Roadmap for a competency-based educational curriculum in epileptology: report of the Epilepsy Education Task Force of the International League Against Epilepsy

Teaching competency in the diagnosis and clinical management of epilepsy is of utmost importance for the ILAE. To achieve this mission, the Task Force for Epilepsy Education (EpiEd) developed a competency-based curriculum for epileptology, covering the spectrum of skills and knowledge for best medical practice. The curriculum encompasses seven domains, 42 competencies, and 124 learning objectives, divided into three levels: entry (Level 1), proficiency (Level 2), and advanced proficiency (Level 3). A survey of the currently existing ILAE-endorsed teaching activities identified a significant gap in education of basic knowledge of epileptology (Level 1). To bridge this gap, a web-based educational tool is being developed. A virtual campus will be constructed around the curriculum, integrating the various educational activities of the ILAE. This paper describes the development of the curriculum and future tasks necessary to achieve the educational goal of the ILAE

Results from the Scottish national HAI prevalence survey

A national point prevalence survey was undertaken over the period of one calendar year in Scotland from October 2005 to October 2006. The prevalence of healthcare-associated infection (HAI) was 9.5% in acute hospitals and 7.3% in non-acute hospitals. The highest prevalence of HAI in acute hospital inpatients was found in the following specialties: care of the elderly (11.9%), surgery (11.2%), medicine (9.6%) and orthopaedics (9.2%). The lowest prevalence was found in obstetrics (0.9%). The most common types of HAI in acute hospital inpatients were: urinary tract infections (17.9% of all HAI), surgical site infections (15.9%) and gastrointestinal infections (15.4%). In non-acute hospitals one in ten inpatients in two specialties (combined) medicine (11.4%) and care of the elderly (7.8%) was found to have HAI, and one in 20 inpatients in psychiatry (5.0%) had HAI. In non-acute hospital patients, urinary tract infections were frequent (28.1% of all HAI) and similarly skin and soft tissue infection (26.8% of all HAI). When combined, these two HAI types affected 4% of all the inpatients in non-acute hospitals. This is the first survey of its kind in Scotland and describes the burden of HAI at a national level

Small-Signal Refinement of Power System Static Load Modelling Techniques

Loads are often represented as a weighted combination of constant impedance (Z), current (I) and power (P) components, so called ZIP models, by various power systems network simulation tools. However, with the growing need to model nonlinear load types, such as LED lighting, ZIP models are increasingly rendered inadequate in fully representing the voltage dependency of power consumption traits. In this paper we propose the use of small-signal ZIP models, derived from a neural network model of appliance level consumption profiles, to enable better characterizations of voltage dependent load behavior. Direct and indirect approaches to small-signal ZIP model parameter estimation are presented, with the latter method shown to be the most robust to neural network approximation errors. The proposed methodology is demonstrated using both simulation and experimentally collected load data.</p

Understanding the scale and nature of outcome change in area-regeneration programmes: evidence from the New Deal for Communities Programme in England

The New Deal for Communities (NDC) Programme is one of the most intensive area-based initiatives (ABIs) launched in England. Between 1998 and 2010, 39 NDC Partnerships were charged with improving conditions in relation to six outcomes within deprived neighbourhoods, each accommodating around 9,800 people. Data point to only modest change, much of which reflected improving attitudes towards the area and the environment. There are problems in identifying positive people-based outcomes because relatively few individuals benefit from relevant initiatives. Few positive benefits leak out of NDC areas. Transformational change was always unlikely bearing in mind the limited nature of additional resources, and because only a minority of individuals directly engage with NDC projects. This evidence supports perspectives of ABIs rooted in 'local-managerialism'

Quantifying the relative importance of riverine and open-ocean nitrogen sources for hypoxia formation in the northern Gulf of Mexico

The Mississippi and Atchafalaya River System discharges large amounts of freshwater and nutrients into the northern Gulf of Mexico (NGoM). These lead to increased stratification and elevate primary production in the outflow region. Consequently, hypoxia (oxygen <62.5 mmol/m3), extending over an area of roughly 15,000 km2, forms every summer in bottom waters. High‐resolution models have significantly improved our understanding of the processes controlling hypoxia formation in the NGoM and have strongly implicated riverine nutrients as the dominant nutrient source. However, the relative importance of different nutrient sources (i.e., the Mississippi and Atchafalaya Rivers and offshore) has not been assessed before now. Here, we combine a high‐resolution model with an element tracing method to directly quantify the relative contributions of nitrogen from the two rivers and the open ocean to primary production and sediment oxygen consumption, which is the main oxygen sink contributing to hypoxia in the NGoM. Our results indicate that, averaged over 2001–2011, Mississippi and Atchafalaya nitrogen support 51 ± 9% and 33 ± 9% of summer sediment oxygen consumption, respectively, while open‐ocean nitrogen supports 16 ± 2%. The higher relative impact of Mississippi inputs results from longer transit times compared to those of Atchafalaya inputs. We also analyze the effect of riverine nitrogen load reductions and a larger diversion of discharge to the Atchafalaya River. These scenario simulations show that nutrient load reductions are most effective in mitigating hypoxia

A decrease of calcitonin serum concentrations less than 50 percent 30 minutes after thyroid surgery suggests incomplete C-cell tumor tissue removal

The prognosis of medullary thyroid carcinoma (MTC) depends on the completeness of the first surgical treatment. To date, it is not possible to predict whether the tumor has been completely removed after surgery. The aim of this study was to evaluate the reliability of an intraoperative calcitonin monitoring as a predictor of the final outcome after surgery in patients with MTC

Labour supply and skills demands in fashion retailing

If, as Adam Smith once famously suggested, Britain was a nation of shopkeepers then it is now a nation of shopworkers. Retail is now a significant part of the UK economy, accounting for £256 billion in sales and one-third of all consumer spending (Skillsmart, 2007). It is the largest private sector employer in the UK, employing 3m workers, or 1 in 10 of the working population. For future job creation in the UK economy retail is also similarly prominent and the sector is expected to create a further 250,000 jobs to 2014 (Skillsmart, 2007). The centrality of retail to economic success and job creation is apparent in other advanced economies. For example, within the US, retail sales is the occupation with the largest projected job growth in the period 2004-2014 (Gatta et al., 2009) and in Australia retail accounts for 1 in 6 workers (Buchanan et al., 2003). Within the UK these workers are employed in approximately 290,000 businesses, encompassing large and small organizations and also a number of sub-sectors. This variance suggests that retail should not be regarded as homogenous in its labour demands. Hart et al. (2007) note how skill requirements and the types of workers employed may differ across the sector. This chapter further opens up this point, providing an analysis of the labour supply and skills demands for the sub-sectors of clothing, footwear and leather goods, which are described by Skillsmart (2007: 48) as being 'significant categories in UK retailing'

How children eat may contribute to rising levels of obesity children's eating behaviours: An intergenerational study of family influences

The term ‘obesogenic environment’ is rapidly becoming part of common phraseology. However, the influence of the family and the home environment on children's eating behaviours is little understood. Research that explores the impact of this micro environment and intergenerational influences affecting children's eating behaviours is long overdue. A qualitative, grounded theory approach, incorporating focus groups and semi-structured interviews, was used to investigate the family environment and specifically, the food culture of different generations within families. What emerged was a substantive theory based on ‘ordering of eating’ that explains differences in eating behaviours within and between families. Whereas at one time family eating was highly ordered and structured, typified by the grandparent generation, nowadays family eating behaviours are more haphazard and less ordered, evidenced by the way the current generation of children eat. Most importantly, in families with an obese child eating is less ordered compared with those families with a normal weight child. Ordering of eating' is a unique concept to emerge. It shows that an understanding of the eating process is crucial to the development and improvement of interventions targeted at addressing childhood obesity within the family context

Screening for Gynecologic Conditions With Pelvic Examination US Preventive Services Task Force Recommendation Statement

IMPORTANCE Many conditions that can affect women\u27s health are often evaluated through pelvic examination. Although the pelvic examination is a common part of the physical examination, it is unclear whether performing screening pelvic examinations in asymptomatic women has a significant effect on disease morbidity and mortality. OBJECTIVE To issue a new US Preventive Services Task Force(USPSTF) recommendation on screening for gynecologic conditions with pelvic examination for conditions other than cervical cancer, gonorrhea, and chlamydia, for which the USPSTF has already made specific recommendations. EVIDENCE REVIEW The USPSTF reviewed the evidence on the accuracy, benefits, and potential harms of performing screening pelvic examinations in asymptomatic, nonpregnant adult women 18 years and older who are not at increased risk for any specific gynecologic condition. FINDINGS Overall, the USPSTF found inadequate evidence on screening pelvic examinations for the early detection and treatment of a range of gynecologic conditions in asymptomatic, nonpregnant adult women. CONCLUSIONS AND RECOMMENDATION The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of performing screening pelvic examinations in asymptomatic, nonpregnant adult women. (I statement) This statement does not apply to specific disorders for which the USPSTF already recommends screening (ie, screening for cervical cancer with a Papanicolaou smear, screening for gonorrhea and chlamydia)