Measurement of Change in the Knowledge and Attitude about Leprosy in Physiotherapy Students Undergoing Intensive One Week Training in Leprosy

Leprosy is a disease that causes not only physical problems, but also mental and social problems. In the post integration era, every health care professional needs to understand about leprosy, to be able to diagnose and treat them. Physiotherapy students, in their usual syllabus, have minimal exposure to leprosy, in spite of the fact that they have a major role in preventing impairments and disabilities caused by leprosy, as well as treating such impairments. In order to educate physiotherapy students on leprosy, a one-week intensive training course was organised. This study was done to assess if the intensive training to physiotherapy students resulted in increase in their knowledge on leprosy and change their attitude positively. A batch consisting of 42 physiotherapy students went through the one-week training programme. The improvement in knowledge and attitude were assessed through a pre-test and a post-test design. Results showed that there was significant improvement in knowledge (53.05%) and brought positive change in attitude (75.0%). Such training programmes are recommended for all physiotherapy students.

Persistent infection with neurotropic herpes viruses and cognitive impairment

BACKGROUND

Herpes virus infections can cause cognitive impairment during and after acute encephalitis. Although chronic, latent/persistent infection is considered to be relatively benign, some studies have documented cognitive impairment in exposed persons that is untraceable to encephalitis. These studies were conducted among schizophrenia (SZ) patients or older community dwellers, among whom it is difficult to control for the effects of co-morbid illness and medications. To determine whether the associations can be generalized to other groups, we examined a large sample of younger control individuals, SZ patients and their non-psychotic relatives (n=1852). Method Using multivariate models, cognitive performance was evaluated in relation to exposures to herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2) and cytomegalovirus (CMV), controlling for familial and diagnostic status and sociodemographic variables, including occupation and educational status. Composite cognitive measures were derived from nine cognitive domains using principal components of heritability (PCH). Exposure was indexed by antibodies to viral antigens.

RESULTS

PCH1, the most heritable component of cognitive performance, declines with exposure to CMV or HSV-1 regardless of case/relative/control group status (p = 1.09 × 10-5 and 0.01 respectively), with stronger association with exposure to multiple herpes viruses (β = -0.25, p = 7.28 × 10-10). There were no significant interactions between exposure and group status.

CONCLUSIONS

Latent/persistent herpes virus infections can be associated with cognitive impairments regardless of other health status.

Pertinence of tests used for conformity assessments of fire resistance of nuclear power plant components – opinion of several institutions in Europe

Fire resistance of structures, systems and components (SSC) is widely identified as a fundamental issue for fire risk assessment at nuclear power plants (NPP). It is currently supported by several national or international ambitious experimental programs. Fire risk assessment at NPPs is performed under a series of hypothesis, e.g. the fire load. A problem will arise if tests used for conformity assessment do not appropriately represent the hypothesis selected during the fire risk analysis. In this case, SSCs may possibly be not meeting the expectations related to their fire resistance capacity supposed by the fire risk analysis. Ways of tackling this issue involve a regulatory approach and adapted requirements for components. While the widespread regulatory approach consists in seeking enveloping scenarios and conservative assumptions, a better knowledge of SSCs behaviour under for NPPs typical situations may be also desirable. The Institute for Energy of the European Commission's Joint Research Centre (JRC) at Petten (NL) launched a questionnaire with the aim of gathering opinions of regulatory bodies and their technical support organisations and manufacturers in Europe on this topic. Major goal was to estimate the relevance of the issue according to the perception of the specialists. The present paper collects the answers given by seven entities (AREVA, GRS, iBMB, IRSN, SJUB, SUEZ-TRACTEBEL, and VTT) and makes suggestions for addressing the issues identified by the participants.

Type I reaction in leprosy--a histopathological analysis

Even though type 1 lepra reaction (TIR) is a commonly encountered clinical problem, its histology has not yet been clearly delineated. This study attempts to enumerate the most sensitive parameters for the histological diagnosis of TIR. Case records between March 2007 and September 2007 of patients with TIR were reviewed and the biopsies were evaluated by a pathologist blinded to the previous diagnoses. Twenty three patients were included in the study. The most sensitive parameters in our study were dermal edema, intra-granuloma edema and giant cell size. Though clinical findings should remain the mainstay of diagnosis of TIR, the above mentioned parameters should be evaluated in biopsies of leprosy to look for signs of reaction which might otherwise be missed.

Chemical and toxicological evaluation of transformation products during advanced oxidation processes

The entry of pharmaceuticals into the water cycle from sewage treatment plants is of growing concern because environmental effects are evident at trace levels. Ozonation, UV- and UV/H(2)O(2)-treatment were tested as an additional step in waste water treatment because they have been proven to be effective in eliminating aqueous organic contaminants. The pharmaceuticals carbamazepine, ciprofloxacin, diclofenac, metoprolol and sulfamethoxazole as well as the personal care products galaxolide and tonalide were investigated in terms of degradation efficiency and by-product formation in consideration of toxic effects. The substances were largely removed from treatment plant effluent by ozonation, UV- and UV/H(2)O(2)-treatment. Transformation products were detected in all tested treatment processes. Accompanying analysis showed no genotoxic, cytotoxic or estrogenic potential for the investigated compounds after oxidative treatment of real waste waters. The results indicate that by-product formation from ozonation and advanced oxidation processes does not have any negative environmental impact.

Affinity and its derivatives in the glass transition process

The thermodynamic treatment of the glass transition remains an issue of intense debate. When associated with the formalism of non-equilibrium thermodynamics, the lattice-hole theory of liquids can provide new insight in this direction, as has been shown by Schmelzer and Gutzow [J. Chem. Phys. 125, 184511 (2006)], by Möller et al. [J. Chem. Phys. 125, 094505 (2006)], and more recently by Tropin et al. [J. Non-Cryst. Solids 357, 1291 (2011); ibid. 357, 1303 (2011)]. Here, we employ a similar approach. We include pressure as an additional variable, in order to account for the freezing-in of structural degrees of freedom upon pressure increase. Second, we demonstrate that important terms concerning first order derivatives of the affinity-driving-force with respect to temperature and pressure have been previously neglected. We show that these are of crucial importance in the approach. Macroscopic non-equilibrium thermodynamics is used to enlighten these contributions in the derivation of C(p),κ(T), and α(p). The coefficients are calculated as a function of pressure and temperature following different theoretical protocols, revealing classical aspects of vitrification and structural recovery processes. Finally, we demonstrate that a simple minimalist model such as the lattice-hole theory of liquids, when being associated with rigorous use of macroscopic non-equilibrium thermodynamics, is able to account for the primary features of the glass transition phenomenology. Notwithstanding its simplicity and its limits, this approach can be used as a very pedagogical tool to provide a physical understanding on the underlying thermodynamics which governs the glass transition process.

Coherent backscattering of ultracold atoms

We report on the direct observation of coherent backscattering (CBS) of ultracold atoms in a quasi-two-dimensional configuration. Launching atoms with a well-defined momentum in a laser speckle disordered potential, we follow the progressive build up of the momentum scattering pattern, consisting of a ring associated with multiple elastic scattering, and the CBS peak in the backward direction. Monitoring the depletion of the initial momentum component and the formation of the angular ring profile allows us to determine microscopic transport quantities. We also study the time evolution of the CBS peak and find it in fair agreement with predictions, at long times as well as at short times. The observation of CBS can be considered a direct signature of coherence in quantum transport of particles in disordered media. It is responsible for the so called weak localization phenomenon, which is the precursor of Anderson localization.

Impact of migration on new case detection rates in leprosy in Gudiyatham Taluk, Tamil Nadu, India

Migration of persons affected by leprosy was hinted at as early as 1929 (Bhaskara Rao 1930). All new cases of leprosy in Isfahan Province (Iran) were found to be migrants (Asilian et al 2005). Chudasama (2007) suspected increase in leprosy cases in Surat district to migration. These suggest migration contributes to new cases. This study was done to find out 1. Extent of migration among new cases, 2. Characteristics of migrants, 3. Occupational pattern 4.Reasons for migration. 5. Place of origin of migrants 6. Assimilation of migrants into the society. Trained staff collected information regarding migration using special questionnaire from all 222 new untreated cases from the field area of Community Health department during 2004 to 2008. Migrants were 10.4%. Distribution of place of residence, age, gender, marital status, education, mode of detection, Ridley-Jopling and MB/PB classifications of migrants were not significantly different from that of nonmigrants. Grade 2 deformities were more among migrants. All migrants found occupation. Mostly men migrated for job and women for joining their husbands. The role of migration in increasing the number of new cases cannot be minimized. Enhanced efforts should be made to provide adequate medical, health and rehabilitation services for them also.

Highly sensitive thermal conductivity measurements of suspended membranes (SiN and diamond) using a 3ω-Völklein method

A suspended system for measuring the thermal properties of membranes is presented. The sensitive thermal measurement is based on the 3ω dynamic method coupled to a Völklein geometry. The device obtained using micro-machining processes allows the measurement of the in-plane thermal conductivity of a membrane with a sensitivity of less than 10 nW/K (+∕-5 × 10(-3) Wm(-1) K(-1) at room temperature) and a very high resolution (ΔK/K = 10(-3)). A transducer (heater/thermometer) centered on the membrane is used to create an oscillation of the heat flux and to measure the temperature oscillation at the third harmonic using a Wheatstone bridge set-up. Power as low as 0.1 nW has been measured at room temperature. The method has been applied to measure thermal properties of low stress silicon nitride and polycrystalline diamond membranes with thickness ranging from 100 nm to 400 nm. The thermal conductivity measured on the polycrystalline diamond membrane support a significant grain size effect on the thermal transport.

NRAS mutation status is an independent prognostic factor in metastatic melanoma

BACKGROUND

There is a need for improved prognostic markers in melanoma. In this study, the authors tested the prognostic significance and clinicopathologic correlations of v-raf murine sarcoma viral oncogene homolog B1 (BRAF) and neuroblastoma RAS viral (v-ras) oncogene homolog (NRAS) mutations in patients with metastatic melanoma.

METHODS

Clinical and pathologic data were collected retrospectively on melanoma patients who were clinically tested for BRAF (exon 15) and NRAS (exons 1 and 2) mutations at The University of Texas M. D. Anderson Cancer Center. Analyses were performed to identify significant associations of mutations with tumor and patient characteristics and with survival from the diagnosis of stage IV disease.

RESULTS

The genotypes of the full cohort (n = 677) were 47% BRAF mutation, 20% NRAS mutation, and 32% wild-type for BRAF and NRAS ("WT"). Tumor mutation status was associated (P = .008) with the risk of central nervous system involvement at the diagnosis of stage IV disease, with a higher prevalence observed in BRAF-mutant (24%) and NRAS-mutant (23%) patients than in WT patients (12%). Among patients with nonuveal melanoma who underwent mutation testing within 6 months of stage IV diagnosis (n = 313), patients with NRAS mutations had a median survival of 8.2 months from stage IV diagnosis, which was shorter than the median survival of WT patients (15.1 months; P = .004). Multivariate analysis of this population incorporating age, sex, metastases (M1) category, serum lactate dehydrogenase level, and mutation status confirmed that NRAS mutations are associated independently with decreased overall survival (vs WT; P = .005; hazard ratio, 2.05).

CONCLUSIONS

Patients with BRAF or NRAS mutations were more likely than WT patients to have central nervous system involvement at the time they were diagnosed with distant metastatic disease. NRAS mutation status was identified as an independent predictor of shorter survival after a diagnosis of stage IV melanoma.

Effects of environment and education on knowledge and attitude of nursing students towards leprosy

The objective of this cross-sectional comparative study was to find the effects of environment and education on knowledge and attitude of nursing students towards leprosy. Data were collected, using a pretested questionnaire, from the first year and third year students of a School of Nursing attached to a leprosy specialty hospital and also from a comparable School of Nursing attached to a general hospital. The results showed that trainees acquired more knowledge on leprosy during training in both schools of nursing. However, those trained in leprosy hospital environment had higher knowledge and attitude scores than those trained in general hospital environment. The attitude of the trainees attached to leprosy hospital was favourable even before they had formal training in leprosy. Those trained in the general hospital showed more favourable attitude after training compared to before training. School of Nursing attached to leprosy hospital provided an atmosphere conducive to learning and understanding more about leprosy. The trainees retained what was learnt because of regular association with patients affected by leprosy. For employment in hospital or community based services or research related to leprosy, nurses trained in a leprosy hospital would have added value of knowledge and attitude.

Recent trends in new case detection rates in leprosy by age and sex in Gudiyatham Taluk, Tamil Nadu, India

In the race towards eradication of leprosy, the emphasis has shifted from prevalence to new case detection rates which are proxyfor true incidence rates. There is great need for reliable data on new case detection rates over time, classified by age and sex. In this paper, the trend of age specific and sex specific new cases detection rates, from 2001 to 2009, for the field area of Schieffelin Institute of Health-Research and Leprosy Centre are presented and implications discussed. The appropriate age distribution of Census of India 2001 was used to estimate the age distribution of the area. Three year moving averages were computed for age specific rates. The age group 55+ had the highest rate among all age groups from 2002 to 2006 and afterwards declined a little. The rates of ages 15-34 and 35-54 were high and their patterns over 2002 to 2008 were the same. The specific rates of children (0-14) were declining generally through 2002 to 2008. The specific rates of males were slightly higher than the females all through 2001 to 2009 but the difference between male and female rates was not significant at anyyear (P > 0.05).

Long term sustainability and efficacy of self-care education on knowledge and practice of wound prevention and management among leprosy patients

In a chronic disease like leprosy, assessment of self-care education of long duration is necessary to find out its effectiveness and to bring out sustainability both in the point of view of the provider and of the recipient. Self-care education was imparted to patients for 8 years in the Katpadi Block as part of 'prevention of impairment and disability' programme from the year 2000 onwards. The patients were provided with knowledge regarding 'inspection' for pre-disposing factors of wound development and about external causes (trauma) or dangerous environments for wound development. Additionally, they were given practice on self-care techniques for prevention and management of wounds. Staff as part of their routine work has been doing this. An evaluation, done by independent assessor, compared the effect of this programme with a control area where no such programme was going on. This showed that the self-care education resulted in very high level of knowledge and practice compared to the control area, even up to 100% practice in some aspects. Self-care education is effective, can be sustained for a long time and also can be carried out as part of routine work.

1H NMR relaxation studies of protein-polysaccharide mixtures

NMR water proton relaxation was used to characterize the structure of plant proteins and plant protein-polysaccharide mixtures in aqueous solutions. The method is based on the mobility determination of the water molecules in the biopolymer environment in solutions through relaxation time measurements. Differences of conformation between pea globulin and alpha gliadin seem to control the water molecules mobility in their environment. As deduced from the study of complexes, the electrostatic interactions may also play a major role in the water molecule motions. The phase separation induced under specific conditions seems to promote the translational diffusion of structured water molecules whereas the rotational motion was more restricted.

Temperature of systems out of thermodynamic equilibrium

Two phenomenological approaches are currently used in the study of the vitreous state. One is based on the concept of fictive temperature introduced by Tool [J. Res. Natl. Bur. Stand. 34, 199 (1945)] and recently revisited by Nieuwenhuizen [Phys. Rev. Lett. 80, 5580 (1998)]. The other is based on the thermodynamics of irreversible processes initiated by De Donder at the beginning of the last century [L'Affinite (Gauthier-Villars, Paris, 1927)] and recently used by Moller et al. for a thorough study of the glass transition [J. Chem. Phys. 125, 094505 (2006)]. This latter approach leads to the possibility of describing the glass transition by means of the freezing-in of one or more order parameters connected to the internal structural degrees of freedom involved in the vitrification process. In this paper, the equivalence of the two preceding approaches is demonstrated, not only for glasses but in a very general way for any system undergoing an irreversible transformation. This equivalence allows the definition of an effective temperature for all systems departed from equilibrium generating a positive amount of entropy. In fact, the initial fictive temperature concept of Tool leads to the generalization of the notion of temperature for systems out of thermodynamic equilibrium, for which glasses are just particular cases.