Post-infectious irritable bowel syndrome after intercontinental travel:a prospective multicentre study
Parents' expectations of the outpatient care for daytime urinary incontinence in children:A qualitative study
INTRODUCTION: Daytime urinary incontinence (UI) can have an enormous impact on a child's life, lowering both self-esteem and quality of life. Although most children start therapy after their first visit to our outpatient clinic, no studies have reported on parents' or patients' expectations of care for daytime UI in this setting. OBJECTIVE: We aimed to explore the expectations of the parents of children referred to an outpatient clinic for daytime UI. STUDY DESIGN: This was a qualitative study that involved performing semi-structured interviews with the parents of children who had been referred for daytime UI (with or without nocturnal enuresis). Interviews took place between July 2018 and October 2018 and continued until saturation was reached. The results were transcribed verbatim and analyzed according to Giorgi's strategy of phenomenological data analysis. RESULTS: Nine parents of children, aged 5-12 years old, were interviewed, revealing "(Experienced) Health," Self-management," and "Social Impact" as the main themes that influenced parental expectations. All parents wanted to know if there was a medical explanation for UI, some were satisfied when diagnostics revealed no underlying condition, and others wanted treatment. Parents expressed no preferences about diagnostics or the content and duration of treatment, but they hoped that any previously attempted ineffective steps would not be repeated. Some parents defined treatment success as their child becoming completely dry, but most stated that learning coping strategies was more important. DISCUSSION: This is the first study to explore the expectations of parents when attending outpatient care for children with daytime UI. We employed a strong theoretical framework with a clear interview guide. The main limitations are that we only interviewed parents and that this was a qualitative study, precluding the drawing of firm conclusions. Nevertheless, our results point to the need for quantitative evaluation. CONCLUSION: Expectations seem to be influenced by (experienced) health, efforts at self-management, and the social impact of UI, making it critical that these themes are addressed. It was interesting to note that parents do not always attend outpatient departments with the goal of completely resolving daytime UI. Instead, some only want to know if there is an underlying medical condition or want to reduce the social impact by learning coping mechanisms. Excluding underlying medical conditions may therefore stimulate acceptance of watchful waiting without the need to start treatment
Destination shapes antibiotic resistance gene acquisitions, abundance increases, and diversity changes in Dutch travelers
BACKGROUND: Antimicrobial-resistant bacteria and their antimicrobial resistance (AMR) genes can spread by hitchhiking in human guts. International travel can exacerbate this public health threat when travelers acquire AMR genes endemic to their destinations and bring them back to their home countries. Prior studies have demonstrated travel-related acquisition of specific opportunistic pathogens and AMR genes, but the extent and magnitude of travel\u27s effects on the gut resistome remain largely unknown.
METHODS: Using whole metagenomic shotgun sequencing, functional metagenomics, and Dirichlet multinomial mixture models, we investigated the abundance, diversity, function, resistome architecture, and context of AMR genes in the fecal microbiomes of 190 Dutch individuals, before and after travel to diverse international locations.
RESULTS: Travel markedly increased the abundance and α-diversity of AMR genes in the travelers\u27 gut resistome, and we determined that 56 unique AMR genes showed significant acquisition following international travel. These acquisition events were biased towards AMR genes with efflux, inactivation, and target replacement resistance mechanisms. Travel-induced shaping of the gut resistome had distinct correlations with geographical destination, so individuals returning to The Netherlands from the same destination country were more likely to have similar resistome features. Finally, we identified and detailed specific acquisition events of high-risk, mobile genetic element-associated AMR genes including qnr fluoroquinolone resistance genes, bla
CONCLUSIONS: Our results show that travel shapes the architecture of the human gut resistome and results in AMR gene acquisition against a variety of antimicrobial drug classes. These broad acquisitions highlight the putative risks that international travel poses to public health by gut resistome perturbation and the global spread of locally endemic AMR genes
Import and spread of extended-spectrum beta-lactamase-producing Enterobacteriaceae by international travellers (COMBAT study): a prospective, multicentre cohort study
BACKGROUND: International travel contributes to the dissemination of antimicrobial resistance. We investigated the acquisition of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) during international travel, with a focus on predictive factors for acquisition, duration of colonisation, and probability of onward transmission. METHODS: Within the prospective, multicentre COMBAT study, 2001 Dutch travellers and 215 non-travelling household members were enrolled. Faecal samples and questionnaires on demographics, illnesses, and behaviour were collected before travel and immediately and 1, 3, 6, and 12 months after return. Samples were screened for the presence of ESBL-E. In post-travel samples, ESBL genes were sequenced and PCR with specific primers for plasmid-encoded β-lactamase enzymes TEM, SHV, and CTX-M group 1, 2, 8, 9, and 25 was used to confirm the presence of ESBL genes in follow-up samples. Multivariable regression analyses and mathematical modelling were used to identify predictors for acquisition and sustained carriage, and to determine household transmission rates. This study is registered with ClinicalTrials.gov, number NCT01676974. FINDINGS: 633 (34·3%) of 1847 travellers who were ESBL negative before travel and had available samples after return had acquired ESBL-E during international travel (95% CI 32·1-36·5), with the highest number of acquisitions being among those who travelled to southern Asia in 136 of 181 (75·1%, 95% CI 68·4-80·9). Important predictors for acquisition of ESBL-E were antibiotic use during travel (adjusted odds ratio 2·69, 95% CI 1·79-4·05), traveller's diarrhoea that persisted after return (2·31, 1·42-3·76), and pre-existing chronic bowel disease (2·10, 1·13-3·90). The median duration of colonisation after travel was 30 days (95% CI 29-33). 65 (11·3%) of 577 remained colonised at 12 months. CTX-M enzyme group 9 ESBLs were associated with a significantly increased risk of sustained carriage (median duration 75 days, 95% CI 48-102, p=0·0001). Onward transmission was found in 13 (7·7%) of 168 household members. The probability of transmitting ESBL-E to another household member was 12% (95% CI 5-18). INTERPRETATION: Acquisition and spread of ESBL-E during and after international travel was substantial and worrisome. Travellers to areas with a high risk of ESBL-E acquisition should be viewed as potential carriers of ESBL-E for up to 12 months after return. FUNDING: Netherlands Organisation for Health Research and Development (ZonMw)
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