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1.
iScience ; 25(8): 104794, 2022 Aug 19.
Article in English | MEDLINE | ID: mdl-35968265

ABSTRACT

The rapid adoption of residential solar photovoltaic (PV) is recasting the role of individual households as a dynamic and potent construct critical for emissions mitigation and resilience of the electricity system. As residential PV enters more risk-averse customer segments, broader deployment of residential PV depends on overcoming both financial and informational barriers to adoption. Fast-changing residential PV technologies and associated policies means there is both lack of information and often misinformation among customers-gaps that are addressed effectively with local, trusted information networks, especially for big-ticket items such as residential PV. Here, we use an extensively validated agent-based model of residential PV adoption to analyze the effectiveness of different information intervention designs in spurring PV diffusion. We show that intervention designs are effective when they balance long-distance connections and local reinforcement, matching the intervention to both the informational needs of potential adopters and the structure of the underlying network.

2.
Nurs Educ Perspect ; 43(3): 193-195, 2022.
Article in English | MEDLINE | ID: mdl-35482403

ABSTRACT

ABSTRACT: Organizational and systems leadership, a competency for doctor of nursing practice students, encompasses the evaluation of care delivery systems, accountable care of populations, and resolution of ethical dilemmas. Faculty created an online simulation in which students developed a management proposal for an impending pandemic. All students agreed or strongly agreed that the simulation increased their skills in systems-based thinking, increased their knowledge of others' roles and responsibilities in addressing health care crises, and enabled them to balance ethical considerations and societal interests. Online simulations are a feasible, cost-effective method to foster systems leadership competency and ethical decision-making in doctoral students.


Subject(s)
COVID-19 , Physicians , Students, Nursing , Humans , Leadership
3.
PLoS One ; 17(1): e0262172, 2022.
Article in English | MEDLINE | ID: mdl-35061776

ABSTRACT

In the aftermath of shock events, policy responses tend to be crafted under significant time constraints and high levels of uncertainty. The extent to which individuals comply with different policy designs can further influence how effective the policy responses are and how equitably their impacts are distributed in the population. Tools which allow policymakers to model different crisis trajectories, policy responses, and behavioral scenarios ex ante can provide crucial timely support in the decision-making process. Set in the context of COVID-19 shelter in place policies, in this paper we present the COVID-19 Policy Evaluation (CoPE) tool, which is an agent-based modeling framework that enables researchers and policymakers to anticipate the relative impacts of policy decisions. Specifically, this framework illuminates the extent to which policy design features and behavioral responsiveness influence the efficacy and equity of policy responses to shock events. We show that while an early policy response can be highly effective, the impact of the timing is moderated by other aspects of policy design such as duration and targeting of the policy, as well as societal aspects such as trust and compliance among the population. More importantly, we show that even policies that are more effective overall can have disproportionate impacts on vulnerable populations. By disaggregating the impact of different policy design elements on different population groups, we provide an additional tool for policymakers to use in the design of targeted strategies for disproportionately affected populations.


Subject(s)
COVID-19 , Health Equity , Health Policy , Policy Making , Humans , Systems Analysis
4.
Neotrop Entomol ; 49(1): 52-60, 2020 Feb.
Article in English | MEDLINE | ID: mdl-31912447

ABSTRACT

Ants are an ecologically and evolutionarily diverse group, and they harbor a wide range of symbiotic microbial communities that often greatly affect their biology. Turtle ants (genus Cephalotes) engage in mutualistic relationships with gut bacteria and are exploited by microbial parasites. Studies have shown that associations among these microbial lineages and the turtle ant hosts vary geographically. However, these studies have been limited, and thorough within-species analyses of the variation and structure of these microbial communities have yet to be conducted. The giant turtle ant, Cephalotes atratus (Linnaeus 1758), is a geographically widespread, genetically diverse Neotropical species that has been sampled extensively across its geographic range, making it ideal for analysis of microbial associations. In this study, we verified the presence, genetic variation, and geographic patterns at the individual, colony, and population level of three microbial groups associated with the giant turtle ant: Wolbachia, a genus of facultative bacteria which are often parasitic, affecting host reproduction; Rhizobiales, a mutualistic order of bacteria hypothesized to be an obligate nutritional symbiont in turtle ants; and Ophiocordyceps, a genus of endoparasitic fungi infecting many arthropod species by manipulating their behavior for fungal reproduction. In this study, we found varying degrees of prevalence for two distantly related genotypes (haplogroups) of Wolbachia and high degree of prevalence of Rhizobiales across colonies with little genetic variation. In addition, we found low occurrence of Ophiocordyceps. This study highlights a key first step in understanding the diversity, distribution, and prevalence of the microbial community of C. atratus.


Subject(s)
Alphaproteobacteria/genetics , Ants/microbiology , Hypocreales/genetics , Symbiosis , Wolbachia/genetics , Animals , Genetic Variation , Genotype , South America
5.
Br J Dermatol ; 176(3): 650-658, 2017 Mar.
Article in English | MEDLINE | ID: mdl-27579733

ABSTRACT

BACKGROUND: The burden of psoriasis across many world regions is high and there is a recognized need to better understand the epidemiology of this common skin disorder. OBJECTIVES: To examine changes in the prevalence and incidence of psoriasis, and mortality rates over a 15-year period. METHODS: Cohort study involving analysis of longitudinal electronic health records between 1999 and 2013 using the U.K. Clinical Practice Research Datalink (CPRD). RESULTS: The prevalence of psoriasis increased steadily from 2·3% (2297 cases per 100 000) in 1999 to 2·8% (2815 per 100 000) in 2013, which does not appear to be attributable to changes in incidence rates. We observed peaks in age bands characteristic of early-onset (type I) and late-onset (type II) psoriasis, and changes in incidence and prevalence rates with increasing latitude in the U.K. All-cause mortality rates for the general population and for patients with psoriasis have decreased over the last 15 years. However, the risk of all-cause mortality for patients with psoriasis remains elevated compared with people without psoriasis (hazard ratio 1·21; 95% confidence interval 1·13-1·3) and we found no significant change in this relative excess mortality gap over time. CONCLUSIONS: We found an increasing population living longer with psoriasis in the U.K., which has important implications for healthcare service delivery and for resource allocation. Importantly, early mortality in patients with psoriasis remains elevated compared with the general population and we found no evidence of change in this premature mortality gap.


Subject(s)
Psoriasis/epidemiology , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Child , Child, Preschool , Epidemiologic Methods , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Mortality/trends , Psoriasis/mortality , Residence Characteristics/statistics & numerical data , United Kingdom/epidemiology , Young Adult
7.
Clin Genet ; 87(1): 80-4, 2015.
Article in English | MEDLINE | ID: mdl-24266672

ABSTRACT

Mandibulofacial dysostosis with microcephaly (MFDM) is a sporadic malformation syndrome with severe craniofacial abnormalities, microcephaly, developmental delay, and dysmorphic features. Most cases of clinically diagnosed MFDM remain genetically unexplained, and to the best of our knowledge a total of 35 patients, 31 different mutations, 4 deletions, and 6 reports have been published. Our proband was born at 36 weeks gestation with microcephaly, microcrania, cleft palate, severe retrognathia, oral and pharyngeal dysphagia, bilateral proximal radioulnar synostosis, 11 thoracic ribs, abnormal magnetic resonance imaging (MRI) findings including simplified gyral pattern and mild dilatation of the posterior bodies of the lateral ventricles secondary to thinning of the white matter, high-pitched cry due to unilateral vocal cord paralysis, and dysmorphic features. Array comparative genomic hybridization (aCGH) + single nucleotide polymorphism (SNP) analysis identified a likely de novo pathogenic deletion on chromosome 17q21.31, encompassing the EFTUD2 gene. Our case represents the fifth reported proband to have MFDM caused by small deletions involving EFTUD2. All known mutations involving EFTUD2 result in genetic haploinsufficiency, consistent with our proband's case as well. Her phenotypic features both overlap and expand on the clinical features of previously reported cases, and her genetic diagnosis also supports the use of aCGH as a first-tier testing option for this disorder.


Subject(s)
Abnormalities, Multiple/genetics , Chromosomes, Human, Pair 17/genetics , Comparative Genomic Hybridization/methods , Mandibulofacial Dysostosis/genetics , Microcephaly/genetics , Peptide Elongation Factors/genetics , Ribonucleoprotein, U5 Small Nuclear/genetics , Abnormalities, Multiple/diagnosis , Developmental Disabilities/genetics , Female , Humans , Mandibulofacial Dysostosis/diagnosis , Microarray Analysis , Microcephaly/diagnosis , Polymorphism, Single Nucleotide/genetics , Sequence Deletion/genetics
8.
Phys Med Biol ; 59(5): 1109-19, 2014 Mar 07.
Article in English | MEDLINE | ID: mdl-24556943

ABSTRACT

Accurate temperature measurements are essential to safe and effective thermal therapies for cancer and other diseases. However, conventional thermometry is challenging so using the heating agents themselves as probes allows for ideal local measurements. Here, we present a new noninvasive method for measuring the temperature of the microenvironment surrounding magnetic nanoparticles from the Brownian relaxation time of nanoparticles. Experimentally, the relaxation time can be determined from the nanoparticle magnetization induced by an alternating magnetic field at various applied frequencies. A previously described method for nanoparticle temperature estimation used a low frequency Langevin function description of magnetic dipoles and varied the excitation field amplitude to estimate the energy state distribution and the corresponding temperature. We show that the new method is more accurate than the previous method at higher applied field frequencies that push the system farther from equilibrium.


Subject(s)
Algorithms , Energy Transfer/radiation effects , Magnetite Nanoparticles/chemistry , Magnetite Nanoparticles/radiation effects , Models, Chemical , Computer Simulation , Dose-Response Relationship, Radiation , Magnetic Fields , Magnetite Nanoparticles/ultrastructure , Materials Testing , Radiation Dosage , Temperature
9.
Br J Dermatol ; 169(2): 329-36, 2013 Aug.
Article in English | MEDLINE | ID: mdl-23551271

ABSTRACT

BACKGROUND: Psychological morbidity and reduced quality of life are common and linked with nonadherence to medication in psoriasis. Access to psychological therapy is often poor with long waiting times. Cognitive behavioural therapy (CBT) is a well-accepted therapy for psychological disorders and is particularly effective when tailored to address condition-specific concerns. OBJECTIVES: To determine whether an electronic CBT intervention for Psoriasis (eTIPs) would reduce distress, improve quality of life and clinical severity in patients with psoriasis. METHODS: This was a wait-list, randomized trial of immediate intervention vs. usual care. Self-assessed psoriasis severity (Self-Administered Psoriasis Area and Severity Index), distress (Hospital Anxiety and Depression Scale) and quality of life (Dermatology Life Quality Index) were measured before and after intervention. Analysis was based on complete cases and all cases using multiple imputation to substitute missing values. RESULTS: Anxiety scores between groups were significantly reduced (P < 0·05) for complete cases only; the mean (SD) scores were: intervention 7·6 (3·6) at baseline and 6·1 (3·5) at follow-up vs. control 8·3 (3·5) at baseline and after intervention 8·1 (4·4) (P = 0·004). Depression scores did not change; the experimental group scores at baseline were 5·0 (4·2) and after intervention 4·0 (3·7) vs. control group at baseline 5·2 (3·4) and after intervention 4·9 (3·8). Psoriasis severity scores did not change: baseline scores for the experimental group were 7·5 (6·0) and after intervention 6·5 (8·5) vs. the control group before 8·3 (6·3) and after 7·6 (6·1) (not significant). Quality-of-life scores improved in both analyses (P < 0·05); the intervention group scores before were 6·6 (4·2) and after intervention 5·0 (5·1) vs. control before 7·4 (4·4) and after intervention 7·7 (4·5) (P = 0·042). CONCLUSIONS: This first online CBT intervention for people with skin disease showed improvement in anxiety and quality of life in patients with psoriasis. The results are limited by the large amount of missing data and, at this stage, online delivery cannot substitute for established methods of delivery for CBT.


Subject(s)
Cognitive Behavioral Therapy/methods , Internet , Psoriasis/therapy , Adult , Aged , Analysis of Variance , Female , Humans , Male , Middle Aged , Psoriasis/psychology , Quality of Life , Stress, Psychological/prevention & control , Telemedicine/methods , Treatment Outcome , Young Adult
10.
Rev. chil. dermatol ; 29(2): 140-145, 2013. ilus, tab
Article in Spanish | LILACS | ID: biblio-997564

ABSTRACT

INTRODUCCIÓN: El Carcinoma basocelular (CBC) es la neoplasia más frecuente en la población humana. Se ha observado un aumento de su incidencia en todos los países, incluyendo a Chile. CBC es un tumor heterogéneo clínica e histológicamente. Entre sus factores de riesgo, destaca la exposición a la radiación ultravioleta. En Chile, en la última década se han realizado numerosas campañas de prevención del cáncer cutáneo y de detección precoz de esta neoplasia. El propósito de este trabajo es comparar el comportamiento del CBC en relación a parámetros demográficos, clínicos e histológicos en dos periodos de tiempo, 1995-1999 y 2005-2009 en la población de cuatro hospitales públicos de Santiago de Chile...


INTRODUCTION: Basal cell carcinoma (BCC) is the most common malignancy in the human population. There has been an increased incidence in all countries, including Chile. BCC is a clinically and histologically heterogeneous tumor. The main risk factor of BCC is the ultraviolet radiation exposure. In Chile, in the last decade, there have been numerous campaigns of skin cancer prevention and early detection of this neoplasm. The purpose of this paper is to compare the behavior of BCC in relation to demographic, clinical and histological parameters in two periods, 1995-1999 and 2005-2009 in the population of four hospitals in Santiago de Chile…


Subject(s)
Humans , Male , Adolescent , Psoriasis/epidemiology , Chile , Sex Factors , Epidemiology, Descriptive , Prevalence , Prospective Studies , Age of Onset , Age and Sex Distribution
11.
Med Phys ; 39(6Part5): 3643, 2012 Jun.
Article in English | MEDLINE | ID: mdl-28517672

ABSTRACT

PURPOSE: Magnetic spectroscopy of Brownian motion (MSB) has been used previously to measure temperature, viscosity, and cellular binding in vitro. The MSB signal - a ratio of the 5th to 3rd harmonic of the response from magnetic nanoparticles to an oscillating field - provides insight into particle microenvironment. These biosensing capabilities would be productive in vivo but until now were prevented by sensitivity limits. Our goal was to design and create a similar apparatus for work in vivo. In vivo spectroscopy is a viable precursor to imaging, and is essential for drug delivery or therapeutic methods like hyperthermia. METHODS: Coil geometries were modeled to optimize a uniform Helmholtz drive coil and imaging coil with maximal spatial resolution. The completed apparatus includes balancing and trim coils to zero out unwanted background fields. The coils were characterized and experiments were performed to verify consistency with previous in vitro experiments. Finally, as an in vivo experiment, we took MSB spectra on living mice with five week old melanomas injected with 200ug of 100nm starch coated nanoparticles. RESULTS: The drive coil is capable of sustaining 12.5mT fields up to 1.5kHz with a field variation of 3% throughout the sample volume. The pickup coil is frequency independent and has a vertical and horizontal range of 5mm and 10mm respectively before the MSB signal drops below 50%. The minimum sensitivity is 50-70µg of iron. MSB signal response to viscosity changes shows the same signatures as the in vitro apparatus. The in vivo data showed successful sensing of nanoparticles. We also saw the MSB signal decay with time showing the apparatus can detect changes in particle behavior due to interactions with biology. CONCLUSIONS: We achieved in vivo MSB and due to sufficient sensitivity we are motivated to further work in monitoring in vivo cellular uptake and viscosity.

12.
Rev Med Suisse ; 5(217): 1826, 1828-30, 2009 Sep 16.
Article in French | MEDLINE | ID: mdl-19839371

ABSTRACT

Action research is a useful instrument for the organization health care and the clinical governance of psychiatric institutions. What this type of research offers can be illustrated by the cohort study of migrant patients without health insurance who consulted the Department of Psychiatry of the Vaudois university medical center (CHUV) in 2008. While giving greater visibilty to the psychological suffering and social distress of these patients, the study also enabled the authors to determine which clinical procedures were actually offered to these patients and the amount these procedures cost the department. The small number of cases that were identified as well as their uneven distribution amongst the different services of the department suggest that considerable efforts must still be made to improve access for this population to public psychiatric services.


Subject(s)
Community Mental Health Services/economics , Transients and Migrants , Health Services Accessibility , Hospitals, University , Humans , Medically Uninsured , Switzerland
13.
Resuscitation ; 80(11): 1296-300, 2009 Nov.
Article in English | MEDLINE | ID: mdl-19726121

ABSTRACT

STUDY OBJECTIVE: This study compares adhesive tape, non-adhesive tape and a commercial endotracheal tube holder in terms of the force required to extubate endotracheal tubes from a cadaver. METHODS: A newly deceased, unembalmed cadaver was orotracheally intubated. Senior paramedic students secured the endotracheal tube using adhesive tape applied using the Lillehei method, non-adhesive tape and the Thomas Tube Holder in a random order. The time taken to secure the endotracheal tube and the force required to remove the distal tip of the endotracheal tube from the glottis were recorded. RESULTS: Use of adhesive tape using the Lillehei method resulted in greatest resistance to tube dislodgement, although it took significantly longer to apply than the other two methods. CONCLUSION: Although the Lillehei method provided the greatest resistance to tube dislodgement, it may not be ideal for the prehospital or emergency department context. The Thomas Tube Holder was quick and effective and may provide a good compromise in these environments, although once time is no longer important, clinicians may elect to revert to the Lillehei method which provides greater security.


Subject(s)
Adhesives , Device Removal/methods , Intubation, Intratracheal/instrumentation , Surgical Tape , Cadaver , Humans
15.
Child Care Health Dev ; 35(1): 71-8, 2009 Jan.
Article in English | MEDLINE | ID: mdl-18991973

ABSTRACT

OBJECTIVE: To investigate factors predicting parenting stress in mothers of pre-school children with cerebral palsy. METHOD: Eighty mothers and children participated. Mothers completed the Parenting Stress Index (PSI) and the following measures of family functioning: family support, family cohesion and adaptability, coping strategies, family needs and locus of control. Children were assessed using the Griffiths Scales and the Gross Motor Function measure. The child's home environment was assessed using Home Observation for Measuring the Environment. RESULTS: Mothers had higher mean total PSI scores than the means for the typical sample; 43% had total PSI scores above the threshold for clinical assessment. Cluster analysis demonstrated five distinct clusters of families, more than half of whom were coping well. High stress items were role restriction, isolation and poor spouse support, and having a child who was perceived as less adaptable and more demanding. Lower stress items indicated that this sample of mothers found their children emotionally reinforcing and had close emotional bonds. Regression analysis showed that the factors most strongly related to parenting stress levels were high family needs, low family adaptability and cognitive impairment in the child. CONCLUSIONS: The results confirmed the individuality of families, and that individual characteristics of coping and feeling in control, together with family support and cohesion, are associated with variation in amount of stress experienced in parenting a child with cerebral palsy.


Subject(s)
Cerebral Palsy/psychology , Family/psychology , Mothers/psychology , Parenting/psychology , Adaptation, Psychological , Cerebral Palsy/epidemiology , Child, Preschool , Cluster Analysis , Female , Humans , Infant , Male , Mother-Child Relations , Risk Factors , Social Support , Stress, Psychological , United Kingdom/epidemiology
16.
J Environ Qual ; 37(2): 535-41, 2008.
Article in English | MEDLINE | ID: mdl-18396538

ABSTRACT

Increased CO2 release from soils resulting from agricultural practices such as tillage has generated concerns about contributions to global warming. Maintaining current levels of soil C and/or sequestering additional C in soils are important mechanisms to reduce CO2 in the atmosphere through production agriculture. We conducted a study in northern Alabama from 2003 to 2006 to measure CO2 efflux and C storage in long-term tilled and non-tilled cotton (Gossypium hirsutum L.) plots receiving poultry litter or ammonium nitrate (AN). Treatments were established in 1996 on a Decatur silt loam (clayey, kaolinitic thermic, Typic Paleudults) and consisted of conventional-tillage (CT), mulch-tillage (MT), and no-tillage (NT) systems with winter rye [Secale cereale (L.)] cover cropping and AN and poultry litter (PL) as nitrogen sources. Cotton was planted in 2003, 2004, and 2006. Corn was planted in 2005 as a rotation crop using a no-till planter in all plots, and no fertilizer was applied. Poultry litter application resulted in higher CO2 emission from soil compared with AN application regardless of tillage system. In 2003 and 2006, CT (4.39 and 3.40 micromol m(-2) s(-1), respectively) and MT (4.17 and 3.39 micromol m(-2) s(-1), respectively) with PL at 100 kg N ha(-1) (100 PLN) recorded significantly higher CO2 efflux compared with NT with 100 PLN (2.84 and 2.47 micromol m(-2) s(-1), respectively). Total soil C at 0- to 15-cm depth was not affected by tillage but significantly increased with PL application and winter rye cover cropping. In general, cotton produced with NT conservation tillage in conjunction with PL and winter rye cover cropping reduced CO2 emissions and sequestered more soil C compared with control treatments.


Subject(s)
Agriculture/methods , Air Pollutants/analysis , Carbon Dioxide/analysis , Gossypium , Manure , Alabama , Animals , Carbon/analysis , Environmental Monitoring , Fertilizers , Nitrates , Poultry , Soil/analysis
17.
J Epidemiol Community Health ; 62(4): 361-7, 2008 Apr.
Article in English | MEDLINE | ID: mdl-18339831

ABSTRACT

OBJECTIVE: To assess the cost effectiveness of the Expert Patients Programme (EPP) intervention compared to a treatment as usual alternative. DESIGN: Two-arm pragmatic randomised controlled trial design with waiting list control. SETTING: Community settings in England. PATIENTS: Patients with a wide range of self-defined long-term conditions. INTERVENTION: The EPP based on the US chronic disease self management program (CDSMP), a lay-led self-care group involving six weekly sessions to teach self-care support skills. MAIN OUTCOME MEASURES: Costs estimated over a 6-month period from a societal perspective. Health outcomes estimated in terms of quality adjusted life years (QALYs) generated by patients' response to the EQ5D at baseline and 6-month follow-up. RESULTS: The intervention group is associated with better patient outcomes, at slightly lower cost. Specifically, the intervention group has a 0.020 QALY gain compared with the control group, and a reduced cost of around 27 pounds per patient. The intervention would therefore be considered dominant. While the QALYs gained are small in absolute terms, an additional 0.02 QALY is equivalent to an extra one week of perfect health per year. When the value of a QALY is 20,000 pounds the EPP has a probability of 94% of being cost effective. Indeed, for all plausible values of willingness-to-pay for a QALY the EPP group is more likely to be cost effective than the control group. CONCLUSIONS: The EPP intervention evaluated in this trial is very likely to provide a cost effective alternative to usual care in people with long-term conditions.


Subject(s)
Chronic Disease/therapy , Chronic Disease/economics , Cost-Benefit Analysis , England , Female , Health Resources/economics , Health Resources/statistics & numerical data , Health Status , Humans , Male , Patient Acceptance of Health Care/statistics & numerical data , Quality-Adjusted Life Years
18.
Health Technol Assess ; 11(16): iii-iv, ix-x, 1-71, 2007 May.
Article in English | MEDLINE | ID: mdl-17462166

ABSTRACT

OBJECTIVES: To investigate whether, in the short and medium term, additional support by (a) a physiotherapy assistant improved physical function in young children with spastic cerebral palsy and (b) a family support worker improved family functioning. DESIGN: This was a multi-centre randomised controlled trial (RCT) with blinded assessments and a cost-effectiveness analysis. The children studied had spastic cerebral palsy that was the consequence of perinatal adversity. All were less than 4 years old on entry to the study. SETTING: In the child development centre and in the home. PARTICIPANTS: Seventy-six families completed the intervention period. Forty-three families were reassessed 6 months after the end of the intervention and 34 of these after a further 6-month period. INTERVENTIONS: Randomisation was to: (a) a group who received extra physiotherapy from a physiotherapy assistant; (b) a group who received standard physiotherapy; and (c) a group where the child received standard physiotherapy and the family was also visited by a family support worker. Children in all groups continued to receive standard physiotherapy in addition to the study interventions. MAIN OUTCOME MEASURES: The child outcome measures were motor functioning, developmental status and adaptive functioning. The family outcome measures were self-reported maternal stress, level of family needs and parental satisfaction. RESULTS: There was no evidence that additional physical therapy for 1 hour per week for 6 months by a physiotherapy assistant improved any child outcome measure in the short or medium term. Intervention by a family support worker did not have a clinically significant effect on parental stress or family needs. Over the 6-month period the total cost of services for each child ranged from 250 pounds to 6750 pounds, with higher costs associated with children with more severe impairments. No significant relationship was found between measures of intensity of services received by the children and families and the main outcome measures. Low-functioning children, in terms of both motor and cognitive function, were more likely to receive more services in terms of range and frequency. Parents generally reported high satisfaction ratings after all interventions and some stated that the interventions had benefited the child and/or the family. There was therefore a discrepancy between the perceptions of these parents and the objective, quantitative measurements. The family support workers identified a small number of families who were experiencing considerable family problems, but who had not been referred for appropriate support by any other agency. CONCLUSIONS: The findings of this study provide support for the current literature that there was no evidence that additional intervention (in this case by a physiotherapy assistant or family support worker) helped the motor or general development of young children with spastic cerebral palsy. Nor was there any quantitative evidence that providing extra family support helped levels of parental stress and family needs. The implication was that the provision of extra physical therapy does not necessarily improve the motor function of a young child with cerebral palsy and additional family support should not automatically be assumed to be beneficial. In addition, no significant association was found between the intensity of the local services provided and any outcome measure, other than a slight association with lowered family needs. The provision of local services was related to the severity of the child's impairments and not to family difficulties. A small group of families with complex family problems needed more service input. There was a wide range in the costs of services. Research is needed to examine what 'sufficient' levels of provision or therapy might be for which children and which families. A time series of different levels of input and outcomes would provide valuable information for practitioners. It is also recommended that future assessments of therapies of this type adopt a similar multifaceted approach, which is likely to be more suitable than a simple RCT for the evaluation of clinical interventions where the effects are complex. The most appropriate measures of outcome should be used, including assessment of provision of information and emotional support for families.


Subject(s)
Cerebral Palsy/economics , Cerebral Palsy/therapy , Physical Therapy Modalities/economics , Cerebral Palsy/complications , Child Development , Consumer Behavior , Cost-Benefit Analysis , Disabled Children , Health Status , Humans , Infant , Parents/psychology , Psychomotor Performance , Social Work , Stress, Psychological/etiology , Stress, Psychological/psychology
19.
Theriogenology ; 67(1): 178-84, 2007 Jan 01.
Article in English | MEDLINE | ID: mdl-17109945

ABSTRACT

This study compares the meat composition of the offspring from boars produced by somatic cell nuclear transfer (n=4) to that of the offspring from conventionally produced boars (n=3). In total, 89 commercial gilts were artificially inseminated and 61 progressed to term and farrowed. All of the resulting piglets were housed and raised identically under standard commercial settings and slaughtered upon reaching market weight. Loin samples were taken from each slaughtered animal and shipped offsite for meat composition analysis. In total, loin samples from 404 animals (242 from offspring of clones and 162 from controls) were analyzed for 58 different parameters generating 14,036 and 9396 data points from offspring of clones and the controls, respectively. Values for controls were used to establish a range for each parameter. Ten percent was then added to the maximum and subtracted from the minimum of the control range, and all results within this range were considered clinically irrelevant. Of the 14,036 data points from the offspring of clones, only three points were found outside the clinically irrelevant range, two of which were within the range established by the USDA National Nutrient Database for Standard Reference, Release 18, 2005; website: (www.nal.usda.gov/fnic/foodcomp/search/). The only outlier was the presence of Eicosadienoic acid (C20:2) in one sample which is typically present in minute quantities in pork; no reference data were found regarding this fatty acid in the USDA National Nutrient Database. In conclusion, these data indicated that meat from the offspring of clones was not chemically different than meat from controls and therefore supported the case for the safety of meat from the offspring of clones.


Subject(s)
Cloning, Organism/veterinary , Consumer Product Safety , Meat/analysis , Nuclear Transfer Techniques/veterinary , Swine/genetics , Animal Husbandry/methods , Animals , Case-Control Studies , Female , Male , Swine/physiology
20.
Cloning Stem Cells ; 8(3): 130-9, 2006.
Article in English | MEDLINE | ID: mdl-17009889

ABSTRACT

This study compares the reproductive performance of boars produced by somatic cell nuclear transfer versus conventional breeding. Two different genotypes were selected for comparison: terminal cross line 1 (TX1) and terminal cross line 2 (TX2). The boars selected for comparison from TX1 were three cloned boars, produced by somatic cell nuclear transfer and the conventionally produced progenitor of the clones. The boars selected for comparison from TX2 were a cloned boar produced by somatic cell nuclear transfer and two conventionally produced half sibling boars that were offspring of the progenitor of the clone. Semen from each boar was collected, extended, evaluated and shipped offsite. Upon arrival, the semen was reevaluated and utilized for artificial insemination of 89 commercial gilts, at least 12 gilts per boar, producing 625 piglets. Pregnancy rates were determined at day 30 and 110 of gestation; and farrowing rate and gestation length were recorded. Differences were observed in some of the semen characteristics analyzed with the clones usually possessing superior semen quality to the control, this likely being a result of age differences amongst the clones and controls. Additionally no differences were noted between the clones and controls (progenitor) or between individual boars within genetic line for pregnancy rates, gestation length or any of the litter parameters examined between the clones and controls. These data further support previous reports with limited numbers that the reproductive capabilities of cloned boars are equal to that of conventionally produced boars.


Subject(s)
Cloning, Organism/veterinary , Sus scrofa/physiology , Animals , Breeding , Cloning, Organism/methods , Female , Fertility/physiology , Insemination, Artificial/veterinary , Male , Nuclear Transfer Techniques , Pregnancy , Reproduction/physiology
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