Vitamin D3 content of cows' milk produced in Northern Ireland and its efficacy as a vehicle for vitamin D fortification: a UK model.

Cows' milk is a relatively poor source of vitamin D but figures listed in UK food composition tables may be outdated. Samples of milk were collected for 1-year and vitamin D3 concentrations analysed using HPLC. Milk consumption data were obtained from the National Diet and Nutrition Survey (Years 1-4). A theoretical model applied vitamin D3 fortifications of 1 µg, 1.5 µg and 2 µg/100g to simulate improvements in vitamin D intakes. Mean ± SD vitamin D3 in whole milk was 0.06 ± 0.02 µg/100g. No seasonal differences were apparent. Fortification of cows' milks with 1 µg, 1.5 µg and 2.0 µg/100g, theoretically increased median vitamin D intakes from 2.0 µg/day to 4.2 µg, 5.1 µg and 5.9 µg/day, respectively. Higher vitamin D3 in milk from this study than that currently in food composition tables, suggests further analysis is warranted. This model suggests vitamin D fortification of cows' milk is an effective strategy to help more of the population achieve recently revised RNIs for vitamin D.

A Different Perspective on Breast Implant Surface Texturization and Anaplastic Large Cell Lymphoma (ALCL).

Anaplastic large cell lymphoma (ALCL) is a rare form of lymphoma involving cells of the immune system. It is currently gaining interest because of an association between the development of ALCL and an increased risk in women who have had breast implant surgery. Although not confirmed, many theories exist as to the etiology of this association in women, and there is growing concern that ALCL is more prevalent in women with textured breast implants. In particular, the risk of developing ALCL appears to be related to increasing implant texturization or "surface roughness." This paper examines the current manner of defining and characterizing breast implant surface texture and challenges the appropriateness of applying this technology and linking it to ALCL. It is not a comprehensive review of the etiology of capsular contracture and ALCL, but it proposes an alternative perspective on surface texture measurements from that currently employed and its role in researching the etiology of ALCL. The authors hope that their article will provoke thought and reflection when considering the issues currently being highlighted with regard to texturing of breast implants.

Eight-Year Safety Data for Round and Anatomical Silicone Gel Breast Implants.

BACKGROUND: The safety and efficacy of all medical devices, including breast implants, is important and consistent performance is best shown by undertaking long-term clinical and vigilance studies. Local complications such as capsular contracture and rupture are risks often associated with breast implant surgery. OBJECTIVES: The authors investigate and evaluate the safety and performance of Eurosilicone's (Eurosilicone S.A.S, Apt Cedex, France) Cristalline Paragel breast implants at 8 years postimplantation. METHODS: In this prospective clinical study, 995 Eurosilicone textured cohesive Cristalline Paragel mammary implants were implanted in 526 women undergoing augmentation and reconstructive surgery at 17 centers across France. Complications were recorded at 3 months and annually thereafter for 8 years. Descriptive statistics were used and key complications were analysed using the Kaplan-Meier method. RESULTS: Capsular contracture was reported in 8.5% of implants across all cohorts through 8 years. The Kaplan-Meier risk of capsular contracture (Baker Grade III/IV) per implant was 8.4% in the primary augmentation cohort and 18.0% in the primary reconstruction cohort. Eight implant ruptures were identified by surgeon examination during this follow-up period. The Kaplan-Meier risk of rupture occurring within 8 years postimplantation, across all cohorts, was 1.4% per patient and 0.9% per implant. Actual implant removal rate (explantation/exchange) was 6.0% and 13.8% for primary augmentation and primary reconstruction, respectively. Actual rates of local complications including infection and seroma were low with risk rates of 0.6% and 0.2% by subject. CONCLUSIONS: This multicenter clinical study involving Eurosilicone's silicone gel breast implants in both round and shaped profiles demonstrates an excellent safety and efficacy profile through 8 years.

The In Vitro and In Vivo Effect of Carvacrol in Preventing Campylobacter Infection, Colonization and in Improving Productivity of Chicken Broilers.

The current trend in reducing the antibiotic usage in animal production imposes urgency in the identification of novel biocides. The essential oil carvacrol, for example, changes the morphology of the cell and acts against a variety of targets within the bacterial membranes and cytoplasm, and our in vitro results show that it reduces adhesion and invasion of chicken intestinal primary cells and also biofilm formation. A trial was conducted to evaluate the effects of dietary supplementation of carvacrol at four concentrations (0, 120, 200, and 300 mg/kg of diet) on the performance of Lactobacillus spp., Escherichia coli, Campylobacter spp., and broilers. Each of the four diets was fed to three replicates/trial of 50 chicks each from day 0 to 35. Our results show that carvacrol linearly decreased feed intake, feed conversion rates and increased body weight at all levels of supplementation. Plate count analysis showed that Campylobacter spp. was only detected at 35 days in the treatment groups compared with the control group where the colonization occurred at 21 days. The absence of Campylobacter spp. at 21 days in the treatment groups was associated with a significant increase in the relative abundance of Lactobacillus spp. Also, carvacrol was demonstrated to have a significant effect on E. coli numbers in the cecum of the treatment groups, at all supplementation levels. In conclusion, this study shows for the first time that at different concentrations, carvacrol can delay Campylobacter spp., colonization of chicken broilers, by inducing changes in gut microflora, and it demonstrates promise as an alternative to the use of antibiotics.

Assessment of the Multispecies Freshwater Biomonitor (MFB) in a marine context: the Green crab (Carcinus maenas) as an early warning indicator.

The Multispecies Freshwater Biomonitor is an online continuous biomonitor which utilises impedance conversion to quantitatively record behavioural responses of vertebrates and invertebrates to environmental change. Here, we extend the use of the MFB into the marine aquaculture environment using the Green crab (Carcinus maenas) as a biological monitor. As a ubiquitous and abundant species, C. maenas can be used in applications such as aquaculture and monitoring of diffuse and point source marine pollution. Four experiments were undertaken to establish: (1) if the electrical field generated by the apparatus had any effect on C. maenas; (2) if the behaviour of C. maenas was altered by the presence of ammonia; (3) if the behaviour of C. maenas was affected by the electrical field when ammonia was present and (4) if defined behaviours could be detected by the MFB. There was no significant effect of the current on C. maenas in the MFB. There was a significant difference in overall expression of behaviour in response to an increasing gradient of ammonia and activity of the chamber. Five behaviours, 'walking', 'climbing', 'leg stretch', 'cleaning' and 'inactivity' were detected by the MFB. C. maenas appears to be a suitable candidate for use in the MFB in a marine context. Further testing of the biomonitor and C. maenas is required using other toxicants to establish alarm thresholds that could be used in situ for water quality monitoring.

Impact of the COVID-19 pandemic on radiography practice: findings from a UK radiography workforce survey.

OBJECTIVES: Radiographers are key patient-facing healthcare professionals involved in many aspects of patient care. The working patterns and professional practice of the radiography workforce (RW) has been altered during the COVID-19 pandemic. This survey aimed to assess the impact of the pandemic on radiography practice in the United Kingdom (UK). METHODS: An online cross-sectional survey of the UK RW was performed (March 25th to April 26th, 2020). The survey sought information regarding 1. Demographics 2. Impact of the pandemic on professional practice 3. Infection prevention/control and 4. COVID-19 related stress. Data collected was analysed using the Statistical Package for Social Sciences (v.26). RESULTS: A total of 522 responses were received, comprising n = 412 (78.9%) diagnostic and n = 110 (21.1%) therapeutic RW categories from across the UK. 12.5% (65/522) of the respondents were redeployed. Redeployment did not appear to contribute (p = 0.31) to work-related stress. However, fear of contracting the infection and perceived inadequate personal protective equipment (PPE) were identified as key contributors to stress during the study period. Compared to the therapeutic RW, a significantly higher proportion of the diagnostic RW identified fear of being infected as a major stressor (166/412 (40.3%) vs 30/110 (27.3%), p = 0.01). CONCLUSION: This survey has demonstrated changes to clinical practice, in particular to working patterns, service delivery and infection prevention and control were key contributors to workplace-related stress during the pandemic. ADVANCES IN KNOWLEDGE: Timely and adequate staff training and availability of PPE as well as psychosocial support during future pandemics would enhance quality patient and staff safety.

Effects of robust vocabulary instruction and multicultural text on the development of word knowledge among African American children.

PURPOSE: To examine the effect of a systematic vocabulary instructional technique in African American 2nd-grade children with below average vocabulary skills. An additional goal was to examine the role of book type in the retention of novel vocabulary words. METHOD: Using an adapted alternating treatments design, storybooks were used as a source for contextualizing vocabulary words in the context of robust vocabulary training. Five children's productive definitions were used to assess developing word knowledge using a 4-stage continuum ranging from no knowledge to full concept knowledge. RESULTS: Superior word learning for instruction words in comparison with control words replicated across children provided evidence of behavior change that was attributable to robust vocabulary instruction. Gains in word learning were maintained 2 weeks following conclusion of the study. Use of storybooks that displayed sociocultural images and experiences that were similar to versus different from their own did not have a reliable effect on word learning among these African American children. CONCLUSIONS: The findings demonstrate the potential impact of robust vocabulary instruction for facilitating vocabulary development in children with below average vocabulary skills. Analysis of the results indicates that the use of the African American book was not a potent influence in facilitating retention of words.

Five-Year Retrospective Analysis of Eurosilicone's Silicone Gel-Filled Breast Implants.

BACKGROUND: Silicone breast implants have been widely used for breast augmentation and reconstruction. During this time, silicone breast implants have undergone several modifications to improve their safety, quality, and clinical performance. Complications such as reoperation, capsular contracture, and rupture are risks often associated with breast implants. OBJECTIVES: The authors conducted a retrospective study to analyze and report complication rates associated with Eurosilicone's (Eurosilicone S.A.S, Apt, Cedex, France) silicone gel-filled breast implants over a period of 5 years. METHODS: In this retrospective clinical study, 2151 women who underwent either breast augmentation or breast reconstruction with Eurosilicone breast implants were diagnosed. Data on early and late complications including implant removal (explantation/exchange), capsular contracture, and rupture were collected using questionnaires, completed by 39 surgeons across Italy. RESULTS: Of the 2151, only 60 patients (2.78%) required implant removal. Twenty-five patients experienced capsular contracture (Baker Grade III/IV), giving an actual rate of 1.2%. The actual rate of implant rupture confirmed by breast magnetic resonance images was 0.18% (4 implants). Six patients (0.27%) were diagnosed with breast cancer following breast augmentation, and local complications including hematoma (1 patient) and seroma (2 patients) were experienced. CONCLUSIONS: This retrospective clinical study involving Eurosilicone's round and anatomical textured silicone gel-filled mammary implants demonstrates an excellent safety profile through 5 years.Level of Evidence: 2.

Ten-Year Safety Data for Eurosilicone's Round and Anatomical Silicone Gel Breast Implants.

BACKGROUND: Although silicone breast implants have been available for over 60 years, their safety and efficacy continue to be assessed via long-term clinical and vigilance studies. Complications often associated with breast implant surgery include but are not limited to capsular contracture and rupture. OBJECTIVE: The authors investigate and evaluate the safety and performance of Eurosilicone's (Eurosilicone S.A.S, Apt Cedex, France) Cristalline Paragel breast implants at least 10 years postimplantation. METHODS: Nine hundred and ninety-five of Eurosilicone's textured mammary implants were implanted in 526 women undergoing primary (423 patients) and revision surgery (103 patients) at 17 centers throughout France. Complications were recorded at 3 months and annually thereafter for 10 years. Descriptive statistics were used and the Kaplan-Meier method was utilized to analyze key complications. RESULTS: Seventy-four women (98 implants) experienced capsular contracture across all cohorts. The Kaplan-Meier 10-year cumulative risk of capsular contracture (Baker Grade III/IV) per implant was 11.5% in the primary augmentation cohort and 25.2% in the primary reconstruction cohort. Sixteen implant ruptures were observed by surgeon examination giving a Kaplan-Meier risk of 3.8% per patient and 3.5% per implant. Surgical re-intervention (explantation/exchange) was reported 80 times resulting in a Kaplan-Meier cumulative risk of 13.3% and 31.6% for primary augmentation and primary reconstruction, respectively, per patient. Local complication rates including infection and seroma were low with risk rates of 0.6% and 0.2% by subject. CONCLUSIONS: This multicenter clinical study demonstrates the long-term safety and efficacy profile through 10 years for Eurosilicone round and anatomical silicone gel breast implants.

Increasing print awareness in preschoolers with language impairment using non-evocative print referencing.

PURPOSE: This study examined the extent to which using non-evocative, explicit referencing of print concepts during shared storybook reading in the context of language therapy facilitated print concept knowledge in children with language impairment. METHOD: Five children, ages 4 to 5 years, were provided scripted input on 20 print concepts during shared storybook reading that was incorporated into individualized 30-min language intervention sessions that were conducted in the children's classroom twice weekly. The children were not required to make any response to the input on print concepts, and the input was secondary to instruction in the language targets during the 10-min shared storybook reading activity. RESULTS: Using a single-subject, multiple probe design across subjects, results indicated that children's knowledge of print concepts improved markedly when the procedure was incorporated into shared storybook reading and that they continued to learn and maintain knowledge of print concepts with repeated input. CLINICAL IMPLICATIONS: These findings suggest that children with language impairment may benefit from simple non-evocative, explicit referencing strategies that can be easily incorporated into the context of storybook reading during language therapy, thus providing speech-language pathologists with an additional tool for facilitating children's literacy skills.

The need for technical literacy in doctoral education: a preliminary survey.

An electronic survey was sent to 1,026 rehabilitation sciences faculty members at higher education institutions around the nation to determine the relative importance faculty in the rehabilitation sciences placed on technical literacy skills in higher education. The survey contained a list of 55 technology and distance education skills in six broad areas: electronic searches and resources, computer productivity tools, Web-based instruction, teleconferencing, using technology to deliver instruction, and virtual mentoring. For each skill, respondents indicated the level of importance they attached to each skill as it relates to successful performance as a faculty member in the rehabilitation professions by selecting a number between 1 and 5, with 1 indicating that the skill is not at all important and 5 indicating that the skill is extremely important. The return rate of the survey was 17.6%. Although there was considerable variability for rated importance of skills within categories, results indicated that skills related to computer productivity and electronic searches were judged as most important to faculty success. Those skills related to newer technologies and skills related to troubleshooting were rated as least important. Discussion of these findings and implications for future research and doctoral instruction are presented.

The Use of Silgel STC-SE, a Topical Silicone Gel for the Treatment and Reduction of Hypertrophic and Keloid Scars.

BACKGROUND: A single-center study assessing the efficacy of Nagor's Silgel STC-SE silicone gel to reduce the appearance of hypertrophic and keloid scars. METHODS: A 16-week controlled study of 36 patients with hypertrophic or keloid scars. The subjects were divided between 2 cohorts: one assessing recently healed scars (<6 mo) and other assessing older scars (6 mo to 2 y). The efficacy of Silgel STC-SE on the scar was evaluated by skin hydration, skin moisture evaporation, skin elasticity, basic scar measurements, subjective patient questionnaire data, and image analysis. All subjects had data collected at baseline and weeks 1, 4, 8, 12, and 16. Photographs were taken for image analysis at baseline, week 8, and week 16. Statistical analysis was conducted on all data. RESULTS: Twenty-nine patients completed the study (27 presented with hypertrophic scars and 2 with keloid scars), and 90% reported a marked improvement in their scar appearance. Patient questionnaire data showed great satisfaction with the product. Image analysis showed visual improvement with a statistically significant reduction of the "red" color of scars. Overall, scar dimensions were significantly reduced. There was a significant decrease from baseline levels in average scar length. Skin elasticity, skin hydration, and skin moisture evaporation did not change significantly from baseline. CONCLUSIONS: The results of this study indicate that Silgel STC-SE is an effective treatment in reducing the appearance and red color of hypertrophic scars up to 2 years old. Further study is required to draw significant conclusion in regard to the treatment of keloid scars.

Multidrug-resistant tuberculosis: Treatment and outcomes of 93 patients.

BACKGROUND: Tuberculosis (TB) remains a leading cause of death worldwide and the emergence of multidrug-resistant TB (MDR TB) poses a threat to its control. There is scanty evidence regarding optimal management of MDR TB. The majority of Canadian cases of MDR TB are diagnosed in Ontario; most are managed by the Tuberculosis Service at West Park Healthcare Centre in Toronto. The authors reviewed 93 cases of MDR TB admitted from January 1, 2000 to December 31, 2011. RESULTS: Eighty-nine patients were foreign born. Fifty-six percent had a previous diagnosis of TB and most (70%) had only pulmonary involvement. Symptoms included productive cough, weight loss, fever and malaise. The average length of inpatient stay was 126 days. All patients had a peripherally inserted central catheter for the intensive treatment phase because medications were given intravenously. Treatment lasted for 24 months after bacteriologic conversion, and included a mean (± SD) of 5 ± 1 drugs. A successful outcome at the end of treatment was observed in 84% of patients. Bacteriological conversion was achieved in 98% of patients with initial positive sputum cultures; conversion occurred by four months in 91%. CONCLUSIONS: MDR TB can be controlled with the available anti-TB drugs.

The Coolidge Personality and Neuropsychological Inventory for Children (CPNI). Preliminary psychometric characteristics.

This study describes the preliminary psychometric characteristics of a new parent-as-respondent assessment tool, the Coolidge Personality and Neuropsychological Inventory for Children (CPNI). The CPNI contains 200 items answered on a 4-point Likert-type scale. The CPNI has a three-fold purpose: (a) to assess the 12 personality disorders according to the criteria on Axis II and Appendix B of the Diagnostic and Statistical Manual of Mental Disorders; (b) to assess neuropsychological dysfunction, including Attention-Deficit/Hyperactivity Disorder, Mild Neurocognitive Disorder, executive function deficits, and other related symptoms; and (c) to measure some Axis I diagnoses including Separation Anxiety Disorder, Oppositional Defiant Disorder, depression, and general anxiety, as well as other clinical syndromes. The scale reliabilities and test-retest reliabilities were moderate to high, and construct validity was good, which supports further research with the inventory.

Serving a diverse population: the role of speech-language pathology professional preparation programs.

A national survey of 228 program directors was conducted to determine how master's level professional preparation programs are meeting the challenge of preparing speech-language pathologists to provide quality services to an increasingly diverse population. A total of 91 respondents provided information regarding their programs' efforts to address diversity by increasing the diversity of speech-language pathology professionals, preparing students in research for diverse populations, and providing students with the didactic knowledge and clinical experience required to serve diverse populations. Results indicated that professional preparation programs continue to lag in their enrollment of minority students, but there are efforts actively to recruit and retain students from diverse groups. Much variation in preparation in research was found across programs. Graduate students are being presented with information concerning diversity issues, but clinical experiences vary greatly according to the geographic location of the preparation program and individual practicum placements. Implications of these findings for speech-language pathology preparation programs and other allied health programs are discussed.

Factors in recruitment and employment of allied health students: preliminary findings.

The efforts of a group of participants in the Coalition for Allied Health Leadership program to assess how and why allied health students became interested in their professions and students' plans for future employment are described. Results of a survey administered to 29 physical therapist assistant (PTA) and 54 communication disorders (CD) students revealed that most of the students first learned about their professions through personal experience. Almost half of the PTA students decided to pursue their career after working in another career, and most of the CD students made the decision during high school or in college. The most important factors in students' decisions to enter the professions were a desire to help others and the nature of the work. CD students preferred private practice, whereas the most desired employment setting for PTA students was an outpatient clinical facility. For both groups, the three most important factors influencing where they wish to live and work were job availability, access to medical care, and proximity to family and loved ones. Although half of the CD students hailed from small towns and rural areas, less than one third intended to work in these areas. Implications of survey findings are discussed.