Fetal megacystis: experience of a single tertiary center in Switzerland over 20 years

OBJECTIVES Megacystis (MC) is rare and often associated with other structural and chromosomal anomalies. In euploid cases with early oligohydramnios, prognosis is poor mainly due to pulmonary hypoplasia and renal damage. We report our experience of the past 20 years. METHODS A retrospective review of cases with prenatally diagnosed MC was performed. Complete prenatal as well as postnatal medical records from 1989 to 2009 were reviewed focusing on diagnostic precision, fetal interventions [vesicocentesis (VC), vesicoamniotic shunt (VAS)], short- and long-term outcome, and potential prognostic factors. RESULTS 68 cases were included. Follow-up was available in 54 cases (9 girls and 45 boys including 3 cases with aneuploidy). We found 39 isolated MC at sonography (5 girls and 34 boys). 24 fetuses with isolated MC underwent VC and VAS at 19.6 ± 6.3 and 20 ± 4.9 weeks of gestation, respectively. Survival rate was higher in male than in female fetuses (51 vs. 33%). Renal problems occurred in 4/14 prenatally treated fetuses and in 1/10 when cases with prune belly syndrome (PBS) were excluded from the analysis. CONCLUSIONS Our study shows that a careful selection of cases with MC excluding fetuses with PBS and early treatment has still the potential to improve outcome.

Foodborne illness - An age old problem requiring contemporary solutions

Foodborne illness has always been with us, and food safety is an increasingly important public health issue affecting populations worldwide. In the United States of America, foodborne illness strikes millions of people and kills thousands annually, costing our economy billions of dollars in medical care expense and lost productivity. The nature of food and foodborne illness has changed dramatically in the last century. The regulatory systems have evolved to better assure a safe food supply. The food production industry has invested heavily to meet regulatory requirement and to improve the safety of their products. Educational efforts have increased public awareness of safe food handling practices, empowering consumers to fulfill their food safety role. Despite the advances made, none of the Healthy People 2010 targets for reduction of foodborne pathogens has been reached. There is no single solution to eliminating pathogen contamination from all classes of food products. However, irradiation seems especially suited for certain higher-risk foods such as meat and poultry and its use should advance the goal of reducing foodborne illness by minimizing the presence of pathogenic organisms in the food supply. This technology has been studied extensively for over 50 years. The Food and Drug Administration has determined that food irradiation is safe for use as approved by the Agency. It is time to take action to educate consumers about the benefits of food irradiation. Consumer demand will compel industry to meet demand by investing in facilities and processes to assure a consistent supply of irradiated food products. ^

Standardization of data collection for the Lifetime Surveillance of Astronaut Health (LSAH)

Problems due to the lack of data standardization and data management have lead to work inefficiencies for the staff working with the vision data for the Lifetime Surveillance of Astronaut Health. Data has been collected over 50 years in a variety of manners and then entered into a software. The lack of communication between the electronic health record (EHR) form designer, epidemiologists, and optometrists has led to some level to confusion on the capability of the EHR system and how its forms can be designed to fit all the needs of the relevant parties. EHR form customizations or form redesigns were found to be critical for using NASA's EHR system in the most beneficial way for its patients, optometrists, and epidemiologists. In order to implement a protocol, data being collected was examined to find the differences in data collection methods. Changes were implemented through the establishment of a process improvement team (PIT). Based on the findings of the PIT, suggestions have been made to improve the current EHR system. If the suggestions are implemented correctly, this will not only improve efficiency of the staff at NASA and its contractors, but set guidelines for changes in other forms such as the vision exam forms. Because NASA is at the forefront of such research and health surveillance the impact of this management change could have a drastic improvement on the collection of and adaptability of the EHR. Accurate data collection from this 50+ year study is ongoing and is going to help current and future generations understand the implications of space flight on human health. It is imperative that the vast amount of information is documented correctly.^

Acute, posterior multifocal placoid pigment epitheliopathy: a case of 11 recurrences over 15 years

PURPOSE: To report the case of a patient with recurrent, acute posterior multifocal placoid pigment epitheliopathy. To the best of our knowledge, this is the longest documented course with the greatest number of recurrences reported. METHODS: Observational case report of one patient. A 27-year-old otherwise healthy male patient presented with recurrence of new scotomata over 15 years. Fundus photography, fluorescein angiography, indocyanine green angiography, fundus autofluorescence, and optical coherence tomography documented his clinical course. RESULTS: Over the course of 15 years, the patient developed 11 symptomatic (5 imaging-documented) recurrences of acute, posterior multifocal placoid pigment epitheliopathy affecting both eyes. Each episode manifested with new subjective scotomata and new lesions noted on imaging. Symptoms mostly resolved after each episode, and visual outcome remained excellent (20/20 in the right eye and 20/25 left eye at the last follow-up). CONCLUSION: Although typically monophasic, acute posterior multifocal placoid pigment epitheliopathy can rarely present with a recurrent course over a prolonged period of time and should be considered as a diagnosis in patients presenting with recurrent visual symptoms and new placoid lesions on imaging. In recurrent cases, visual recovery may still remain excellent.

Foreigner? Want to study in Spain? The integration process at universities

The student exchange programs being carried out at universities for over 50 years, have led to changes in the institutions, which had to adapt to accommodate these students. Despite those changes, the integration of foreign students not coming from the aforementioned exchange programs that come to our country to study at the University has been neglected. These students face many barriers (language, cultural and origin customs mainly), so a clear and detailed information would be highly desirable in order to facilitate the necessary arrangements This study aims to show the deficiencies in the integration process and hosting programs faced by a foreign student at University. The study is performed by means of an analysis of statistical data from the Polytechnic University of Madrid and the Civil Engineering School over the last 12 school years (1999 - 2000 to 2010 - 2011), as well as surveys and interviews with some of these students. The study is enhanced with the analysis of the measures and integration methods of the various minorities, which had been implemented by the foremost public universities in Spain, as well as other public and private universities abroad. It illustrates the existing backlog at the Spanish universities with regards to supporting the integration of diversity among foreign students, providing data concerning the growth of such population and its impact at the university, and on the institutions in particular. In an increasingly globalized world, we must understand and facilitate the integration of minorities at University, supplying them, from the first day, and before the enrollment process, the essential elements that will allow their adequate adaptation to the educational process at University. It concludes by identifying the main subjects that need to be tackled to endorse such integration.

A RESPONSABILIDADE SOCIAL EMPRESARIAL COMO FERRAMENTA ESTRATÉGICA E MOTIVACIONAL NA INDÚSTRIA AUTOMOTIVA BRASILEIRA. ESTUDO COMPARATIVO DE CASO: VOLKSWAGEN DO BRASIL (GRANDE ABC) X FIAT AUTOMÓVEIS (BETIM/MG)

Este trabalho propõe-se a mostrar a Responsabilidade Social como uma vantagem competitiva, bem como uma ferramenta estratégica vital para a sobrevivência das empresas em um cenário de rápidas e constantes mudanças. A ressaltar que, a partir do processo de globalização, com a pseudofusão das culturas, muitas empresas viram-se, de uma hora para outra, inseridas em um ambiente extremamente competitivo e aguerrido, onde velhas práticas tiveram que ser abandonadas, porque o cliente, antes jogado à própria sorte, tornou-se rei . Isto é, soberano nas suas escolhas e a razão de ser de uma empresa. Para abalizar as informações prestadas, far-se-á o estudo comparativo de caso, por meio de uma pesquisa qualitativa descritiva, entre a Volkswagen Brasil empresa de origem alemã, instalada há mais de 50 anos no país e que detinha a liderança absoluta do mercado até o início do século XXI mas que a perdeu para a Fiat Automóveis de origem italiana, instalada há pouco mais de 30 anos, na cidade mineira de Betim e que conseguiu reverter uma imagem negativa perante os consumidores, tendo como uma das suas ações, a Responsabilidade Social como ferramenta estratégica e motivacional do seu público interno, numa clara cultura social . Enquanto que, recentemente, a Volkswagen enfrentou um longo e desgastante processo de negociação sindical em face do processo de demissão de milhares de empregados por carta da sua unidade de São Bernardo do Campo, o que pôs em xeque as suas práticas e a sua efetiva preocupação com o social. A Pesquisa IPEA de Indicadores Sociais, na sua segunda edição, é elemento norteador do trabalho desenvolvido que traz como principais revelações: a Responsabilidade Social no Brasil ainda é incipiente, está em processo de gestação a ISO 26001, a preocupação ambiental alastra-se por todo o planeta e os gestores, antes atentos quase que exclusivamente ao lucro, passam a ser cobrados pelos possíveis impactos socioambientais de suas decisões no presente.(AU)

A RESPONSABILIDADE SOCIAL EMPRESARIAL COMO FERRAMENTA ESTRATÉGICA E MOTIVACIONAL NA INDÚSTRIA AUTOMOTIVA BRASILEIRA. ESTUDO COMPARATIVO DE CASO: VOLKSWAGEN DO BRASIL (GRANDE ABC) X FIAT AUTOMÓVEIS (BETIM/MG)

Este trabalho propõe-se a mostrar a Responsabilidade Social como uma vantagem competitiva, bem como uma ferramenta estratégica vital para a sobrevivência das empresas em um cenário de rápidas e constantes mudanças. A ressaltar que, a partir do processo de globalização, com a pseudofusão das culturas, muitas empresas viram-se, de uma hora para outra, inseridas em um ambiente extremamente competitivo e aguerrido, onde velhas práticas tiveram que ser abandonadas, porque o cliente, antes jogado à própria sorte, tornou-se rei . Isto é, soberano nas suas escolhas e a razão de ser de uma empresa. Para abalizar as informações prestadas, far-se-á o estudo comparativo de caso, por meio de uma pesquisa qualitativa descritiva, entre a Volkswagen Brasil empresa de origem alemã, instalada há mais de 50 anos no país e que detinha a liderança absoluta do mercado até o início do século XXI mas que a perdeu para a Fiat Automóveis de origem italiana, instalada há pouco mais de 30 anos, na cidade mineira de Betim e que conseguiu reverter uma imagem negativa perante os consumidores, tendo como uma das suas ações, a Responsabilidade Social como ferramenta estratégica e motivacional do seu público interno, numa clara cultura social . Enquanto que, recentemente, a Volkswagen enfrentou um longo e desgastante processo de negociação sindical em face do processo de demissão de milhares de empregados por carta da sua unidade de São Bernardo do Campo, o que pôs em xeque as suas práticas e a sua efetiva preocupação com o social. A Pesquisa IPEA de Indicadores Sociais, na sua segunda edição, é elemento norteador do trabalho desenvolvido que traz como principais revelações: a Responsabilidade Social no Brasil ainda é incipiente, está em processo de gestação a ISO 26001, a preocupação ambiental alastra-se por todo o planeta e os gestores, antes atentos quase que exclusivamente ao lucro, passam a ser cobrados pelos possíveis impactos socioambientais de suas decisões no presente.(AU)

Effects of the Heartbeat Wales programme over five years on behavioural risks for cardiovascular disease: quasi-experimental comparison of results from Wales and a matched reference area

Objective: To assess the net 5 year effects of intervention of a community based demonstration project, the Heartbeat Wales programme, on modifiable behavioural risks for prevention of cardiovascular disease.

Greetings: 50 years of Atomic Bomb Casualty Commission–Radiation Effects Research Foundation studies

The Atomic Bomb Casualty Commission was established in Hiroshima in 1947 and in Nagasaki in 1948 under the auspices of the U.S. National Academy of Sciences to initiate a long-term and comprehensive epidemiological and genetic study of the atomic bomb survivors. It was replaced in 1975 by the Radiation Effects Research Foundation which is a nonprofit Japanese foundation binationally managed and supported with equal funding by the governments of Japan and the United States. Thanks to the cooperation of the survivors and the contributions of a multitude of scientists, these studies flourish to this day in what must be the most successful long-term research collaboration between the two countries. Although these studies are necessarily limited to the effects of acute, whole-body, mixed gamma-neutron radiation from the atom bombs, their comprehensiveness and duration make them the most definitive descriptions of the late effects of radiation in humans. For this reason, the entire world relies heavily on these data to set radiation standards. As vital as the study results are, they still represent primarily the effects of radiation on older survivors. Another decade or two should correct this deficiency and allow us to measure definitively the human risk of heritable mutation from radiation. We look to the worldwide radiation and risk community as well as to the survivors who have contributed so much to what has been done already to accomplish this goal.