Patterns of internet use by parents of children attending a pediatric surgical service.

PURPOSE: The internet has revolutionised the way we search for information. We determined the level of internet use by parents of children attending general surgical services and identified trends in online information-seeking behaviour. METHODS: A questionnaire based on the work by Boston and Tassone was distributed to parents attending both the day surgical units and surgical outpatients department in a paediatric tertiary referral centre. RESULTS: There were 214 (82.3 %) questionnaires returned, with 82 (38.3 %) of respondents having searched the internet regarding their child's surgical issue. Access to a smartphone, a university education and private health insurance were factors that positively influenced online searching (p < 0.005). Of those respondents who searched the internet, 42 (51 %) felt that information they found online was understandable, while only 14 (17 %) admitted to online sourced information influencing the treatment decisions they had made for their children. When asked to rank information sources on Likert-type scales in terms of importance; parents ranked the surgeon as most important (mean = 4.73), whilst the internet ranked lowest (mean = 3.02). CONCLUSION: We demonstrated significant use of the internet amongst those attending paediatric general surgical services. Clinician sourced information remains important, however we should engage with patients to utilise this vast resource effectively.

Measurements and simulations of ultralow emittance and ultrashort electron beams in the linac coherent light source.

The Linac Coherent Light Source (LCLS) is an x-ray free-electron laser project presently in a commissioning phase at the SLAC National Accelerator Laboratory. We report here on very low-emittance measurements made at low bunch charge, and a few femtosecond bunch length produced by the LCLS bunch compressors. Start-to-end simulations associated with these beam parameters show the possibilities of generating hundreds of GW at 1.5 A x-ray wavelength and nearly a single longitudinally coherent spike at 1.5 nm with 2-fs duration.

The rate of horizontal transmission of antibiotic resistance plasmids is increased in food preservation-stressed bacteria.

AIM: The aim of this study was to investigate the possibility that sublethal food preservation stresses (high/low temperature, osmotic and pH stress) can alter the rate of horizontal transmission of antibiotic resistance (ABR) plasmids between Escherichia coli strains and between E. coli and Salmonella serotype Typhimurium. METHODS AND RESULTS: Escherichia coli donor cultures, carrying F1 plasmid R386 and Inc I1 plasmid TP307 and E. coli and Salm. Typhimurium recipient cultures were prestressed under a range of sublethal environmental conditions (high/low temperature, osmotic and pH stress). The prestressed donor and recipient cultures were then mated and the transmission rate calculated. The study found that the horizontal transmission rate of plasmids R386 and TP307 was significantly increased (P < 0.05) when prestressed donor and recipient cells are mated under conditions of environmental stress. CONCLUSION: The results from this study indicate that, the sublethal stresses that food pathogens encounter in modern food preservation systems increase the inter- and intra-specific horizontal transmission of selected ABR plasmids. SIGNIFICANCE AND IMPACT OF THE STUDY: Increased use of bacteriostatic (sublethal), rather than bacteriocidal (lethal) food preservation systems, may be contributing to the dissemination of ABR among important food borne pathogens.

Emerging insights into peripartum cardiomyopathy.

Peripartum cardiomyopathy (PPCM) is relatively common in the Hospital Albert Schweitzer (HAS) district of Haiti. This investigation was carried out to expand epidemiologic data aiming at identifying risk factors for PPCM in this population. The HAS District PPCM Registry with 74 PPCM patients, enrolled from 1 February 2000 to 1 September 2002, served to identify the PPCM patients involved in this study. Thirty-seven non-PPCM Haitian mothers from the HAS district served as controls in the case-control study I and 32 non-PPCM Haitian mothers from the HAS district served as controls for the case-control study II. Following informed consent, patients and controls participated in clinical examination, echocardiography, epidemiologic questionnaire interviews, and immunohaematologic testing. Findings revealed: increased parity in PPCM vs control mothers (4.6 vs 3.3, p = 0.0252); 47% of the PPCM mothers had their initial diagnosis with the 5th or more pregnancy; increased number of patients with some hospital prenatal care in PPCM vs control mothers (42% vs 0%, p = 0.00001); and increased valley unit PPCM vs control mothers with no formal schooling (54% vs 24%, p = 0.0054). However, when hill-unit controls were included, there was no statistical difference in this category. Taking drinking-water from the river was found in 11% of the valley PPCM mothers vs 0% of the valley control mothers (p = 0.0509). Although the first 59 PPCM cases identified came from the valley units, recent identification of PPCM mothers in the hill unit indicates similar incidence of PPCM in mothers of remote hill area compared to the valley mothers--approximately 1 per 350 to 400 livebirths. Although the cause of PPCM and reasons for increased incidence in the HAS district of Haiti remain unknown, initial data present emerging insights and avenues to pursue in subsequent studies.

An intervention technique for children with autistic spectrum disorder: joint attentional routines.

Virtually all children with autism are deficient in joint attentional skills. The impact of this deficit may be understood in the context of pragmatically based explanations of language acquisition. In this view, each step in the ontongeny of joint attention is consequential for language development. Thus, it is important that speech-language pathologists understand the developmental course of joint attention so that intervention may start at the earliest step possible. In this article, we review the literature on joint attention and its relationship with other rule systems of language. We discuss the ontogeny of joint attention in typical children. Finally, we describe the developmental course of joint attention as a framework for language intervention through the study of one case.

The health sciences communicator as faculty developer.

To determine the content for a model faculty development program for primary care faculty, a combination of the Delphi and Nominal Group Technique was used resulting in a curriculum with five units of instruction: development of curriculum and instruction, teaching methods, evaluation, administration, and academic survival skills. A philosophy for conducting faculty development is presented which includes concepts of andragogy, technology transfer, the diffusion of innovation, and networking. Program types include short-term, long-term, and extended programs such as fellowships.

Changing mental health services in Madrid: international issues.

With the backing of a socialist government that came to power in 1982, mental health services in Spain are shifting away from institutional and custodial care toward community-based services. Provincial governments now control most mental health programs as a result of a law passed in 1983. In Madrid, mental health service priorities include preventing psychiatric hospitalization, developing a range of residential facilities, reducing the population of chronic patients in hospitals, and improving the quality of hospital care. A network of 20 health promotion centers is being developed to serve newly identified patients, while long-stay hospital patients who can be discharged will become the responsibility of social services. From an international perspective, the most interesting aspect of the Spanish transformation is how the country will deal with the problems other nations have encountered in implementing systems reforms.

Overview of the Community Mental Health Centers Program from an evaluation perspective.

The 18-year Community Mental Health Center (CMHC) Program of the National Institute of Mental Health (NIMH) was a complex and ambitious social experiment. This review identifies nine of the major goals of the program and examines available evaluative information on how well each was achieved. The most significant achievements of the program include increasing the quantity and range of public mental health services. Equality of access to services was also improved but all inequities were not removed. Problems continue to exist in funding services on the basis of need, in providing services to chronic clients, and in coordinating services. Prevention efforts suffered from uncertainties and perhaps overly optimistic expectations. The achievements of the program are currently threatened by third-party reimbursement mechanisms, the loss of federal leadership and oversight, and the loss of a community orientation in public mental health services. A great deal can be learned from the achievements and the shortfalls of the CMHC program that may be useful in state and federal mental health planning.

A study of coordination of services: referrals.

This article reports a study of referrals among social service and mental health agencies. Staff from human service agencies were interviewed about the process of referring and asked to make simulated referrals using mock clients constructed for this study. Interview data show lack of communication and inappropriate referrals as the biggest problems with the referral system. Interjudge agreement about the simulated referral choices was found to be not significantly different from chance. The data also suggest that agency staff refer on the basis of "habits" as much or more than on the basis of client problems. The frequency of inappropriate simulated referrals was relatively high (15%) considering that agencies included in the sample are large public agencies with broad definitions of what clients are appropriate for their services. Implications of these findings are discussed in terms of existing incentives for agencies to cooperate or compete and need for methodology to evaluate service delivery systems or networks.