The effectiveness of a standardised preoperative preparation in reducing child and parent anxiety: a single-blind randomised controlled trial.

AIMS: To evaluate the effect of a structured preoperative preparation on child and parent state anxiety, child behavioural change and parent satisfaction. BACKGROUND: It is estimated that around 50-70% of hospitalised children experience severe anxiety and distress prior to surgery. Children who are highly anxious and distressed preoperatively are likely to be distressed on awakening and have negative postoperative behaviour. Although education before surgery has been found to be useful mostly in North America, the effectiveness of preoperative preparation programme adapted to the Australian context remains to be tested. DESIGN: This single-blind randomised controlled study was conducted at a tertiary referral hospital for children in Western Australia. METHODS: Following ethics approval and parental consent, 73 children and one of their carers (usually a parent) were randomly assigned into two groups. The control group had standard practice with no specific preoperative education and the experimental group received a preoperative preparation, including a photo file, demonstration of equipment using a role-modelling approach and a tour. RESULTS: The preoperative preparation reduced parent state anxiety significantly (-2·32, CI -4·06 to -0·56, p = 0·009), but not child anxiety (-0·59, CI -1·23 to 0·06, p = 0·07). There was no significant difference in child postoperative behaviour or parent satisfaction between the groups. There was a significant two-point pain score reduction in the preoperative preparation group, when compared with the control group median 2 (IQR 5) and 4 (IQR 4), respectively (p = 0·001).¦CONCLUSIONS: Preoperative preparation was more efficient on parent than child. Although the preoperative preparation had limited effect on child anxiety, it permitted to decrease pain experience in the postoperative period.¦RELEVANCE TO CLINICAL PRACTICE: Parents should be actively involved in their child preoperative preparation.

Application de nanoparticules luminescentes pour la detection de traces papillaires

Après avoir situé le contexte de la recherche et défini les enjeux principaux du travail, différents types de nanoparticules, ainsi que leurs principales caractéristiques, sont parcourues. L'élaboration de critères de sélection ayant permis de déterminer les types de nanoparticules potentiellement adaptés à !a détection de traces papillaires, l'étude s'est alors focalisée sur deux familles de composés: les quantum dots et les nanoparticules d'oxyde de silicium. Deux types de quantum dots ont été synthétisés : le tellurure de cadmium et le sulfure de zinc). Ils n'ont toutefois pas permis la détection de traces papillaires réalistes. En effet, seules des traces fraîches et enrichies en sécrétions ont pu être mises en évidence. Toutefois, des résultats ont été obtenus avec les deux types de quantum dots pour la détection de traces papillaires sanglantes. Après optimisation, les techniques rivalisent avec les méthodes couramment appliquées en routine. Cependant, l'interaction se produisant entre les traces et les nanoparticules n'a pas pu être déterminé. Les nanoparticules d'oxyde de silicium ont dès lors été appliquées dans le but de comprendre plus en détails les interactions avec les traces papillaires. Ces nanoparticules ont l'avantage d'offrir un très bon contrôle de surface, permettant ainsi une étude détaillée des phénomènes en jeu. Des propriétés de surface variables ont dès lors été obtenues en greffant diverses molécules à la surface des nanoparticules d'oxyde de silicium. Après avoir exploré différentes hypothèses d'interaction, il a pu être déterminé qu'une réaction chimique se produit lors qu'un groupement de type carboxyle est présent à la surface des particules. Ce groupement réagit avec les fonctions amines primaires des sécrétions. L'interaction chimique a ensuite pu être renforcée par l'utilisation d'un catalyseur, permettant d'accélérer la réaction. Dans la dernière partie du travail, les nanoparticules d'oxyde de silicium ont été comparées à une technique utilisée en routine, la fumigation de cyanoacrylate. Bien que des études plus approfondies soient nécessaires, il s'avère que l'application de nanoparticules d'oxyde de silicium permet une détection de très bonne qualité, moins dépendante du donneur que les techniques courantes. Ces résultats sont prometteurs en vue du développement d'une technique possédant une sensibilité et une sélectivité accrue. - Having situated the background of research and identified key issues of work, different types of nanoparticles and their main features are reviewed. The development of selection criteria lead to the identification of nanoparticles types potentially suitable for fingermarks detection. The study focused then On two families of compounds: quantum dots and silicon oxide nanoparticles. Two types of quantum dots were synthesized and characterised: cadmium telluride and zinc sulphide. Unfortunally, they did not allow the detection realistic fingermarks. Indeed, only fresh and groomed fingermarks have been detected. However, results have been obtained with both types of quantum dots for the detection of fingermarks in blood. After optimization procedures, the quantum dots based teshniques compete with the methods currently used in routine. However, the interaction occurring between fingermarks and nanoparticles could not be determined. Silicon oxide nanoparticles have therefore been applied in order to understand in detail the interactions With fingermarks. These nanoparticles have the advantage of providing a very good surface control, allowing am in-depth study of the phenomena involved. Versatile surface properties were therefore obtained by grafting various molecules on the surface of silicon oxide nanoparticles. Different hypotheses were investigated and it was determined that a chemical reaction occurred between the surface functionalised nanoparticles and the fingermark residues. The carboxyl groups on the surface of the particles react with primary amines of the secretions. Therefore, this interaction was improved by the use of a catalyst. In the last part of the work, silicon oxide nanoparticles were compared to a routinely used technique: cyanocrylate fuming. Although further studies are still needed, it appears that the application of silicon oxide nanoparticles allows fingermark detection of very good quality, with a lowered donor dependency. These results are promising for the development of techniques with greater sensitivity and selectivity.

Gonadal alterations in male whitefish Coregonus fatioi: no evidence for genetic damage reducing viability in early life stages.

In recent years, numerous cases of morphological gonadal alterations in fish have been recorded throughout the world and across a wide range of species. In the whitefish Coregonus fatioi from the pre-alpine Lake Thun (Switzerland), the frequency of gonadal alterations is particularly high and the variety of alteration types large. Little is known about the proximal causes and the direct consequences of these morphological features on population persistence. In particular, the potential for the observed alterations to be the phenotypic expression of reduced genetic quality has not yet been addressed. In this study, we used offspring survival during embryogenesis as a proximate indicator of male genetic quality and tested whether the presence of gonadal alterations in males is an indicator of reduced quality. Embryos resulted from in vitro fertilizations of gametes from 126 males and females. We found no significant correlation between embryo survival and gonadal alteration in adults. Our findings suggest that in C. fatioi of Lake Thun, alterations in gonad morphology are not a phenotypic expression of variation in genetic quality.

La datation des traces digitales (partie I): revue critique

« Quel est l'âge de cette trace digitale?» Cette question est relativement souvent soulevée au tribunal, lorsque la personne suspectée admet avoir laissé ses empreintes digitales sur une scène de crime mais prétend l'avoir fait à un autre moment que celui du crime et pour une raison innocente. Au travers de différents exemples américains et européens, ce premier article met en évidence le manque de consensus actuel dans les réponses données à cette question par les experts du domaine. Cette disparité dans le traitement des cas de datation de traces digitales est sans doute due au fait qu'aucune méthodologie n'est pour l'heure validée et acceptée par l'ensemble de la communauté forensique. En effet, cet article recense les études menées sur la datation des traces digitales sous forme d'une revue critique et met ainsi en évidence le fait que la plupart de ces méthodes souffrent de problèmes limitant leur application pratique. Toutefois, cette revue permet également d'identifier une approche ayant le potentiel d'apporter des réponses pratiques aux questions de datation, à savoir l'approche se basant sur l'étude du vieillissement de composés cibles intrinsèques aux traces digitales. Cette approche prometteuse ouvre des pistes afin de proposer une méthodologique formelle de datation des traces digitales. Une telle proposition permettrait d'apporter une information pertinente à la justice et fera l'objet de la seconde partie de cet article.

Reducing Prescription Drug Abuse in Iowa, January 5, 2011

Prescription drug abuse is the nation’s fastest-growing drug problem, as outlined by the White House Office of National Drug Control Policy’s 2011 national plan “Responding to America’s Prescription Drug Abuse Crisis.” The urgency of the challenge is underscored in other reports, including a recent analysis by the Centers for Disease Control (CDC) that said: “Overdoses involving prescription painkillers are at epidemic levels and now kill more Americans than heroin and cocaine combined.” According to the CDC, more than 40 people die in America every day from overdoses involving narcotic pain relievers such as hydrocodone (Vicodin), oxycodone (Oxycontin), methadone and oxymorphone (Opana). In Iowa, the situation is similar, at least in some ways. Prescription drug abuse is one of the fastest-growing forms of substance abuse in our state too, though its scope is smaller and on a more manageable scale when compared with most other states. The Iowa Department of Public Health, Bureau of Vital Statistics, reports the drug overdose deaths of at least 130 Iowans over the last three years (2008-2010) due to non-heroin opioids (i.e., prescription pain relievers such as oxycodone, hydrocodone and methadone), nearly as many as for the previous eight years combined (149 from 2000-2007).

L'exploitation des traces dans les accidents de la circulation

Les investigations dans le milieu des accidents de la circulation sont très complexes. Elles nécessitent la mise en oeuvre d'un grand nombre de spécialités venant de domaines très différents. Si certains de ces domaines sont déjà bien exploités, d'autres demeurent encore incomplets et il arrive de nos jours d'observer des lacunes dans la pratique, auxquelles il est primordial de remédier.Ce travail de thèse, intitulé « l'exploitation des traces dans les accidents de la circulation », est issu d'une réflexion interdisciplinaire entre de multiples aspects des sciences forensiques. Il s'agit principalement d'une recherche ayant pour objectif de démontrer les avantages découlant d'une synergie entre les microtraces et l'étude de la dynamique d'un accident. Afin de donner une dimension très opérationnelle à ce travail, l'ensemble des démarches entreprises a été axé de manière à optimiser l'activité des premiers intervenants sur les lieux.Après une partie introductive et ayant trait au projet de recherche, traitant des aspects théoriques de la reconstruction d'une scène d'accident, le lecteur est invité à prendre connaissance de cinq chapitres pratiques, abordés selon la doctrine « du général au particulier ». La première étape de cette partie pratique concerne l'étude de la morphologie des traces. Des séquences d'examens sont proposées pour améliorer l'interprétation des contacts entre véhicules et obstacles impliqués dans un accident. Les mécanismes de transfert des traces de peinture sont ensuite étudiés et une série de tests en laboratoire est pratiquée sur des pièces de carrosseries automobiles. Différents paramètres sont ainsi testés afin de comprendre leur impact sur la fragilité d'un système de peinture. Par la suite, une liste de cas traités (crash-tests et cas réels), apportant des informations intéressantes sur le traitement d'une affaire et permettant de confirmer les résultats obtenus est effectuée. Il s'ensuit un recueil de traces, issu de l'expérience pratique acquise et ayant pour but d'aiguiller la recherche et le prélèvement sur les lieux. Finalement, la problématique d'une banque de données « accident », permettant une gestion optimale des traces récoltées est abordée.---The investigations of traffic accidents are very complex. They require the implementation of a large number of specialties coming from very different domains. If some of these domains are already well exploited, others remain still incomplete and it happens nowadays to observe gaps in the practice, which it is essential to remedy. This thesis, entitled "the exploitation of traces in traffic accidents", arises from a multidisciplinary reflection between the different aspects of forensic science. It is primarily a research aimed to demonstrate the benefits of synergy between microtrace evidence and accidents dynamics. To give a very operational dimension to this work, all the undertaken initiatives were centred so as to optimise the activity of the first participants on the crime scene.After an introductory part treating theoretical aspects of the reconstruction of an accident scene the reader is invited to get acquainted with five practical chapters, according to the doctrine "from general to particular". For the first stage of this practical part, the problem of the morphology of traces is approached and sequences of examinations are proposed to improve the interpretation of the contacts between vehicles and obstacles involved in an accident. Afterwards, the mechanisms of transfer of traces of paint are studied and a series of tests in laboratory is practised on pieces of automobile bodies. Various parameters are thus tested to understand their impact on the fragility of a system of paint. It follows that a list of treated cases (crash-tests and real cases) is created, allowing to bring interesting information on the treatment of a case and confirm the obtained results. Then, this work goes on with a collection of traces, stemming from the acquired experience that aims to steer the research and the taking of evidence on scenes. Finally, the practical part of this thesis ends with the problem of a database « accident », allowing an optimal management of the collected traces.

Engineering Study for Reducing Sign Vandalism Final Report Highway Research Advisory Board Projec HR 246, June 1992

Sign vandalism has traditionally been a vexing problem for Iowa counties. The extent of the cost and incidence of these acts have never been fully ascertained, but a 1990 survey indicated that they cost Iowa counties more than 1.5 million dollars annually. In 1990, the Iowa Legislature recognized the seriousness of the problem and strengthened the existing sign vandalism law by increasing the penalty for illegal possession of a traffic control device from a simple to a serious misdemeanor. However, the courts must be willing to prosecute vandals to the magnitude provided in the Iowa Code. An educational campaign begun in 1987 involving over 200 Iowa school districts to educate students on the seriousness of the problem evidently did not have the effect of dramatically reducing the overall cost of sign vandalism in Iowa. This study sought to define the scope of the problem and possibly offer some effective countermeasures to combat sign vandalism and theft in Iowa.

Zoledronic Acid in Reducing Clinical Fracture and Mortality after Hip Fracture.

BACKGROUND: Mortality is increased after a hip fracture, and strategies that improve outcomes are needed. METHODS: In this randomized, double-blind, placebo-controlled trial, 1065 patients were assigned to receive yearly intravenous zoledronic acid (at a dose of 5 mg), and 1062 patients were assigned to receive placebo. The infusions were first administered within 90 days after surgical repair of a hip fracture. All patients received supplemental vitamin D and calcium. The median follow-up was 1.9 years. The primary end point was a new clinical fracture. RESULTS: The rates of any new clinical fracture were 8.6% in the zoledronic acid group and 13.9% in the placebo group, a 35% risk reduction (P = 0.001); the respective rates of a new clinical vertebral fracture were 1.7% and 3.8% (P = 0.02), and the respective rates of new nonvertebral fractures were 7.6% and 10.7% (P = 0.03). In the safety analysis, 101 of 1054 patients in the zoledronic acid group (9.6%) and 141 of 1057 patients in the placebo group (13.3%) died, a reduction of 28% in deaths from any cause in the zoledronic-acid group (P = 0.01). The most frequent adverse events in patients receiving zoledronic acid were pyrexia, myalgia, and bone and musculoskeletal pain. No cases of osteonecrosis of the jaw were reported, and no adverse effects on the healing of fractures were noted. The rates of renal and cardiovascular adverse events, including atrial fibrillation and stroke, were similar in the two groups. CONCLUSIONS: An annual infusion of zoledronic acid within 90 days after repair of a low-trauma hip fracture was associated with a reduction in the rate of new clinical fractures and improved survival. (ClinicalTrials.gov number, NCT00046254.).

The effect of ammonium ferric hexacyanoferrate on reducing radiocaesium transfer from grass silage to sheep

Selostus: [sup 134]Cs-aktiivisuuspitoisuuden vähentäminen ferriheksasyanoferraatin avulla

Biomarkers of oxidative stress and its association with the urinary reducing capacity in bus maintenance workers.

BACKGROUND: Exposure to particles (PM) induces adverse health effects (cancer, cardiovascular and pulmonary diseases). A key-role in these adverse effects seems to be played by oxidative stress, which is an excess of reactive oxygen species relative to the amount of reducing species (including antioxidants), the first line of defense against reactive oxygen species. The aim of this study was to document the oxidative stress caused by exposure to respirable particles in vivo, and to test whether exposed workers presented changes in their urinary levels for reducing species.METHODS: Bus depot workers (n = 32) exposed to particles and pollutants (respirable PM4, organic and elemental carbon, particulate metal content, polycyclic aromatic hydrocarbons, NOx, O3) were surveyed over two consecutive days. We collected urine samples before and after each shift, and quantified an oxidative stress biomarker (8-hydroxy-2'-deoxyguanosine), the reducing capacity and a biomarker of PAH exposure (1-hydroxypyrene). We used a linear mixed model to test for associations between the oxidative stress status of the workers and their particle exposure as well as with their urinary level of reducing species.RESULTS: Workers were exposed to low levels of respirable PM4 (range 25-71 μg/m3). However, urinary levels of 8-hydroxy-2'-deoxyguanosine increased significantly within each shift and between both days for non-smokers. The between-day increase was significantly correlated (p < 0.001) with the concentrations of organic carbon, NOx, and the particulate copper content. The within-shift increase in 8OHdG was highly correlated to an increase of the urinary reducing capacity (Spearman ρ = 0.59, p < 0.0001).CONCLUSIONS: These findings confirm that exposure to components associated to respirable particulate matter causes a systemic oxidative stress, as measured with the urinary 8OHdG. The strong association observed between urinary 8OHdG with the reducing capacity is suggestive of protective or other mechanisms, including circadian effects. Additional investigations should be performed to understand these observations.