A feasibility study of signed consent for the collection of patient identifiable information for a national paediatric clinical audit database

Objectives: To investigate the feasibility of obtaining signed consent for submission of patient identifiable data to a national clinical audit database and to identify factors influencing the consent process and its success. Design: Feasibility study. Setting: Seven paediatric intensive care units in England. Participants: Parents/guardians of patients, or patients aged 12-16 years old, approached consecutively over three months for signed consent for submission of patient identifiable data to the national clinical audit database the Paediatric Intensive Care Audit Network (PICANet). Main outcome measures: The numbers and proportions of admissions for which signed consent was given, refused, or not obtained (form not returned or form partially completed but not signed), by age, sex, level of deprivation, ethnicity (South Asian or not), paediatric index of mortality score, length of hospital stay (days in paediatric intensive care). Results: One unit did not start and one did not fully implement the protocol, so analysis excluded these two units. Consent was obtained for 182 of 422 admissions (43%) (range by unit 9% to 84%). Most (101/182; 55%) consents were taken by staff nurses. One refusal (0.2%) was received. Consent rates were significantly better for children who were more severely ill on admission and for hospital stays of six days or more, and significantly poorer for children aged 10-14 years. Long hospital stays and children aged 10-14 years remained significant in a stepwise regression model of the factors that were significant in the univariate model. Conclusion: Systematically obtaining individual signed consent for sharing patient identifiable information with an externally located clinical audit database is difficult. Obtaining such consent is unlikely to be successful unless additional resources are specifically allocated to training, staff time, and administrative support

Representations of sport in the revolutionary socialist press in Britain, 1988–2012

This paper considers how sport presents a dualism to those on the far left of the political spectrum. A long-standing, passionate debate has existed on the contradictory role played by sport, polarised between those who reject it as a bourgeois capitalist plague and those who argue for its reclamation and reformation. A case study is offered of a political party that has consistently used revolutionary Marxism as the basis for its activity and how this party, the largest in Britain, addresses sport in its publications. The study draws on empirical data to illustrate this debate by reporting findings from three socialist publications. When sport did feature it was often in relation to high profile sporting events with a critical tone adopted and typically focused on issues of commodification, exploitation and alienation of athletes and supporters. However, readers’ letters, printed in the same publications, revealed how this interpretation was not universally accepted, thus illustrating the contradictory nature of sport for those on the far left

Instantons and Monopoles in General Abelian Gauges

A relation between the total instanton number and the quantum-numbers of magnetic monopoles that arise in general Abelian gauges in SU(2) Yang-Mills theory is established. The instanton number is expressed as the sum of the `twists' of all monopoles, where the twist is related to a generalized Hopf invariant. The origin of a stronger relation between instantons and monopoles in the Polyakov gauge is discussed.Comment: 28 pages, 8 figures; comments added to put work into proper contex

The Economic Resource Receipt of New Mothers

U.S. federal policies do not provide a universal social safety net of economic support for women during pregnancy or the immediate postpartum period but assume that employment and/or marriage will protect families from poverty. Yet even mothers with considerable human and marital capital may experience disruptions in employment, earnings, and family socioeconomic status postbirth. We use the National Survey of Families and Households to examine the economic resources that mothers with children ages 2 and younger receive postbirth, including employment, spouses, extended family and social network support, and public assistance. Results show that many new mothers receive resources postbirth. Marriage or postbirth employment does not protect new mothers and their families from poverty, but education, race, and the receipt of economic supports from social networks do

Scaling analysis of the magnetic monopole mass and condensate in the pure U(1) lattice gauge theory

We observe the power law scaling behavior of the monopole mass and condensate in the pure compact U(1) gauge theory with the Villain action. In the Coulomb phase the monopole mass scales with the exponent \nu_m=0.49(4). In the confinement phase the behavior of the monopole condensate is described with remarkable accuracy by the exponent \beta_{exp}=0.197(3). Possible implications of these phenomena for a construction of a strongly coupled continuum U(1) gauge theory are discussed.Comment: Added references [1

A study to assess the prevalence of exercise-induced bronchoconstriction in inter-county hurling

Exercise-Induced Bronchoconstriction (EIB) is an acute, transient airway narrowing occurring after exercise which may impact athletic performance. Studies report 10% of the general population and up to 90% of asthmatics experience EIB. Ninety-two players from three elite hurling squads underwent a spirometric field-based provocation test with real-time heart rate monitoring and lactate measurements to ensure adequate exertion. Players with a new diagnosis of EIB and those with a negative field-test but with a previous label of EIB or asthma underwent further reversibility testing and if negative, methacholine challenge. Eight (8.7%) of players had EIB, with one further athlete having asthma with a negative field test. Interestingly, only three out of 12 players who had previously been physician-labelled with EIB or asthma had their diagnosis objectively confirmed. Our study highlights the role of objective testing in EIB

The Stratigraphy of Central and Western Butte and the Greenheugh Pediment Contact

The Greenheugh pediment at the base of Aeolis Mons (Mt. Sharp), which may truncate units in the Murray formation and is capped by a thin sandstone unit, appears to represent a major shift in climate history within Gale crater. The pediment appears to be an erosional remnant of potentially a much more extensive feature. Curiositys traverse through the southern extent of Glen Torridon (south of Vera Rubin ridge) has brought the rover in contact with several new stratigraphic units that lie beneath the pediment. These strata were visited at two outcrop-forming buttes (Central and Western butte- both remnants of the retreating pediment) south of an orbitally defined boundary marking the transition from the Fractured Clay-bearing Unit (fCU) and the fractured Intermediate Unit (fIU). Here we present preliminary interpretations of the stratigraphy within Central and Western buttes and propose the Western butte cap rocks do not match the pediment capping unit

Possible retardation effects of quark confinement on the meson spectrum

The reduced Bethe-Salpeter equation with scalar confinement and vector gluon exchange is applied to quark-antiquark bound states. The so called intrinsic flaw of Salpeter equation with static scalar confinement is investigated. The notorious problem of narrow level spacings is found to be remedied by taking into consideration the retardation effect of scalar confinement. Good fit for the mass spectrum of both heavy and light quarkomium states is then obtained.Comment: 14 pages in LaTex for

Correlates of Complete Childhood Vaccination in East African Countries.

Despite the benefits of childhood vaccinations, vaccination rates in low-income countries (LICs) vary widely. Increasing coverage of vaccines to 90% in the poorest countries over the next 10 years has been estimated to prevent 426 million cases of illness and avert nearly 6.4 million childhood deaths worldwide. Consequently, we sought to provide a comprehensive examination of contemporary vaccination patterns in East Africa and to identify common and country-specific barriers to complete childhood vaccination. Using data from the Demographic and Health Surveys (DHS) for Burundi, Ethiopia, Kenya, Rwanda, Tanzania, and Uganda, we looked at the prevalence of complete vaccination for polio, measles, Bacillus Calmette-Guérin (BCG) and DTwPHibHep (DTP) as recommended by the WHO among children ages 12 to 23 months. We conducted multivariable logistic regression within each country to estimate associations between complete vaccination status and health care access and sociodemographic variables using backwards stepwise regression. Vaccination varied significantly by country. In all countries, the majority of children received at least one dose of a WHO recommended vaccine; however, in Ethiopia, Tanzania, and Uganda less than 50% of children received a complete schedule of recommended vaccines. Being delivered in a public or private institution compared with being delivered at home was associated with increased odds of complete vaccination status. Sociodemographic covariates were not consistently associated with complete vaccination status across countries. Although no consistent set of predictors accounted for complete vaccination status, we observed differences based on region and the location of delivery. These differences point to the need to examine the historical, political, and economic context of each country in order to maximize vaccination coverage. Vaccination against these childhood diseases is a critical step towards reaching the Millennium Development Goal of reducing under-five mortality by two-thirds by 2015 and thus should be a global priority