Shallow-water spinal injuries--devastating but preventable.

BACKGROUND: Shallow-water diving injuries have devastating consequences for patients and their families, requiring intensive use of resources in both the acute and rehabilitative phases of injury. With the final clinical outcome often poor, the question is raised as to whether a target group can be identified for whom to implement a preventive programme. OBJECTIVE: To evaluate the demographics, clinical features and outcomes of shallow-water diving injuries in an acute spinal cord injury (ASCI) unit. MATERIALS AND METHODS: All patients admitted to the ASCI unit with diving-related injuries were entered into the study. Data regarding demographics, injury profile and subsequent management were collated. All case notes and X-rays were reviewed. Ethical approval was obtained. RESULTS: Forty-six patients were reviewed from 19 April 2003 to 8 February 2009. A steady annual increase in diving injuries was noted. A very specific patient profile was identified: 91% male incidence, average age 23 years, 37% admitted alcohol use, with a summer-time prevalence. Compression-flexion type injuries were most prevalent, with an orthopaedic level of C5 and neurological level of C4 being the most common injury sites. A third of diving injuries occurred in the sea, 20% in swimming pools, 20% in rivers, 11% in tidal pools and 4% in dams. CONCLUSION: A very specific patient profile was identified, and the severity of shallow-water diving injuries was confirmed. No current preventive programme exists except for a single television advertisement. These data will be used to motivate further educational and preventive programmes for reducing the incidence of diving-related injuries.

Development of an international spinal injury prevention module: application of the international classification of external cause of injury to spinal cord injury.

STUDY DESIGN: An end-user response survey and assessments of inter-rater reliability before and after training. OBJECTIVES: Evaluate the spinal cord injury (SCI) application of the international classification of external cause of injury (ICECI) in a mixed group of untrained and trained coders to assess agreement, refine coding and training methodology. SETTING: An interactive coding workshop for an international group of coders with varying previous training. METHODS: Evaluate content validity (qualitative survey) and inter-rater reliability (kappa estimate of agreement) of the ICECI in a variety of injury scenarios presented within a computerized data-entry and training module. The results of this evaluation are compared with an earlier published gold standard. RESULTS: The ICECI is a flexible data coding system that appears to work with reasonable content validity in the regions assessed with English-language coders. Training appeared to narrow the difference between the inexperienced and trained coders. This is reflected in a borderline tendency for lower kappa scores pre-training compared with an earlier examined group of expert coders (P=0.073) but no difference in kappa scores after training (P=0.67). Computer-based training on a face-to-face level with computerized data entry appears an effective tool for training coders to use the ICECI. CONCLUSIONS: This report shows that using electronic data-entry and training assistance, inexperienced coders using the SCI-ICECI computerized system quickly approach the levels of agreement of trained coders in related data systems. The content validity of the training data set is adequate but needs to include more cases representative for use in SCI.

Influence of Host Resistance and Insecticide Seed Treatments on Curly Top in Sugar Beets.

Curly top on sugar beets (Beta vulgaris) caused by Beet severe curly top virus or closely related species is a considerable problem in arid growing regions of the western United States. Two insecticide seed treatments, Poncho Beta (60 g a.i. clothianidin + 8 g a.i. beta-cyfluthrin/100,000 seed) and Gaucho (45 g a.i. imidacloprid/100,000 seed), and four sugar beet hybrids varying in curly top resistance were evaluated for their influence on the control of curly top in comparison with untreated checks. Plots were established at two locations in southern Idaho in 2005 and evaluated for curly top. Moderate to severe curly top due to natural inoculum and leafhopper infestations occurred at both locations. Untreated, the four hybrids performed as expected with the fewest curly top symptoms on PM21 and the most on Monohikari. Both insecticide treatments lowered curly top ratings compared with the untreated check, but Poncho Beta reduced symptoms more than Gaucho as the season progressed. Poncho Beta led to increased yield and estimated recoverable sugar across all hybrids at harvest, particularly on the more susceptible hybrids. When considering the yield parameters for only the most resistant hybrids individually, Poncho Beta did not always outperform Gaucho. Poncho Beta provided a level of control that would justify its application as a supplement to host resistance under Idaho conditions.

Spatial modelling of individual-level parasite counts using the negative binomial distribution.

We present a spatial model for the mean and correlation of highly dispersed count data, and apply it to individual-level counts of the nematode Wuchereria bancrofti, a parasite of humans which causes the disease lymphatic filariasis. Our model uses the negative binomial distribution, whose shape parameter is a convenient index of over-dispersion. Spatial association is quantified in terms of a characteristic length, which has an intuitive interpretation as the distance over which correlation decreases by half. Demographic surveillance and mapping enable us to include individual-level covariates such as age and sex. We discuss the distinctive features of our model and interpret the results in terms of the epidemiology of lymphatic filariasis and possible implications for control programmes.

[Participative management in nursing service]. / Deelnemende bestuur in 'n verpleegdiens.

The management style of the nursing service manager influences the facilitation of health, quality nursing care and quality work life of the nurses. No evidence of any research in this regard-within the context of nursing service-in South Africa could be found. The concept participative management, as well as the process (with applicable guidelines) therefore requires investigation. The purpose with this article is to isolate (identify and define) the central concepts pertaining to participative management in a nursing service, as well as the exploration and description of the process of participative management (with applicable guidelines). An exploratory, descriptive and qualitative research design was followed. Individual interviews with management experts were conducted. Content analysis of these interviews were done, as well as a literature control. A conceptual definition was formulated by inference of data, as well as the description of the process of participative management, with applicable guidelines. It is recommended that this definition be submitted to further refinement to form the foundation of a model for participative management in a nursing service. It will also be meaningful to research the costs and other implications related to participative management in a nursing service.

Mammalian pheromone studies, VII. Identification of thiazole derivatives in the preorbital gland secretions of the grey duiker, Sylvicapra grimmia, and the red duiker, Cephalophus natalensis.

2-Isobutyl-1,3-thiazole and its 4,5-dihydro derivative were identified in the preorbital gland secretions of the grey duiker, Sylvicapra grimmia, and the red duiker, Cephalophus natalensis, but are absent from the preorbital secretion of the blue duiker, C. monticola. These two compounds which are present in high, but varying concentrations in the secretions of male grey duikers, are present in low concentrations in the secretions of females. This seems to be the only consistent significant difference between the secretions of male and female grey duikers and together with the fact that only males mark out their territories, was construed as evidence in favour of these two compounds playing a significant role in the territorial behaviour of male grey duikers.

Cytokeratins in normal and malignant transitional epithelium. Maintenance of expression of urothelial differentiation features in transitional cell carcinomas and bladder carcinoma cell culture lines.

The pattern of cytokeratins expressed in normal urothelium has been compared with that of various forms of transitional cell carcinomas (TCCs; 21 cases) and cultured bladder carcinoma cell lines, using immunolocalization and gel electrophoretic techniques. In normal urothelium, all simple-epithelium-type cytokeratins (polypeptides 7, 8, 18, 19) were detected in all cell layers, whereas antibodies to cytokeratins typical for stratified epithelia reacted with certain basal cells only or, in the case of cytokeratin 13, with cells of the basal and intermediate layers. This pattern was essentially maintained in low-grade (G1, G1/2) TCCs but was remarkably modified in G2 TCCs. In G3 TCCs simple-epithelial cytokeratins were predominant whereas the amounts of component 13 were greatly reduced. Squamous metaplasia was accompanied generally by increased or new expression of some stratified-epithelial cytokeratins. The cytokeratin patterns of cell culture lines RT-112 and RT-4 resembled those of G1 and G2 TCCs, whereas cell line T-24 was comparable to G3 carcinomas. The cell line EJ showed a markedly different pattern. The results indicate that, in the cell layers of the urothelium, the synthesis of stratification-related cytokeratins such as component 13 is inversely oriented compared with that in other stratified epithelia where these proteins are suprabasally expressed, that TCCs retain certain intrinsic cytoskeletal features of urothelium, and that different TCCs can be distinguished by their cytokeratin patterns. The potential value of these observations in histopathologic and cytologic diagnoses is discussed.

Development of cell surface polarity in the epithelial Madin-Darby canine kidney (MDCK) cell line.

The development of surface polarity has been studied in the epithelial Madin-Darby canine kidney (MDCK) cell line by examining two basolateral markers: a monoclonal antibody against a 58-kd protein and [35S]methionine uptake. The surface distribution of these markers was followed after plating the cells on coverslips or nitrocellulose filters. In subconfluent monolayers the apical surface of many cells was stained with the anti-58-kd antibody. Clearing of the apical surface occurred first after confluency had been reached in cells grown on coverslips. Similarly, in cells grown on filters the basolateral 58-kd protein disappeared from the apical surface concomitantly with the development of a measurable electrical resistance over the cell monolayer. The uptake of [35S]methionine was measured from both sides of filter-grown cells and began to polarize early after seeding, reaching a value of greater than 98% basolateral in the fully polarized monolayer. These results emphasize that the development of surface polarity in MDCK cells is a gradual process, and that extensive cell-cell contacts seem to be required for complete surface polarization.

The attack phase of human complement: differentiation between membrane binding and complex formation by the detection of neoantigen expression in situ. A morphometric immunoferritin study.

C5-9 neoantigen was found by morphometric immunoferritin staining on the membrane of guinea pig erythrocytes lyzed by reactive lysis C5b6 or acid-activated C5 + C6 and C7, C8, and C9. Neoantigen first appeared at the C7 step, increasing with C8, and decreasing after the addition of C9. The incubation of E with C5-C8 or C5-C9 at 0 degrees C resulted in EC5-8 without neoantigen. Reincubation of these cells after washing at 37 degrees C for 5 min led to neoantigen expression. An energy-requiring step is postulated after binding of C5-C8 and needed for C9 binding and lysis.