Twenty-two years of candidaemia surveillance: results from a Norwegian national study.

Several studies have reported an increased incidence of candidaemia and a redistribution of species, with a decrease in the number of Candida albicans isolates. In Norway, a prospective, national surveillance study of candidaemia has been ongoing since 1991. Data from the period 1991-2003 have been published previously. The aim of this study was to follow up the incidence, species distribution and antifungal susceptibility of Candida species isolates from blood cultures in the period 2004-2012, and compare them with the corresponding findings from the period 1991-2003. Blood culture isolates of Candida species from all medical microbiological laboratories in Norway were identified and susceptibility tested at the Norwegian Mycological Reference Laboratory. A total of 1724 isolates were recovered from 1653 patients in the period 2004-2012. Comparison of the two periods showed that the average incidence of candidaemia episodes per 100 000 inhabitants increased from 2.4 (1991-2003) to 3.9 (2004-2012). The increase in incidence in the latter period was significantly higher in patients aged >40 years (p 0.001), and a marked increase was observed in patients aged >60 years (p < 0.001). In conclusion, the average incidence in Norway over a period of 22 years modestly increased from 2.4 to 3.9 per 100,000 inhabitants, this being mainly accounted for by candidaemia in the elderly. The species distribution was stable, and the rate of acquired resistance was low.

A report on neurosurgical workforce in the countries of the EU and associated states. Task Force "Workforce Planning", UEMS Section of Neurosurgery.

AIM: Aim of this report was to present recently collected data on neurosurgical workforce in the countries of the EU and associated states. METHODS: Data were obtained from 27 countries by means of a questionnaire developed by members of a working group of the UEMS Section of Neurosurgery (UEMS = Union Europénne des Médecins Spécialistes; European Union of Medical Specialists). Most data originate from 2005/2006. Results were discussed, amended, and approved by the countries' delegates of the UEMS Section of Neurosurgery. RESULTS: The number of Neurosurgeons (NS) per population varies considerably among these countries. The mean is one neurosurgeon per 99,152 population. The number of neurosurgical operations per population per year varies similarly with a mean of 1,642 operations per million population/year. Countries with fewer neurosurgeons per population tend to have less neurosurgical operations per population and vice versa. The average number of operations performed by one neurosurgeon per year (annual caseload) is between 56 and 300 with a mean of 154. A numerus clausus for neurosurgical training is reported in 13 countries, another 13 countries have no numerus clausus. The annual intake of new trainees is between 2.4 and 10.3% of the number of accredited neurosurgeons with a mean of approx. 5.2%. The average yearly loss rate due to retirement, sickness, other activities, etc. can only be estimated and lies in the range between 2.3 and 3.36% of the number of accredited NS. According to the figures provided by the countries, the total number of accredited NS in 2005/2006 was approx. 6,280 for a population of about 504.7 millions. These countries had an annual intake of approx. 332 new trainees.

Regional patterns of birthweights in Papua New Guinea in relation to diet, environment and socio-economic factors.

Regional differences in mean birthweight in rural Papua New Guinea (PNG) and the importance of differences in family diet and maternal education and socio-economic status on such patterns were explored using birthweight data collected by the 1982/83 PNG National Nutrition Survey. A total of 6137 birthweight measurements from 85 PNG districts were available, representing 22% of all children included in the survey. The nature of possible selection biases are assessed and their implications discussed. Hierarchical Bayesian spatial models based on conditional autoregressive (CAR) priors were used to model spatial patterns in birthweights and their relation to different sets of covariates. Birthweights were found to exhibit striking geographical differences. Children from the central PNG highlands and from affluent lowland areas had the highest birthweights, while they were lowest in the (largely lowland) Sepik, Western, Madang and Milne Bay Provinces and in remote highland fringe areas. Maternal education, socio-economic status and diet were all important predictors, but only differences in family diet were correlated with the observed spatial patterns. The results of the present study highlight the importance of nutrition and socio-economic status in explaining differences in birthweights in PNG. Besides improving maternal health, interventions for improving birthweights in PNG should therefore aim at strengthening the economic base of rural populations and promote the cultivation and consumption of high quality foods.

The Earth's Angular Momentum Budget on Subseasonal Time Scales.

Irregular length of day (LOD) fluctuations on time scales of less than a few years are largely produced by atmospheric torques on the underlying planet. Significant coherence is found between the respective time series of LOD and atmospheric angular momentum (AAM) determinations at periods down to 8 days, with lack of coherence at shorter periods caused by the declining signal-to-measurement noise ratios of both data types. Refinements to the currently accepted model of tidal Earth rotation variations are required, incorporating in particular the nonequilibrium effect of the oceans. The remaining discrepancies between LOD and AAM in the 100- to 10-day period range may be due to either a common error in the AAM data sets from different meteorological centers, or another component of the angular momentum budget.

Earth's Variable Rotation.

Recent improvements in geodetic data and practical meteorology have advanced research on fluctuations in the Earth's rotation. The interpretation of these fluctuations is inextricably linked with studies of the dynamics of the Earth-moon system and dynamical processes in the liquid metallic core of the Earth (where the geomagnetic field originates), other parts of the Earth's interior, and the hydrosphere and atmosphere. Fluctuations in the length of the day occurring on decadal time scales have implications for the topography of the core-mantle boundary and the electrical, magnetic, and other properties of the core and lower mantle. Investigations of more rapid fluctuations bear on meteorological studies of interannual, seasonal, and intraseasonal variations in the general circulation of the atmosphere and the response of the oceans to such variations.

Motions of the Earth's Core and Mantle, and Variations of the Main Geomagnetic Field.

Theoretical work on the magnetohydrodynamics of the earth's liquid core indicates (a) that horizontal variations in the properties of the core-mantle interface that would escape detection by modern seismological methods might nevertheless produce measurable geomagnetic effects; (b) that the rate of drift, relative to the earth's surface, of nonaxisymmetric features of the main geomagnetic field might be much faster than the average zonal speed of hydrodynamic motion of core material relative to the surrounding mantle; and (c) why magnetic astronomical bodies usually rotate. Among the consequences of (a) and (b) are the possibilities that (i) the shortest interval of time that can be resolved in paleomagnetic studies of the geocentric axial dipole component of the earth's magnetic field might be very much longer than the value often assumed by many paleomagnetic workers, (ii) reversals in sign of the geomagnetic dipole might be expected to show some degree of correlation with processes due to motions in the mantle (for example, tectonic activity, polar wandering), and (iii) variations in the length of the day that have hitherto been tentatively attributed to core motions may be due to some other cause.