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Background: High response rates for patient surveys are required in medical literature to ensure non-response bias is minimised. It is often difficult to achieve a satisfactory response rate as patient engagement in surveys is decreasing. A major barrier to phone surveys is getting patients to answer calls from unknown numbers. Purpose: To design a methodology which boosts response rates for telephone-based patient surveys. Research Design: We prospectively analysed the effectiveness of our methodology for increasing patient participation using caller ID and text messanging. Study Sample: Two waves totalling 1313 patients were contacted for participation in a patient survey for a descriptive quantitative and qualitative cohort study using our developed methadology. Data Analysis: We analysed the timepoints at which successful contact was made when using caller ID and text messanging. Results: We achieved a call answer rate of 85.4%, which was a 70.8% increase when compared to a similar patient cohort contacted via blocked caller ID (i.e. with privacy settings). Conclusion: We have developed a simple, inexpensive methodology which, when tested outside the Australian setting and for other projects, shows promise for increasing patient survey response rate.

This article presents the evidence base for ‘operator models’ – that is, how to deliver a sustainable service through the interaction of the ‘client’, ‘revenue collector’ and ‘operator’ functions – for municipal solid waste management in emerging and developing countries. The companion article addresses a selection of locally appropriate operator models. The evidence shows that no ‘standard’ operator model is effective in all developing countries and circumstances. Each city uses a mix of different operator models; 134 cases showed on average 2.5 models per city, each applying to different elements of municipal solid waste management – that is, street sweeping, primary collection, secondary collection, transfer, recycling, resource recovery and disposal or a combination. Operator models were analysed in detail for 28 case studies; the article summarises evidence across all elements and in more detail for waste collection. Operators fall into three main groups: The public sector, formal private sector, and micro-service providers including micro-, community-based and informal enterprises. Micro-service providers emerge as a common group; they are effective in expanding primary collection service coverage into poor- or peri-urban neighbourhoods and in delivering recycling. Both public and private sector operators can deliver effective services in the appropriate situation; what matters more is a strong client organisation responsible for municipal solid waste management within the municipality, with stable political and financial backing and capacity to manage service delivery. Revenue collection is also integral to operator models: Generally the municipality pays the operator from direct charges and/or indirect taxes, rather than the operator collecting fees directly from the service user.

The feasibility of commercial-scale composting of waste biomass from the control of invasive Acacia species was investigated. Pile temperatures exceeded 65ºC for several months, indicating that the composting process was effective at pathogen inactivation and seed destruction. Mineralisation of Acacia biomass was described by a two-component, first-order exponential model; the pool sizes for labile and recalcitrant organic matter (OM) were similar and in the approximate ranges: 360–410 g kg-1 and 350–390 g kg-1 of initial OM, respectively. Concentrations of conservative nutrients increased proportionally to OM mineralisation, enriching the compost as an agricultural nutrient source. Nitrogen concentrations also increased, but were more dynamic as nitrogen losses were difficult to control, although we suggest that they may be potentially minimised by restricting the turning frequency. The physicochemical characteristics of the stabilised end-product, and the high OM content and low electrical conductivity (-1), in particular, were suitable for soil improvement or as substrate components.

Background Tubulointerstitial nephritis (TIN) is typically seen in association with drug exposure and infection or in autoimmune diseases such as Sjogren's syndrome or systemic lupus erythematosis. The recently described IgG4-related systemic diseases can affect many organ systems including the kidney and typically respond to corticosteroid treatment. Case We present a case of IgG4-related TIN in a patient with concomitant chronic lymphocytic leukemia. To our knowledge, IgG4-related TIN has not been associated with any hematological disorder such as chronic lymphocytic leukemia. Conclusion We propose that all kidney biopsies with significant plasma cell infiltrate should be stained for IgG4 as response to treatment is common.

Background Sudden cardiac arrest (SCA) is the single most common cause of death in ESRD, and it is implicated in over 50% of all cardiac deaths in hemodialysis patients. The prognosis for survival following an in-hemodialysis clinic arrest is dismal, with one series reporting a 32% 30-day survival rate and a 15% 1-year survival rate. The purpose of this study was to identify factors that predict survival following an in-clinic arrest in the outpatient hemodialysis population. Methods All patients who suffered in-center SCA in the Gambro Healthcare System in the US from 2002-2005 were identified. Baseline demographic and clinical characteristics at the time of the event were compared between patients who did and patients who did not survive for 6 months after the event. Univariate and multivariate models were constructed to identify predictors of survival. Results 789 patients who suffered from in-clinic SCA were identified; 124 patients (16%) survived 30 days and 85 patients (11%) survived 180 days. Univariable predictors of survival included younger age (62.6 yrs vs 68.6 yrs, p = .0001), female gender (60% vs 53%, p = .02), longer dialysis vintage (4.7 vs 3.3 yrs, p Conclusions This study verifies the abysmal outcome of SCA in a large, nationally representative, and contemporary cohort of hemodialysis patients. This analysis also suggests novel risk associations of advanced age and use of catheter-based dialysis access with outcome. However, few traditional cardiovascular risk factors are associated with survival from SCA. Future studies should focus on prevention or modification of nontraditional risk factors to improve outcomes from SCA.

Medical students at four regional medical schools were administered a questionnaire regarding drug, alcohol, and tobacco use, and involvement in sensation-seeking sports and activities. Results of the study indicated that tobacco use was minimal, drug use was moderately low, and alcohol use was extensive. Increased alcohol use was strongly correlated with heavy drinking patterns in parents and male students while decreased drinking was strongly correlated with frequent religious attendance patterns. Students actively using drugs were more likely to have heavy drinking parents and to attend church infrequently. Protestant students and black students were least likely to be involved in drug use. Drug, alcohol, and tobacco use were significantly correlated. Those who use drugs tend to be heavy drinkers and smokers. Preventive education programs can utilize the results in medical school to inform students of potential problem areas based on sociodemographic influences.