Improving the Administration of Justice in Traffic Courts

It is high time that the bar should give careful thought to that part of the traffic enforcement problem which is legal and judicial. It is time to examine the fundamental theory of traffic law, the reason for the existence of such a body of law, and to ask whether it is being administered in tribunals equipped with proper facilities and adequate knowledge. It is time to inquire what is the purpose of traffic law, and whether its administration is such as to help serve that purpose. Such inquiry will reveal some strange and disturbing facts

An evaluation of Swim 21

Swim 21 is the Amateur Swimming Association’s club development model, a planning tool based on the principles of long term athlete development. Swim 21 aims to provide appropriate opportunities for swimmers in order to assist them to attain their full potential. Therefore Swim 21 is intended to focus on the needs of swimmers, enabling clubs to help athletes, teachers, coaches and administrators to achieve their full potential

The public's perception of the role of community pharmacists in Wales

Objective To investigate the general public's perceptions of the community pharmacist's (CP) role in Wales by exploring understanding, awareness of services provided and potential interventions for promoting the role of CPs. Methods Qualitative methodology using focus group (FG) discussions exploring opinions, facilitated by a moderator (pharmacist) and an assistant. Topics discussed included the following: what a CP does; reasons for visiting; from whom they seek advice on medicines or lifestyle issues; use of traditional and newer services and promotion of services. The groups, totalling 32 participants, represented non‐users and users of pharmacy services, that is pupils from a local secondary school (x1 group), people from the local community (x3) and patients plus carers from a Parkinson's disease group (x1). FG discussions were recorded and transcribed verbatim, and analysis was undertaken to identify themes. Key findings Traditional dispensing and supply of medicines roles were clearly recognised, but poor awareness of the newer services emerged, particularly in public health roles. CP's professionalism was acknowledged, but there was confusion over where they ‘fit’ within the National Health Service or with General Practitioners, with concerns or misconceptions raised over the impact of commercialism on professionalism. Conclusions Based on these findings, the public is accepting of the extended role of CPs and would engage with CPs for a wider range of services. However, there is a lack of awareness of what public health services are available. Considerable work is needed to increase public awareness, during the strategic development of these services in Wales

The hidden endoscopic burden of sleeve gastrectomy and its comparison with Roux-en-Y gastric bypass

© Published by Hellenic Society of Gastroenterology. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: http://www.annalsgastro.gr/index.php/annalsgastro/article/view/2284/1663BACKGROUND:This study aimed to assess the endoscopic burden of bariatric surgical procedures at our trust. This is an enhanced parallel study to "The Hidden Endoscopic burden of Roux-en-Y Gastric Bypass" published in Frontline Gastroenterology in 2013 incorporating the data for sleeve gastrectomy and comparison with Roux-en-Y gastric bypass (RYGB). METHODS:This is a retrospective study that included 211 patients undergoing sleeve gastrectomy over a 34-month period. We utilized previously collected data for the RYGB patient cohort which included 553 patients over a 29-month period. We searched our hospital endoscopic database for patients who underwent post-operative endoscopy for indications related to their surgery. RESULTS:16.6% of the sleeve gastrectomy patients required post-operative endoscopy, of whom 11.4% underwent therapeutic procedures. This compares to 20.4% of the RYGB cohort of whom 50.4% needed therapeutic procedures (P<0.001). 1.9% of sleeve gastrectomy patients encountered a post-operative staple line leak and collectively required 29 endoscopic procedures. One patient also developed stricturing (0.47%) requiring 18 pneumatic dilatations. 11.4% of the RYGB cohort developed an anastomotic stricture requiring 57 balloon dilatation procedures. To date, these procedures have accumulated an equivalent cost of €159,898 in endoscopy tariffs, or €177 per RYGB and €373 per sleeve gastrectomy performed. CONCLUSIONS:Bariatric surgery can have significant implications in terms of patient morbidity and financial cost. Having a local bariatric surgery service increases the demand for endoscopic procedures in our hospital, both in investigating for and dealing with post-operative complications. Provision of extra resources and expertise needs to be taken into account.Published versio

Do consulting services affect audit quality? Evidence from the workforce

There is a long-standing question in the literature about whether and how consulting services in audit firms affect audit quality. We address this question by using a unique and comprehensive office-level dataset of employment profiles and skills, covering approximately 86% of all employees at large U.S. public accounting firms. We guide our empirical analyses with interviews with 15 audit partners, which reveal that consulting expertise is used in approximately 60%-80% of audit engagements, and the main rationale for such collaboration is knowledge sharing and improved audit quality. In our empirical analyses, we document a positive effect of consulting employees on audit quality. Specifically, one standard deviation increase in the share of consulting employees in an office results in a 2.7 percentage point reduction in restatements in that office. This effect is strongest when consulting employees have skills complimentary to auditors, including special industry skills, technical skills and management skills, supporting the knowledge sharing hypothesis. In addition, we demonstrate that the effect increases with of consulting employees’ tenure with a firm, does not diminish over time, is present for both Big4 and non-Big4 firms, and is more pronounced for larger, more complex and more important audit clients

Maturity associated differences in match running performance in elite male youth soccer players

Purpose: To investigate the influence of maturation on match running performance in elite male youth soccer players. Methods: A total of 37 elite male youth soccer participants from an English professional soccer academy from the U14s, U15s, and U16s age groups were assessed over the course of 1 competitive playing season (2018-2019). Relative biological maturity was assessed using percentage of predicted adult height. A global positioning system device was used between 2 and 30 (mean = 8 [5]) times on each outfield player. The position of each player in each game was defined as defender, midfielder, or attacker and spine or lateral. A total of 5 match-running metrics were collected total distance covered, high-speed running distance, very high-speed running distance, maximum speed attained, and number of accelerations. Results: Relative biological maturity was positively associated with all global positioning system running metrics for U14s. The U15/16s showed variation in the associations among the global positioning system running metrics against maturity status. A multilevel model which allowed slopes to vary was the best model for all parameters for both age groups. In the U14 age group, advanced maturation was associated with greater high-speed running distance. However, maturation did not contribute toward variance in any of the indices of running performance in the U15/16s. In the U15/16 age group, significance was observed in the spine/lateral playing positions when undertaking actions that required covering distance at high speeds. Conclusions: Maturation appeared to have an impact on match-running metrics within the U14s cohort. However, within the U15/16s, the influence of maturation on match-running metrics appeared to have less of an impact

Evaluation of patient reported outcome measurements as a reliable tool to measure acceptability of the taste of paediatric medicines in an inpatient paediatric population

Objective To evaluate the age appropriateness and suitability of patient-reported outcome measures to assess the acceptability of the taste of oral liquid medicines in children. Design and setting An observational mixed-methods study involving children aged 2-16 years taking oral liquid medicine in paediatric inpatient wards across the West Midlands (UK). Assessment tools included patient-reported scores on the taste of medicines via a five-point Facial Hedonic Scale; a Visual Analogue Scale (VAS); a question, 'Did you think the medicine tasted OK?' and researcher observations of facial expressions and behaviours immediately before, during and after administration. Results 611 children participated. The percent unable to complete the scales was 7% (n=46) for the VAS; 2% (n=15) for the hedonic scale and 1% (n=7) for the question about taste. Significant correlations (Spearman's r) were observed between the patient-reported outcome measures: 0.80 and 0.78 for the taste question and hedonic and VAS, respectively, and 0.84 for the hedonic and VAS. Researcher observations demonstrated the ability of the patient to take the medicine as intended but did not provide sensitive measures of taste. 5% of administrations were not taken as intended by the children. Medicines known to have poor taste (clarithromycin and prednisolone) showed mean hedonic and VAS scores of ≥3.5 and >65 mm, respectively. Conclusions Patient-reported outcome measures correlate with each other and are a useful means to assess the taste (and acceptability) of medicines. Hedonic scales are better understood by children and should be the first choice tool in the assessment of medicines taste

Cross-Lingual Cross-Media Content Linking: Annotations and Joint Representations

Dagstuhl Seminar 15201 was conducted on “Cross-Lingual Cross-Media Content Linking: Annotations and Joint Representations”. Participants from around the world participated in the seminar and presented state-of-the-art and ongoing research related to the seminar topic. An executive summary of the seminar, abstracts of the talks from participants and working group discussions are presented in the forthcoming sections

Endothelial injury in rheumatoid arthritis: a crosstalk between dimethylarginines and systemic inflammation

BACKGROUND: Symmetric (SDMA) and asymmetric (ADMA) dimethylarginines have emerged as novel biomarkers of cardiovascular disease (CVD) in several disease settings associated with atherosclerosis. Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease characterized by high CVD mortality and morbidity. ADMA and SDMA levels are abnormal in RA patients, but their correlation with assessments of endothelial function and structure remains unknown. We aimed to investigate whether SDMA and ADMA are associated with carotid intima media thickness (cIMT) and arterial stiffness as well as non-invasive assessments of in vivo micro- and macrovascular endothelial function in RA patients with high systemic inflammatory load. METHOD: ADMA and SDMA levels were measured using immunoassays in 197 RA individuals. Twenty-six of these [23 (86.4%) females, median age 70, quartiles (60, 73)] were identified as having high inflammatory markers [erythrocyte sedimentation rate (ESR) >25 mm/hr and C-reactive protein (CRP) > 5 mg/L], and were compared to the remainder of the cohort. Patients underwent assessments of microvascular endothelium-dependent and endothelium-independent function [laser Doppler imaging with iontophoresis of acetylcholine (Ach) and sodium-nitroprusside (SNP) respectively], macrovascular endothelium-dependent and endothelium-independent function (flow-mediated dilatation and glyceryl-trinitrate-mediated dilation respectively), and vascular morphology [pulse wave analysis, and carotid intima media thickness (cIMT)]. RESULTS: Significant interactions with inflammation were detected in the associations between ACh and both SDMA (p = 0.014) and ADMA:SDMA ratio (p = 0.027), as well as between SNP and SDMA (p = 0.042) and between arterial stiffness and ADMA:SDMA (p = 0.036), with the associations being stronger in the patients with high inflammatory markers in each case. CONCLUSIONS: Besides their emerging role as markers of endothelial dysfunction SDMA and ADMA may promote endothelial injury in RA as mediators of the adverse effects of systemic inflammation on micro- and macrovasculature respectively in patients with active disease