Objective: To identify and describe advantages, challenges, and ethical considerations of web based behavioural data collection. Methods: This discussion is based on the authors’ experiences in ...survey development and study design, respondent recruitment, and internet research, and on the experiences of others as found in the literature. Results: The advantages of using the world wide web to collect behavioural data include rapid access to numerous potential respondents and previously hidden populations, respondent openness and full participation, opportunities for student research, and reduced research costs. Challenges identified include issues related to sampling and sample representativeness, competition for the attention of respondents, and potential limitations resulting from the much cited “digital divide”, literacy, and disability. Ethical considerations include anonymity and privacy, providing and substantiating informed consent, and potential risks of malfeasance. Conclusions: Computer mediated communications, including electronic mail, the world wide web, and interactive programs will play an ever increasing part in the future of behavioural science research. Justifiable concerns regarding the use of the world wide web in research exist, but as access to, and use of, the internet becomes more widely and representatively distributed globally, the world wide web will become more applicable. In fact, the world wide web may be the only research tool able to reach some previously hidden population subgroups. Furthermore, many of the criticisms of online data collection are common to other survey research methodologies.
Modulation of postsynaptic AMPA receptors in the brain by phosphorylation may play a role in the expression of synaptic plasticity at central excitatory synapses. It is known from biochemical studies ...that GluR1 AMPA receptor subunits can be phosphorylated within their C terminal by cAMP-dependent protein kinase A (PKA), which is colocalized with the phosphatase calcineurin (i.e., phosphatase 2B). We have examined the effect of PKA and calcineurin on the time course, peak open probability (P(O, PEAK)), and single-channel properties of glutamateevoked responses for neuronal AMPA receptors and homomeric GluR1(flip) receptors recorded in outside-out patches. Inclusion of purified catalytic subunit Calpha-PKA in the pipette solution increased neuronal AMPA receptor P(O,PEAK) (0.92) compared with recordings made with calcineurin included in the pipette (P(O,PEAK) 0.39). Similarly, Calpha-PKA increased P(O,PEAK) for recombinant GluR1 receptors (0. 78) compared with patches excised from cells cotransfected with a cDNA encoding the PKA peptide inhibitor PKI (P(O,PEAK) 0.50) or patches with calcineurin included in the pipette (P(O,PEAK) 0.42). Neither PKA nor calcineurin altered the amplitude of single-channel subconductance levels, weighted mean unitary current, mean channel open period, burst length, or macroscopic response waveform for recombinant GluR1 receptors. Substitution of an amino acid at the PKA phosphorylation site (S845A) on GluR1 eliminated the PKA-induced increase in P(O,PEAK), whereas the mutation of a Ca(2+), calmodulin-dependent kinase II and PKC phosphorylation site (S831A) was without effect. These results suggest that AMPA receptor peak response open probability can be increased by PKA through phosphorylation of GluR1 Ser845.
To cite this article: Chan‐Yeung M, Anthonisen NR, Becklake MR, Bowie D, Sonia Buist A, Dimich‐Ward H, Ernst P, Sears MR, Siersted HC, Sweet L, Van Til L, Manfreda J. Geographical variations in the ...prevalence of atopic sensitization in six study sites across Canada. Allergy 2010; 65: 1404–1413.
Background: Geographical variations in atopic sensitization in Canada have not been described previously. This study used the standardized protocol of the European Community Respiratory Health Survey‐1 (ECRHS‐1) to investigate the distribution and predictors of atopic sensitization in six sites across Canada and to compare the results with some ECRHS‐1 centers.
Methods: Adults aged 20–44 years in six study sites across Canada underwent allergy skin testing using 14 allergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae) cat, cockroach, grasses (Timothy grass, Kentucky grass), molds (Cladosporium herbarium, Alternaria alternata, Aspergillus fumigatus, Penicillium), trees (tree mix, birch, Olea europea), and common ragweed.
Results: The overall prevalence of atopy (skin test over 0 mm to any allergen) was 62.7%. There was significant geographical variation in the prevalence of atopy in the six study sites (lowest 55.6% 95% C.I.51.3–59.9 in Prince Edward Island, highest 66.0 61.7–70.3 in Montreal) and of sensitization to each of the allergens tested even after adjustment for confounders. When the first eight of the nine allergens in the ECRHS were used to estimate the prevalence of atopic sensitization, the prevalence of atopy in Canada was 57% compared with 35.2% overall for centers in the ECRHS. The prevalence of atopy in Vancouver (57% 52.3–61.8) was close to that of Portland, Oregon (52.1% 46.2–58.0).
Conclusion: There was a significant variation in atopic sensitization among different study sites across Canada. The prevalence of atopic sensitization is relatively high in Canada compared with sites in the ECRHS and this may, in part, account for the high prevalence of asthma and asthma symptoms in Canada.
Conventionally, the upper limit of normal for the common bile duct as measured by ultrasound is considered to be 6 mm. This review is a somewhat personalized account of how that number became the ...convention and cautions the reader to avoid being slavish in the use of this number. Two specific cautions are not to apply this limit to older patients and to consider where in the common bile duct the measurement was taken, as measurements taken closer to the pancreas may be larger than ones closer to the liver.
Currently, no reference or normative values for spirometry based on a randomly selected Canadian population exist.
The aim of the present analysis was to construct spirometric reference values for ...Canadian adults 20 to 90 years of age by combining data collected from healthy lifelong nonsmokers in two population-based studies.
Both studies similarly used random population sampling, conducted using validated epidemiological protocols in the Canadian Obstructive Lung Disease study, and the Lung Health Canadian Environment study. Spirometric lung function data were available from 3042 subjects in the COLD study, which was completed in 2009, and from 2571 subjects in the LHCE study completed in 1995. A total of 844 subjects 40 to 90 years of age, and 812 subjects 20 to 44 years of age, were identified as healthy, asymptomatic, lifelong nonsmokers, and provided normative reference values for spirometry. Multiple regression models were constructed separately for Caucasian men and women for the following spirometric parameters: forced expiratory volume in 1 s (FEV(1)), forced vital capacity (FVC) and FEV(1)⁄FVC ratio, with covariates of height, sex and age. Comparison with published regression equations showed that the best agreement was obtained from data derived from random populations.
The best-fitting regression models for healthy, never-smoking, asymptomatic European-Canadian men and women 20 to 90 years of age were constructed. When age- and height-corrected FEV(1), FVC and FEV(1)⁄FVC ratio were compared with other spirometry reference studies, mean values were similar, with the closest being derived from population-based studies.
These spirometry reference equations, derived from randomly selected population-based cohorts with stringently monitored lung function measurements, provide data currently lacking in Canada.
Asthma education decreases the number of emergency visits in specific subgroups of patients with asthma. However, it remains unknown whether this improvement is related only to the use of an action ...plan alone or to other components of the educational intervention. A total of 126 patients consulting urgently for an acute asthma exacerbation were recruited; 98 completed the study. The first 45 patients were assigned to Group C (control; usual treatment). Thereafter, patients were randomized to either Group LE (limited education; teaching of the inhaler technique plus self- action plan given by the on call physician) or Group SE (same as group LE plus a structured educational program emphasizing self-capacity to manage asthma exacerbations). At baseline, there was no difference between groups in asthma morbidity, medication needs, or pulmonary function. After 12 mo, only Group SE showed a significant improvement in knowledge, willingness to adjust medications, quality of life scores, and peak expiratory flows. In the last 6 mo, the number of unscheduled medical visits for asthma was significantly lower in Group SE in comparison with groups C and LE (p = 0.03). The number (%) of patients with unscheduled medical visits also decreased significantly in Group SE compared with Groups C and LE (p = 0.02). We conclude that a structured educational intervention emphasizing self-management improves patient outcomes significantly more than a limited intervention or conventional treatment.
Physician competence in the performance of sonographic studies was assessed after their involvement in predetermined increments of cases to determine whether the case volumes currently required by ...the American Institute of Ultrasound in Medicine and the American College of Radiology for training in sonography can be lowered substantially.
Sonographic competence tests were administered to 10 first-year diagnostic radiology residents after their involvement in increments of 50 cases, up to a total of 200 cases (four competency tests). Each competency test consisted of the resident's independently scanning and interpreting 10 clinically mandated studies that were scored in comparison with the examination performed by the sonographer and interpreted by an attending radiologist. Trainee studies were graded on the percentage of anatomic landmarks depicted, the number of reporting errors, the number of clinically significant reporting errors, and the percentage of cases receiving a passing score.
Although resident performance improved progressively with increasing experience for all parameters assessed, performance of the group was poor even after their involvement in 200 cases. At this testing level, the mean percentage of anatomic landmarks depicted successfully was 56.5%; the mean total reporting errors per case was 1.2; the mean clinically significant errors per case was 0.5; and the mean percentage of cases receiving a passing score was 16%. Impressive performance differences were observed among residents for all parameters assessed, and these differences were not explained by the number of months of radiology training the resident had taken before the sonography rotation.
Involvement in 200 or fewer cases during the training period is not sufficient for physicians to develop an acceptable level of competence in sonography.
As housing supply in England reaches crisis point, Duncan Bowie provides a critical review of housing policy under successive UK governments. From Blair's New Labour and Cameron's Coalition ...government to the 2016 Housing and Planning Act, Bowie demonstrates how successive governments have failed to provide adequate, affordable housing, leading to a chronic lack of provision.
Exploring the inter-relationship between housing, planning and land policies, Bowie puts forward a reform programme based on an alternative set of policy priorities and delivery mechanisms, arguing the case for an integrated approach on land, taxation, planning and public investment to provide radical solutions to a growing crisis.
CT24ICU PROTOCOLS Bowie, D. R.
ANZ journal of surgery,
05/2007, Letnik:
77, Številka:
s1
Journal Article
Recenzirano
During its development in the past 4 decades the perioperative care of cardiac surgery patients has been the most protocolised in any branch of surgery. Initially this protocolisation was developed ...to allow the introduction to the clinical environment of applied physiology which had previously only been possible in the research laboratory. Invasive pressure monitoring, blood chemistry management, cardiac performance manipulation and coagulation control were all subject to rule based management which could be successfully implemented by staff with a wide range of knowledge and experience. Coronary Artery Surgery is now proported to be the commonest single procedure performed in North America and what was once considered 'Miraculous' is now routine. Active Physiological management which was once only the realm of specialised units is now taught to all medical students. The protocols used in the perioperative management of 21st century cardiac surgery patients although still based on sound physiological criteria are now directed towards resource optimisation. Low mortality is now a given and so techniques which decreasing ICU and hospital stay and maximise value for money while at the same time decreasing complication rates are the new focus. PUBLICATION ABSTRACT
Airway hyperresponsiveness in elite athletes Langdeau, J B; Turcotte, H; Bowie, D M ...
American journal of respiratory and critical care medicine,
05/2000, Letnik:
161, Številka:
5
Journal Article
Recenzirano
It has been suggested that high-level training could contribute to the development of airway hyperresponsiveness (AHR), but the comparative effects of different sports on airway function remains to ...be determined. We evaluated 150 nonsmoking volunteers 18 to 55 yr of age; 100 athletes divided into four subgroups of 25 subjects each according to the predominant estimated hydrocaloric characteristic of ambient air inhaled during training: dry air (DA), cold air (CA), humid air (HA) and a mixture of dry and humid air (MA), and 50 sedentary subjects. Each subject had a respiratory questionnaire, a methacholine challenge, allergy skin-prick tests, and heart rate variability recording for evaluation of parasympathetic tone. The athletes had a 49% prevalence of AHR (PC(20) < 16 mg/ml), with a mean PC(20) of 16.9 mg/ml, compared with 28% (PC(20): 35.4) in sedentary subjects (p = 0.009). The prevalence (%) of AHR and mean PC(20) (mg/ml) varied as followed in the four subgroups of athletes: DA: 32% and 30.9; CA: 52% and 15.8; HA: 76% and 7.3; and MA: 32% and 21.5 (p = 0.002). The estimated parasympathetic tone was higher in athletes (p < 0.001), but this parameter showed only a weak correlation with PC(20) (r = -0.17, p = 0.04). This study has shown a significantly higher prevalence of AHR in athletes than in the control group because of the higher prevalence in the CA and HA groups. Parasympathetic activity may act as modulator of airway responsiveness, but the increased prevalence of AHR in our athlete population may be related to the type and possibly the content of inhaled air during training.
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