Dialectical behaviour therapy: effect of a coordinated implementation approach on programme sustainability.

Sustainability of DBT programmes and the factors which potentially influence this has received little attention from researchers. In this article, we review the literature reporting on sustainability of DBT programmes in outpatient settings. We also seek to advance the limited knowledge on this topic by reporting on the sustainability of DBT programmes delivered by teams that trained via a coordinated implementation approach in Ireland. As part of this perspective piece we conducted a systematic literature search which identified four studies reporting on DBT programme sustainability. All four reported on programmes delivered by teams that had received training as per the DBT Intensive Training Model. The findings of these studies are summarised and we consider the effect on DBT programme sustainability of introducing a coordinated implementation approach in Ireland.

Leadless Micra Pacemaker Use in the Pediatric Population: Device Implantation and Short-Term Outcomes.

The development of Leadless cardiac pacemakers avoids the inherent complications that may occur secondary to lead insertion. A large number of devices have been inserted in adult patients although data in pediatric patients are lacking. We aimed to assess our experience with the Leadless device in the pediatric population. We performed a retrospective study on all pediatric patients who underwent insertion of a Leadless pacemaker in our center. Data were collected for demographic, procedural, and outcome variables. Nine patients with a median (IQR) age and weight of 13 (12-14) years and 37 (31-50) kg, respectively, were enrolled. The median (IQR) procedural time was 62 (60-65) min with insertion thresholds of 0.5 (0.35-1) Volts at 0.24 ms. All devices were successfully inserted without complication. One device was replaced with a single-lead endocardial pacemaker at 1 year for increased thresholds. Leadless pacemaker device insertion is feasible in pediatric patients. Further studies and long-term follow-up are needed to ascertain device longevity and complication rates.

"Semenly" Harmless Back Pain: An Unusual Presentation of a Subcutaneous Abscess

Aims We report, with review of the literature, the case of a patient who developed a subcutaneous abscess after intravenously injecting his own semen in an attempt to treat longstanding back pain. He had devised this "cure" independent of medical advice. Methods A review of EMBASE, PubMed, google scholar and the wider internet was conducted with an emphasis on parenteral semen for the treatment of back pain and for other medical and non-medical uses. Results There were no other reported cases of intravenous semen injection found across the medical literature. A broader search of internet sites and forums found no documentation of semen injection for back pain treatment or otherwise. Conclusion While suicide attempt by intravenous injection of harmful substances is well described, this unique case demonstrates risks involved with innovative treatments prior to clinical research in the form of phased trials inclusive of safety and efficacy assessments.

The detection of a population of submillimeter-bright, strongly lensed galaxies.

Gravitational lensing is a powerful astrophysical and cosmological probe and is particularly valuable at submillimeter wavelengths for the study of the statistical and individual properties of dusty star-forming galaxies. However, the identification of gravitational lenses is often time-intensive, involving the sifting of large volumes of imaging or spectroscopic data to find few candidates. We used early data from the Herschel Astrophysical Terahertz Large Area Survey to demonstrate that wide-area submillimeter surveys can simply and easily detect strong gravitational lensing events, with close to 100% efficiency.

Wearable monitoring of seated spinal posture.

This work describes the evaluation of a wearable plastic optical fiber (POF) sensor for monitoring seated spinal posture, as compared to a conventional expert visual analysis, and the development of a field-deployable posture monitoring system. A garment-integrated POF sensor was developed and tested on nine healthy subjects. Data from the wearable sensor were compared to data taken simultaneously from a marker-based motion capture system, for accuracy and reliability. Peak analysis of the resulting data showed a mean time error of 0.53 plusmn 0.8 s, and a mean value error of 0.64 plusmn 3.1 deg, which represents 14.5% of the average range of motion. Expert determination of transitional (good to bad) posture showed a variation of 20.9% of range of motion. These results indicate that the wearable sensor approximates the accuracy of expert visual analysis, and provides sufficient accuracy of measurement to reliably monitor seated spinal posture.

Embryo and foetal loss in beef heifers between day 14 of gestation and full term.

Following insemination, reproductive failure in cattle is largely manifested as embryo mortality and is a major source of financial loss to livestock producers. Ongoing studies at this laboratory into factors affecting embryo mortality have facilitated the collection of new data on the extent and timing of embryo and foetal mortality in cattle. Oestrus was synchronised in 158 beef cross heifers and following artificial insemination, embryo and foetal survival rates were determined on days 14 and 30 after insemination and subsequently at calving. Embryo survival rates measured on days 14, 30 and at full term were similar at 68%, 76% and 71.8%, respectively (P0.05). Based on morphological examination, all the 14-day-old embryos recovered were assessed as grade 1. These results provide new information indicating that most embryo losses in heifers have occurred before day 14 after insemination.

Accessibility to general practitioners in rural South Australia. A case study using geographic information system technology.

OBJECTIVE: To demonstrate the potential of GIS (geographic information system) technology and ARIA (Accessibility/Remoteness Index for Australia) as tools for medical workforce and health service planning in Australia. DESIGN: ARIA is an index of remoteness derived by measuring road distance between populated localities and service centres. A continuous variable of remoteness from 0 to 12 is generated for any location in Australia. We created a GIS, with data on location of general practitioner services in non-metropolitan South Australia derived from the database of RUMPS (Rural Undergraduate Medical Placement System), and estimated, for the 1170 populated localities in South Australia, the accessibility/inaccessibility of the 109 identified GP services. MAIN OUTCOME MEASURES: Distance from populated locality to GP services. RESULTS: Distance from populated locality to GP service ranged from 0 to 677 km (mean, 58 km). In all, 513 localities (43%) had a GP service within 20 km (for the majority this meant located within the town). However, for 173 populated localities (15%), the nearest GP service was more than 80 km away. There was a strong correlation between distance to GP service and ARIA value for each locality (0.69; P < 0.05). CONCLUSIONS: GP services are relatively inaccessible to many rural South Australian communities. There is potential for GIS and for ARIA to contribute to rational medical workforce and health service planning. Adding measures of health need and more detailed data on types and extent of GP services provided will allow more sophisticated planning.

Temporary exposure of ovine embryos to an advanced uterine environment does not affect fetal weight but alters fetal muscle development.

Embryo transfer techniques may result in fetuses that are heavier at birth and that have been described as highly muscled. The aim of this study was to investigate myogenesis in lambs derived from embryo transfer. Embryos were transferred at Day 3 (estrus = Day 0) to a 3 days-advanced uterine environment, maintained there for 3 days, recovered, and then returned to a synchronous (Day 6) uterus; these fetuses comprised the asynchronous group. Control animals were created by synchronous embryo recovery and single transfer at Day 3. Asynchronous transfer did not affect fetal weight or curved crown-rump length between 46 and 135 days of gestation. No differences were detected between groups at Days 110-135 with respect to muscle mass or protein, RNA, and DNA content. However, total muscle fiber number was significantly increased in plantaris muscles from the asynchronous groups at Day 110 and Day 125, suggestive of prolonged hyperplasia. In addition, the levels of Myf 5 protein and the secondary-to-primary fiber ratio were altered in plantaris muscle from the asynchronous group. The growth data are in contrast to previously reported findings. The results show that fetal myogenesis can be altered by very early events in embryogenesis and suggest that any inferences made solely on the basis of fetal or muscle weight may be fallacious.

Fetal growth and development following temporary exposure of day 3 ovine embryos to an advanced uterine environment.

The effect of exposing Day 3 ovine embryos to an advanced uterine environment for a period of 3 days on subsequent fetal growth and development between Day 35 and Day 135 of gestation was studied. Day 3 embryos were recovered from superovulated donor ewes and transferred to synchronous final or asynchronous temporary recipients for 3 days. Embryos were recovered from these temporary recipients and transferred to Day 6 final recipients. Gravid uteri were recovered, weighed and dissected on Days 35, 45, 60, 90, 110, 125 and 135 of gestation. Fetal weight and length data were analysed by fitting non-linear Gompertz models of the form log(e) y = a - be(-ct), where y is fetal size and t is time from conception. Various terms including treatment, gestational age, embryo stage at transfer and fetal sex were fitted to this model. Fetal development was assessed by relating organ weight to fetal bodyweight using the linear allometric equation log(e) y = log(e) a + b log(e) x, where y is organ weight and x is fetal weight. Temporary exposure of Day 3 embryos to an advanced uterine environment did not increase the rate of embryo development and had no effect on fetal growth and development between Days 35 and 135 of gestation in this study. A single Gompertz model (log(e) y = 10.134 - 17.047e(-0.1733t)) explained 99.8% of the variation in fetal weight. Of terms fitted to this model only gestational age and fetal sex influenced fetal weight, with male fetuses being 5% heavier (P<0.05) than female fetuses. Fetal development was also unaffected by experimental treatment in this study. Allometric coefficients established for various fetal components agreed well with those from previously published studies.

Electron spin resonance spin-label studies of mouse olfactory epithelium.

Three classes of interaction of spin-labeled odors with olfactory membrane of mouse were identified by electron spin resonance spectroscopy and correlated with the olfactory potencies of those odors. Also, variation of fluidity in this membrane was probed using spin-labeled lipids in which the nitroxide group was at increasing distances from the lipid headgroup. A cooperative model of olfactory transduction in agreement with the results is introduced, and typical dose response curves are computed that can predict molecular features necessary for a strong odor.

Search for superconducting regions in lysozyme.

The rate of electron transfer between a spin-labeled lysozyme molecule and a platinum electrode was measured in aqueous solution in the presence and absence of an external magnetic field of approximately 100 mT. The rate showed no significant change. This behavior is unlikely to be consistent with the regions of superconductivity in lysozyme proposed by Ahmed et al.