Changes in mood, depression and suicidal ideation after commencing pregabalin for neuropathic pain

Background Pregabalin is a treatment option for patients with persistent neuropathic pain. Its use has been associated with changes in mood and the development of depression and/or suicidal ideation. Objective Case presentations were reviewed of five patients reporting changes in mood, depression and suicidal ideation from the first 50 (approximately) patients commenced on pregabalin at the clinic. Discussion Although these patients had a history of depression, their mood had been stable before commencing pregabalin. Soon after commencement they reported changes in mood, and development of depression and/or suicidal ideation, which improved with dose reduction or cessation of pregabalin. Ultimately, all five patients ceased pregabalin treatment. Suicidal ideation is a recog-nised adverse effect of pregabalin. Patients should be warned of and monitored for deterioration in mood.

Recruiting and retaining plasmapheresis donors: A critical belief analysis

This paper identifies critical beliefs underpinning intentions to commence and continue plasmapheresis donation. Whole blood (n = 624) and first-time plasmapheresis (n = 460) donors completed a cross-sectional survey assessing the belief-base of the theory of planned behaviour and rated their plasmapheresis donation intentions. While the idea of red blood cells being returned was a key deterrent for all donors, critical beliefs underlying commencement and continuation in the plasmapheresis donor panel differed and varied as a function of blood donation history. Findings will assist the development of targeted persuasion messages to optimise recruitment and retention of plasmapheresis donors in a non-remunerated context.

Undergraduate public health students and perceptions of qualitative research: A trajectory of understanding from airy fairy to a valuable tool

Many undergraduate public health students enter introductory qualitative research units with limited or negative perceptions of qualitative research, potentially compromising learning outcomes. Unit teaching, structure and assessment provide opportunities for students to develop positive perceptions of qualitative research. Through a mixed-methods study of undergraduate public health students enrolled in a qualitative research unit, we establish students’ perceptions of qualitative research at the commencement and conclusion of the unit, and determine the critical teaching and learning events which contributed to positive changes in students’ perceptions. This study demonstrates that the structuring of an introductory qualitative research unit around varied opportunities for experiential learning provides a positive introductory learning experience and enables undergraduate public health students to recognise the real-world uses and value of qualitative research.

Attainment of early feeding milestones in preterm neonates

Objective: This study aimed to document the ages at which preterm neonates commence suckle-feeds and attain exclusive suckle-feeding, as well as the time taken to transition from commencement of suckle-feeds to exclusive suckle-feeding. It was hypothesized that gestational age (GA) at birth and degree of neonatal morbidity would influence the timing of these early feeding milestones. Study Design: A chart review was conducted for all neonates born <37;0 weeks GA admitted to a tertiary level perinatal facility over a 12-month period (n=735). Complete data relating to attainment of feeding milestones were available on 472 neonates. Results: Correlation analysis indicated that both a low GA at birth and a high neonatal morbidity rating were statistically significantly correlated with an increased transition time from commencement of suckle-feeds to exclusive suckle-feeding. Cox regression indicated that both of these variables were statistically significant risk factors for a delayed GA at attainment of exclusive suckle-feeding. Conclusion: Preterm neonates who were less mature at birth and/or who displayed a greater degree of neonatal morbidity took longer to transition from starting suckle-feeds to achieving independent suckle-feeding, and were more mature at attainment of independent suckle-feeding.

Colonoscopy preparation in children: Safety, efficacy, and tolerance of high- versus low-volume cleansing methods

Background: The use of large-volume electrolyte balanced solutions as preparation for colonoscopy often results in poor patient compliance and acceptance. The tolerance, safety, and efficacy of high-versus low volume colon-cleansing methods as preparation for colonoscopy in children were compared by randomized operator-blinded trial. Methods: Twenty-nine children ages 3.6-14.6 years had either high-volume nasogastric balanced polyethylene glycol electrolyte lavage (20 ml/kg/h) until the effluent was clear (n = 15), or two oral doses of sodium phosphate solution (22.5-45 ml) separated by oral fluid intake (n = 14). Results: Both preparations were equally effective. The low-volume preparation was better tolerated and caused less discomfort that the high-volume preparation, judging by serial nurse observations. The incidence of abdominal symptoms, diarrhea, sleep disturbance, and vomiting was not significantly different between the two groups. Both groups had a small reduction in mean hematocrit and serum calcium levels. The sodium phosphate preparation caused increases in mean serum sodium concentrations from 140 to 145 mmol/L and serum phosphate concentrations from 1.41 to 2.53 mmol/L. Ten hours after the commencement of the preanesthetic fast, these concentrations had returned to normal. Conclusions: There are advantages in terms of tolerance, discomfort, and case of administration with acceptable colonic cleansing with the use of the less-invasive oral sodium phosphate low-volume colon-cleansing preparation in children. Safe use requires ensuring an adequate oral fluid intake during the preparation time and avoidance of use in patients with renal insufficiency.

Serum immunoglobulin G directed against porcine trypsin in the serum of cystic fibrosis children receiving porcine pancreatic enzyme supplements

Cystic fibrosis (CF) patients require pancreatic enzyme replacement therapy to correct pancreatic insufficiency. These enzymes are derived from porcine pancreas and are known to be antigenic. To determine the possible clinical consequences, a specific ELISA was developed to detect IgG antibody directed against porcine trypsin (PTAb) in the sera of CF patients. The assay was used to evaluate the occurrence of PTAb in a cross sectional study of 103 CF patients in relation to the introduction of porcine enzyme therapy, clinical status and genotype. Antibodies against porcine trypsin were detected in the sera of 63% of patients unrelated to the age of commencement or the duration of enzyme therapy. No differences were observed in the clinical status of CF patients who had developed PTAb (n = 65) and those who had no detectable PTAb (n = 38) as determined from: the current prescribed dose of porcine pancreatic enzyme capsules; Z scores for height and weight; and respiratory function tests. It is suggested that the PTAb commonly found in the sera of CF patients are of doubtful clinical significance but the prospect of PTAb contributing to immune complex disease should be examined further.

Evaluation of growth and changes in body composition following neonatal diagnosis of cystic fibrosis

Early deficits in nutritional status that might require specific treatment and early response to nutritional therapy were studied longitudinally in 25 infants with cystic fibrosis (CF) diagnosed by neonatal screening, using anthropometric and research body composition methodology, and evaluation of pancreatic function. At the time of confirmed diagnosis (mean 5.4 weeks), body mass, length, total body fat (TBF), and total body potassium (TBK) were all significantly reduced. Following diagnosis and commencement of therapy there was a normalization of weight, length, and TBK by 6-12 months of age, indicating catch-up growth. But in some individuals the response was incomplete, and as a group, mean total body fat remained significantly lower than normal at 1 year of age. Seven of 25 (28%) were pancreatic sufficient at diagnosis, and all but one had evidence of declining pancreatic function requiring the institution of pancreatic enzyme therapy during the next 1-9 months. The median age of commencement of enzyme therapy was 10 weeks (range 5 weeks to 11 months). These longitudinal assessments emphasize the dynamic changes occurring in absorptive function, body composition, and nutritional status following neonatal diagnosis of cystic fibrosis and may reflect previously described abnormalities of energy metabolism in this age group. Abnormal body composition is evident in most CF infants following diagnosis by neonatal screening but pancreatic damage may still be evolving. We suggest that early active nutritional therapy and surveillance for changes in pancreatic function are warranted in CF infants diagnosed by neonatal screening.

Tendinopathy alters ultrasound transmission in the patellar tendon during squatting

Measurement of loading patterns of the patellar tendon during activity is important in understanding tendon injury. We used transmission-mode ultrasonography to investigate patellar tendon loading during squatting in adults with and without tendinopathy. It was hypothesized that axial ultrasonic velocity, a surrogate measure of the elastic modulus of tendon, would be lower in tendinopathy. Ultrasound velocity was measured in both patellar tendons of adults with unilateral patellar tendinopathy (n=9) and in healthy controls (n=16) during a bilateral squat manoeuvre. Sagittal knee movement was measured simultaneously with an electrogoniometer. Statistical comparisons between healthy and injured tendons were made using 2–way mixed–design ANOVAs. Axial ultrasound velocity in both symptomatic and asymptomatic patellar tendons in tendinopathy was approximately 15% higher than in healthy tendons at the commencement (F1,23=5.2, P<.05) and completion (F1,23=4.5, P<.05) of the squat. While peak velocity was ≈5% higher during both flexion (F1,23=5.4, P<.05) and extension (F1,23=5.3, P<.05) phases, there was no significant between–group difference at the mid–point of the movement. There were no significant differences in the rate and magnitude of knee movement between groups. Although further research is required, these findings suggest enhanced baseline muscle activity in patellar tendinopathy and highlight fresh avenues for its clinical management.

Two-dimensional solidification in a cylindrical mold with imperfect mold contact

A two-dimensional axisymmetric problem of solidification of a superheated liquid in a long cylindrical mold has been studied in this paper by employing a new embedding technique. The mold and the melt has an imperfect contact and the heat transfer coefficient has been taken as a function of space and time. Short-time exact analytical solutions for the moving boundary and temperature distributions in the liquid, solid and mold have been obtained. The numerical results indicate that with the present solution, for some parameter values, substantial solidified thickness can be obtained. The method of solution is simple and straightforward, and consists of assuming fictitious initial temperatures for some suitable fictitious extensions of the actual regions. Sufficient conditions for the commencement of the solidification have been discussed.

Isolation of Pseudomonas pseudomallei from clay layers at defined depths

Twelve strains of Pseudomonas pseudomallei were isolated from the soil and water of a sheep paddock over a two-year period. The organism was recovered from the clay layer of the soil profile as well as from water that seeps into this layer during the "wet" season. Five isolates were obtained before the commencement of the "wet" season; environmental factors appear to play an important role in the survival of Ps. pseudomallei during the "dry" season. Lower isolation rates were recorded than those indicated by workers in southeast Asia and Iran.

Maaseutuopistoista Yliopistoon : Maatalous- ja metsätieteiden tutkimus- ja opetustoiminnan akatemisoitumisprosessi Helsingin Yliopistossa vuoteen 1945

From Provincial Institutes to the University. The Academisation Process of the Research and Teaching of Agricultural and Forest Sciences at the University of Helsinki before 1945. This study focuses on the teaching and research conducted in the Faculty of Agriculture and Forestry at the University of Helsinki, as well as in its predecessor, the Section of Agriculture and Economics before 1945. The study falls into the field of university history. Its key research question is the academisation process, an example of which is the academisation process of the teaching and research of agricultural and forest sciences in Finland. From a perspective of university history, the study looks at academisation as the beginning of university-level teaching and research in these fields, or their relocation to a university or another institute of university standing. In addition to the above, the academisation process also includes the establishment of the position of the subjects and their acceptance as part of university activity. Academic closure, on the other hand, prevents the academisation of new subjects. In Finland, the preliminary stage of the academisation of the research and teaching of the agriculture and forestry was the Age of Utility, when questions concerning the subjects became part of clerical and civil service training at the Royal Academy of Turku in the mid-18th century. In the mid-19th century, as a result of social and economic development, agricultural and forestry professionals needed more theoretical professional training. At that time, the Imperial Alexander University was focused on traditional professional training and theoretical education, so, because of this academic closure, practical training for agronomists and foresters was organised at first outside the University at the Mustiala Agricultural Institute and the Evo Forest Institute. In the late 19th century, discussion began on the reform of higher agricultural and forestry education. This led, from the 1890s, to the academisation of higher agricultural and forestry education and research at the Alexander University. Academisation was followed by a transitional stage, during which the work of the Section of Agriculture and Economics, which had begun in 1902, became more established in about 1910. The position of the agricultural and forest sciences was, however, largely temporary, because of the planned Agricultural University. A sign of this establishment and of the rise in scientific status of the subjects was the commencement of operations of the Faculty of Agriculture and Forestry in 1924. Furthermore, as a consequence of the development of the subjects and the collapse of the Agricultural University project, agricultural and forest sciences gradually began to be accepted at the University of Helsinki from the end of the 1920s. This led to the allocation of sites for the faculty buildings and research farms, and to the building of ‘Metsätalo’ before the Second World War. Key words: academisation, academisation process, academic closure, university history, University of Helsinki, Faculty of Agriculture and Forestry, agricultural sciences, forest sciences, agronomy training, forestry training

Weed eradication - an economic perspective

There has been recent interest in determining the upper limits to the feasibility of weed eradication. Although a number of disparate factors determine the success of an eradication program, ultimately eradication feasibility must be viewed in the context of the amount of investment that can be made. The latter should reflect the hazard posed by an invasion, with greater investment justified by greater threats. In simplest terms, the effort (and hence investment) to achieve weed eradication comprises the detection effort required to delimit an invasion plus the search and control effort required to prevent reproduction until extirpation occurs over the entire infested area. The difficulty of estimating the required investment at the commencement of a weed eradication program (as well as during periodic reviews) is a serious problem. Bioeconomics show promise in determining the optimal approach to managing weed invasions, notwithstanding ongoing difficulties in estimating the costs and benefits of eradication and alternative invasion management strategies. A flexible approach to the management of weed invasions is needed, allowing for the adoption of another strategy when it becomes clear that the probability of eradication is low, owing to resourcing or intractable technical issues. Whether the considerable progress that has been achieved towards eradication of the once massive witchweed invasion can be duplicated for other weeds of agricultural systems will depend to a large extent upon investment (. $250 million over 50 yr in this instance). Weeds of natural ecosystems seem destined to remain more difficult eradication targets for a variety of reasons, including higher impedance to eradication, more difficulty in valuing the benefits arising from eradication, and possibly less willingness to pay from society at large.

Lukemisen vaikeuden kuntoutus ensiluokkalaisilla : Kolme pedagogista interventiota

Remediation of Reading Difficulties in Grade 1. Three Pedagogical Interventions Keywords: initial teaching, learning to read, reading difficulties, intervention, dyslexia, remediation of dyslexia, home reading, computerized training In this study three different reading interventions were tested for first-graders at risk of reading difficulties at school commencement. The intervention groups were compared together and with a control group receiving special education provided by the school. First intervention was a new approach called syllable rhythmics in which syllabic rhythm, phonological knowledge and letter-phoneme correspondence are emphasized. Syllable rhythmics is based on multi-sensory training elements aimed at finding the most functional modality for every child. The second intervention was computerized training of letter-sound correspondence with the Ekapeli learning game. The third intervention was home-based shared book reading, where every family was given a story book, and dialogic reading style reading and writing exercises were prepared for each chapter of the book. The participants were 80 first-graders in 19 classes in nine schools. The children were matched in four groups according to pre-test results: three intervention and one control. The interventions took ten weeks starting from September in grade 1. The first post-test including several measures of reading abilities was administered in December. The first delayed post-test was administered in March, the second in September in grade 2, and the third, “ALLU” test (reading test for primary school) was administered in March in grade 2. The intervention and control groups differed only slightly from each other in grade 1. However, girls progressed significantly more than boys in both word reading and reading comprehension in December and this difference remained in March. The children who had been cited as inattentive by their teachers also lagged behind the others in the post-tests in December and March. When participants were divided into two groups according to their initial letter knowledge at school entry, the weaker group (maximum 17 correctly named letters in pre-test) progressed more slowly in both word reading and reading comprehension in grade 1. Intervention group and gender had no interaction effect in grade 1. Instead, intervention group and attentiveness had an interaction effect on most test measures the inattentive students in the syllable rhythmic group doing worst and attentive students in the control group doing best in grade 1. The smallest difference between results of attentive and inattentive students was in the Ekapeli group. In grade 2 still only minor differences were found between the intervention groups and control group. The only significant difference was in non-word reading, with the syllable rhythmics group outperforming the other groups in the fall. The difference between girls’ and boys’ performances in both technical reading and text comprehension disappeared in grade 2. The difference between the inattentive and attentive students cold no longer be found in technical reading, and the difference became smaller in text comprehension as well. The difference between two groups divided according to their initial letter knowledge disappeared in technical reading but remained significant in text comprehension measures in the ALLU test in the spring of grade 2. In all, the children in the study did better in the ALLU test than expected according to ALLU test norms. Being the weakest readers in their classes in the pre-test, 52.3 % reached the normal reading ability level. In the norm group 72.3 % of all students attained normal reading ability. The results of this study indicate that different types of remediation programs can be effective, and that special education has been apparently useful. The results suggest careful consideration of first-graders’ initial reading abilities (especially letter knowledge) and possible failure of attention; remediation should be individually targeted while flexibly using different methods.

Retinal photography screening programs to prevent vision loss from diabetic retinopathy in rural and urban Australia: A review

Purpose This review assessed the effectiveness of diabetic retinopathy (DR) screening programs, using retinal photography in Australian urban and rural settings, and considered implications for public health strategy and policy. Methods An electronic search of MEDLINE, PubMed, and Embase for studies published between 1 January 1996 and the 30 June 2013 was undertaken. Key search terms were “diabetic retinopathy,” “screening,” “retinal photography” and “Australia.” Results Twelve peer-reviewed publications were identified. The 14 DR screening programs identified from the 12 publications were successfully undertaken in urban, rural and remote communities across Australia. Locations included a pathology collection center, and Indigenous primary health care and Aboriginal community controlled organizations. Each intervention using retinal photography was highly effective at increasing the number of people who underwent screening for DR. The review identified that prior to commencement of the screening programs a median of 48% (range 16–85%) of those screened had not undergone a retinal examination within the recommended time frame (every year for Indigenous people and every 2 years for non-Indigenous people in Australia). A median of 16% (range 0–45%) of study participants had evidence of DR. Conclusions This review has shown there have been many pilot and demonstration projects in rural and urban Australia that confirm the effectiveness of retinal photography-based screening for DR

Population structure, effective population size and adverse effects of stocking in the endangered Australian eastern freshwater cod Maccullochella ikei

Microsatellite markers were used to examine spatio-temporal genetic variation in the endangered eastern freshwater cod Maccullochella ikei in the Clarence River system, eastern Australia. High levels of population structure were detected. A model-based clustering analysis of multilocus genotypes identified four populations that were highly differentiated by F-statistics (FST = 0· 09 − 0· 49; P < 0· 05), suggesting fragmentation and restricted dispersal particularly among upstream sites. Hatchery breeding programmes were used to re-establish locally extirpated populations and to supplement remnant populations. Bayesian and frequency-based analyses of hatchery fingerling samples provided evidence for population admixture in the hatchery, with the majority of parental stock sourced from distinct upstream sites. Comparison between historical and contemporary wild-caught samples showed a significant loss of heterozygosity (21%) and allelic richness (24%) in the Mann and Nymboida Rivers since the commencement of stocking. Fragmentation may have been a causative factor; however, temporal shifts in allele frequencies suggest swamping with hatchery-produced M. ikei has contributed to the genetic decline in the largest wild population. This study demonstrates the importance of using information on genetic variation and population structure in the management of breeding and stocking programmes, particularly for threatened species.