Literature Review: Equality of Opportunity in Relation to the DHSSPS Draft Equality Scheme

This review of the literature on equality of opportunity issues was commissioned by the Department of Public Health, Social Sevices and Public Safety.

Comparison of the Proportion Method With Mycobacteria Growth Indicator Tube and E-test for Susceptibility Testing of Mycobacterium tuberculosis

The aim of this study was to investigate the correlation between proportion method with mycobacteria growth indicator tube (MGIT) and E-test for Mycobacterium tuberculosis. Forty clinical isolates were tested. MGIT and E-test with the first line antituberculous drugs correlated with the proportion method. Our results suggested that MGIT and E-test methods can be routinely used instead of the proportion method.

One-tube nested Polymerase Chain Reaction for detection of Chlamydia trachomatis

Here we present a one-tube nested PCR test, which allows the detection of minimal quantities of Chlamydia trachomatis in human fluids. This assay includes the use of an internal control to avoid false negative results due to the presence of inhibitors. The results obtained show that this assay is robust enough to be used for clinical diagnosis.

Clarification of the Meaning of "Beneficial Owner" in the OECD Model Tax Convention: Comment on the April 2011 Discussion Draft

In April 2011, the OECD released an important discussion draft that is intended to clarify the meaning of the term "beneficial ownership" under articles 10, 11 and 12 of the OECD Model (2010). This article discusses these proposals and demonstrates that some refinement is necessary.

Preliminary draft of regulations to be made under the Protection of Life During Pregnancy Bill, 2013

Preliminary draft of regulations to be made under the Protection of Life During Pregnancy Bill, 2013 Preliminary draft of Regulations to be made under the Protection of Life During Pregnancy Bill, 2013. It is the intention to bring these Regulations into effect when the Bill is enacted. The Regulations are as follows: Click here to download The Protection of Life During Pregnancy Act 2013 (Certification Regulations) PDF 466KB Click here to download The Protection of Life During Pregnancy Act 2013 (Application for Review of Medical Opinion) PDF 219KB Click here to download The Protection of Life During Pregnancy Act 2013 (Notifications) PDF 180KB

Delirium: draft full guideline for consultation

A clinical practice guideline on Delirium is being developed for use in the NHS in England, Wales and Northern Ireland. Registered stakeholders for this guideline are invited to comment on the provisional recommendations via this website.�� Individuals and organisations not registered as stakeholders are not able to comment, we recommend that you register as a stakeholder or you contact the registered stakeholder organisation that most closely represents your interests and pass your comments to them. Note that the provisional recommendations presented here do not constitute the Institute's formal guidance on this topic. The recommendations are provisional and may change after consultation. Consultation dates: 11 November 2009 - 6 January 2010 Consultation documents Full guidelineFull guideline appendicesAlgorithmNICE guidelineConsultation comments proforma��

Draft genome of the globally widespread and invasive Argentine ant (Linepithema humile).

Ants are some of the most abundant and familiar animals on Earth, and they play vital roles in most terrestrial ecosystems. Although all ants are eusocial, and display a variety of complex and fascinating behaviors, few genomic resources exist for them. Here, we report the draft genome sequence of a particularly widespread and well-studied species, the invasive Argentine ant (Linepithema humile), which was accomplished using a combination of 454 (Roche) and Illumina sequencing and community-based funding rather than federal grant support. Manual annotation of >1,000 genes from a variety of different gene families and functional classes reveals unique features of the Argentine ant's biology, as well as similarities to Apis mellifera and Nasonia vitripennis. Distinctive features of the Argentine ant genome include remarkable expansions of gustatory (116 genes) and odorant receptors (367 genes), an abundance of cytochrome P450 genes (>110), lineage-specific expansions of yellow/major royal jelly proteins and desaturases, and complete CpG DNA methylation and RNAi toolkits. The Argentine ant genome contains fewer immune genes than Drosophila and Tribolium, which may reflect the prominent role played by behavioral and chemical suppression of pathogens. Analysis of the ratio of observed to expected CpG nucleotides for genes in the reproductive development and apoptosis pathways suggests higher levels of methylation than in the genome overall. The resources provided by this genome sequence will offer an abundance of tools for researchers seeking to illuminate the fascinating biology of this emerging model organism.

Health Inequalities Intervention Tool. East of England. Draft Spec - Autumn 2007

Pilot approaches that will be used in the Phase 2 of National Health Inequalities Intervention Tool, due to be launched early 2008.

The London Health Inequalities Strategy - Draft for public consultation

This is the very first Health Inequality Strategy to be published for public consultation by the London Mayor. As such it represents a momentous step forward in galvanising action across London to address the health inequalities which prevent many Londoners from enjoying their life to the full and making the most of what London has to offer. The Greater London Authority Act 2007 requires that the strategy identifies the health inequalities, the priorities for reducing them and the role to be played by a defined list of key partners in order to implement the strategy. It defines health inequalities as inequalities in respect of life expectancy or general state of health which are wholly or partly a result of differences in respect of general health determinants۪, which it describes as: (a) standards of housing, transport services or public safety; (b) employment prospects, earning capacity and any other matters that affect levels of prosperity; (c) the degree of ease or difficulty with which persons have access to public services; (d) the use, or level of use, of tobacco, alcohol or other substances, and any other matters of personal behaviour or lifestyle, that are or may be harmful to health, and any other matters that are determinants of life expectancy or the state of health of persons generally, other than genetic or biological factors.

HSCB/PHA Draft Commissioning Plan 2011/2012

The draft Commissioning Plan was approved by the boards of the HSCB and PHA on Thursday 30 June 2011 for onward transmission to the DHSSPS for Ministerial consideration.Further refinement of the draft plan will take place in July and early August with a view to bringing a final draft plan to the August board meetings of the HSCB and PHA.

Analyse UBM du site de filtration après sclérectomie profonde postérieure modifiée utillisant un tube Ex-PRESS? X-50

Purpose: To study the filtering site using ultrasound biomicroscopy. (UBM) after posterior deep sclerectomy with Ex-PRESS? X-50 implant in patients undergoing filtering surgery.¦Methods: Twenty-six patients that participated in this prospective, non comparative study underwent a posterior deep sclerectomy and an Ex- PRESS? X-50 tube implantation. Clinical outcome factors recorded include: intraocular pressure, number of antiglaucoma medications, best corrected visual acuity (BCVA), frequency and types of complications. Six months postoperatively, an ultrasound biomicroscopy examination was performed.¦Results: Mean follow up was 12.0±3.4 months. Mean IOP decreased from 21 ±5.7 mmHg to 12.4±3 mmHg. At last follow-up examination, 65% of eyes had a complete success and 30% a qualified success. The mean number of antiglaucoma medications decreased from 2.5±1.2 preoperatively to 0.7±1 at the last follow-up postoperatively. BCVA was not changed. 27 complications were observed. On the UBM images, the mean intrascleral space volume was 0.25±0.27 mm3 and no relationship was found between volume and intraocular pressure reduction. We noted in 5/26 (19%) eyes a suprachoroïdal hypoechoic. Low-reflective blebs (L-type) were the most common: 15/26 (58%). No correlation between UBM findings and surgical success was evident.¦Conclusions: Deep sclerectomy with Ex-PRESS? X-50 tube implantation seems an efficient glaucoma surgery. It allows satisfactory IOP reduction with a low number of post operative complications. The advantages of deep sclerectomy with collagen implant are maintained with this modified technique. In both, the same reflective types of filtering blebs are present (high, low, encapsulated and flat). The UBM underlines the three mechanisms of aqueous humor resorption previously identified but no correlation with surgical success can be proved.¦-¦Ce travail de thèse est une analyse par ultrasonographic biomicroscopique (UBM) du site de filtration après sclérectomie profonde postérieure modifiée avec implantation d'un tube Ex- PRESS? X-50.¦Vingt six patients atteints d'un glaucome à angle ouvert, ont participé à cette étude prospective et non-comparative. Le critère d'inclusion est un glaucome à angle ouvert non contrôlé malgré un traitement topique maximal.¦Différents types de chirurgie filtrante sont effectués dans la chirurgie du glaucome dont la trabéculectomie et la sclérectomie profonde.¦L'intervention chirurgicale pratiquée dans cette étude consiste en l'implantation d'un tube Ex-PRESS? X-50 de format défini (3 mm de longueur et 50 μπι de diamètre interne) dans la chambre antérieure,au niveau du trabeculum, sous un volet scléral, ce qui permet le drainage de l'humeur aqueuse vers les espaces sous-conjonctivaux, avec diminution de la pression intraoculaire.¦Cette technique implique uniquement une dissection d'un volet scléral superficiel , sans volet scléral profond comme d'une sclérectomie profonde classique.¦Les modes de fonctionnement de cette sclérectomie profonde modifiée sont explorés par UBM, qui donne des images à haute résolution, semblables à des coupes anatomiques. Le volume de l'espace intrascléral créé artificiellement peut en effet être mesuré et mis en corrélation avec la pression intraoculaire et donc avec le taux de succès. Les différents types d'échogénécité de la bulle de filtration sous-conjonctivale provoquée par la dérivation de l'humeur aqueuse sont également observés. La présence éventuelle d'une filtration supplémentaire au niveau choroïdien est aussi détectée.¦De février 2007 à juin 2008, nous avons suivi chez les vingt six yeux des vingt six patients le volume intrascléral, la filtration sous-conjonctivale et la filtration choroïdienne le cas échéant, de même que l'acuité visuelle, la pression intraoculaire, le nombre de traitement antihypertenseur topique et les complications.¦Les résultats démontrent une réduction de 41 % par rapport à la pression intraoculaire préopératoire, ce qui est statistiquement significatif (p<0.0005). En ce qui concerne l'acuité visuelle, les valeurs demeurent stables. Par ailleurs, le nombre de médicaments antiglaucomateux diminue de façon significative de 2.5 ± 1.2 en préopératoire à 0.7 ± 1.0 au dernier examen (p<0.0005). Le volume de l'espace intrascléral, apparaissant toujours en échographie d'aspect fusiforme, n'est pas corrélé de façon significative avec un meilleur succès chirurgical bien que l'on aperçoive une tendance à une corrélation entre un plus grand volume et une pression intraoculaire plus basse.¦La classification la bulle de filtration se fait selon les 4 catégories de bulle de filtration décrites dans la littérature. La répartition révèle une majorité de type L soit hypoéchogène: 15/26 (58%) et une proportion identique, soit, 4/26 (16%), de bulles hyperéchogènes (type H) et encapsulées (type E); les bulles de filtration plates et hyperéchogènes (type F) sont les moins nombreuses 3/26 (11 %).¦La ligne hyporéflective visible dans 19 % des cas entre la sclère et la choroïde représentant potentiellement un drainage suprachoroïdien, n'est pas associée statistiquement à une meilleure filtration et une pression intraoculaire plus basse mais demeure une troisième voie de filtration, en plus de la filtration sous-conjonctivale et intrasclérale.¦En conclusion, cette technique différente, offrant une plus grande sécurité et des résultats satisfaisants sur l'abaissement de la pression intraoculaire, peut être, dans certains cas, une alternative à la sclérectomie profonde classique ,dont elle partage les mécanismes de filtration objectivés par ultrasonographic biomicrioscopique.

The bioavailability of bromazepam, omeprazole and paracetamol given by nasogastric feeding tube.

AIMS: To characterize and compare the pharmacokinetic profiles of bromazepam, omeprazole and paracetamol when administered by the oral and nasogastric routes to the same healthy cohort of volunteers. METHODS: In a prospective, monocentric, randomized crossover study, eight healthy volunteers received the three drugs by the oral (OR) and nasogastric routes (NT). Sequential plasma samples were analyzed by high-performance liquid chromatography-UV, pharmacokinetic parameters (Cmax, AUC(0-infinity), t(1/2), k(e), tmax) were compared statistically, and Cmax, AUC(0-infinity) and t(max) were analyzed for bioequivalence. RESULTS: A statistically significant difference was seen in the AUC(0-infinity) of bromazepam, with nasogastric administration decreasing availability by about 25%: AUC(OR) = 2501 ng mL(-1) h; AUC(NT) = 1855 ng mL(-1) h (p < 0.05); ratio (geometric mean) = 0.74 [90% confidence interval (CI) 0.64-0.87]. However, this does not appear to be clinically relevant given the usual dosage range and the drug's half-life (approx. 30 h). A large interindividual variability in omeprazole parameters prevented any statistical conclusion from being drawn in terms of both modes of administration despite their similar average profile: AUC(OR) = 579 ng mL(-1) h; AUC(NT) = 587 ng mL(-1) h (p > 0.05); ratio (geometric mean) = 1.01 (90% CI 0.64-1.61). An extended study with a larger number of subjects may possibly provide clearer answers. The narrow 90% confidence limits of paracetamol indicate bioequivalence: AUC(OR) = 37 microg mL(-1) h; AUC(NT) = 41 microg mL(-1) h(p > 0.05); ratio (geometric mean) = 1.12 (90% CI 0.98-1.28). CONCLUSION: The results of this study show that the nasogastric route of administration does not appear to cause marked, clinically unsuitable alterations in the bioavailability of the tested drugs.

Serial QuantiFERON-TB Gold In-Tube assay and tuberculin skin test to diagnose latent tuberculosis in household Mexican contacts: conversion and reversion rates and associated factors using conventional and borderline zone definitions

A cohort of 123 adult contacts was followed for 18‐24 months (86 completed the follow-up) to compare conversion and reversion rates based on two serial measures of QuantiFERON (QFT) and tuberculin skin test (TST) (PPD from TUBERSOL, Aventis Pasteur, Canada) for diagnosing latent tuberculosis (TB) in household contacts of TB patients using conventional (C) and borderline zone (BZ) definitions. Questionnaires were used to obtain information regarding TB exposure, TB risk factors and socio-demographic data. QFT (IU/mL) conversion was defined as <0.35 to ≥0.35 (C) or <0.35 to >0.70 (BZ) and reversion was defined as ≥0.35 to <0.35 (C) or ≥0.35 to <0.20 (BZ); TST (mm) conversion was defined as <5 to ≥5 (C) or <5 to >10 (BZ) and reversion was defined as ≥5 to <5 (C). The QFT conversion and reversion rates were 10.5% and 7% with C and 8.1% and 4.7% with the BZ definitions, respectively. The TST rates were higher compared with QFT, especially with the C definitions (conversion 23.3%, reversion 9.3%). The QFT conversion and reversion rates were higher for TST ≥5; for TST, both rates were lower for QFT <0.35. No risk factors were associated with the probability of converting or reverting. The inconsistency and apparent randomness of serial testing is confusing and adds to the limitations of these tests and definitions to follow-up close TB contacts.