Regulations and policy measures related to the reduction of ambient particulate matter

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Corneal sensitivity is related to established measures of diabetic peripheral neuropathy

Purpose:  The objective was to investigate the association between corneal sensitivity and established measures of diabetic peripheral neuropathy (DPN). Methods:  Corneal sensitivity was measured in 93 individuals with diabetes, 146 diabetic individuals without neuropathy and 61 control individuals without diabetes or neuropathy using a non-contact corneal aesthesiometer at the baseline visit of a five-year longitudinal natural history study of DPN. The correlation between corneal sensitivity and established measures of neuropathy was estimated and multi-dimensional scaling was used to represent similarities and dissimilarities between variables. Results:  The corneal sensitivity threshold was significantly correlated with a majority of established measures of DPN. Correlation coefficients ranged from -0.32 to 0.26. Using multi-dimensional scaling, non-contact corneal aesthesiometry was closer to the neuropathy disability score, diabetic neuropathy symptom score and Neuropad and most dissimilar to electrophysiological parameters and quantitative sensory testing. Conclusion:  Corneal sensitivity, although not strongly related, is associated with other functional measures of DPN and might provide a useful adjunct in identifying functional loss of small nerve fibre integrity.

Inconsistency of surrogate measures of alcohol-related accidents in South Australia

Three major changes in drink driving enforcement have occurred in South Australia since 1981. The effect of these changes on a number of surrogate measures of alcohol involvement in accidents were investigated. The surrogates included alcohol involvement of driver fatalities, and combinations of casualty, serious casualty, single vehicle and nighttime accidents. Data from previous studies were also cited. It was found that relationships between surrogate measures were inconsistent, and incompatible with assumptions about drink driving levels and related accidents. It was concluded that until these effects are understood the use of surrogate measures should be treated with caution.

Verteporfin Photodynamic Therapy Cohort Study Report 2: Clinical Measures of Vision and Health-Related Quality of Life

Purpose: To quantify decreases in health-related quality of life (HRQoL) for given deterioration in clinical measures of vision; to describe the shape of these relationships; and to test whether the gradients of these relationships change with duration of visual loss.

Best practices, policy convergence and the WTO trade-related investment measures

Includes bibliography

Age-related differences in time-limit performance and force platform-based balance measures during one-leg stance

Poor posture control has been associated with an increased risk of falls and mobility disability among older adults. This study was conducted to assess the test-retest reliability and sensitivity to group differences regarding the time-limit (TLimit) of one-leg standing and selected balance parameters obtained with a force platform in older and young adults. A secondary purpose was to assess the relationship between TLimit and these balance parameters. Twenty-eight healthy older adults (age: 69±5years) and thirty young adults (age: 21±4years) participated in this study. Two one-leg stance tasks were performed: (1) three trials of 30s maximum and (2) one TLimit trial. The following balance parameters were computed: center of pressure area, RMS sway amplitude, and mean velocity and mean frequency in both the anterio-posterior and medio-lateral directions. All balance parameters obtained with the force platform as well as the TLimit variable were sensitive to differences in balance performance between older and young adults. The test-retest reliability of these measures was found to be acceptable (ICC: 0.40-0.85), with better ICC scores observed for mean velocity and mean frequency in the older group. Pearson correlations coefficients (r) between balance parameters and TLimit ranged from -0.16 to -0.54. These results add to the current literature that can be used in the development of measurement tools for evaluating balance in older and young adults. © 2013 Elsevier Ltd.

Approach to prophylactic measures for central venous catheter-related infections in hemodialysis: A critical review

Vascular access is the major risk factor for bacteremia, hospitalization, and mortality among hemodialysis (HD) patients. The type of vascular access most associated with bloodstream infection is central venous catheter (CVC). The incidence of catheter-related bacteremia ranges between 0.6 and 6.5 episodes per 1000 catheter days and increases linearly with the duration of catheter use. Given the high prevalence of CVC use and its direct association with catheter-related bacteremia, which adversely impacts morbidity and mortality rates and costs among HD patients, several prevention measures aimed at reducing the rates of CVC-related infections have been proposed and implemented. As a result, a large number of clinical trials, systematic reviews, and meta-analyses have been conducted in order to assess the effectiveness, clinical applicability, and long-term adverse effects of such measures. In the following article, prophylactic measures against CVC-related infections in HD patients and their possible advantages and limitations will be discussed, and the more recent literature on clinical experience with prophylactic antimicrobial lock therapy in HD CVCs will be reviewed.

Event-related potential and EEG measures in Parkinson's disease without and with dementia

Nondemented Parkinson’s disease (PD) patients showed increased amplitude of event-related potential component P3. We recorded 18-channel spontaneous eyes-closed resting EEG and auditory oddball event-related potentials in 29 PD patients and 11 age-matched controls. Combining Mini-Mental State Examination score and oddball P3 counting performance, 15 patients were intellectually normal, 7 moderately, and 7 severely demented. P3 and N1 amplitude and latency, mean amplitude of 1,024 ms post-stimulus (separate after rare and after frequent stimuli), and resting EEG total power for 40 s were computed, and linearly regressed for age, sex, and L-dopa dosage. In nondemented PD patients, increased P3 amplitude was confirmed, but N1 amplitude and mean amplitude after rare and frequent stimuli were also increased as well as – most important – resting EEG total power. With increasing dementia, amplitude and power decreased, and P3 latency increased. Task demands cannot explain increased P3 amplitude, since similarly increased EEG total power was found during no-task resting. Prospective studies must determine whether P3 amplitude and EEG power in nondemented PD patients can serve as predictors of dementia.

Development and assessment of traffic-related emission abatement measures for the Madrid city (Spain) through the WRF-SMOKE-CMAQ modelling system

The achievement of the limit values established in the European legislation pose an important handicap for large urban areas with intense road traffic, such as Madrid (Spain). Despite permanent measures included in air quality plans it is important to assess additional measures that may be temporally applied under unfavourable conditions. This paper reports on the simulation of different traffic restriction strategies in Madrid for high-pollution episodes.

Legislative and regulatory measures for preventing alcohol-related drownings and near-drownings

Objective: Alcohol contributes to about 30% of drowning fatalities associated with recreational aquatic activity and to 35% of drownings associated with boating. We consider regulatory and legislative strategies for preventing such deaths. Methods: We contacted water police in each Australian State and Territory to identify legislation creating alcohol-related offences for operators of recreational boats in their jurisdiction and to determine whether they conducted random breath testing (RBT). We also sought information from all 152 (81 urban and 71 rural) local government councils in NSW regarding restrictions on consumption of alcohol in public places within their shires. Results: Four Australian States (New South Wales, Queensland, Victoria and South Australia) have legislation prescribing maximum blood alcohol concentrations (BACs) for operators of recreational boats; all support this with RBT Western Australia, Tasmania and the Australian Capital Territory define more general offences for operating vessels while under the influence, of alcohol. Prohibitions or restrictions on consumption of alcohol in public places exist in 78 of the 86 shires in NSW that responded: 69 councils had alcohol-free zones, 53 restricted consumption of alcohol in public parks and reserves, and 33 had prohibitions or restrictions in some aquatic environments. Conclusions/implications: Legislation restricting BACs for recreational boat operators should be adopted in all Australian States and Territories. Optimal legislation would require that all occupants of recreational boats are required to comply with prescribed BAC levels, including when vessels are at anchor. Extension of by-laws prohibiting or restricting the consumption of alcohol specifically in aquatic environments warrants consideration.

The effects of a lutein-based supplement on objective and subjective measures of retinal and visual function in eyes with age-related maculopathy - a randomised controlled trial

Lutein and zeaxanthin are lipid-soluble antioxidants found within the macula region of the retina. Links have been suggested between increased levels of these carotenoids and reduced risk for age-related macular disease (ARMD). Therefore, the effect of lutein-based supplementation on retinal and visual function in people with early stages of ARMD (age-related maculopathy, ARM) was assessed using multi-focal electroretinography (mfERG), contrast sensitivity and distance visual acuity. A total of fourteen participants were randomly allocated to either receive a lutein-based oral supplement (treated group) or no supplement (non-treated group). There were eight participants aged between 56 and 81 years (65·50 (sd 9·27) years) in the treated group and six participants aged between 61 and 83 years (69·67 (sd 7·52) years) in the non-treated group. Sample sizes provided 80 % power at the 5 % significance level. Participants attended for three visits (0, 20 and 40 weeks). At 60 weeks, the treated group attended a fourth visit following 20 weeks of supplement withdrawal. No changes were seen between the treated and non-treated groups during supplementation. Although not clinically significant, mfERG ring 3 N2 latency (P= 0·041) and ring 4 P1 latency (P= 0·016) increased, and a trend for reduction of mfERG amplitudes was observed in rings 1, 3 and 4 on supplement withdrawal. The statistically significant increase in mfERG latencies and the trend for reduced mfERG amplitudes on withdrawal are encouraging and may suggest a potentially beneficial effect of lutein-based supplementation in ARM-affected eyes. Copyright © 2012 The Authors.