Miracle-dz/UniFAR-FTUs huggingface dataset:
Oral health interventions in Australian Aboriginal communities: a review of the literature

Aboriginal Australians experience significant disparities in oral health with even poorer outcomes reported in rural and remote areas. The high rates of preventable dental disease in Aboriginal communities are a serious concern from a social standpoint and in terms of service provision and health care expenditure. In this review, primary research literature was comprehensively reviewed. Papers were selected if they reported designing or implementing an intervention or oral health programme specific to the needs of Aboriginal communities. Twenty-one publications fulfilled the inclusion criteria with 19 different interventions being described. Interventions were categorized using a classification adapted from the work of Whitehead (2002). The review identified interventions that aimed to reduce early childhood caries, increase services to remote communities, develop the role of Aboriginal health workers, improve oral health literacy, establish water fluoridation and provide periodontal therapy. Implementing successful oral health interventions in Aboriginal communities is a challenge that is compounded by the complex interplay between psychosocial and cultural determinants. Even interventions that follow a rigorous and consultative design have a high failure rate in Aboriginal communities if upstream determinants of health are not adequately understood and addressed.
Choice of secondary prevention improves risk factors after acute coronary syndrome: 1-year follow-up of the CHOICE (Choice of Health Options In prevention of Cardiovascular Events) randomised controlled trial

Objective: To determine the effect of a new CHOICE (Choice of Health Options In prevention of Cardiovascular Events) programme on cardiovascular risk factors in acute coronary syndrome (ACS) survivors. Design: Single-blind randomised controlled trial. Setting: Tertiary referral hospital in Sydney Australia. Patients: 144 ACS survivors who were not accessing standard cardiac rehabilitation. Data were also collected on a further 64 ACS survivors attending standard cardiac rehabilitation. Intervention: The CHOICE group (n = 72) participated in a brief, patient-centred, modular programme comprising a clinic visit plus telephone support, encompassing mandatory cholesterol lowering and tailored preferential risk modification. The control group (n = 72) participated in continuing conventional care but no centrally coordinated secondary prevention. Main outcome measures: Values for total cholesterol, systolic blood pressure, smoking status and physical activity. Results: CHOICE and control groups were well matched at baseline. At 12 months, the CHOICE group (n = 67) had significantly better risk factor levels than controls (n = 69) for total cholesterol (TC) (mean (SEM) 4.0 (0.1) vs 4.7 (0.1) mmol/l, p<0.001), systolic blood pressure (131.6 (1.8) vs 143.9 (2.3) mm Hg, p<0.001), body mass index (28.9 (0.7) vs 31.2 (0.7) kg/m2, p = 0.025) and physical activity (1369.1 (167.2) vs 715.1 (103.5) METS/kg/min, p = 0.001) as well as a better knowledge of risk factor targets. Also at 1 year, fewer CHOICE participants (21%) had three or more risk factors above widely recommended levels then controls (72%) (p<0.001). Conclusions: Participation in a brief CHOICE programme significantly improved the modifiable risk profiles and risk factor knowledge of ACS survivors over 12 months. CHOICE is an effective alternative for dealing with the widespread underuse of existing secondary prevention programmes. Trial registration number: ISRCTN42984084
Emergence of the concept of platelet reactivity monitoring of response to thienopyridines

Clinical trials have demonstrated the beneficial impact of clopidogrel in preventing major adverse cardiovascular events (MACE), particularly in patients undergoing percutaneous coronary intervention (PCI). The concept of biological clopidogrel resistance emerged with the finding of persistent platelet activation despite clopidogrel therapy in some patients. Further, a link between biological clopidogrel resistance and thrombotic recurrence after PCI was observed and a threshold of platelet reactivity (PR) for thrombotic events was suggested. Consistently, in recent trials, enhanced PR inhibition translated into a reduction in the rate of MACE after PCI. This review aims to present the emergence of the concept of PR monitoring in patients undergoing PCI following recent advances in this field.
Ethical Decision-Making in Two Care Homes

Codes of ethics and conduct each try to set out what society expects of social service workers in their day-to-day practice. The tensions within these expectations are acknowledged in the literature, which reveals a growing concern that personal social service workers should be conversant with ethical theory and its implications for practice. Based on data from a survey of all workers in two care homes for older people, this paper examines the ethical principles underlying day-to-day decisions. Analysis of the data notes some variation in the complexity of response to simulated vignettes, where more autonomous practice was suggested by responses from care-qualified staff and by workers managed by a social worker. Overall, while there is evidence of a consistent commitment to offer the best possible care to each resident, few of these workers, at any level, are aware of the ethical basis for their day-to-day decisions; indeed there is little indication that they are aware that the decisions are ethical at all. This paper suggests that the conflation of rules of the job with moral rules occurs across staffing levels and concludes that all care staff training should include a more specific focus on ethical reasoning.
Intermittent hypoxia and activation of inflammatory molecular pathways in OSAS

Abstract Obstructive sleep apnoea syndrome (OSAS) represents a highly prevalent disease and is recognized as a risk factor for the development of various cardiovascular disorders. The pathogenesis of cardiovascular complications in OSAS is not completely understood, but the unique form of hypoxia with repetitive short cycles of desaturation followed by rapid reoxygenation termed intermittent hypoxia (IH) is likely to play a significant role. There is increasing evidence that IH leads to a preferential activation of inflammatory over adaptive pathways. This promotes activation of various inflammatory cells, particularly lymphocytes and monocytes, with the downstream consequence of expression of pro-inflammatory cytokines, chemokines and adhesion molecules that may contribute to endothelial dysfunction. This review provides a critical analysis of the current evidence of inflammatory mechanisms initiated by IH that may contribute to the cardiovascular pathogenesis in OSAS.
Functional forms for photon spectra of clinical linacs

Specifying photon spectra of clinical linacs using a functional form is useful for many applications, including virtual source modelling and spectral unfolding from dosimetric measurements such as transmission data or depth-dose curves. In this study, 11 functional forms from the literature are compiled and quantitatively compared. A new function is proposed which offers improvements over existing ones. The proposed function is simple, physics-based and has four free parameters, one of which is the mean incident electron kinetic energy. A comprehensive benchmark set of validated, high-precision Monte Carlo spectra is generated and used to evaluate the strengths and limitations of different functions. The benchmark set has 65 spectra (3.5–30 MV) from Varian, Elekta, Siemens, Tomotherapy, Cyberknife and research linacs. The set includes spectra on- and off-axis from linacs with and without a flattening filter, and in treatment and imaging modes. The proposed function gives the lowest spectral deviations among all functions. It reproduces the energy fluence values in each bin for the benchmark set with a normalized root-mean-square deviation of 1.7%. The mean incident electron kinetic energy, maximum photon energy, most-probable energy and average energy are reproduced, on average, within 1.4%, 4.3%, 3.9% and 0.6% of their true values, respectively. The proposed function is well behaved when used for spectral unfolding from dosimetric data. The contribution of the 511 keV annihilation peak and the energy spread of the incident electron beam can be added as additional free parameters.
Predicting outcome after valve replacement

Objective: To identify the key predictors of performance on a 6-minute walk and health-related quality of life (QOL) one year after cardiac valve replacement and to use the predictors to guide clinical practice and optimise outcome. Design: Prospective cohort study. Setting: Tertiary cardiothoracic centre in the UK. Patients: 225 patients having first time valve replacement with a mean age 67.1 (SD 12.1) years. Main outcome measures: Mortality, morbidity, NYHA, performance on a 6-minute walk and health-related QOL one year after surgery. Results: One year after valve replacement 90% of patients were alive and free from a major event related to their surgery. NYHA category fell by 0.6. Performance on a 6-minute walk improved by 42% and QOL improved on all subscales and both composite scores of the SF-36 QOL questionnaire. Although physical QOL scores improved they did not normalise, unlike the mental QOL scores which were near normal on both occasions. Independent baseline predictors of 6-minute walk performance at one year were baseline walk performance, age and belief in surgery as a treatment. Independent baseline predictors of one year physical QOL were baseline physical QOL and walk performance. Independent baseline predictors of one year mental QOL were depression, baseline mental QOL and age, with age having a positive effect. Conclusions: One year after valve replacement patients can expect a significant improvement in their exercise tolerance and QOL but their physical QOL is unlikely to be normal. Outcome may be improved by treating depression and modifying negative illness beliefs preoperatively.
A Comparison of Utilization of Hospice Services Between Hispanics and Whites

Past studies have shown that proportionately fewer Hispanics than Whites were admitted to hospice. Not many studies documented Hispanics' use of hospice service after hospice admission. The purpose of this study was to compare Hispanics' and Whites' utilization of hospice services. The design was a retrospective chart review completed in a Hispanic-majority city. Four Medicare-certified hospice agencies in the area participated by providing charts (N = 500) for review. Demographic/informational variables and service utilization variables were collected. Service utilization included length of service, total visits, and discipline-specific visits. Data were analyzed using analysis of variance with a level of significance set at . 05. The results showed that ethnicity did not significantly influence length of service or total visits; however, Whites received more visits than Hispanics from social workers, aides, and spiritual counselors. Results were considered within the context of cultural value differences between Hispanics and Whites. Hospice providers can use the study information to develop patient-centered care for Hispanics.
The Effects of Drug Treatment and Supervision on Time to Rearrest among Drug Treatment Court Participants

Past research has generally shown that drug courts are reaching their target offenders and that program participants are rearrested at a lower or equivalent rate than comparison offenders. Few analyses have been conducted to test the relative effects of different drug court elements, however. The current research takes a closer look at the two main components of the drug court, supervision and treatment, to determine whether one is more effective at preventing failure, or whether the combination of both is necessary to observe a decreased risk of failure. Attending treatment significantly decreased the risk of failure over a two-year follow-up period, while receiving supervision did not. Offenders who received both supervision and treatment had the longest survival times, but not significantly longer than those who received treatment only. Implications for drug courts in general are discussed, as well as avenues for future research in this field.
Out-of-hospital cardiac arrest in South Asian and white populations in London: database evaluation of characteristics and outcome

Objective: To compare out-of-hospital cardiac arrest (OOHCA) characteristics in white and South Asian populations within Greater London. Methods: Data for OOHCAs were extracted from 1 April 2003 to 31 March 2007. Primary study variables included age, gender, ethnicity, response times from 999 call to ambulance arrival, initial cardiac rhythm, whether bystander cardiopulmonary resuscitation was provided before arrival of the London Ambulance Service (LAS) NHS Trust crew, whether the arrest was witnessed (bystander or LAS crew) and hospital outcome, including survival to hospital admission and discharge. Results: Of 13 013 OOHCAs of presumed cardiac cause, 3161 (24.3%) had ethnicity codes assigned. These comprised 63.1% (n = 1995) white and 5.8% (n = 183) South Asian people, with the remainder from other backgrounds. White patients were on average 5 years older than South Asians (69.5 vs 64.6, p<0.005). Response time (7.48 min vs 7.46 min), bystander cardiopulmonary resuscitation (34.4% vs 29.7%), initial cardiac rhythm (29.5% vs 30.4%) and survival to admission (22.2% vs 22.5%) and discharge (8.7% vs 8.9%) were comparable between the two ethnic groups. South Asians were slightly more likely to have a witnessed an OOHCA than their white counterparts (OR = 1.1, 95% CI 1.0 to 1.2). Discussion: The quality of care provided was comparable between white and South Asian populations. The data support the emerging view that South Asians’ high mortality from coronary heart disease reflects higher incidence rather than higher case fatality. South Asians had an OOHCA at a significantly younger age. The study demonstrates the importance of ethnic coding within the emergency services.
Abstinence and drug abuse treatment: Results from the Drug Outcome Research in Scotland study

Aims: To identify the proportion of drug users contacting drug treatment services in Scotland who were able to become abstinent 33 months after having started a new episode of treatment and to identify which services were most closely associated with such abstinence. Design: Follow-up survey of 695 of the Drug Outcome Research in Scotland respondents 33 months following recruitment into the study. Setting: Scotland. Participants: Injecting drug users who were initially contacted at drug treatment services and then followed up for 33 months post-recruitment. Measurements: Self-reported drug use and service usage. Findings: Although becoming drug free was the expressed goal of the majority of drug users recruited into the Drug Outcome Research in Scotland study, at 33 months following recruitment only 5.9% of females and 9.0% of males had been totally drug free (excluding possible alcohol and tobacco use) for a 90-day period in advance of being interviewed. There was considerable variation within this study in the proportion of drug users becoming drug free dependent upon the services they had been in contact with. The level of achieved abstinence in this Scottish study was substantially lower than that identified in the National Treatment Outcomes Research Study in England. Conclusions: There is a need to establish why so few drug users in contact with the methadone programme in Scotland appear able to become drug free 33 months after having contacted this service. On the basis of the results presented in this paper there is a need to ensure that drug users seeking help in becoming drug free are able to access residential rehabilitation services although at the present time such services are relatively rare within Scotland.
The domestic horse harbours Y-chromosomal microsatellite polymorphism only on two widely distributed male lineages.

Source/description: Mitochondrial DNA (mtDNA) and the paternally inherited portion of the Y chromosome (NRY) are inherited uniparentally and do not recombine. They provide a tool for constructing female and male genealogical histories and have therefore been widely analysed in a broad range of wild and domesticated animals. In livestock, mtDNA and NRY markers act as an informative tool to elucidate the origin of breeds and to trace maleand female-mediated gene flow. Paradoxically, horses (Equus caballus) have the largest mtDNA diversity among domestic species, and mtDNA has been widely used to investigate the origin of domestic horse breeds, but only limited sequence diversity has been described on the NRY. In a recent paper, we presented the first polymorphic Y-chromosomal markers for paternal lineage analysis in modern domestic horses. They resulted in only six haplotypes, all clearly distinct from the Przewalski horse (Equus przewalskii). Only single mutational steps separate the modern horse Y-chromosomal haplotypes from each other. Horse paternal lineages seem therefore closely related, but Y-chromosomal diversity might be underestimated on the sequence level due to ascertainment bias. Highly mutable microsatellite markers may help to increase the resolution, as shown in cattle. An initial investigation of five Y-chromosomal microsatellites revealed no polymorphism and thus supported a very close relationship and recent origin of the modern horse haplotypes. In this study, we investigate Y-chromosomal lineages in greater depth using eight newly identified Y-chromosomal microsatellite markers in a comprehensive sample set containing all modern and Przewalski horse Y-chromosomal haplotypes.
Bias in estimates of seat belt effectiveness

An objective measure of seat belt use is needed to enable us to assess their effectiveness A lack of consensus on the effectiveness of seat belts, when used, is remarkable given that belts have been standard equipment in passenger cars for more than 30 years in the highly industrialized countries. In the 1970s, examination of 19 studies of seat belt effectiveness, when used, found estimates varying from 7.5% to 85.6%. The correlation of the estimates with reported use suggested that the higher estimates were in error because of claimed use by non-users in crashes.1 Comparisons of police reported belt use by the fatally injured and survivors in front seats of the same vehicle before 1985 in the United States indicated belt effectiveness of about 40%–45%. 2 Studies using this method were thought to be more valid because within-vehicle crash forces were more similar than comparisons of occupants of vehicles among a variety of types of crashes. When belt use laws were enacted in a number of states in the United States in the mid to late 1980s, belt use increased substantially and car model year specific death rates declined commensurate with a belt effectiveness of …
Haplotype diversity in autochthonous Balkan cattle breeds.

The Bulgarian Grey cattle (BGC) and theShorthorn Rhodopean cattle (SRC) are Balkan indigenousbreeds that are part of the Podolian and Brachicerous(Busha) cattle groups respectively. Concerning the mtDNAdiversity of Balkan cattle breeds, previous studies focusedon Busha cattle and Grey cattle populations.
Response to “Comment on ‘Visual Contrast Sensitivity in Children Exposed to Tetrachloroethylene’ by Storm et al”

T he author’s major criticism of our report is that we intentionally engaged in “selective reporting” such that “a great many contrary findings were excluded” to suggest “a spuriously consistent negative effect on vision from trace levels of perchloroethylene (perc) exposure. ” In particular, the author argues that (1) we do not acknowledge or discuss selection bias resulting in over representation of “exposed” subjects; (2) we do not present unpublished study findings that are contrary to the findings published here; (3) multiple comparisons increase the possibility that the statistically significant findings reported are due to chance; (4) the association between lower socioeconomic status and exposure confounds our ability to associate exposure and visual contrast sensitivity (VCS); and (5) our results are inconsistent with available literature. We welcome the opportunity to respond to each of these comments. Selection bias would be a concern in our study if those with elevated perc exposures and altered VCS or color vision were more likely to have participated than others.1 However, this bias was minimized by our recruitment methods. Earlier research had shown that perc exposures might be elevated in some, but not all, residential buildings where a dry cleaner using perc was colocated; that VCS or color vision might be harmed by such exposures; and that children might be more affected by perc exposure than adults. To investigate these possibilities, we designed our study to evaluate the relationships between individual measurements
Gender differences in the implementation of cardiovascular prevention measures after an acute coronary event

Objective To compare gender-related lifestyle changes and risk factor management after hospitalisation for a coronary event or revascularisation intervention in Europe. Method The EUROASPIRE III survey was carried out in 22 European countries in 2006–2007. Consecutive patients having had a coronary event or revascularisation before the age of 80 were identified. A total of 8966 patients (25.3% women) were interviewed and underwent clinical and biochemical tests at least 6 months after hospital admission. Trends in cardiovascular risk management were assessed on the basis of the 1994–1995, 1999–2000 and 2006–2007 EUROASPIRE surveys. Results Female survey participants were generally older and had a lower educational level than male participants (p<0.0001). The prevalences of obesity (p<0.0001), high blood pressure (BP) (p=0.001), elevated low-density lipoprotein (LDL)-cholesterol (p<0.0001) and diabetes (p<0.0001) were significantly higher in women than in men, whereas current smoking (p<0.0001) was significantly more common in men. The use of antihypertensive and antidiabetic drugs (but not that of other drugs) was more common in women than in men. However, BP (p<0.0001), LDL-cholesterol (p<0.0001) and HbA1c (p<0.0001) targets were less often achieved in women than in men. Between 1994 and 2007, cholesterol control improved less in women than in men (interaction: p=0.009), whereas trends in BP control (p=0.32) and glycaemia (p=0.36) were similar for both genders. Conclusion The EUROASPIRE III results show that despite similarities in medication exposure, women are less likely than men to achieve BP, LDL-cholesterol and HbA1c targets after a coronary event. This gap did not appear to narrow between 1994 and 2007.