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Make-at-home nasal irrigation solutions are often recommended for treating chronic rhinosinusitis. Many patients will store pre-made solution for convenient use. This study investigated the microbiological properties of differing recipes and storage temperatures.
Method
Three irrigation recipes (containing sodium chloride, sodium bicarbonate and sucrose) were stored at 5oC and 22oC. Further samples were inoculated with Staphylococcus aureus and Pseudomonas aeruginosa. Sampling and culturing were conducted at intervals from day 0–12 to examine for bacterial presence or persistence.
Results
No significant bacterial growth was detected in any control solution stored at 5oC. Saline solutions remained relatively bacterial free, with poor survival of inoculated bacteria, which may be related to either lower pH or lower osmolality. Storing at room temperature increased the risk of contamination in control samples, particularly from pseudomonas.
Conclusion
If refrigerated, pre-made nasal irrigation solutions can be stored safely for up to 12 days without risking cross-contamination to irrigation equipment or patients.
Carers of people experiencing a first episode of psychosis are at an increased risk of developing their own physical and mental health problems. Psychoeducation has been found to improve carer wellbeing and reduce distress. However, few psychoeducation interventions have considered the resource constraints on mental health services and the impact that these can have on the implementation of any such interventions. The present service evaluation aimed to evaluate an abbreviated version (sole session) of a previously tested psychoeducation intervention (three sessions) that targets less adaptive illness beliefs (n = 17). Pre–post effect sizes reveal that all of the carers’ illness beliefs changed in the desired direction, with four out of the 10 illness beliefs associated with large to moderate improvements. When compared with the outcomes obtained in our evaluation of the more intensive, three-session version of the intervention, the between-group effects largely favoured the three-session version but were mostly small. Moderate to large effects in favour of the three-session version were found for two of the 10 illness beliefs. These findings support the further investigation of the sole session psychoeducation intervention as part of a randomised controlled trial.
Key learning aims
(1) To evaluate the impact of a sole-session psychoeducation intervention on illness beliefs.
(2) To compare the outcomes of the sole-session psychoeducation intervention to the previous, more intensive (three-session) version of the same intervention.
(3) To consider the value of research approaches to evaluating psychoeducation interventions for carers of people with psychosis.
We conducted unmanned aerial vehicle lidar missions in the Maya Lowlands between June 2017 and June 2018 to develop appropriate methods, procedures, and standards for drone lidar surveys of ancient Maya settlements and landscapes. Three site locations were tested within upper Usumacinta River region using Phoenix Lidar Systems: Piedras Negras, Guatemala, was tested in 2017, and Budsilha and El Infiernito, both in Mexico, were tested in 2018. These sites represent a range of natural and cultural contexts, which make them ideal to evaluate the usefulness of the technology in the field. Results from standard digital elevation and surface models demonstrate the utility of deploying drone lidar in the Maya Lowlands and throughout Latin America. Drone survey can be used to target and efficiently document ancient landscapes and settlement. Such an approach is adaptive to fieldwork and is cost effective but still requires planning and thoughtful evaluation of samples. Future studies will test and evaluate the methods and techniques for filtering and processing these data.
The International Mineralogical Association's approved amphibole nomenclature has been revised in order to simplify it, make it more consistent with divisions generally at 50%, define prefixes and modifiers more precisely and include new amphibole species discovered and named since 1978, when the previous scheme was approved. The same reference axes form the basis of the new scheme and most names are little changed but compound species names like tremolitic hornblende (now magnesiohornblende) are abolished and also crossite (now glaucophane or ferroglaucophane or magnesioriebeckite or riebeckite), tirodite (now manganocummingtonite) and dannemorite (now manganogrunerite). The 50% rule has been broken only to retain tremolite and actinolite as in the 1978 scheme so the sodic calcic amphibole range has therefore been expanded. Alkali amphiboles are now sodic amphiboles. The use of hyphens is defined. New amphibole names approved since 1978 include nyböite, leakeite, kornite, ungarettiite, sadanagaite and cannilloite. All abandoned names are listed. The formulae and source of the amphibole end member names are listed and procedures outlined to calculate Fe3+ and Fe2+ when not determined by analysis.
A review of recent literature supports the notion that organisms may achieve nanoscale control over the hierarchical assembly of organic–inorganic materials by compartmentalizing reactions into small volumes containing specifically functionalized macromolecules. Such confinement may introduce a degree of determinism to the stochastic process of nucleation by greatly reducing the number of nucleation events, allowing an organism to control nucleation using “soft” organic substrates. In this way, the polymorph, orientation, shape, and size of a crystalline building block can be selected, and its assembly into a larger structure orchestrated by the organic matrix.
The Fukuda stepping test is commonly used to assess peripheral vestibular function. It has, however, been suggested that its maximal sensitivity and specificity are 70 per cent and 50 per cent, respectively. This study was undertaken to evaluate environmental factors that may influence the reliability of this assessment and hence to ‘sharpen’ its use in a clinical setting.
Methods:
Forty-four participants aged between 20 and 43 years were asked to perform the Fukuda stepping test in both a standard clinic room and a soundproofed room under the following conditions in a randomised order: on the floor versus on foam; with and without a sound-localising source; and with and without ear defenders.
Results:
Significant differences in the extent of rotation were found when comparing the results obtained in several settings, including standing on the floor in a standard room versus a soundproofed room (p = 0.036), and standing on foam in a standard room versus a soundproofed room (p = 0.015).
Conclusion:
Our results suggest that certain alterations to the test environment may improve the sensitivity of this clinical examination.
Peripheral vestibular function is commonly assessed using the Unterberger test. Patients are asked to march on the spot and their extent of rotation is recorded. The sensitivity of this test depends on an assessor accurately estimating the degree of rotation. This study therefore aimed to compare observer estimates with a smartphone application (DplusR Balance) that accurately records rotation.
Method:
Twenty-five participants were asked to estimate the degree of rotation in 10 successive Unterberger tests performed by a volunteer.
Results:
The average difference between estimated and application recorded extent of rotation was 30°.
Conclusion:
Assessors poorly estimate the degree of rotation in this clinical test, to an extent sufficient to affect clinical interpretation and diagnosis. We recommend the use of this application or alternative methods to record the degree of rotation in patients.
There has been no previous research to demonstrate the risk of noise-induced hearing loss in industry in Nepal. Limited research on occupational noise-induced hearing loss has been conducted within small-scale industry worldwide, despite it being a substantial and growing cause of deafness in the developing world.
Method:
The study involved a cross-sectional audiometric assessment, with questionnaire-based examinations of noise and occupational history, and workplace noise level assessment.
Results:
A total of 115 metal workers and 123 hotel workers (control subjects) were recruited. Noise-induced hearing loss prevalence was 30.4 per cent in metal workers and 4.1 per cent in hotel workers, with a significant odds ratio of 10.3. Except for age and time in occupation, none of the demographic factors were significant in predicting outcomes in regression analyses. When adjusted for this finding, and previous noise-exposed occupations, the odds ratio was 13.8. Workplace noise was significantly different between the groups, ranging from 65.3 to 84.7 dBA in metal worker sites, and from 51.4 to 68.6 dBA in the control sites.
Conclusion:
Metal workers appear to have a greater risk of noise-induced hearing loss than controls. Additional research on occupational noise-induced hearing loss in Nepal and small-scale industry globally is needed.
Extreme impacts can result from extreme weather and climate events, but can also occur without extreme events. This chapter examines two broad categories of impacts on human and ecological systems, both of which are influenced by changes in climate, vulnerability, and exposure: first, the chapter primarily focuses on impacts that result from extreme weather and climate events, and second, it also considers extreme impacts that are triggered by less-than-extreme weather or climate events. These two categories of impacts are examined across sectors, systems, and regions. Extreme events can have positive as well as negative impacts on ecosystems and human activities.
Economic losses from weather- and climate-related disasters have increased, but with large spatial and interannual variability (high confidence, based on high agreement, medium evidence). Global weather- and climate-related disaster losses reported over the last few decades reflect mainly monetized direct damages to assets, and are unequally distributed. Estimates of annual losses have ranged since 1980 from a few US$ billion to above 200 billion (in 2010 dollars), with the highest value for 2005 (the year of Hurricane Katrina). In the period 2000 to 2008, Asia experienced the highest number of weather- and climate-related disasters. The Americas suffered the most economic loss, accounting for the highest proportion (54.6%) of total loss, followed by Asia (27.5%) and Europe (15.9%). Africa accounted for only 0.6% of global economic losses. Loss estimates are lower bound estimates because many impacts, such as loss of human lives, cultural heritage, and ecosystem services, are difficult to value and monetize, and thus they are poorly reflected in estimates of losses. [4.5.1, 4.5.3.3, 4.5.4.1]
In a former paper published in these Proceedings it was shown that an integral function of order less than 1 cannot have any asymptotic periods, and it was suggested that a function of order 1 can have at most a set Kω(k=±1, ±2, …). This was subsequently found to be the case. Meromorphic functions for which K, the exponent of convergence of the poles, is less than ρ, the order, behave in many ways like integral functions, so we should expect that (i) if 0≦κ<ρ1 there should be no asymptotic periods, (ii) 0≦κ<ρ1 either none or else a single sequence kω(k = ±1, ±2, …). It will be shown that this is so.
A common method of solving a linear differential equation consists in expressing the differential operator as a product of factors. The possibility of doing so has been studied extensively by Vessiot, following the work of Picard and Drach, on the lines of the Galois theory of algebraic equations. The analogous process of resolving a, linear differential system, consisting of an equation together with boundary conditions, into two or more systems of lower order does not seem to have been investigated. Such a resolution is not always possible, even in cases where the differential equation can be factorised. Thus the system
Let R be a (1 — 1) relation between the members of two similar classes A, B1. It correlates the members of a subclass X of A to the members of a certain subclass Y of B1 and thus defines a relation ρ connecting X and Y. It is clear that ρ is a (1 – 1) relation and that it has the property (M). If X1ρ Y1, X2ρY2, then implies
Theorem 1 needs very little explanation. It is the converse of the well known theorem that the indefinite integral F(x) of a function f(x) possesses a derivate on the right at every point at which f(x + 0) exists. If f(x + 0) does not exist, nothing can be said as to the existence or otherwise of F+(x); but in a general way we might expect that the integral of a function which oscillates comparatively slowly, say sin (log x) at x = 0, would be more likely to possess a derivate than that of a function which oscillates more rapidly, say . It appears from Theorem 1 that this is not by any means the case. In fact the integral of sin (log x) has not a definite derivate at x = 0 while that of has such a derivate.
The term “flat” is used to indicate that the minimum modulus of a function in a region is (in some sense) of the same order as the maximum modulus. Some properties concerned with this notion are described below. They came to light during an attempt to answer a question put to me by Professor Littlewood.
A period of a function f(z) is defined to be a number w(≠0) such that
is identically zero; and it is not a difficult matter to show that an integral function may either have no periods or else a single sequence kλ, k = ±1, ±2, ….