Temporal distribution of trauma deaths: Quality of trauma care in a developing country

Background: Examination of the epidemiology and timing of trauma deaths has been deemed a useful method to evaluate the quality of trauma care. Objective: The purpose of this study was to evaluate the quality of trauma care in a regional trauma system and in a university hospital in Brazil by comparing the timing of deaths in the studied prehospital and in-hospital settings to those published for trauma systems in other areas. Methods: We analyzed the National Health Minister`s System of Deaths Information for the prehospital mortality and we retrospectively collected the demographics, timelines, and trauma severity scores of all in-hospital patients who died after admission through the Emergency Unit of Hospital das Clinicas de Ribeirao Preto between 2000 and 2001. Results. During the study period, there were 787 trauma fatalities in the city: 448 (56.9%) died in the prehospital setting and 339 (43.1%) died after being admitted to a medical facility. In 2 years, 238 trauma deaths occurred in the studied hospital, and we found a complete clinical set of data for 224 of these patients. The majority of deaths in the prehospital setting were caused by penetrating injuries (66.7%), whereas in-hospital mortality was mainly because of blunt traumas (59.1%). The largest number of in-hospital deaths occurred beyond 72 hours of stay (107 patients-47%). Conclusions: The region studied showed some deficiencies in prehospital and in-hospitals settings, in particular in the critical care and short-term follow-up of trauma patients when compared with the literature. Particularly, the late mortality may be related to training and human resources deficiency. Based on the timeline of trauma deaths, we can suggest that the studied region needs improvements in the prehospital trauma system and in hospital critical care.

Reference distribution of the bioelectrical impedance vector in healthy term newborns

Bioelectrical impedance vector analysis (BIVA) is a new method that is used for the routine monitoring of the variation in body fluids and nutritional status with assumptions regarding body composition values. The aim of the present study was to determine bivariate tolerance intervals of the whole-body impedance vector and to describe phase angle (PA) values for healthy term newborns aged 7-28 d. This descriptive cross-sectional study was conducted on healthy term neonates born at a low-risk public maternity. General and anthropometric neonatal data and bioelectrical impedance data (800 mu A-50 kHz) were obtained. Bivariate vector analysis was conducted with the resistance-reactance (RXc) graph method. The BIVA software was used to construct the graphs. The study was conducted on 109 neonates (52.3% females) who were born at term, adequate for gestational age, exclusively breast-fed and aged 13 (SD 3.6) d. We constructed one standard, reference, RXc-score graph and RXc-tolerance ellipses (50, 75 and 95 %) that can be used with any analyser. Mean PA was 3.14 (SD 0.43)degrees (3.12 (SD 0.39)degrees for males and 3.17 (SD 0.48)degrees for females). Considering the overlapping of ellipses of males and females with the general distribution, a graph for newborns aged 7-28 d with the same reference tolerance ellipse was defined for boys and girls. The results differ from those reported in the literature probably, in part, due to the ethnic differences in body composition. BIVA and PA permit an assessment without the need to know body weight and the prediction error of conventional impedance formulas.

Molecular characteristics of extended-spectrum beta-lactamase-producing Escherichia coli from Rio de Janeiro, Brazil

Twenty-five extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli clinical isolates from Rio de Janeiro, Brazil were characterized by isoelectric focusing, PCR and sequencing of bla(ESBL) genes, plasmid-mediated quinolone resistance determinants, phylogenetic groups, replicon typing, pulsed-field electrophoresis, and multilocus sequencing typing. Twenty-three (92%) ESBL-producing E. coli isolates were positive for bla(CTX-M) genes, aac(6`)-lb-cr, and qnrB. Genetic relatedness of ESBL producers clustered seven (28%) CTX-M-15-producing isolates as sequence type (ST) 410, clonal complex (CC) 23, and two (8%) as clone O25-ST131. Our results illustrate the predominance of phylo-group A (52%), ST410 (CC 23) and CTX-M-15 among ESBL-producing E. coli isolates from hospitals in Rio de Janeiro.

Human settlements: Australia state of the environment report, 2001

Australia’s transition to the 21st century has been marked by an extended period of economic prosperity unmatched for several decades, but one in which a series of question marks are being raised in three principal areas: in relation to the environment, the social well-being of the population, and the future path of economic development. The first concern, which is of primary interest in this report, relates to the physical environment of cities and their surrounding regions, and the range of pressures exerted by population and human activity. The report begins by noting the increasing divergence of the prime indicator of national economic performance—gross domestic product (GDP)—from the Genuine Progress Indicator (GPI). GPI is a new experimental measure of sustainable development that accommodates factors currently unaccounted for in GDP, such as income distribution, value of household work, cost of unemployment, and various other social and environmental costs. The divergence of these two indicators in recent decades suggests that Australia’s growth has been heavily dependent on the draw-down of the nation’s stocks of capital assets (its infrastructure), its human and social capital, and its natural capital (Hamilton 1997).

Estimating Income Inequality in China Using Grouped Data and the Generalized Beta Distribution

There are two main types of data sources of income distributions in China: household survey data and grouped data. Household survey data are typically available for isolated years and individual provinces. In comparison, aggregate or grouped data are typically available more frequently and usually have national coverage. In principle, grouped data allow investigation of the change of inequality over longer, continuous periods of time, and the identification of patterns of inequality across broader regions. Nevertheless, a major limitation of grouped data is that only mean (average) income and income shares of quintile or decile groups of the population are reported. Directly using grouped data reported in this format is equivalent to assuming that all individuals in a quintile or decile group have the same income. This potentially distorts the estimate of inequality within each region. The aim of this paper is to apply an improved econometric method designed to use grouped data to study income inequality in China. A generalized beta distribution is employed to model income inequality in China at various levels and periods of time. The generalized beta distribution is more general and flexible than the lognormal distribution that has been used in past research, and also relaxes the assumption of a uniform distribution of income within quintile and decile groups of populations. The paper studies the nature and extent of inequality in rural and urban China over the period 1978 to 2002. Income inequality in the whole of China is then modeled using a mixture of province-specific distributions. The estimated results are used to study the trends in national inequality, and to discuss the empirical findings in the light of economic reforms, regional policies, and globalization of the Chinese economy.

Algebraic Bethe ansatz for integrable extended Hubbard models arising from supersymmetric group solutions

Integrable extended Hubbard models arising from symmetric group solutions are examined in the framework of the graded quantum inverse scattering method. The Bethe ansatz equations for all these models are derived by using the algebraic Bethe ansatz method.

Integrable extended hubbard models with boundary Kondo impurities

Three kinds of integrable Kondo impurity additions to one-dimensional q-deformed extended Hubbard models are studied by means of the boundary Z(2)-graded quantum inverse scattering method. The boundary K matrices depending on the local magnetic moments of the impurities are presented as nontrivial realisations of the reflection equation algebras in an impurity Hilbert space. The models are solved by using the algebraic Bethe ansatz method, and the Bethe ansatz equations are obtained.

Effect of cantilever length and framework alloy on the stress distribution of mandibular-cantilevered implant-supported prostheses

The purpose of this in vitro study was to analyze the stress distribution on components of a mandibular-cantilevered implant-supported prosthesis with frameworks cast in cobalt-chromium (Co-Cr) or palladium-silver (Pd-Ag) alloys, according to the cantilever length. Frameworks were fabricated on (Co-Cr) and (Pd-Ag) alloys and screwed into standard abutments positioned on a master-cast containing five implant replicas. Two linear strain gauges were fixed on the mesial and distal aspects of each abutment to capture deformation. A vertical static load of 100 N was applied to the cantilever arm at the distances of 10, 15, and 20 mm from the center of the distal abutment and the absolute values of specific deformation were recorded. Different patterns of abutment deformation were observed according to the framework alloy. The Co-Cr alloy framework resulted in higher levels of abutment deformation than the silver-palladium alloy framework. Abutment deformation was higher with longer cantilever extensions. Physical properties of the alloys used for framework interfere with abutment deformations patterns. Excessively long cantilever extensions must be avoided. To cite this article:Jacques LB, Moura MS, Suedam V, Souza EAC, Rubo JH. Effect of cantilever length and framework alloy on the stress distribution of mandibular-cantilevered implant-supported prostheses.Clin. Oral Impl. Res. 20, 2009; 737-741.doi: 10.1111/j.1600-0501.2009.01712.x.

Effect of abutment`s height and framework alloy on the load distribution of mandibular cantilevered implant-supported prosthesis

In cantilevered implant-supported complete prosthesis, the abutments` different heights represent different lever arms to which the abutments are subjected resulting in deformation of the components, which in turn transmit the load to the adjacent bone. The purpose of this in vitro study was to quantitatively assess the deformation of abutments of different heights in mandibular cantilevered implant-supported complete prosthesis. A circular steel master cast with five perforations containing implant replicas (O3.75 mm) was used. Two groups were formed according to the types of alloy of the framework (CoCr or PdAg). Three frameworks were made for each group to be tested with 4, 5.5 and 7 mm abutments. A 100 N load was applied at a point 15 mm distal to the center of the terminal implant. Readings of the deformations generated on the mesial and distal aspects of the abutments were obtained with the use of strain gauges. Deformation caused by tension and compression was observed in all specimens with the terminal abutment taking most of the load. An increase in deformation was observed in the terminal abutment as the height was increased. The use of an alloy of higher elastic modulus (CoCr) also caused the abutment deformation to increase. Abutment`s height and framework alloy influence the deformation of abutments of mandibular cantilevered implant-supported prosthesis. To cite this article:Suedam V, Capello SouzaEA, Moura MS, Jacques LB, Rubo JH. Effect of abutment`s height and framework alloy on the load distribution of mandibular cantilevered implant-supported prosthesis. Clin. Oral Impl. Res. 20, 2009; 196-200.doi: 10.1111/j.1600-0501.2008.01609.x.

On single laws for varieties of quasigroups associated with extended cycle systems

It has been previously shown by Lindner and Rodger that quasigroups associated with 2-perfect extended m-cycle systems can be equationally defined if and only if m is an element of {3, 5, 7}. In this paper we present a single identity for each such m which is equivalent to the identities given for these varieties.

Closure of the Challinor Centre II: An extended report on 95 individuals after 12 months of community living

As part of an institutional closure programme, 95 individuals with an intellectual disability were relocated to community-based group homes. Each individual was assessed 6 months prior to the relocation and then again after 1, 6, and 12 months of community living. Assessments involved ratings of adaptive and maladaptive behaviour, choice-making, and life circumstances. The group means comparing institution to community ratings showed improvements in adaptive functioning but no significant change in maladaptive behaviour. There were also improvements in life circumstances and increased opportunities for choice-making following relocation to the community. These outcomes suggest that relocation to the community was associated with a more active and normalised lifestyle than experienced in the institutional setting.

Ecological distribution of mosquito larvae of the Anopheles punctulatus group on Niolam (Lihir) Island, Papua New Guinea

We surveyed the larval habitats of member,, of the Anopheles punctulatus group of mosquitoes on Niolam (Lihir) Island. Papua New Guinea. Identification of this group was undertaken by polymerase chain reaction-restriction fragment length polymorphism analysis of the amplified internal transcribed spacer unit 2 of rDNA. because morphologic separation of member species is unreliable. The most widespread malaria vector species and their most common larval habitats identified to aid source-reduction programs for malaria control. The most ubiquitous species was An. punctulatus, followed by An. farauti no. 2. then An. farauti s.s. Anopheles punctulatus has increased relative to An.farauti s.l. since the start of development projects on Lihir Island. The most common larval habitats were shallow temporary pools with clay substrate and with plants or floatage. These habitats. mostly encountered alongside poorly drained roads, may be increased by development projects.