A comparison of self-report and health care provider data to assess surveillance definitions of influenza-like illness in outpatients

Objective: Several surveillance definitions of influenza-like illness (ILI) have been proposed, based on the presence of symptoms. Symptom data can be obtained from patients, medical records, or both. Past research has found that agreements between health record data and self-report are variable depending on the specific symptom. Therefore, we aimed to explore the implications of using data on influenza symptoms extracted from medical records, similar data collected prospectively from outpatients, and the combined data from both sources as predictors of laboratory-confirmed influenza. Methods: Using data from the Hutterite Influenza Prevention Study, we calculated: 1) the sensitivity, specificity and predictive values of individual symptoms within surveillance definitions; 2) how frequently surveillance definitions correlated to laboratory-confirmed influenza; and 3) the predictive value of surveillance definitions. Results: Of the 176 participants with reports from participants and medical records, 142 (81%) were tested for influenza and 37 (26%) were PCR positive for influenza. Fever (alone) and fever combined with cough and/or sore throat were highly correlated with being PCR positive for influenza for all data sources. ILI surveillance definitions, based on symptom data from medical records only or from both medical records and self-report, were better predictors of laboratory-confirmed influenza with higher odds ratios and positive predictive values. Discussion: The choice of data source to determine ILI will depend on the patient population, outcome of interest, availability of data source, and use for clinical decision making, research, or surveillance. © Canadian Public Health Association, 2012.

Health care needs of community-dwelling older adults

Objective. To identify, assess, and rank the importance of health care needs of community-dwelling older adults. Method. A structured telephone interview with 107 respondents (physicians, direct service providers and administrators) about the importance of a list of 31 health care needs of older adults. Respondents also identified the single most important health issue facing local older adults now and in the next 5 to 10 years. Results. The five most important health care needs, in descending order, are: care-giver support services, community long-term care services services for people with demential/Alzheimer's disease, palliative/end-of-life care, and services for cancer patients and their families. Community long-term care services were identified as the single most important health issue both now and in the next 5 to 10 years. Conclusion. The study findings should be of value to health and social service researchers, planners, providers and administrators regarding the needs of community-dwelling older adults.

Optimizing Research on End-of-Life Care for Seniors:The Collective New Emerging Team on End of Life Care for Seniors University of Ottawa, Institute of Palliative Care

Background: End-of-life care for seniors is an important and neglected area of research. The University of Ottawa Institute of Palliative Care has expanded its research capacity by developing a Canadian Institutes of Health Research (CIHR) funded new emerging team on end-of-life care for seniors. This initiative brings together an interdisciplinary team of researchers from palliative care and geriatrics to develop a comprehensive program of research. Methods: 1) A variety of investigators from the fields of palliative care and geriatrics and disciplines of epidemiology, medicine, nursing, psychology and social work will collaborate on the development of a research agenda focussed on end-of-life care for seniors. 2) The conceptual model for the research program consists of 4 broad interrelated domains that are congruent with the CIHR themes of health services, clinical issues, population health and psychosocial, cultural, spiritual and ethical issues; this framework will guide the research program and all studies emanating from the program. 3) Research studies will focus on 5 areas of inquiry that are central to end-of-life care for seniors: palliative end-of-life care for rural seniors, care settings, burden, role of volunteers, and delirium. Results: This new team has the potential to obtain peer-reviewed funding, recruit and train a new generation of researchers, and build a network of concerned researchers. Conclusions: The new team should ultimately contribute to an improved quality of care for seniors who are approaching death.

Suspected giant cell arteritis:A study of referrals for temporal artery biopsy

Background: The purpose of this study is to describe the nature of cases undergoing temporal artery biopsy (TAB) for suspected giant cell arteritis (GCA). Methods: A retrospective review of case notes was undertaken for all patients on whom ophthalmologists had performed TAB in 2 teaching hospitals between 1995 and 2001. Presenting symptoms, referring specialty, TAB result, treatment, and discharge diagnosis were recorded. Results: Ophthalmologists performed TAB on 110 patients for suspected GCA. A variety of specialties referred patients to ophthalmology for TAB; presenting symptoms varied with referral source. Of the 110 TABs, 21 (19%) were reported as positive for GCA, 84 (76%) were negative, and 5 (4.5%) were reported as inadequate. The symptoms most commonly associated with a positive TAB were visual disturbance (15/21) and headache (15/21).The odds ratios for having a positive TAB result rather than a negative result were 1.0 for the presence of headache, 4.1 for visual disturbance, and 6.7 for jaw claudication. Interpretation: Physicians were faced with a different population of GCA suspects than ophthalmologists. While physicians should be alert to the significance of visual symptoms or jaw claudication, ophthalmologists should be ready to facilitate prompt TABs when appropriate. TAB should be performed promptly and an adequate length of artery taken for biopsy. An argument can be made that TAB is not needed in cases of suspected GCA. However, a positive result provides firm justification for the use of steroids. We feel that TAB has a useful role and we make reference to methods to maximize its usefulness.

Detailed validation of an automotive catalysis model using spatially resolved measurements within the catalyst substrate

Many kinetic models have appeared in literature in past decades using two main approaches: the traditional global kinetics approach, or the more complex micro-kinetics approach. Whether global or micro-kinetics, kinetic models have been based on experimental data obtained at the end of the monolith. The experimental procedure using end pipe analysis may give an accurate overview of the reaction mechanisms that occur; however, the lack of information from within the catalyst can ultimately lead to inaccuracies in the kinetic model and parameters used.

Using SpaciMS, a spatially resolved experimental technique developed at the Queen's University Belfast, information from within the catalyst can be obtained. This minimally invasive technique provides detailed information of the gas concentration and temperature profile from inside the catalytic monolith. This paper presents a kinetic model and simulations validated against experimental data obtained from three positions inside the catalyst monolith at 2, 14, and 26 mm in, using data from the SpaciMS. Also, simulations of end pipe analysis, using a commercial reactor, for the CO oxidation are presented and analyzed. The simulations presented are for varying concentrations of both CO and O2 (0.5 % and 1 % CO, 0.5 % and 2 % O2) for both the global and micro-kinetic approach.

Correlation of Static Ageing Effects on Automotive Catalysts

This study identifies and analyzes the effect that aging time and temperature have on the CO light-off activity of three-way catalyst samples, aged in a static air (oxidizing) atmosphere. The bench aging time (BAT) equation proposed by the Environmental Protection Agency (EPA), which describes aging as dependent upon time at temperature, was used to calculate a range of oven aging times and temperatures based on a RAT-A engine bench aging cycle.

CO light-off tests carried out on cores aged between 800 and 900 °C have shown that it is the aging temperature that has the greatest effect on catalyst deterioration for static aging testing, with aging time having little effect. These results were in contradiction to the BAT equation, an industry norm for the aging of catalysts. This demonstrates that static aging, whilst showing how temperature affects aging, gives little or no time effects. The results have shown that static aging is not representative of actual aging on a vehicle.

Progressive aging conducted at a temperature of 1000 °C was shown to cause a decrease in catalyst activity as the aging time increased. However, even in these extreme conditions, static aging gave a slower rate of aging with time when compared to engine aging as defined by the BAT equation. Overall, static aging in air has been shown to produce a greater increase in aging due to temperature than predicted by the BAT equation, but less aging due to aging time.

Due North? Do American Theories of Legislative Committees Apply to Canada?

Several theories of legislative organisation have been proposed to explain committee selection in American legislatures, but do these theories travel outside the United States? This paper tests whether these theories apply to data from the Canadian House of Commons. It was found that the distributive and partisan models of legislative organisation explain committee composition in Canada. In many cases, committees in the House of Commons are made up of preference outliers. As predicted by partisan models, it was also found that the governing party stacks committees with its members, but this is conditional upon the strength of the governing party.

Intracellular survival of Burkholderia cepacia complex in phagocytic cells

Burkholderia cepacia complex (Bcc) species are a group of Gram-negative opportunistic pathogens that infect the airways of cystic fibrosis patients, and occasionally they infect other immunocompromised patients. Bcc bacteria display high-level multidrug resistance, and chronically persist in the infected host while eliciting robust inflammatory responses. Studies using macrophages, neutrophils and dendritic cells, combined with advances to genetically manipulate these bacteria have increased our understanding of the molecular mechanisms of virulence in these pathogens and the molecular details of cell-host responses triggering inflammation. This article discusses our current view of the intracellular survival of B. cenocepacia within macrophages.

Radiative rates for E1, E2, M1, and M2 transitions among the 3s23p5, 3s3p6, and 3s23p43d configurations of Cl-like W LVIII

We report calculations of energy levels, radiative decay rates, and lifetimes for transitions among the 3s²3p⁵, 3s3p⁶, and 3s²3p⁴3d configurations of Cl-like W LVIII. The general-purpose relativistic atomic structure package (GRASP) has been adopted for our calculations. Comparisons are made with the most recent results of Mohan et al. (Can. J. Phys. 92, 177 (2014). doi:10.1139/cjp-2013-0348) and discrepancies in lifetimes are noted, up to four orders of magnitude in some instances. Our energy levels are estimated to be accurate to better than 0.5%, whereas results for radiative rates and lifetimes should be accurate to better than 20%.