Increasing uptake of influenza vaccine by pregnant women post H1N1 pandemic: a longitudinal study in Melbourne, Australia, 2010 to 2014

Background: A Melbourne (Australia) university affiliated, tertiary obstetric hospital provides lay and professional education about influenza vaccine in pregnancy annually each March, early in the local influenza season. Responding to a 2011 survey of new mothers' opinions, the hospital made influenza vaccine freely available in antenatal clinics from 2012. We wished to determine influenza vaccination uptake during pregnancy with these strategies 5 years after 2009 H1N1. Methods: Face to face interviews based on US Center for Disease Control and Prevention Pregnancy Risk Assessment Monitoring System with new mothers in postnatal wards each July, 2010 to 2014. We calculated recalled influenza vaccine uptake each year and assessed trends with chi square tests, and logistic regression. Results: We recorded 1086 interviews. Influenza vaccination during pregnancy increased by 6% per year (95% confidence interval 4 to 8%): from 29.6% in 2010 to 51.3% in 2014 (p < 0.001). Lack of discussion from maternity caregivers was a persistent reason for non-vaccination, recalled by 1 in 2 non-vaccinated women. Survey respondents preferred face to face consultations with doctors and midwives, internet and text messaging as information sources about influenza vaccination. Survey responses indicate messages about vaccine safety in pregnancy and infant benefits are increasingly being heeded. However, there was progressively lower awareness of maternal benefits of influenza vaccination, especially for women with risk factors for severe disease. Conclusions: We observed improving influenza vaccination during pregnancy. There is potential to integrate technology such as text message or internet with antenatal consultations to increase vaccination coverage further

Organizing the U.S. Health Care Delivery System for High Performance

Analyzes the fragmentation of the healthcare delivery system and makes policy recommendations -- including payment reform, regulatory changes, and infrastructure -- for creating mechanisms to coordinate care across providers and settings

Early modern Oxford bindings in twenty-first century markup

Purpose – The Bodleian Binders Book contains nearly 150 pages of seventeenth century library records, revealing information about the binders used by the library and the thousands of bindings they produced. The purpose of this paper is to explore a pilot project to survey and record bindings information contained in the Binders Book. Design/methodology/approach – A sample size of seven pages (91 works, 65 identifiable bindings) to develop a methodology for surveying and recording bindings listed in the manuscript. To create a successful product that would be useful to bindings researchers, it addressed questions of bindings terminology and the role of the library in the knowledge creation process within the context that text encoding is changing the landscape of library functions. Text encoding formats were examined, and a basic TEI (Text Encoding Initiative) transcription was produced. This facilitates tagging of names and titles and the display of transcriptions with text images. Findings – Encoding was found not only to make the manuscript content more accessible, but to allow for the construction of new knowledge: characteristic Oxford binding traits were revealed and bindings were matched to binders. Plans for added functionality were formed. Originality/value – This research presents a “big picture” analysis of Oxford bindings as a result of text encoding and the foundation for qualitative and statistical analysis. It exemplifies the benefits of interdisciplinary methods – in this case from Digital Humanities – to enhance access to and interpretation of specialist materials and the library's provenance record

Pulsed electromagnetic energy treatment offers no clinical benefit in reducing the pain of knee osteoarthritis: a systematic review

Background The rehabilitation of knee osteoarthritis often includes electrotherapeutic modalities as well as advice and exercise. One commonly used modality is pulsed electromagnetic field therapy (PEMF). PEMF uses electro magnetically generated fields to promote tissue repair and healing rates. Its equivocal benefit over placebo treatment has been previously suggested however recently a number of randomised controlled trials have been published that have allowed a systematic review to be conducted. Methods A systematic review of the literature from 1966 to 2005 was undertaken. Relevant computerised bibliographic databases were searched and papers reviewed independently by two reviewers for quality using validated criteria for assessment. The key outcomes of pain and functional disability were analysed with weighted and standardised mean differences being calculated. Results Five randomised controlled trials comparing PEMF with placebo were identified. The weighted mean differences of the five papers for improvement in pain and function, were small and their 95% confidence intervals included the null. Conclusion This systematic review provides further evidence that PEMF has little value in the management of knee osteoarthritis. There appears to be clear evidence for the recommendation that PEMF does not significantly reduce the pain of knee osteoarthritis

Blazar Optical Variability in the Palomar-QUEST Survey

We study the ensemble optical variability of 276 FSRQs and 86 BL Lacs in the Palomar-QUEST Survey with the goal of searching for common fluctuation properties, examining the range of behavior across the sample, and characterizing the appearance of blazars in such a survey so that future work can more easily identify such objects. The survey, which covers 15,000 square degrees multiple times over 3.5 years, allows for the first ensemble blazar study of this scale. Variability amplitude distributions are shown for the FSRQ and BL Lac samples for numerous time lags, and also studied through structure function analyses. Individual blazars show a wide range of variability amplitudes, timescales, and duty cycles. Of the best sampled objects, 35% are seen to vary by more than 0.4 magnitudes; for these, the fraction of measurements contributing to the high amplitude variability ranges constantly from about 5% to 80%. Blazar variability has some similarities to that of type I quasars but includes larger amplitude fluctuations on all timescales. FSRQ variability amplitudes are particularly similar to those of QSOs on timescales of several months, suggesting significant contributions from the accretion disk to the variable flux at these timescales. Optical variability amplitudes are correlated with the maximum apparent velocities of the radio jet for the subset of FSRQs with MOJAVE VLBA measurements, implying that the optically variable flux's strength is typically related to that of the radio emission. We also study CRATES radio-selected FSRQ candidates, which show similar variability characteristics to known FSRQs; this suggests a high purity for the CRATES sample.Comment: 29 pages, 12 figures. Accepted for publication in Ap

“The Incest Plot” in John Banville’s Ancient Light

Ancient Light (2012), o terceiro e (até hoje) livro final da série Alexander and Cass Cleave de John Banville é um texto no qual os personagens que morreram nos livros anteriores são reciclados e trazidos de volta, como papeis em um filme, interpretado por personagens cuja caracterização em si se confunde com os papeis que estão interpretando. A preocupação estabelecida de Banville com o retorno ao passado e o retrocesso do passado adquire uma dimensão intrigantemente excessiva neste romance. Ancient Light apresenta uma versão mais acentuada do que Neil Murphy chamou de “mundo intertextual banvilleano entrelaçado” (86). Este artigo analisará o romance usando as ideias de Stephanie Insley Hershinow sobre “o enredo incestuoso”. Ela chama esta estrutura de “modelo de autoencerramento tautológico - o abraço da mansidão, da repetição, até mesmo da redundância, sobre a mudança” (150). Afirmo que a própria infra-estrutura do romance é um “autoencerramento tautológico”. As características de “auto-samudez, repetição [e] redundância” são inescapáveis neste romance, e a “mudança” convencionalmente oferecida por terceiros livros em trilogias simplesmente não deve ser encontrada na terceira parcela incessantemente auto-referencial de Banville. Em sua discussão sobre o incesto como forma, Hershinow afirma que “destacar a forma é a única maneira de ver as formas que o incesto excede suas manifestações literais” (156). Ela ainda sugere que o incesto “é uma forma de o romance explorar a quantidade mínima de diferença necessária para que a narrativa continue a funcionar como tal, para experimentar o minimalismo da narrativa” (ibidem). A estrutura da trama, assim como uma interpretação mais literal do “incesto” será minada, dado que o desejo do narrador por sua filha morta Cass é a principal força animadora por trás da narrativa.Ancient Light (2012), the third and (to date) final book in the Alexander and Cass Cleave series by John Banville, is a text in which characters who died in the previous books are recycled and brought back as roles in a film, played by characters whose characterisation itself blurs with the roles they are playing. Banville’s established preoccupation with returning to the past and retracing old ground takes on an intriguingly excessive dimension in this novel. Ancient Light presents a heightened version of what Neil Murphy has referred to as an “interlocked intertextual Banvillean world” (86). This article will examine the book using Stephanie Insley Hershinow’s ideas around “the incest plot.” She calls this structure a “model of tautological self-enclosure – the embrace of self-sameness, repetition, even redundancy, over change” (150). My claim is that the novel’s very infrastructure is one of “tautological self-enclosure.” The features of “self-sameness, repetition [and] redundancy” are inescapable in this novel, and the “change” conventionally offered by third books in trilogies is simply not to be encountered in Banville’s relentlessly self-referential third instalment. In her discussion of incest as form, Hershinow contends that “highlighting form is the only way to see the ways that incest exceeds its literal manifestations” (156). She further suggests that incest “is a way for the novel to explore the minimal amount of difference required for narrative to continue to function as such, to experiment with narrative minimalism” (ibid.). The plot structure, as well as a more literal interpretation of ‘incest’ will be mined, given that the narrator’s desire for his dead daughter Cass is the primary animating force behind the narrative