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Methadone maintenance is currently the predominant form of opioid substitution treatment available in the Republic of Ireland. Prescribing decisions currently involve urine testing for drug use. Urine testing may involve provision of a supervised sample in some circumstances, despite recommendations made in 2010 to abandon this practice. This project aims to evaluate the accuracy and acceptability of oral fluid testing for patients on methadone maintenance and also gather patient views on their treatment. Patients attending for methadone maintenance at 4 general practices were invited to take part in this study, which involved taking an additional oral fluid test and a questionnaire. Fifty-five patients agreed to participate. Fifty-two (95%) found the oral fluid test acceptable, and almost two-thirds would prefer to see it used instead of urine testing. Oral fluid provided similar results to urine testing for all drugs except benzodiazepines. Self-report identified cocaine and opiate use not detected by oral fluid or urine testing. This study presents evidence that oral fluid testing is acceptable to most patients. While oral fluid testing was inferior to urine testing for benzodiazepines, it may have an adjunctive role to play in methadone maintenance provision. Patients reported more negative than positive aspects of methadone maintenance.

The objective of this systematic review is to extract and study evidences available toassess the effectiveness of low level laser therapy (LLLT) on acceleration of Orthodontic tooth movement. The data sources used were electronic data bases including EMBASE, PubMed, Scopus and Google Scholar. References from collectedarticles were hand searched. Search was not bound with any time limits. Randomized control and clinical trials were also included. Search terms included were orthodontic movement speed/accelerated tooth movement/ LLLT/ Cold-soft diode laser/ Ga-Al-As laser/ low intensity laser/ light therapy/ phototherapy/ photobiostimulation. Only those studies which falls in the moderate to high category on assessment with Cericato et al. method for bias assessment were included. Double extractors did the data collection and at the time of controversies a blinded expert were approached for final decision. Nine studies seemed to be eligible for this study. An energy input of 4.2-8J sq.cm, wavelength of 780-904 nm applied for 80-100 sec/tooth within a time period of 4-6 days per month was found to be effective in demonstrating accelerated orthodontic tooth movement. Some scientific evidence for low level laser therapy causing accelerated orthodontic tooth movement was demonstrated. Those high evidence studies which came up with laser having no benefits on tooth movement explained their pit falls in the discussion, giving reason why they failed to observe any benefit in tooth movement.

The application of three-dimensional computational fluid dynamics in twin-screw compressors provides an outstanding opportunity for developers to gain an understanding of the complex internal flow phenomena occurring within the machine. Equipped with this knowledge, design parameters, such as clearances and port geometry, can be optimised, to enhance performance. However, as with all modelling, be it numerical or analytical, a high degree of certainty in the accuracy of the results is necessary. This paper presents the results of a study of oil-free twin screw compressor in which the results of two modelling techniques are compared. The modelling techniques used are an analytical non-dimensional thermodynamic chamber model and a numerical computational fluid dynamic model. The paper presents an overview of an oil-free twin screw compressor machine, before describing important operating characteristics and the modelling techniques used. To validate, both models are compared against historical test data, this validation indicated the chamber model is more accurate. Following this, the focus will be on the comparison of key performance indicators, including, volume flow rate, volumetric efficiency, indicated power, and discharge temperature at varying duty points. The paper concludes that the difference between both models decreases as the compressor operating speed increases, although the level of variance is dependent on pressure ratio.

As more patients come directly to critical care units after surgery, nurses need to know about anesthesia and its complications. This article reviews commonly used anesthetics, their adverse effects, and nursing management of complications.

Clupeiform fish species, including the Gulf menhaden (Brevoortia patronus) that belong to the subfamily Alosinae, can detect ultrasound. Clupeiform fishes are unique in that they have specialized gas-filled bullae in the head associated with the ear via the bulla membrane and with the lateral line via the lateral recess membrane. It has been hypothesized that the utricle of the inner ear is responsible for ultrasound detection through a specialized connection to the gas-filled bullae complex. Here, we show that the lateral line and its connection to the gas-filled bullae complex via the lateral recess are involved in ultrasound detection in Gulf menhaden. Removal of a small portion of the lateral line overlying the lateral recess membrane eliminates the ability of Gulf menhaden to detect ultrasound. We further show that the gas-filled bullae vibrates in response to ultrasound, that the gas-filled bullae are necessary for detecting ultrasound, and that the bullae connections to the lateral line via the lateral recess membrane play an important role in ultrasound detection. These results add a new dimension to the role of the lateral line and bullae as part of the ultrasonic detection system in Gulf menhaden

Most fish cannot hear frequencies above 3 kHz, but a few species belonging to the subfamily Alosinae (family Clupeidae) can detect intense ultrasound. The response of adult specimens of the European allis shad (Alosa alosa) to sinusoidal ultrasonic pulses at 70 and 120 kHz is tested. The fish showed an intensity-graded response to the ultrasonic pulses with a response threshold between 161 and 167 dB re 1 µPa (pp) for both frequencies. These response thresholds are similar to thresholds derived from juvenile American shad (Alosa sapidissima) in previous studies, supporting the suggestion that these members of Alosinae have evolved a dedicated ultrasound detector adapted to detect and respond to approaching echolocating toothed whales.

Transurethral resection of the prostate (TURP) for benign prostatic hypertrophy is a common surgical procedure in the United States. Left untreated, benign prostatic hypertrophy can lead to detrimental consequences such as renal failure from urinary obstruction. Although TURP is a common procedure, it is not without risk. Complications can occur, and the perianesthesia nurse must be familiar with them and their treatment. Complications related to the surgical procedure and the anesthesia technique must be assessed and treated quickly to prevent morbidity and mortality in these patients. The perianesthesia nurse is instrumental in managing and preventing complications associated with transurethral resection of the prostate.

Background Trauma while travelling as a passenger in a motor vehicle is a leading cause of mortality and hospitalisation for children in New Zealand. Serious trauma is often the result of poorly fitting or incorrectly used child restraints. Aims/Objectives/Purpose The purpose of the study was to gather new information about what Starship families know about the safe use of child car restraints, what they practice and what opportunities exist for promoting child restraint use within the clinical setting. Methods All 200 families within five wards were provided with a short, structured interview. Questions asked about usual child car restraint use, the trip to hospital and plans for the trip home. Convenience sampling was used and the sample population was compared with the total population. Results/Outcome Most families of children younger than five attending Starship understand and are compliant with the current New Zealand Road Rule; however there is a marked drop in child restraint use after children reach five, with over half (58.8%) of families unaware of best practice recommendations to keep children in car restraints until they reach 148 cm in height. Once families were offered information about best practice they were shocked they had not been doing the best for their child. Significance/Contribution to the Field There is an opportunity for Starship to improve child restraint practice. Many families would benefit from support both with access to child restraints and with the provision of best practice information while they are attending the hospital with their child. It has become a common practice in Lagos Metropolise and other major cities in Nigeria to see commercial vehicles and motor bikes driving on public pedestal walkways especially during rush hours when there is heavy traffic. Some motor bikes and motor vehicle drivers especially the commercial vehicle drivers drives on pedestal walkways even in the presence of law enforcement official around without any sanction, thereby forcing school children and other people walking to jump into the main road to avoid being knock down. Sometimes children walking on the pedestal walkways are knock down and are injuried. Aims/Objectives/Purpose This study was conducted to: Analyse the impact of driving on Pedestal walkways on children safety in Nigeria; Capture children perception of their safety while walking on the pedestal walkways; Draw the attention of the government and policy makers to put in place laws, regulations and appropriate sanctions to deter motor vehicle drivers from driving on pedestal walkways; Draw the attention of the law enforcement officials to the danger that motorbikers and motor vehicles driving on the pedestal walkways pose to children and others. Methods The study was carried out in 5 out of the 20 Local Government Areas (LGAs) in Lagos State. The study involved the documentation of accidents involving children being knock down by of motor vehicle and motorbikes on pedestal walkways for a period of 1 year from February 2010 to January 2011. The study was carried out with the aid of shop attendants that work in shops located close the pedestal walkways. The shops attendants were recruited to monitor and document incidents of motor bikes and motor vehicles driving on pedestal walkways and accidents involving children between age 1–10 years old. The second part involve using key informant interview to determine the perception of children about their safety while walking on pedestal walkway daily to and from school. All 10 children (mainly school children) were interviewed in each of the five LGAs. Results/Outcome The results show that commercial vehicles and motor bikes drives on the pedestal walkways daily especially when there is traffic. The data gathered from the study sites revealed that an average of 50 children are knocked down within the five Local Government by motorbikes and commercial vehicles monthly while walking on pedestal walkways. So for the 12 months that the study was carried out about 600 children were knocked down by motor bikes and motor vehicles. The result of the key informant interview shows that 89.3% of the total number of children interviewed said their are not safe walking on the walkways while motor bikes and motor vehicles drive on the same pedestal walkways while 10.7% said they do not know whether they are safe walking on the pedestal walkways while motorbikes and vehicles drive on the walkways. Significance/Contribution to the Field The study was able to monitor and document accidents that happened in the pedestal walkway involving children, capture children perception of their safety while walking on the pedestal walkways; draw the attention of the government and policy makers to put in place laws, regulations and appropriate sanctions to deter motor vehicle drivers from driving on pedestal walkways, thus improving safety for children as they walk to and fro school daily in the streets of Lagos metropolise.