Does prophylactic endoscopic sphincterotomy prevent recurrent biliary problems in patients with gallstones and a normal cholangiogram?

Endoscopic sphincterotomy (ES) is indicated in patients with confirmed bile duct stones at endoscopic retrograde cholangiopancreatography (ERCP). The role of ES in patients with suspected bile duct stones but a normal cholangiogram, in the prevention of recurrent biliary symptoms, when cholecystectomy is not planned, is unclear.

Posting Incognito ... Males with Eating Problems: Online Emotional Expression and Support

Qualitative research in the area of eating disorders (eds) has predominantly focused on females,whilst the experiences of males’ remains poorly understood. due to the secretive nature of eating problems/eds it can be difficult to explore the experiences of males with these problems; however, online support groups/message boards, which are common and popular, provide a non-invasive
forum for researchers to conduct research. This study analyzed naturally occurring discussions on an internet message board dedicated to males and eating problems using content analysis. Two major overarching themes of emotional expression (sharing feelings of disturbed eating attitudes and emotions; being secretive) and support (informational and emotional) were identified. The message board provided a vital support system for this group, suggesting that online message boards may be an important avenue for health professionals to provide information, support, and advice.

Do obesity and sleep problems cluster in the workplace?:A multivariate, multilevel study

OBJECTIVES: The aim of this study was to examine the co-occurrence of obesity and sleep problems among employees and workplaces. METHODS: We obtained data from 39 873 men and women working in 3040 workplaces in 2000-2002 (the Finnish Public Sector Study). Individual- and workplace-level characteristics were considered as correlates of obesity and sleep problems, which were modelled simultaneously using a multivariate, multilevel approach. RESULTS: Of the participants, 11% were obese and 23% reported sleep problems. We found a correlation between obesity and sleep problems at both the individual [correlation coefficient 0.048, covariance 0.047, standard error (SE) 0.005) and workplace (correlation coefficient 0.619, covariance 0.068, SE 0.011) level. The latter, but not the former, correlation remained after adjustment for individual- and workplace-level confounders, such as age, sex, socioeconomic status, shift work, alcohol consumption, job strain, and proportion of temporary employees and manual workers at the workplace. CONCLUSIONS: Obese employees and those with sleep problems tend to cluster in the same workplaces, suggesting that, in addition to targeting individuals at risk, interventions to reduce obesity and sleep problems might benefit from identifying "risky" workplaces.

From bit level systolic arrays to HDTV processor chips

The initial part of this paper reviews the early challenges (c 1980) in achieving real-time silicon implementations of DSP computations. In particular, it discusses research on application specific architectures, including bit level systolic circuits that led to important advances in achieving the DSP performance levels then required. These were many orders of magnitude greater than those achievable using programmable (including early DSP) processors, and were demonstrated through the design of commercial digital correlator and digital filter chips. As is discussed, an important challenge was the application of these concepts to recursive computations as occur, for example, in Infinite Impulse Response (IIR) filters. An important breakthrough was to show how fine grained pipelining can be used if arithmetic is performed most significant bit (msb) first. This can be achieved using redundant number systems, including carry-save arithmetic. This research and its practical benefits were again demonstrated through a number of novel IIR filter chip designs which at the time, exhibited performance much greater than previous solutions. The architectural insights gained coupled with the regular nature of many DSP and video processing computations also provided the foundation for new methods for the rapid design and synthesis of complex DSP System-on-Chip (SoC), Intellectual Property (IP) cores. This included the creation of a wide portfolio of commercial SoC video compression cores (MPEG2, MPEG4, H.264) for very high performance applications ranging from cell phones to High Definition TV (HDTV). The work provided the foundation for systematic methodologies, tools and design flows including high-level design optimizations based on "algorithmic engineering" and also led to the creation of the Abhainn tool environment for the design of complex heterogeneous DSP platforms comprising processors and multiple FPGAs. The paper concludes with a discussion of the problems faced by designers in developing complex DSP systems using current SoC technology. © 2007 Springer Science+Business Media, LLC.

Systolic building block for high performance recursive filtering

A novel bit level systolic array is presented that can be used as a building block in the construction of recursive digital filters. The circuit accepts bit-parallel input data, is pipelined at the bit level, and exhibits a very high throughput rate. The most important feature of the circuit is that it allows recursive operations to be implemented directly without incurring the large m cycle latency (where m is approximately the word length) normally associated with such systems. The use of this circuit in the construction of both first- and second-order IIR (infinite-impulse-response) filters is described.

Algorithms and architectures for high performance recursive filtering

Recently, a number of most significant digit (msd) first bit parallel multipliers for recursive filtering have been reported. However, the design approach which has been used has, in general, been heuristic and consequently, optimality has not always been assured. In this paper, msd first multiply accumulate algorithms are described and important relationships governing the dependencies between latency, number representations, etc are derived. A more systematic approach to designing recursive filters is illustrated by applying the algorithms and associated relationships to the design of cascadable modules for high sample rate IIR filtering and wave digital filtering.

Systematic methodology for the design of high performance recursive digital filters

A systematic design methodology is described for the rapid derivation of VLSI architectures for implementing high performance recursive digital filters, particularly ones based on most significant digit (msd) first arithmetic. The method has been derived by undertaking theoretical investigations of msd first multiply-accumulate algorithms and by deriving important relationships governing the dependencies between circuit latency, levels of pipe-lining and the range and number representations of filter operands. The techniques described are general and can be applied to both bit parallel and bit serial circuits, including those based on on-line arithmetic. The method is illustrated by applying it to the design of a number of highly pipelined bit parallel IIR and wave digital filter circuits. It is shown that established architectures, which were previously designed using heuristic techniques, can be derived directly from the equations described.

Economic Vulnerability and the Severity of Debt Problems::An Analysis of the Irish EU-SILC 2008

In this article, using Ireland where debt issues are of particular salience, as a test case, we seek to locate over-indebtedness and the severity of debt problems in the context of the broader economic circumstances of households. In doing so, we first identify an economically vulnerable segment of households and then explore the debt experience of vulnerable and non-vulnerable households. Our analysis reveals a striking contrast between the debt experiences of less than one in five households defined as economically vulnerable and all others. Financial exclusion, relating to access to a bank account and a credit card, was found to increase debt levels. However, such effects were modest. The impact of economic vulnerability seems to be largely a consequence of its relationship to a wide
range of socio-economic attributes and circumstances. The manner in which a potential debt crisis
unfolds will be shaped by the broader socio-economic structuring of life-chances. Any attempt to
respond to such problems by concentrating on financial exclusion or household behaviour or, indeed,
triggering factors without taking the wider social structuring of economic vulnerability is likely to be
both seriously misguided and largely ineffective.

Perceptions of resident behavior problems and their clinical management in Long Term Care facilities

The objective of this study was to describe the perceptions of Long Term Care (LTC) service providers in urban Canadian care facilities regarding the prevalence and nature of resident behavior problems and how staff manage these problems. Key informants from 15 LTC facilities housing 1,928 residents, participated in a cross sectional survey which employed semi-structured telephone interviews. Respondents estimated that on average 61% (n = 1,176) of residents had some type of mental health/behavioral problem, with facility estimates ranging from 20% to 90%. The most frequently reported problem behaviors included: general agitation and restlessness (36%); pacing and aimless wandering (28%); hoarding things (24%); hitting either self or others (23%); and verbal aggression (22%). Behaviors reported by respondents as "disruptive" or "very disruptive" were screaming (13%), sexual disinhibition (10%), and hitting either self or others (10%). The most common interventions used by staff were behavioral interventions followed by the use of medications. Low levels of staffing and educational training of staff were among the most common factors recognized as contributing to the difficulty in caring for residents with mental health needs.

Behavior problems in children requiring inpatient rehabilitation treatment for asthma

Forty-eight asthmatic children (age 6-16 years), inpatients at the Hugh McMillan Medical Centre, were rated by their parents on their behavior using Achenbach's Child Behaviour Checklist. Completed checklists were used to determine normalized T scores for behavior syndromes, and these were compared against norms for clinically referred and nonreferred children. Behavior problems were elevated compared with nonreferred children for both boys and girls, with boys scoring at a clinical level. While many behavior problems were recognized, somatic complaints was a prominent syndrome, particularly for those in the 6-11-year age group.

A Unified Scheduler for Recursive and Task Dataflow Parallelism

Task dataflow languages simplify the specification of parallel programs by dynamically detecting and enforcing dependencies between tasks. These languages are, however, often restricted to a single level of parallelism. This language design is reflected in the runtime system, where a master thread explicitly generates a task graph and worker threads execute ready tasks and wake-up their dependents. Such an approach is incompatible with state-of-the-art schedulers such as the Cilk scheduler, that minimize the creation of idle tasks (work-first principle) and place all task creation and scheduling off the critical path. This paper proposes an extension to the Cilk scheduler in order to reconcile task dependencies with the work-first principle. We discuss the impact of task dependencies on the properties of the Cilk scheduler. Furthermore, we propose a low-overhead ticket-based technique for dependency tracking and enforcement at the object level. Our scheduler also supports renaming of objects in order to increase task-level parallelism. Renaming is implemented using versioned objects, a new type of hyper object. Experimental evaluation shows that the unified scheduler is as efficient as the Cilk scheduler when tasks have no dependencies. Moreover, the unified scheduler is more efficient than SMPSS, a particular implementation of a task dataflow language.