Miracle-dz/UniFAR-FTUs huggingface dataset:
An Advisory Committee Statement (ACS); National Advisory Committee on Immunization (NACI): an update on the use of conjugate pneumococcal vaccines in childhood.

The National Advisory Committee on Immunization (NACI)† provides the Public Health Agency of Canada (PHAC) with ongoing and timely medical, scientific, and public health advice relating to immunization. PHAC acknowledges that the advice and recommendations set out in this statement are based upon the best current available scientific knowledge and is disseminating this document for information purposes. People administering the vaccine should also be aware of the contents of the relevant product monograph(s). Recommendations for use and other information set out herein may differ from that set out in the product monograph(s) of the Canadian manufacturer(s) of the vaccine(s). Manufacturer(s) have sought approval of the vaccine(s) and provided evidence as to its safety and efficacy only when it is used in accordance with the product monographs. NACI members and liaison members conduct themselves within the context of the PHAC’s Policy on Conflict of Interest, including yearly declaration of potential conflict of interest.
Assessment of Microbial Quality and Antibacterial Activity of Commonly used Hand Washes

Hands are the highways to the transmission and spread of pathogens that causes diseases, food borne illnesses and nosocomial infections. Hand washing is the act of cleansing the hands with water or another liquid, with or without the use of soap or other detergents, to ensure proper hand hygiene. To determine the microbiological quality and the antibacterial property and dilution effects on activity of hand wash, seven brands of hand washes were evaluated using susceptibility test by agar well diffusion, minimum inhibitory dilution and time kill test. This was done by assessing different dilutions of the hand washes against standardized 1.5x10 8 cells of Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa. Results showed that all the hand washes were sterile and all the brands had some level of antibacterial activity. The hand washes were more active on Staphylococcus aureus and Escherichia coli than on Pseudomonas aeruginosa. Activity decreased with dilution as neat and 2 -1 dilutions gave better results compared to 2 -2 , 10 -1 and 10 -2 . Hib hand wash killed all test organisms when exposed for 2, 5 and 10 minutes and at neat and 2 -1 dilutions but not at 2 -2 , 10 -1 and 10 -2 . Rev and Pan hand washes though are sterile, were least active in all the tests. The minimum inhibitory dilution and minimum bactericidal dilution for most of the hand wash was at neat concentration. The time kill test showed that the effect of the hand wash was highest at 5 and 10 minutes and at neat (undiluted) for all the test organisms. It is advised that the dilution of hand washes a common practice in most eateries must stop as these products are not active when diluted, hands
Venous thromboembolism prophylaxis in a general hospital.

OBJECTIVE To evaluate the use of venous thromboembolism (VTE) prophylaxis in a general hospital. METHODS A cross-sectional cohort study at the Hospital Nossa Senhora da Conceição, located in the city of Porto Alegre, Brazil, involving a random sample of patients admitted between October of 2008 and February of 2009. We included patients over 18 years of age and hospitalized for more than 48 h. The exclusion criteria were anticoagulant use, pregnancy, puerperium, and a history of thromboembolic disease. The adequacy of prophylaxis was evaluated in accordance with a protocol created by the Hospital and principally based on the American College of Chest Physicians guidelines, eighth edition. RESULTS We included 262 patients. The mean age was 59.1 ± 16.6 years. The most common risk factors were immobilization (in 70.6%), infection (in 44.3%), cancer (in 27.5%), obesity (in 23.3%), and major surgery (in 14.1%). The risk of VTE was classified as high and moderate in 143 (54.6%) and 117 (44.7%) of the patients, respectively. Overall, 46.2% of the patients received adequate prophylaxis, 25% of those with > three risk factors for VTE and 18% of those with cancer, the differences between these last two groups and their counterparts (patients with < three risk factors and those without cancer) being statistically significant (p < 0.001 for both). CONCLUSIONS Our data reveal that nearly all patients at our hospital were at risk for VTE, and that less than half received adequate VTE prophylaxis, which is in agreement with the literature. It is surprising that inadequate prophylaxis is more common in high-risk patients.
Suspended in Blood and Circulating Within, Cell Free (cf) DNA Connects with a Vast Range of Adverse Human Health Conditions Including Cancer: A Review.

Cell free DNA (cfDNA) is now emerging as potent biomarker in cancer diagnostics as well as an useful tool for non-invasive diagnostic methods related to a wide range of clinical conditions. Its extraction from blood is crucial to exploitation as a biomarker. Link of cfDNA has been established with a wide range of health conditions including autoimmune diseases, sepsis and trauma, heart diseases and dialytic processes. However, its utility in prenatal diagnosis has been one of the most widely investigated areas of research. Association of cfDNA with cancer and its methylation status as a potent prognostic marker is also assuming increasing significance in recent times. Its association with different forms of cancer with special reference to breast cancer is notable. A doubtful mammographic findings does indicate other testing that involve imaging techniques but the final diagnosis is established by a biopsy in particular to differentiate malignant from benign tumors. Although this is an established process that has considerably reduced mortality, several lacunae indicate the need for superior prognostic and diagnostic markers. In these contexts, cfDNA has been discussed in this review.
Students' Perceptions of Pharmacy as a Specialization and their Future Career, a Cross Sectional Study of Final Year Pharmacy Students in Jordan

This study aimed to establish a baseline understanding of the career aspirations, motivations and expectations of students within undergraduate pharmacy education in Jordan and to examine students’ incentives to select pharmacy and how they feel about their choice as they are approaching graduation. A draft survey instrument was designed to collect the required information. The questionnaire was administered to final year pharmacy students (B.Sc. Pharmacy and PharmD) at the University of Jordan and the Jordan University of science and Technology. The questionnaire was administered at the end of all lectures at both universities. Following data collection, responses were coded and entered into a customized database in SPSS, version 17, for statistical analyses. Chi-square and Fisher exact tests were used to test for significant differences between groups A total of 240 final-year pharmacy students took part in the present study. The majority of respondents (n=147, 61.3%) indicated that pharmacy was not their first choice of study at the time of application to universities. More than half (n=138, 57.5%) the respondents claimed that they were optimistic regarding the future of pharmacy as a profession. When asked to rank pharmacy among different suggested professions, the majority of respondents (n=95, 39.58%) ranked pharmacy second after medicine and before dentistry. The majority of respondents (n=202, 84.17%) thought they had a positive self image. Students studying pharmacy seem to have optimistic aspirations of their future career and a positive image. Further qualitative research is needed to gain more in-depth understanding of this issue and to create a realistic connection between market needs and pharmacy education outputs.
Erythromycin Prophylaxis for Pertussis

A neonate admitted to the newborn nursery was found to have bacteriologically proven Bordetella pertussis whooping cough, and two of seven infants exposed to this child became infected. Erythromycin administration to the seven infants apparently prevented further infection as well as the appearance of clinical disease in the two infected infants. This limited experience supports previous reports of the efficacy of erythromycin in preventing B. pertussis infection and disease in susceptible children.
Undergraduate physiotherapy students’ knowledge of Diabetes Mellitus: Implications for education

Diabetes mellitus is a growing public health concern and its prevalence is escalating exponentially, with a high frequency of morbidity, premature mortality, disability and loss of productivity. Since health education has become an important part of medical care physiotherapy students are potentially well suited to assist with the combat of this disease. The study aimed to determine the knowledge of diabetes mellitus and its risk factors of undergraduate physiotherapy students in the Western Cape. The study incorporated a quantitative, cross-sectional design. Three hundred and thirty eight (338) students completed the structured, self-administered questionnaire consisting of three sections, namely socio-demographic information, diabetes mellitus risk factors and the validated 24-item diabetes Knowledge Questionnaire (dKQ-24). Both descriptive and inferential statistics were employed and the alpha level was set at p < 0.05. overall, 60.7% of the study sample had adequate knowledge of diabetes mellitus (≥ 75% correct answers), while 32.5% and 6.8% had marginal (≥60 ≤ 74% correct answers) and inadequate knowledge (<59% correct answers) respectively. Seven of the nine diabetes mellitus risk factors could readily be identified by 89.7% of the participants. Smoking (64.8%) and high blood pressure (69.0%) were not readily identified as common diabetes mellitus risk factors. Significant associations with diabetes risk factors were found for gender and year of study. The study has reinforced the need for continuous education of physiotherapy students regarding diabetes mellitus and its risk factors, as inadequate knowledge of diabetes mellitus could influence the effectiveness of patient education and therefore have dangerous consequences for the patient diagnosed with diabetes mellitus.
Resuscitation fluids in trauma, part II: which fluid should I give?

compartment interfaces, and changes in the interfaces during the pathophysiological processes of hypovolaemic shock is important. Total body water in man is approximately 60% of total body weight and is distributed within several compartments. The intracellular component is the largest, comprising about two-thirds of total body water (30 L). The extra-cellular fluid constitutes the remaining one-third of total body water (15 L), and may be subdivided further into two compartments: the intravascular compartment, with 3 L plasma and 2 L blood cells (strictly intracellular), and the interstitial compartment of approximately 12 L. Trauma may disturb the pattern of fluid distribution between compartments either by increasing the permeability of the barriers separating compartments, such as occurs during SIRS, or by altering compartment composition such as reducing blood volume during haemorrhage. Resuscitation fluids may be isotonic, hypotonic or hypertonic with respect to plasma. They may be either crystalloid or colloid solutions, and these factors will dictate their distribution with respect to the semipermeable membranes separating the different compartments of the body. The osmotic pressure generated by a solute is proportional to the number of molecules or ions of solute and to their charge characteristics, and is independent of solute molecular size. Solutes that pass freely across a semipermeable membrane do not generate any osmotic pressure, and are effectively a component of the solvent, with respect to that membrane. Water moves freely across a semi-permeable membrane and does so from an area of low osmolality to one of higher osmolality, and this movement continues until the osmotic pressures are equal on both sides of the membrane. Intravenous fluids are administered into the intravascular space contained within the vessel and capillary walls. The capillary walls are freely Trauma 2006; 8: 111–121
Bearing Responsibility: How Caregivers to the Mentally Ill Assess Their Obligations

Based on 50 in-depth interviews, this article describes how family caregivers to a spouse, parent, child, or sibling suffering from depression, manic-depression, or schizophrenia negotiate their involvement with the ill person. The central research question asks: ‘what features of the situation do family members take into account as they try to operationalize boundaries of obligation between themselves and the mentally ill person in their lives? ’ Data analysis of the joint experience of caregivers and family members reveals four interpretive junctures that mark transitions in the way caregivers assess their obligations. They are: hoping and learning, revising expectations, assessing responsibility, and preserving oneself. These categories capture clear regularities in the way respondents re-interpret their obligations to care over time. Our analysis suggests the need for a research agenda that looks more closely at how negotiations between caregivers and sick family members are mediated by their gender and status within the family.
Effects of a Teacher-Centred, School-Based Intervention Program on Health Behavior and Cardiovascular Disease Risk in Elementary School Children

The increasing prevalence of overweight and obese children along with accompanying comorbidities has prompted an early acknowledgement of a healthy lifestyle. The purpose of this study was to examine the effect of a teacher-centered, school-based intervention on cardiovascular disease (CVD) risk and health behavior in elementary school children. 935 first- and second-grade children in southwest Germany provided valid data at baseline and follow-up. Trained technicians measured height and weight along with blood pressure, cholesterol, and intra-abdominal fat to determine CVD risk. Parent questionnaires were used to assess children’s health behavior. Within one year CVD risk declined in the intervention group, particularly due to an attenuation of the age-related increase in mean arterial pressure. The age-related decline in habitual sports participation was attenuated, and children in the intervention groups displayed higher odds of playing outside. Further, the consumption of sugar-sweetened beverages declined in the intervention group, and TV time remained stable, while it increased in the control group. These results indicate that a teacher-centered intervention positively affects health behavior and CVD risk. The incorporation of the intervention by the classroom-teacher should allow for a sustainable participation, which may result in more pronounced effects over time.
Moving Towards Best Practice: Documenting and Learning from Existing Community Health/Care Worker Programmes

Published by Health Systems Trust Tel: 031 - 307 2954 Fax: 031 - 304 0775 Email: hst@hst.org.za Web: http://www.hst.org.za 401 Maritime House Salmon Grove Victoria Embankment Durban 4001 South Africa September 2007 This study was funded by the Research Directorate of the National Department of Health Research funded by: Directorate: Health Systems Research, Research Co-Ordination and Epidemiology, National Department of Health, Pretoria, South Africa Suggested citation: Friedman I, Ramalepe M, Matjuis F, Lungile Bhengu L, Lloyd B, Mafuleka A, Ndaba L and Boloyi B. Moving Towards Best Practice: Documenting and Learning from Existing Community Health/Care Worker Programmes. Durban: Health Systems Trust; 2007 The information contained in this publication may be freely distributed and reproduced, as long as the source is acknowledged, and it is used for non-commercial purposes. Project funded by the National Department of Health
Assessment of Hearing Loss in Tympanic Membrane Perforation at Tertiary Care Hospitals

OBJECTIVE: To evaluate and analyze the degree of deafness in tympanic membrane perforation based on size, site and duration of perforation. METHODS: 90 patients of both sex were selected randomly for this study with age 20 years and above randomly. Size of tympanic membrane perforation was evaluated under operating microscope. Patients were divided into three groups according to size; group I (small), Group II (medium), Group III (large). Hearing loss was measured in each case with pure tone audiometry. RESULTS: Deafness increased as the perforation size increased [I vs. II (t - 3.23,p <0.01), II vs. III (t - 7.19, p < 0.001), I vs. III (t - 10.88, p < 0.001)]. The degree of deafness was more in posterior quadrant perforation than anterior quadrant perforation but difference was not significant statistically (t - 1.25, p (0.05). The degree of deafness was more in malleolar perforation (t 4.64, p < 0.01). Deafness increased as the duration of disease increased [A vs. B (t - 3.01, p < 0.03), A vs. C (t - 6.49, p < 0.001), B vs. C.
When Is Integrated Positron Emission Tomography/Computed Tomography More Accurate Than Side-by-Side Interpretation of Positron Emission Tomography and Computed Tomography?

Methods: Forty-one consecutive oncology patients referred for PET/CTwho had contemporary DCT scans for review were enrolled. Body regions assessed on a DCT scan were assessed on PET/CTand by side-by-side reading of PET and DCT (SBS PET/DCT). Lesions identified on DCT, the CT portion of PET/CT, SBS PET/DCT, and the reading of fused PET/CT images were scored as benign or malignant. The PET portion of the PET/CT study was read by 2 teams: the first read the SBS PET/DCT scan and the other read the complete fused PET/CT scan. For discordant lesions, the final diagnosis was determined by pathologicfindings (n = 6) or imaging follow-up (n = 21). Results: Twenty-seven (16.1%) of the 168 lesions were discordant when comparing analysis of fused PET/CT and SBS PET/DCT. Sixteen (9.5%) were fundamentally discordant, and 11(6.6%) were discordant in degree of confidence. For all discordant lesions only, the sensitivity, specificity, negative predictive value, positive predictive value, and accuracy for PET/CT were 100%, 33%, 100%, 94%, and 78%, respectively, and for SBS PET/DCT, they were 38%, 50%, 19%, 73%, and 30%, respectively (P , 0.001 for sensitivity, P = not specific for specificity). The 2 main causes for misclassification on SBS PET/DCT were incorrect localization (n = 12) and changes occurring in the time gap between DCT and PET/CT (n = 4). Conclusions: In-line PET/CT offers better lesion localization in comparison to the visual fusion of PET and CT, especially for small lymph nodes, lesions adjacent to mobile organs, or lesions adjacent to the chest or abdominal wall.
Analysis of the acid-base disorders of critically ill patients in the medical intensive care unit

Background : Acid-base imbalances are common in critically ill patients; however, the incidence of acid-base imbalances in the medical intensive care units has not been fully determined. In this study, we investigated the incidence and the type of acid-base imbalances in critically ill patients and we assessed which variables were associated with the patients' outcome. Methods : One hundred eighty-seven patients (122 men, age: 61.2±12.8 years) were enrolled. All the patients were admitted to the medical intensive care unit between January 2005 and December 2005. All the data sets included simultaneous measurements of an arterial blood gas with base excess, the serum electrolytes, the anion gap and the APACHE II scores. Results : The mortality rate was 56.7%. The incidence of acid-base imbalances was as follows: 25.1% were single disorders that existed with only a single primary acid-base imbalance, 48.7% were double disorders, 13.4% were triple disorders and 12.8% were normal (no disorders). The incidence of metabolic acidosis was 57.8% and the mortality rate was not different according to the type of acid-base imbalances. There were significant differences between the nonsurvivors and survivors according to the pH (7.34 vs. 7.41, respectively), HCO-3 (20.68 mmol/L vs. 25.90 mmol/L, respectively), ECF base excess (-5.19 vs. 1.19, respectively), the anion gap (18.57 mmol/L vs. 13.77 mmol/L, respectively), the corrected anion gap (23.63 mmol/L vs. 17.96 mmol/L, respectively), the serum albumin (2.37 g/dL vs. 2.74 g/dL, respectively), and the APACHE II scores (20.7 vs 17.2, respectively). However, on the Cox proportional hazard regression analysis, only the APAHCE II scores affected the patients' outcome. Conclusions : There were diverse acid-base imbalances in the critically ill patients and the incidence of metabolic acidosis was highest among the acid-base imbalances. The best predictor of the patients' outcome was the APACHE II scores.
Health inequalities among men and women in contrasting welfare statesBritain and three Nordic countries compared

This paper compares the degree and patterning of health inequalities among men and women in 4 different welfare states: in Britain and in 3 Nordic countries (Finland, Norway and Sweden). It is argued that the structural position including social class/employment status and material living standards are determinants of men's health, but additional determinants of women's health include family roles. Employment patterns are similar for men in all 4 countries and for Finnish women, but differ for women in the other 3 countries where women take part-time jobs or, particularly in Britain, where more women are full-time housewives. Prevalence data from comparable surveys in the 4 countries are presented and further analysed by means of logistic regression analysis. Associations with limiting long-standing illness are examined by age, social class, material living standards and family roles. Contrary to expectations inequalities in health are more pronounced for both employed men and employed women in the Nordic countries than in Britain. For men in all 4 countries and for Finnish and Swedish women, age and social class are strongly associated with ill-health. For Norwegian women the evidence remains unclear. Employment participation among British women is lower than in the other 3 countries and in the examination of their ill-health a role framework complements the structural one: in addition to age and social class, marital status and parental status are associated with their ill-health.