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Agricultural insect pests (AIPs) are widely successful in adapting to natural and anthropogenic stressors, repeatedly overcoming population bottlenecks and acquiring resistance to intensive management practices. Although they have been largely overlooked in evolutionary studies, AIPs are ideal systems for understanding rapid adaptation under novel environmental conditions. Researchers have identified several genomic mechanisms that likely contribute to adaptive stress responses, including positive selection on de novo mutations, polygenic selection on standing allelic variation and phenotypic plasticity (e.g., hormesis). However, new theory suggests that stress itself may induce epigenetic modifications, which may confer heritable physiological changes (i.e., stress‐resistant phenotypes). In this perspective, we discuss how environmental stress from agricultural management generates the epigenetic and genetic modifications that are associated with rapid adaptation in AIPs. We summarise existing evidence for stress‐induced evolutionary processes in the context of insecticide resistance. Ultimately, we propose that studying AIPs offers new opportunities and resources for advancing our knowledge of stress‐induced evolution. [ABSTRACT FROM AUTHOR]

Objective: Critical components of the nasal endoscopic examination have not been definitively established for either the normal examination or for clinical disorders. This study aimed to identify concordance among rhinologists regarding the importance of examination findings for various nasal pathologies. Study Design: A consortium of 19 expert rhinologists across the United States was asked to rank the importance of findings on nasal endoscopy for 5 different sinonasal symptom presentations. Setting: An online questionnaire was distributed in July 2023. Methods: The questionnaire utilized JotForm® software and featured 5 cases with a set of 4 identical questions per case, each covering a common indication for nasal endoscopy. Rankings were synthesized into Normalized Attention Scores (NASs) and Weighted Normalized Attention Scores (W‐NASs) to represent the perceived importance of each feature, scaled from 0 to 1. Results: General concordance was found for examination findings on nasal endoscopy within each case. The perceived features of importance differed between cases based on clinical presentation. For instance, in evaluating postnasal drip, the middle meatus was selected as the most important structure to examine (NAS, 0.73), with mucus selected as the most important abnormal finding (W‐NAS, 0.66). The primary feature of interest for mucus was whether it was purulent or not (W‐NAS, 0.67). Similar analyses were performed for features in each case. Conclusion: The implicit framework existing among rhinologists may help standardize examinations and improve diagnostic accuracy, augment the instruction of trainees, and inform the development of artificially intelligent algorithms to enhance clinical decision‐making during nasal endoscopy. [ABSTRACT FROM AUTHOR]

Objectives: Bone resorption of more conventional vascularized bone grafts have been well described showing minimal resorption over time. Few studies have evaluated osseous union and bone resorption in scapula tip free flaps (STFF) in the reconstruction of mandibulectomy defects. We aimed to describe our series on STFF with respect to osseous union and bone resorption over time. Methods: Retrospective chart review of patients receiving STFF from January 2014–January 2017 (n = 25). A neuroradiologist analyzed follow‐up CT scans to assess (1) STFF complete, partial, or no osseous union with native mandible and (2) STFF volume change over time in a subset with multiple follow‐up scans (n = 18). Results: Twenty‐three of 25 patients (92%) showed complete or partial STFF osseous union with native mandible either distally or proximally. STFF volume change ranged from +4.8 to −54% (median −0.5%) over median follow‐up interval of 23 months. History of chemoradiation therapy, bisphophonate use, sex, age, or smoking history did not correlate with bone resorption. Conclusions: STFFs shows high rates of osseous union and limited bone resorption that is equivalent to, or less than, vascularized fibular and iliac crest flaps. Clinically, this translates into both optimal healing and functional and cosmetic outcomes, especially in the setting of prior therapies. Level of Evidence: 4 Laryngoscope, 133:2597–2602, 2023 [ABSTRACT FROM AUTHOR]

Objective: To evaluate the predictive ability of symptom self‐localization to distinguish obstructive eustachian tube dysfunction from non‐obstructive salpingitis. Methods: Adult (age ≥18 years) patients with a primary complaint of aural discomfort who underwent diagnostic nasal endoscopy and tympanometry at a tertiary academic center were enrolled. Symptoms were self‐localized by using a single finger on the affected side. All patients completed the 7‐item Eustachian Tube Dysfunction Questionnaire (ETDQ‐7) and underwent scoring of eustachian tube inflammation using the Endoscopic Evaluation of the Eustachian Tube (3ET) system. Results: Seventy‐three patients were included in the study. Symptoms were localized to the external auditory canal (EAC) in 28 (38.4%), to the infratemporal fossa (ITF) below the lobule in 37 (50.7%), and to the preauricular region in 8 (11.0%). Demographics and medical history were similar between groups. The EAC group had significantly more negative tympanometric peak pressure (TPP) (median, −92.0 daPa; IQR, 95.5) and higher 3ET scores. In contrast, the ITF group had normal TPP (median, −2.0 daPa; IQR, 7.0) and higher 3ET scores. The preauricular group was more likely to have temporomandibular joint or pterygoid muscle pain. ETDQ‐7 scores did not differ significantly between groups. Conclusion: Symptom localization is associated with specific objective findings in the evaluation of aural discomfort. Patients with pain localizing to the ITF are more likely to have findings of eustachian tube salpingitis without obstruction whereas patients with symptoms deep in the EAC are more likely to have findings consistent with obstructive eustachian tube dysfunction. Level of Evidence: 3 Laryngoscope, 133:1818–1823, 2023 [ABSTRACT FROM AUTHOR]

Background: Oral cavity reconstruction is very challenging anatomical subsite to reconstruct. Large defects often require free tissue reconstruction to provide the best chance of form and function. Additionally, free tissue reconstruction aids to prevent fistula formation. We aimed to determine outcomes of oral cavity defect reconstruction using scapular tip free flaps with a myogenous intraoral component. Methods: All patients with a mandibular or maxillary bony defect that included a disruption of the intraoral mucosa component between 07/1/14 and 07/31/17. Patients were reconstructed with a scapular tip free flap, which included a muscular component that was used to recreate the oral mucosa. The primary study outcomes were flap success rates, development of orocutaneous or oronasal fistula, rate of resuming oral diet as well as the occurrence of medical and surgical complications in the first month following surgery. The tested hypothesis was formulated before data collection began. Results: Twenty‐five patients were identified by the study criteria. There was one (4%) flap that failed, while orocutaneous fistula occurred in two patients (8%). Prior history of osteoradionecrosis was a statistically significant predictor of overall complication (p <.05). Conclusions: Intraoral myogenous reconstruction allows for re‐mucosalization of the oral cavity defect and is associated with high viability and low‐complication rates. In patients with amenable oral mucosal defects, a myogenous scapular tip free flap is a suitable reconstructive option. [ABSTRACT FROM AUTHOR]

A new forest biorefining model is emerging in which high‐value materials would be produced alongside a cellulosic sugar by‐product in facilities scaled to match fiber availability in northern forests. As these emerging biorefining technologies are being developed by private entities, the economics associated with them are little known. The goal of this study is to use publicly available information to carry out an initial techno‐economic assessment for two emerging biorefining technologies: one that produces sugar and hydrolysis lignin (H‐lignin) from thermomechanical pulping (TMP) and another that produces sugar, lignosulfonate, and nanocellulose. The break‐even price for H‐lignin and nanocellulose is estimated for the respective technology and a credit is applied for cellulosic sugar and other co‐product sales based on current market value. It was found that the minimum product selling price (MPSP) for H‐lignin was within the range of high purity lignin but not enough is known about the properties of H‐lignin to determine if this is a reasonable value for prospective end uses. The estimated MPSP of nanocellulose was found to be considerably lower than for more conventional nanocellulose‐producing methods that use Kraft or dissolving pulp as a starting point. The nanocellulose produced through the second process modeled has different properties than conventional nanocellulose, which need to be further explored. Having a sense of the cost to produce these novel materials will help to direct research on viable end uses. The methodology presented, using only publicly available information, can also be replicated for other emerging technologies. © 2021 Society of Chemical Industry and John Wiley & Sons, Ltd [ABSTRACT FROM AUTHOR]

Objective: To describe the level of knowledge of human papillomavirus (HPV) and HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) among the general population and health care providers.Data Sources: Systematic search was performed on December 20, 2018, using MEDLINE (1966 to December 2018), EMBASE (1975 to December 2018), Web of Science (1900 to December 2018), and CENTRAL (1996 to December 2018) databases. English-language literature involving human subjects was used, and studies were limited to case series, case-control, cohort, and randomized controlled trial designs.Review Methods: Studies were included if they assessed knowledge of HPV and HPV-associated OPSCC. The primary outcome measure was the knowledge of HPV-associated OPSCC among the general population and with health care providers. Meta-analysis of proportions was attempted using random-effects model. The PRISMA guidelines were used for accuracy of reporting.Results: Thirty-two studies were included with 17,288 participants. There was a high degree of heterogeneity preventing completion of a meta-analysis. Knowledge of HPV and HPV-associated OPSCC varied between the general population and health care providers. The proportion of the general population and health care providers with knowledge of HPV ranged from 16% to 75% and 21% to 84%, respectively. Knowledge of HPV-associated OPSCC was greater in health care providers and ranged from 22% to 100% compared with the general population, which ranged from 7% to 57%.Conclusion: There is a knowledge gap of HPV-associated OPSCC for both the general population and health care providers. Additional education may not only increase awareness but may also result in prevention and earlier detection. [ABSTRACT FROM AUTHOR]

Objective: Rhinitis medicamentosa (RM) is a common condition resulting from overuse of topical nasal decongestants. Despite the prevalence in otolaryngologic practice, a clear treatment protocol has not been established. Our objective was to review the current published literature pertaining to the treatment of RM with the possibility of finding data that support one treatment over another.Data Sources: PubMed, Embase, Cochrane, and Web of Science databases were examined for patients diagnosed with RM resulting from chronic use of topical nasal decongestants.Review Methods: The PRISMA standard (Preferred Reporting Items for Systematic Reviews and Meta-analyses) was utilized to identify English-language studies reporting treatment of patients with the primary diagnosis of RM after chronic use of a topical decongestant. Outcome measures of interest included patient-reported symptom relief and objective parameters. MINORS criteria (methodological index for nonrandomized studies) were used to assess the quality of articles.Results: A total of 350 articles were identified, 9 of which met final inclusion criteria for qualitative analysis. Outcomes defined in each publication were highly varied and relied on several unstandardized measures. The most commonly reported treatment option was topical nasal steroids, although overall there was limited evidence on which to base treatment recommendation.Conclusions: There is not adequate evidence to develop a standardized treatment protocol for RM. The development of a uniform questionnaire, standard outcomes to be measured, and a method of assessing such outcomes is necessary. Prospective randomized controlled studies are warranted to determine the optimal treatment regimen following diagnosis of RM. [ABSTRACT FROM AUTHOR]

Abstract: In response to reported findings of infectious salmon anaemia virus (ISAV) in British Columbia (BC), Canada, in 2011, U.S. national, state and tribal fisheries managers and fish health specialists developed and implemented a collaborative ISAV surveillance plan for the Pacific Northwest region of the United States. Accordingly, over a 3‐1/2‐year period, 4,962 salmonids were sampled and successfully tested by real‐time reverse‐transcription PCR. The sample set included multiple tissues from free‐ranging Pacific salmonids from coastal regions of Alaska and Washington and farmed Atlantic salmon (Salmo salar L.) from Washington, all representing fish exposed to marine environments. The survey design targeted physiologically compromised or moribund animals more vulnerable to infection as well as species considered susceptible to ISAV. Samples were handled with a documented chain of custody and testing protocols, and criteria for interpretation of test results were defined in advance. All 4,962 completed tests were negative for ISAV RNA. Results of this surveillance effort provide sound evidence to support the absence of ISAV in represented populations of free‐ranging and marine‐farmed salmonids on the northwest coast of the United States. [ABSTRACT FROM AUTHOR]

Objective: Postoperative use of anticoagulation after free tissue transfer in head and neck ablative procedures is common practice, but a clear protocol has not been well established. The outcome measures including total flap failure, thrombosis, and hematoma formation for different anticoagulation regimens in free tissue transfer in the head and neck were reviewed.Data Sources: PubMed, Ovid, and Cochrane databases were examined for patients who underwent free tissue transfer following head and neck ablative procedures.Review Methods: Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were utilized to identify English-language studies reporting anticoagulation regimens following free tissue transfer in head and neck ablative procedures. Outcomes included total flap failure, thrombosis, and hematoma formation. Two independent reviewers assessed the quality of the articles by using the Methodological Index for Non-Randomized Studies.Results: A total of 368 articles were identified. An additional 36 articles were identified through screening of reference lists. Twenty-one of these studies met final inclusion criteria for qualitative analysis. Outcome data on total flap failure, thrombosis, and hematoma formation were extracted and analyzed for comparison against all anticoagulation regimens. Total flap failure, thrombosis, and hematoma formation rates were 4.4%, 4.5%, and 2.2%, respectively. Individual study rates ranged from 0.0% to 10.7%, 0.0% to 10.4%, and 0.6% to 7.2%, respectively.Conclusions: There is not adequate evidence to develop a standardized anticoagulation protocol for head and neck free flap procedures. Comparable flap complications were reported between all the employed anticoagulation methods studied, though significant variability in study design among articles existed. Prospective, randomized studies are warranted to determine the optimal postoperative anticoagulation regimen following free tissue transfer of the head and neck. Laryngoscope, 128:412-421, 2018. [ABSTRACT FROM AUTHOR]

Objective Angioedema is a potentially life-threatening complication of angiotensin-converting enzyme inhibitor (ACEI) use, occurring in up to 0.5% of users. Although the pathophysiology of ACEI-induced angioedema is attributable to elevated serum bradykinin, standard management typically includes corticosteroids and antihistamines. We sought to summarize the evidence supporting pharmacotherapy for ACEI-induced angioedema. Data Sources PubMed, MEDLINE, and Embase portals. Methods A systematic literature review was conducted according to the PRISMA guidelines. Databases were queried by 3 independent reviewers for English-language studies published between 1980 and 2017. The initial search screened for all occurrences of "angioedema" and then was further refined to include studies of ACEI-related cases and exclude hereditary angioedema. Results Five articles representing 218 cases were identified, including 3 randomized controlled trials and 2 prospective case series with historical controls. One of 2 studies of icatibant (bradykinin B2 receptor antagonist) found more rapid symptom improvement than that with a control group of corticosteroids and antihistamines. Two studies of ecallantide (plasma kallikrein inhibitor) and 1 study of C1 inhibitor replacement found no significant benefit over control. No studies were identified that compared the efficacy of corticosteroids with antihistamines, of one dose with another, of fresh frozen plasma, or of combination therapy. Conclusion The efficacy of treatment of ACEI-induced angioedema with bradykinin antagonists, kallikrein inhibitor, and C1 inhibitor warrants further study. Although consistent benefit of these medications has not been demonstrated, their use has not caused harm. One study examining off-label use of icatibant has demonstrated efficacy over control. In addition, further study is needed to establish the efficacy and mechanism of action of standard pharmacotherapy such as corticosteroids and antihistamines in treatment of this condition. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: Unlike lymphadenectomy at other sites, there is no discrete lymph node count defining an adequate neck dissection. The purpose of this study was to determine the minimum lymph node yield (LNY) of an elective level I-III neck dissection required to reliably capture any positive nodes present in these nodal basins.Study Design: Retrospective single-institution analysis.Methods: All patients with the diagnosis of head and neck squamous cell carcinoma who underwent elective level I-III neck dissection between 2004 and 2015 at our institution were analyzed. Preoperatively, patients had no clinical or radiographic evidence of lymphadenopathy. Patients with unknown number of lymph nodes on pathology report were excluded. Age, gender, race, history of radiation, tumor subsite, stage, surgeon, LNY, and number of positive nodes were recorded; bilateral neck dissections were reported separately.Results: One hundred eighteen level I-III neck dissections met criteria and were included in the study. Mean LNY was 21.15, and metastatic disease was present in 24.5% of cases, with 8.4% of cases being N2. The highest portion of positive lymph nodes was present in the group with 18 to 24 lymph nodes (36%), which was significantly higher than the group with <18 (14.89%) (P = .044).Conclusions: Although there is no accepted minimum for LNY in level I-III neck dissection, at least 18 nodes may be considered an adequate LNY. Such a yield reliably allows for capture of occult disease within these nodal basins.Level Of Evidence: 4. Laryngoscope, 127:2070-2073, 2017. [ABSTRACT FROM AUTHOR]

Intercropping is a farming practice involving two or more crop species, or genotypes, growing together and coexisting for a time. On the fringes of modern intensive agriculture, intercropping is important in many subsistence or low-input/resource-limited agricultural systems. By allowing genuine yield gains without increased inputs, or greater stability of yield with decreased inputs, intercropping could be one route to delivering 'sustainable intensification'. We discuss how recent knowledge from agronomy, plant physiology and ecology can be combined with the aim of improving intercropping systems. Recent advances in agronomy and plant physiology include better understanding of the mechanisms of interactions between crop genotypes and species - for example, enhanced resource availability through niche complementarity. Ecological advances include better understanding of the context-dependency of interactions, the mechanisms behind disease and pest avoidance, the links between above- and below-ground systems, and the role of microtopographic variation in coexistence. This improved understanding can guide approaches for improving intercropping systems, including breeding crops for intercropping. Although such advances can help to improve intercropping systems, we suggest that other topics also need addressing. These include better assessment of the wider benefits of intercropping in terms of multiple ecosystem services, collaboration with agricultural engineering, and more effective interdisciplinary research. [ABSTRACT FROM AUTHOR]

To penetrate soil, a root requires pressure both to expand the cavity it is to occupy, σn, and to overcome root-soil friction, σf. Difficulties in estimating these two pressures independently have limited our ability to estimate the coefficient of soil-root friction, μsr. We used a rotated penetrometer probe, of similar dimensions to a root, and for the first time entering the soil at a similar rate to a root tip, to estimate σn. Separately we measured root penetration resistance (PR) Qr. Root PR was between two to four times σn. We estimated that the coefficient of root-soil friction ( μsr) was 0.21-0.26, based on the geometry of the root tip. This is slightly larger than the 0.05-0.15 characteristic of boundary lubricants. Scanning electron microscopy showed that turgid border cells lined the root channel, supporting our hypothesis that the lubricant consisted of mucilage sandwiched between border cells and the surface of the root cap and epidermis. This cell-cell lubrication greatly decreased the friction that would otherwise be experienced had the surface of the root proper slid directly past unlubricated soil particles. Because root-soil friction can be a substantial component of root PR, successful manipulation of friction represents a promising opportunity for improving plant performance. [ABSTRACT FROM AUTHOR]

Background Despite epidemic numbers of obese and overweight pre-school children, professionals report a lack of confidence and self-efficacy in working with parents around lifestyle change. HENRY - Health Exercise Nutrition for the Really Young - trains health and community practitioners to work more sensitively and effectively with parents of babies and pre-school children around obesity and lifestyle concerns. Underpinned by the Family Partnership Model, reflective practice and solution-focused techniques, it offers face-to-face training and e-learning. This paper describes the development, pilot and evaluation of HENRY Sure Start Children's Centres. Methods Twelve Children's Centres in Oxfordshire took part in the pilot involving 137 staff. Questionnaires were administered at the end of training courses. Self-reported confidence ratings were obtained before and after training. Postal questionnaires were sent to Centre managers 2-6 months later to ascertain long-term effects. Nine managers participated in in-depth interviews. A further 535 learners completed the e-learning course and online feedback. Results One hundred and thirty-one staff (96%) completed the training course and valued it as a way of enhancing skills and knowledge. Mean (±SD) self-reported confidence ratings increased (4.1 ± 0.7 to 7.2 ± 0.7; P < 0.00001). An influence on personal as well as professional lives was apparent. Long-term follow-up indicated ongoing impact attributed to HENRY on both Centres and staff. All 535 e-learners successfully completed: 98% would recommend HENRY; 94% thought it enhanced their skills as well as knowledge. Conclusions HENRY is an innovative approach that offers some promise in tackling obesity through training community and health practitioners to work more effectively with parents of very young children. It appears to have an effect on participants' personal lives as well as professional work. A large-scale long-term study would be required to ascertain if there is the desired impact on young children's lifestyles and risk of obesity. [ABSTRACT FROM AUTHOR]

Early detection of developmental problems improves outcomes for parents and children. Parents want to be involved in assessment and need high-quality, accurate, and reliable data on child development to help monitor progress and inform decisions on referral. The aim of this paper is to review which websites are readily accessible to parents on child development and to assess their quality. An internet search (on Google and Yahoo) was conducted using the search terms 'child development', 'parenting', and 'developmental milestones'. Criteria were agreed for evaluating web-based resources, adapted from and based on previously reported methods. Data were collected on site content, diagrams and layout, readability (Flesch Reading Ease Scale), design, navigability, overall design, and interactive features. Forty-four relevant websites were identified for further analysis: six government, three university, 15 health-care professional, four American Academy of Pediatrics, 10 by journalists, and six undisclosed. The best websites are presented, with justification for their choice. Overall, information available for parents about child development is accurate but much of it is incomplete, unclear, or difficult to access. There is a need to develop an easily accessible, clear, and authoritative resource for parents with illustrations. Focus groups are being held to inform this research further. [ABSTRACT FROM AUTHOR]

Pathogenesis of febrile seizures (FS), causing the most common of types of seizures in children, remains unknown. Genetic factors appear to play a pivotal role and FS can be inherited as a monogenic or genetically complex disorder. Several risks factors have been proposed but many of the previously reported genetic associations were not replicated. Non-coding polymorphisms in the myo-inositol monophosphatase 2 gene ( IMPA2) have been suggested as a susceptibility factor for FS in Japanese patients. It is unknown whether genetic variants in the same gene constitute a risk factor for FS in other ethnic groups because the frequency of FS is significantly higher in Japanese children than in Caucasian patients. We investigated the role of the IMPA2 gene in a cohort of 96 unrelated Caucasian subjects with a history of FS. We did not identify any significant differences in genotypes of cases and matched controls; no mutations or non-synonymous polymorphisms were detected in these individuals. Our data suggest that the genetic variants in the IMPA2 gene are not associated with a risk of FS in Caucasian patients and patients from various genetic groups are likely to have different genetic causes of FS. [ABSTRACT FROM AUTHOR]

Little information is available regarding the relationship of Caribbean bean landraces with the Andean and Mesoamerican gene pools of common bean (Phaseolus vulgaris L.) While small-seeded Meso-american black beans are prevalent in pads of the Caribbean, many of the regionally preferred red mottled and medium-to-large-seeded bean landraces found there are postulated to belong to the Andean gene pool. To test this hypothesis, we analyzed the morphological characteristics, phenological traits, phaseolin status, and random amplified polymorphic DNA (RAPD) banding patterns of 54 red mottled or large-seeded bean landraces and cultivars from the Caribbean (16 from the Dominican Republic, 14 from Haiti, 1 from Jamaica and 23 from Puerto Rico) compared with 11 Andean bean lines from other regions. To estimate phylogenetic relationships among the fines, distances were calculated and dendrograms constructed for morphological and/or phenological and molecular characteristics by the complete clustering method. The landraces were grouped into two clusters morphologically: one with Mesoamerican characteristics, which included all the red mottled lines from Haiti and three landraces from the Dominican Republic collected near the Haitian border and the other with Andean characteristics, which included all the lines from Puerto Rico and the remaining lines from the Dominican Republic. RAPD and phaseolin polymorphisms identified three groups, one corresponding to the genotypes with Mesoamerican morphologies, one to those with Andean morphologies, and another that had Andean phenotypes but proximity to the Mesoamerican group, suggesting possible introgression between the gene pools. Phaseolin variability agreed with other molecular and morphological data allowing the assignment of genotypes to a Mesoamerican or Andean gene pool. Knowledge of this variability may provide useful information concerning the potential value of Caribbean landraces to Andean bean breeding programs. [ABSTRACT FROM AUTHOR]

To assess the feasibility of implementing the Child Health Assessment at School Entry (CHASE) questionnaire, developed to capture the multiple dimensions of the health of children in their first year at school, and to evaluate data quality, reliability and validity.Parents of 278 year-1 children, from 10 primary schools in two London boroughs, received a parent questionnaire and school nurses completed a separate questionnaire from health and education records for children whose parents consented. Additional data on free school meal eligibility and ethnicity were obtained from the two Local Education Authorities. The parent questionnaire included the Strengths and Difficulties Questionnaire (SDQ) and four dimensions of the Child Health Questionnaire Parent Form-28 (CHQ-PF28).Response rate was 61%. The association between school free school meals eligibility and response rate in each school approached significance (r = –0.62,P = 0.05). Data completeness of the parent questionnaire was high (mean 98%). Data completeness of the school nurse questionnaire was more variable (mean 82%). Cronbach's Alpha was greater than 0.6 for four of the five SDQ scales and greater than 0.7 for the two CHQ-PF28 multi-item scales. Relative to parents with qualifications, parents with no qualifications rated their children as having significantly more conduct problems, peer problems, and overall mental health problems (P < 0.01) as assessed by the SDQ, and significantly lower global health (P < 0.01) as assessed by the CHQ-PF28. Children with special educational needs and children with long-standing illness or disability were rated as having significantly lower global health (P < 0.05) than children without these. Sample tables of inter-school and inter-borough comparison of key findings demonstrate considerable differences in physical and mental health status.The questionnaire was acceptable to parents and school nurses, and feasible to implement within existing school resources. Initial tests of internal reliability and validity are satisfactory. These data have the potential to inform interventions and service provision at school and borough level, and public health trends over time. [ABSTRACT FROM AUTHOR]

To develop a multiprofessional consensus about the relative contributions of the components of children's health and well-being and to develop a questionnaire that can be used to assess these in London's children.Semi-structured interviews with health, education and social services professionals were used to identify areas to include in the questionnaire. These ideas were used as the basis for a wider Delphi consultation, with 79 experts in the area of child health. Round 1 of the Delphi asked panellists to rate 54 items as to whether they should be included in the questionnaire or not. Responses were divided into four categories: item to be included measurement method agreed, item to be included measurement method not agreed, no consensus, or excluded. In round 2, consensus was sought for the categories where there was none following round 1.Themes identified by the interviews were: economic factors, ethnicity, environment, nutrition, hygiene and physical activity, growth, suffers from chronic/serious illness, development, disability and learning, accidents and hospital attendances, self-regulation, psychological well-being, significant life events. After Delphi round 1, items included, where quality measurement method was agreed, were: deprivation index (from postcode), child's ethnicity, temporary accommodation, care status, registered with general practitioner, dental visits, height, weight, special educational needs status, baseline educational assessment result, immunization status, visual and hearing function. Following round 2, items relating to chronic illness, mental health, physical functioning, general health, self-esteem, family cohesion and accident status were agreed for inclusion with a measurement method also agreed. The questionnaire was acceptable to parents.The validity, reliability and feasibility of this questionnaire must now be examined. This data set, if collected across London, would substantially increase the public health data available and allow trends in health to be monitored. [ABSTRACT FROM AUTHOR]

In the UK, a national personal child health record (PCHR) with local adaptations is in widespread use. Previous studies report that parents find the PCHR useful and that health visitors use it more than other health professionals. This study was carried out in Nottingham, where the local PCHR is similar to the national PCHR. To explore variation in use of the PCHR made by mothers with differing social characteristics, to compare heath visitors’ and general practitioners’ (GPs’) use of the PCHR, and to compare health visitors’ and GPs’ perceptions of the PCHR with those of mothers for whose children they provide care. Questionnaires to 534 parents registered with 28 general practices and interviews with a health visitor and GP at each practice. A score per mother for perceived usefulness of the PCHR was developed from the questionnaire, and variation in the score was investigated by linear regression adjusted for clustering. Four hundred and one (75%) questionnaires were returned. Three hundred and twenty-five (82%) mothers thought the PCHR was very good or good. Higher scores for usage of the PCHR were significantly associated with teenage and first-time mothers, but no association was found with mother's social class, education or being a single parent. There was no association between variation in the score and practice, health visitor or GP characteristics. Mothers, health visitors and GPs reported that mothers took the PCHR to baby clinic more frequently than when seeing their GP, and that health visitors wrote in the PCHR more frequently than GPs. Eighteen (67%) health visitors and 20 (71%) GPs said they had difficulty recording information in the PCHR. The PCHR is used by most mothers and is important for providing health promotion material to all families with young children. It may be particularly useful for first-time and teenage mothers. [ABSTRACT FROM AUTHOR]

Abstract Objective To develop a framework for measuring the quality of preschool child health surveillance acceptable to primary health care teams and measurable at individual primary health care team level. Design Published research evidence was identified and criteria developed by a local multidisciplinary expert group. The criteria were discussed with primary health care teams. How well they were achieved was assessed. Setting Twenty-eight general practices in one health authority area. Methods Data collection included observation of baby clinics, interviews with health visitors and general practitioners (GPs), questionnaires to parents, collation of child health surveillance reviews recorded in personal child health records and immunization rates. Results The criteria for assessing preschool child health surveillance were thought to be acceptable and achievable by primary health care teams. Fifteen of the 22 criteria used to assess baby clinics were met by over 90% of practices. Almost all practices completed child health surveillance reviews within a standard time and achieved 90% coverage for primary immunizations. At many practices, less than 90% of parents felt welcome at the baby clinic, usually had enough time to talk to their health visitor or had the purpose or results of the 6 to 8 week child health surveillance review explained to them. GPs were less likely than health visitors to discuss health promotion at child health surveillance reviews (χ2 11.52, P = 0.0007). Few practices had a call-up and recall system for all reviews. Conclusion The framework that we developed for assessing preschool child health surveillance was acceptable and achievable by primary health care teams. [ABSTRACT FROM AUTHOR]

AIMS: This paper discusses whether there should be universal or selective provision of health visiting services. The aim is to show the central relevance of the work of the late epidemiologist, Geoffery Rose, to arguments advocating the retention of a universal health visiting service. BACKGROUND: In the United Kingdom (UK), health visiting moved, in the early years of the twentieth century, from being focused on the needs of poor families to becoming a universally provided service. Recent debates about the future of British health visiting have again raised the issue of whether health visiting remains a universal service, or should be targeted only on the most needy. STRUCTURE: Following an exposition of Rose's work, two kinds of problems with which health visitors are concerned, depression and child abuse, are used to illustrate the ways in which Rose's approach can be applied to health visiting. CENTRAL THESIS: Rose argued that the bulk of problems in society arise in the many who are not at especially high risk, rather than in the few who are at high risk. This is because of a very large number of people who are not at especially high risk. Consequently, following Rose, this paper argues that in relation to such problems as depression or child abuse, to target health visiting services only on those at high risk would be to leave untouched a vast burden of health and social problems. In the context of identifying people who are at greatest risk, Rose argued that no screening instrument can ever be sufficiently precise to accurately identify those most likely to suffer problems. In corroboration of Rose's argument, this paper illustrates the pitfalls of health visitors' attempts to screen for families at greatest risk through the use of such instruments as checklists of risk factors. CONCLUSIONS: It is concluded that it is neither possible to screen accurately for those at greatest risk, nor desirable to target services only on those at greatest risk. Therefore, it is advocated that health visiting should remain a universal service. However, it is recognized that within a universally provided service, some clients will require a greater intensity of input than others. In assessing the need for services, it is argued that the professional judgements of health visitors are crucial. [ABSTRACT FROM AUTHOR]

In this paper we argue that evidence-based practice, which is being introduced throughout the British National Health Service to make decisions about the allocation of limited resources, provides a welcome opportunity for health visitors to demonstrate their efficacy, skills and professionalism. However, the paper argues that to view health visiting as evidence-based is not to reduce health visiting merely to a technology through which scientific solutions are applied to social problems. Rather, health visiting needs to be viewed as a political movement, based on a particular model of society, which shapes the goals which health visitors pursue and influences the strategies they adopt to achieve their goals. The paper describes various models of health visiting as a way of showing how the goals of health visiting are always framed within a particular set of assumptions and causal explanations. The paper then turns to look at the issue of evaluating health visiting services. It is argued that evaluation should properly take account of the models which shape health visitors' goals and intervention strategies, and in turn, health visitors need to be explicit about the theoretical frameworks underpinning their interventions. Finally, it is argued that health visitors' knowledge and understanding of a range of models of society enables them to move between the various models to choose the most appropriate and effective means of intervention. Hence it is concluded that the emphasis on evidence-based practice provides health visitors with a valuable opportunity to show that their unique, professional skills and understanding are the preconditions for effective intervention. [ABSTRACT FROM AUTHOR]

Increased leaf phosphorus (P) concentration improved the water-use efficiency (WUE) and draught tolerance of regularly defoliated white clover plants by decreasing the rate of daily transpiration per unit leaf area in dry soil. Night transpiration was around 17% of the total daily transpiration. The improved control of transpiration in the high-P plants was associated with an increased individual leaf area and WUE that apparently resulted from net photosynthetic assimilation rate being reduced less than the reductions in the transpiration (27% vas 58%). On the other hand, greater, transpiration from low-P plants was associated with poor stomatal control of transpirational loss of water, less ABA in the leaves when exposed to dry soil, and thicker and smaller leaf size compared with high-P leaves. The leaf P concentration was positively related with leaf ABA, and negatively with transpiration rates, under dry conditions (P <0.001). However, leaf ABA was not closely related to the transpiration rate, suggesting that leaf P concentration has a greater influence than ABA on the transpiration rates. [ABSTRACT FROM AUTHOR]

Ten cases of uni- or bilateral restrictive ventromedial strabismus in young dogs of different breeds are reported. Clinically, abnormalities were restricted to the extraocular muscles with sparing of the masticatory muscles and limb muscles. This was supported in some cases by imaging studies, electrophysiology, and immunocytochemical assay for antibodies against type 2M fibers. Histologically, there was variable lymphocytic plasmacytic mononuclear cell infiltration and fibrosis. This disorder is similar in many aspects to chronic masticatory myositis with focal myositis and subsequent fibrosis. Surgical correction may restore eye position and vision. [ABSTRACT FROM AUTHOR]

This article explores the commercialization of the rap music youth subculture. Rap music has moved from the inner cities into the mainstream of popular culture. Mass media advertisers have recognized the value of using rap to sell their products, even though they do not always have a thorough understanding of the subculture from which it came. Youth subculture have been often organized around music. For example, there was the punk rock subculture, which originated in England in the 1970s. Since about 1945, technological advances have played an important part in determining what type of popular music is recorded and promoted by the mass media. The criticism that rap has become too commercialized stems from a similar criticism that has often expressed about all types of popular music. To some, industrialization of music means a shift from active musical production to passive pop consumption, the decline of cultural traditions and community. Rap is possibly the commercial equivalent of what the Marxist writer Adorno called part-interchangeability or pseudo-individualization, two methods of capitalist production. Part-interchangeability is when mass-produced parts from one product line are used in another different product. Pseudo-individualization is when the same products are made to seem different by the use of individual gimmicks. Television advertising provides an excellent medium for examining the influence of rap on the mainstream audience.

Objectives To investigate the efficacy of an advanced transurethral thermotherapy (TUMT) device (T3, Urologix) using urodynamic analysis in addition to the standard evaluation protocol in patients with symptomatic benign prostatic hyperplasia (BPH). Patients and methods Fifty men with symptomatic BPH were assessed using the AUA symptom score, uroflowmetry and ultrasonography (to determine prostatic volume and residual urinary volume) before and 6 weeks, 3, 6 and 12 months after thermotherapy. TUMT was delivered using a focused microwave energy system for 1 h in each patient, treated on an out-patient basis. Video pressure flow studies with advanced urodynamic analysis were also performed before and 3 months after treatment. Results The mean AUA symptom score decreased by 63%, the mean peak flow rate increased by 64% and the post-void residual volume decreased by 30% 3 months after treatment; this improvement was maintained at one year after treatment. Advanced urodynamic analysis showed that 52% of the patients had a decreased severity of obstruction. Furthermore, the efficiency of detrusor contraction improved in 86% of the patients. The improvement in the symptom score, flow rate and residual urine was significantly better in patients with marginal obstruction than in patients with unequivocal obstruction. Conclusion Urodynamic analysis can predict the treatment outcome of TUMT and the results of thermotherapy are significantly better in patients with marginal prostatic bladder outflow obstruction. [ABSTRACT FROM AUTHOR]

This study explores the effects of consumer knowledge on respondents' evaluations of both known and unknown brands that include either a 2-year or a 20-year warranty. Both experts and nonexperts evaluated warranty as more important than brand name in their product quality decision. Warranty length was positively correlated with product quality perceptions for both known and unknown brands. With the unknown brand, nonexperts perceived significant improvement in product quality when the warranty length was increased from 2 to 20 years. For the known brand, nonexperts perceived little difference in quality for the two warranty lengths. Experts indicated no significant differences in perceived quality, given the four brand/warranty-length conditions. The results indicate that warranty length is most heavily weighted as a cue to product quality when consumers are not highly knowledgeable, and the brand name is not well known. ©1996 John Wiley & Sons, Inc. [ABSTRACT FROM AUTHOR]

ABSTRACT This paper examines the insurance industry for evidence of the inflation-caused wealth-transfer hypothesis originally formulated by Irving Fisher and John Keynes. Contrary to the prediction of this hypothesis, net creditors (mostly property-liability insurers) showed better performance during periods of positive unexpected inflation while net debtors (mostly life insurers) showed no significant effects from either positive or negative unexpected inflation. In summary, the statistical evidence for a wealth transfer due to unexpected inflation is absent for most insurers and, where it exists, it is contrary to that predicted by the Fisher-Keynes hypothesis. [ABSTRACT FROM AUTHOR]

This article discusses the need for university insurance instructor to teach problem solving techniques to students. The instructor will have to change some instructional activities in teaching problem solving in insurance courses. To successfully teach problem-solving, the explicit or, more likely, the implicit instructional objectives must be totally revised to reflect new behaviors, and mastery demonstrations consistent with the problem solving skill will be required. The students generally recognize the importance of problem solving skills and value the opportunity to hone them.

Rhabdomyosarcoma of the ear region has been considered uniformly lethal. In view of this, two cases of rhabdomyosarcoma of the ear region are presented. Each occurred within the first four years of life. The first case was one of a two-year-old male with rhabdomyosarcoma of the mastoid area invading the lateral portion of the dura. He was treated with radical neck dissection and wide local excision of the tumor, including resection of dura and grafting of the defect; he also received Velban, Vincristine, and Cytoxan. He is alive and free of disease 96 months after the initial diagnosis. The second case was one of a three and one half year old male who had alveolar rhabdomyosarcoma of the post-auricular region of the right ear. This was treated with radical neck dissection, radical local excision and an 18-month course of Vincristine and Actinomycin D. This patient is alive and free of disease 25 months after the original diagnosis. It is encouraging that we have one long-term survivor and one survivor of over two years, from a disease previously considered as uniformly lethal. Awareness by the otologist of the presence of this tumor and attention to the child in the first decade of life presenting with an apparent suppurative ear disease with unusual lack of systemic systems, particularly when associated with a facial nerve paralysis, will lead to earlier diagnosis and more vigorous treatment. Perhaps more of these children can be salvaged with the combination of early diagnosis, radical surgical removal and chemotherapy. [ABSTRACT FROM AUTHOR]

The article describes two red-mottled common bean germplasm lines, the PR9745-232 and RMC-3, with resistance to bean golden yellow mosaic virus (BGYMV). PR9745-232 is derived from the double-cross Indeterminate Jamaica Red, a pink-striped landrace with a Type III growth habit and heat tolerance. On the other hand, PR9180-25C is a red-mottled breeding line selected for heat tolerance and resistance to common bacterial blight. On a one-to-nine disease rating scale in which one is resistant and nine is highly susceptible, PR9745-232 had an average BGYMV score of one in the Dominican Republic in 1998, 1999 and 2000, and in Haiti in 1999.

Within-year changes in parameters of the single-porosity van Genuchten model and the dual-porosity bi-exponential model for water retention characteristics were determined for a shallow Entisol in farmland and forestland. Tension infiltration data showed that soil macropores were the main contributing pores to fast drainage under both land uses in the rainy summer. For regions with shallow soils underlain by fractured parent rocks, it is important to understand the characteristics of soil water retention and hydraulic conductivity. This knowledge could support the development of strategies to manage water for crops. A farmland and a forestland with thin Entisols, located in hilly central Sichuan on the Yangtze River's upper reaches, were chosen as experimental fields. A variety of parameters related to hydraulically effective macroporosity (pore radius >125 µm), the single-porosity van Genuchten model, and the dual-porosity bi-exponential (BE) model for water retention characteristics were determined. Tension infiltration data showed that soil macropores were the main pores (accounting for 87.9-99.7%) contributing to fast drainage at all tested soil depths under both land uses in the rainy summer, in spite of their very low percentage of the total porosity (0.61-3.06%). The available soil water content, determined as the drainable soil textural porosity using the bi-exponential model (ϑtxt-BE), was found to be very low (0.032-0.091 m³ m-3) and negatively (P < 0.05) related to the initial soil water content at the time of sampling, resulting in high vulnerability of the crops grown on the farmland to drought. Plowing operations and periodical drying appeared to be the two main factors controlling the within-year change in soil hydraulic properties. For agricultural soils showing a bimodal pore size distribution, the soil's capacity to hold crop-available water in textural pores, which may vary with the time of year, rather than the total soil water content should be analyzed to inform decisions on irrigation operations including required amounts. [ABSTRACT FROM AUTHOR]

Nutritionally enhanced beans (NEB) with more Fe and Zn than conventional beans (CB) and nutritionally enhanced maize (NEM) with more tryptophan and lysine than conventional maize (CM) were developed as part of a crop-biofortification strategy to improve human nutrition. Proxy measures were used to assess Fe and Zn bioavailability and protein digestibility of a bean recipe ( fríjol sancochado) and a maize–milk recipe ( mazamorra) prepared with enhanced or conventional crops in Colombia. Fe concentration was similar in the cooked NEB and CB and in NEM and CM ( P≥ 0.05); in vitro Fe dialyzability was similar in cooked NEB (9.52%) and CB (9.72%) and greater for NEM (37.01%) than CM (32.24%). Zn concentration was higher in the uncooked and cooked NEB than in the CB ( P < 0.05); phytate: Zn molar ratios were high in cooked NEB (36: 1) and CB (47: 1), suggesting low Zn bioavailability, and not different from each other ( P = 0.07). There were no differences in Zn concentration or phytate: Zn molar ratio in the maize recipes. Nitrogen, tryptophan, and lysine concentrations were higher in the cooked NEM than CM; nitrogen was higher in the cooked NEB than CB ( P < 0.05). In vitro protein digestibility was comparable (82% to 83%) for NEM and CM and higher for NEB (84%) than for CB (82%). The higher nutrient concentrations + similar bioavailability (protein in NEM, Zn in NEB), same nutrient concentrations + higher bioavailability (Fe in NEM) or higher nutrient concentrations + higher bioavailability (protein in NEB) can translate into more nutrients absorbed and utilized by the body. [ABSTRACT FROM AUTHOR]

The objectives of this study were to quantify the prevalence of vitamin D insufficiency and deficiency in pregnancy, explore associated risk factors and discuss the public health implications. The study used retrospective analysis of randomly selected data. This is the first report on serum vitamin D levels in an unselected multi-ethnic population of pregnant women collected between April 2008 and March 2009. Women with sufficient stored serum were randomly selected from among all women who delivered between April 2008 and March 2009. Serum vitamin D levels were determined using liquid chromatography coupled to tandem mass spectrometry. Vitamin D levels were analysed with respect to ethnicity (marking skin tone), calendar quartile, body mass index (BMI), trimester and parity. Deficiency was defined as <25 nmol L(-1) , insufficiency 25-75 nmol L(-1) and adequacy >75 nmol L(-1) . Three hundred and forty-six women were included and represented the total population regarding skin tone, quartile, BMI, gestation and parity. Overall, 18% [95% confidence interval (CI): 15-23%] of sample women had adequate vitamin D levels; 36% were deficient, 45% insufficient. Among women with dark skin, only 8% (95% CI: 5-12%) had adequate levels compared with 43% (95% CI: 33-53%) of those with light skin. Obese women were found have significantly lower vitamin D levels than non-obese women. Vitamin D deficiency and insufficiency are prevalent year-round among pregnant women in North West London, especially those with darker skin. Existing supplementation guidelines should be supported; however, other measures are required to improve status among all women., (© 2012 Blackwell Publishing Ltd.)

Sex-biased dispersal (SBD) is common in many vertebrates, including primates. However, dispersal patterns in New World primates may vary among closely related taxa or populations in different local environments. Here, we test for SBD in an endangered New World primate, the Central American Squirrel Monkey (Saimiri oerstedii citrinellus). Previous studies of behavioral ecology suggest predominantly female dispersal in S.o. oerstedii in the Southern Pacific region of Costa Rica. However, our genetic data do not support strongly female-biased dispersal in S.o. citrinellus in the Central Pacific region. Our tests for SBD using microsatellite data including comparisons of isolation-by-distance, AI(c) , and F(ST) values between males and females were not significant. Also, we found greater population genetic structure in mitochondrial markers than in microsatellite markers, indicative of predominantly male dispersal. We conclude that both sexes disperse in S.o. citrinellus, and that males probably disperse over longer distances. We discuss how spatial and temporal variation among local populations should be taken into account when studying dispersal patterns and especially sex bias., (© 2011 Wiley Periodicals, Inc.)

Childhood developmental assessment is an essential skill that medical students must attain during their education. The authors describe a new technique which is neither laborious nor time-consuming for both staff and students. Groups of 40 students were taught normal developmental examinations using a novel interactive approach during a lecture. The method proved successful in terms of student evaluation, cost effectiveness of medical teaching time and acceptability to the children used for the demonstration. Audio-visual equipment, available in most teaching centres, was used that was easily and cheaply installed for the purpose of the session.

1. The paraventricular hypothalamic nucleus (PVH) is a complex structure with both neuroendocrine and autonomic functions. It is a major source of vasopressin and the primary source of corticotropin-releasing factor. In addition, parvicellular PVH neurons have reciprocal connections with brainstem autonomic centres and directly innervate sympathetic preganglionic neurons. Evidence is reviewed which indicates that in conscious rats PVH activation increases blood pressure, heart rate, renal nerve activity and plasma renin activity. 2. In conscious rats, a non-hypotensive haemorrhage (13 mL/kg blood loss over 24 min) results in increased numbers of Fos-immunoreactive cell nuclei within both magnocellular and parvicellular PVH neurons, including the ventral medial parvicellular regions known to contain neuronal projections to brainstem autonomic centres and spinal cord sympathetic preganglionic neurons. 3. Cell-selective ibotenate lesions of the parvicellular PVH significantly blunt the corticosterone response but do not alter blood pressure, heart rate or plasma renin concentration response to non-hypotensive or hypotensive haemorrhage. This and earlier studies indicate that, while the PVH is necessary for the corticosterone response and contributes to increased vasopressin release during blood loss, it does not play an important role in the sympathetic nervous system and renin-angiotensin responses to hypovolaemia and hypotension. 4. There is evidence to indicate that the parvicellular PVH serves as a necessary relay for cardiovascular and renin responses to certain behavioural stressors. We propose that cardiovascular information relayed to parvicellular PVH autonomic regions may be used to modulate behavioural, rather than homeostatic, effects on haemodynamics and renin release.