Has carotid artery stenting found its place? A 10-year regional centre perspective

The post-Carotid Revascularization Endarterectomy versus Stenting Trial era has seen a dramatic decline in the practice of carotid artery stenting (CAS). A retrospective review of prospectively collected CAS outcomes over a 10-year period by a single operator was undertaken to determine if this change in practice is justified and to identify the place of carotid stenting in current practice.

The role of general and specific stressors in the health and well-being of call centre operators

The call centre industry has developed a reputation for generating a highly stressful work environment with high absenteeism and turnover rates. Research has identified role ambiguity, role conflict, role overload, and work-family conflict as common stressors in other settings. Call centre research has additionally identified performance monitoring, job design and job opportunities as call centre specific stressors.OBJECTIVE AND METHODS: This study investigated the impact of the identified stressors on burnout, somatic symptomology, and turnover intent among 126 call centre representatives (CCRs) from 11 call centres in metropolitan Melbourne, Australia.

The interior of our memories: a history of Melbourne's Jewish holocaust centre

The Interior of Our Memories describes the development of the Centre within global Holocaust memorial activity, both during the Holocaust and in the following decades when many survivors made new lives for themselves in Melbourne. The story begins, not in March 1984 when it first opened its doors, but during the Holocaust, when survivors began gathering documents. The book provides a history of the Centre’s early days and examines its transformation from a collection of photos, documents and material objects into the modern, educationally focused organisation it is today. The book situates the Jewish Holocaust Centre within a broader context, exploring issues of memory, testimony, the role of the museum within contemporary society, and what we can learn from one of the worst tragedies in human history.

Evolving epidemiology of injecting drug use-associated infective endocarditis: a regional centre experience

INTRODUCTION AND AIMS: Injecting drug use (IDU) is a major risk factor for infective endocarditis (IE). An understanding of the epidemiology of IE and IDU is vital for delivery of health care for this disease. Our aim was to examine the rates of IDU-associated IE (IDU-IE) in a single centre over the last 12 years. DESIGN AND METHODS: Retrospective analysis of two cohorts of consecutive patients (n = 226) admitted with IE from 2002 to 2013. Numbers of cases and rates of IE were compared between two cohorts (2002-2006 and 2009-2013). Rate ratios were calculated using Poisson distributions. Poisson regression was used to examine relationship over time. RESULTS: One hundred thirty cases of endocarditis were seen in the first observation period (6 IDU-IE) and 96 in the second observation period (15 IDU-IE). The estimated incidence rate of IE had fallen from 10.1 to 6.45 per 100, 000 person-years [rate ratio 0.64, 95% confidence interval (CI) 0.48, 0.85]. In contrast, the estimated incidence rate of IDU-E has risen from 0.48 to 0.79 per 100, 000 person-years (rate ratio 1.65, 95% CI 0.59, 4.57). Incidence rate regression suggests that the number of IDU-IE cases is expected to increase by a factor of 1.25 (95%CI 1.09-1.44) for each increase of 1 year. DISCUSSION AND CONCLUSIONS: Over the last decade, there has been a decrease in incidence rate and total number of cases of IE but a rise in rate and number of cases of IDU-IE. This may indicate increasing IDU or increased rates of endocarditis in intravenous drug users in this region. This finding may inform health-care planning in the area.

Internationalisation in vocational education and training : moving from the periphery to the centre of VET?

Internationalisation has been one of the most notable phenomena facing tertiary education around the globe over the past three decades. Internationalisation is a crucial response to the demands to develop graduates who possess adequate skills, knowledge and attributes to engage and perform in a globalised and intercultural world.

Occurrence of fungi in water used at a haemodialysis centre

Aims: The aim of this study was to identify and determine the diversity, occurrence and distribution of fungi in water used at a haemodialysis centre.Methods and Results: Samples in the hydraulic circuit for the distribution of the water, dialysate samples and samples of sterilization solution from dialysers were collected over a 3-month period, and 500 ml of each sample was filtered through membranes. All together 116 isolates of fungi were recovered from 89% of all water samples collected inside the haemodialysis unit, with prevalence of moulds in tap water samples and of yeasts in dialysate samples. Fusarium spp. was the most abundant genus found, whereas Candida parapsilosis was the predominant yeast species.Conclusions: This study demonstrated that various fungi were present in the water system. These data suggest the inclusion of the detection and quantification of fungi in the water of haemodialysis.Significance and Impact of the Study: The recovery of fungi from aqueous haemodialysis environments implies a potential risk for haemodialysis patients and indicates the need for continuous maintenance and monitoring. Further studies on fungi in haemodialysis water systems are required to investigate the organism ability to persist, their role in biofilm formation and their clinical significance.

Isolation and isoenzyme characterization of Leishmania (Viannia) braziliensis from a case of human cutaneous leishmaniasis in northeast centre of the state of São Paulo

The diagnosis of human cutaneous leishmaniasis in small towns is sometimes made without the species identification of the Leishmania, even in areas without previous epidemiological surveys. Here we report the isolation of a Leishmania strain from a patient of Rincão, state of São Paulo, that was identified by isoenzyme characterization as L. (Viannia) braziliensis. Sand fly collections were made in the area where the patient live in order to investigate the likely vector species.

Influences of the load centre of gravity on heavy vehicle acceleration

The aim of this paper is to analyse the influence of the load centre of gravity on heavy vehicle acceleration. This analysis is done through a method in which a vehicle centre of gravity map is used. A model for the driving force is presented for bus, truck and tractor-semi trailer combinations. The proposed model takes into consideration the resistance forces (drag, rolling resistance, translation and rotation acceleration, climbing resistance) and the 4 X 2 traction system. The positions of the vehicle centre of gravity as a function of the position of the load centre of gravity are determined. The vehicle acceleration is calculated based on the position of the load centre of gravity. This study analyses the acceleration of one of the Mercedes-Benz do Brasil tractor-semitrailer vehicle. A comparison of the acceleration for different maximum adhesion coefficients and ramps are presented, showing new results. An example showing the variations of the load centre of gravity position with the acceleration time and distance is provided. The load centre of gravity position is important for vehicle safety and the efficiency and economy in the transportation of the load.