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"Alderman, Daniel"
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A concise companion to postwar British and Irish poetry
This text introduces students to the most important poetic figures, movements, contexts, and trends in post-war British and Irish poetry, providing a much-needed reference point in a sprawling and often contentious field.
Book
Pleural effusions in the Medical ICU : Prevalence, causes, and clinical implications
To determine the prevalence and causes of pleural effusions in patients admitted to a medical ICU (MICU).
Prospective.
MICU in a tertiary care hospital.
One hundred consecutive patients admitted to the MICU at the Medical University of South Carolina whose length of stay exceeded 24 h had chest radiographs reviewed daily and chest sonograms performed within 10 h of their latest chest radiograph.
The prevalence of pleural effusions in 100 consecutive MICU patients was 62%, with 41% of effusions detected at admission. Fifty-seven of 62 (92%) pleural effusions were small. Causes of pleural effusions were as follows: heart failure, 22 of 62 (35%); atelectasis, 14 of 62 (23%); uncomplicated parapneumonic effusions, seven of 62 (11%); hepatic hydrothorax, five of 62 (8%); hypoalbuminemia, five of 62 (8%); malignancy, two of 62 (3%); and unknown, three of 62 (5%). Pancreatitis, extravascular catheter migration, uremic pleurisy, and empyema caused an effusion in one instance each. Heart failure was the most frequent cause of bilateral effusions (13/34 [38%]). When compared with patients who never had effusions during their MICU stay, patients with pleural effusions were older (54+/-2 years, mean+/-SEM, vs 47+/-2 years [p=0.04]), had lower serum albumin concentration (2.4+/-0.1 vs 3.0+/-0.01 g/dL [p=0.002]), higher acute physiology and chronic health evaluation II scores during the initial 24 h of MICU stay (17.2+/-1.1 vs 12+/-1.2 [p=0.010]), longer MICU stays (9.8+/-1.0 vs 4.6+/-0.7 days [p=0.0002]), and longer mechanical ventilation (7.0+/-1.3 vs 1.9+/-0.7 days [p=0.004]). No patient died as a direct result of his or her pleural effusion. Chest radiograph readings had good correlation with chest sonograms (p<0.0001).
Pleural effusions in MICU patients are common, and most are detected by careful review of chest radiographs taken with the patient in erect or semierect position. When clinical suspicion for infection is low, observation of these effusions is warranted initially, because most are caused by noninfectious processes that should improve with treatment of the underlying disease.
Journal Article
Rub a dub dub
In this original version of the traditional nursery rhyme, the butcher, the baker, and the candlestick maker try their hands at fishing, with disastrous results. Includes musical notation.
Book
Intergenerational nutrition benefits of India’s national school feeding program
India has the world’s highest number of undernourished children and the largest school feeding program, the Mid-Day Meal (MDM) scheme. As school feeding programs target children outside the highest-return “first 1000-days” window, they have not been included in the global agenda to address stunting. School meals benefit education and nutrition in participants, but no studies have examined whether benefits carry over to their children. Using nationally representative data on mothers and their children spanning 1993 to 2016, we assess whether MDM supports intergenerational improvements in child linear growth. Here we report that height-for-age z-score (HAZ) among children born to mothers with full MDM exposure was greater (+0.40 SD) than that in children born to non-exposed mothers. Associations were stronger in low socioeconomic strata and likely work through women’s education, fertility, and health service utilization. MDM was associated with 13–32% of the HAZ improvement in India from 2006 to 2016.
India’s national school feeding program is the largest of its kind in the world, but the long-term program benefits on nutrition are unknown. Here, the authors show intergenerational program benefits, in that women who received free meals in primary school have children with improved linear growth.
Journal Article
The impact of food for education programs on school participation in Northern Uganda
There is a general consensus that food for education (FFE) programs increase primary school participation. Although this view is widely held, there is limited causal evidence to support it. Moreover, little is known about how the design of FFE programs affects schooling outcomes. This article presents evidence of the impacts of alternative methods of FFE delivery on schooling in Northern Uganda using a randomized controlled evaluation conducted from 2005 to 2007. We compare the impacts of the World Food Program’s in-school feeding program (SFP) with an experimental take-home rations (THR) program conditional on school attendance. Results show that the in-school meals program increased enrollment for those children who were not enrolled at baseline but who had reached the recommended age of school entry. For many outcomes we cannot reject that the THR impact is equivalent to that of the SFP. Both programs had large impacts on school attendance and reduced grade repetition. The SFP program also reduced girls’ age at entry to primary school. Neither program affected progression to secondary school, but children in grade 6 in SFP schools at baseline were significantly more likely to remain in primary school and repeat a grade than drop out. Program benefits may be improved by offering school meals in secondary schools as well, so that the attraction of school meals is at least neutral with respect to grade progression.
Journal Article
Pleural Effusions in the Medical ICU
To determine the prevalence and causes of pleural effusions in patients admitted to a medical ICU (MICU).
Prospective.
MICU in a tertiary care hospital.
One hundred consecutive patients admitted to the MICU at the Medical University of South Carolina whose length of stay exceeded 24 h had chest radiographs reviewed daily and chest sonograms performed within 10 h of their latest chest radiograph.
The prevalence of pleural effusions in 100 consecutive MICU patients was 62%, with 41% of effusions detected at admission. Fifty-seven of 62 (92%) pleural effusions were small. Causes of pleural effusions were as follows: heart failure, 22 of 62 (35%); atelectasis, 14 of 62 (23%); uncomplicated parapneumonic effusions, seven of 62 (11%); hepatic hydrothorax, five of 62 (8%); hypoalbuminemia, five of 62 (8%); malignancy, two of 62 (3%); and unknown, three of 62 (5%). Pancreatitis, extravascular catheter migration, uremic pleurisy, and empyema caused an effusion in one instance each. Heart failure was the most frequent cause of bilateral effusions (13/34 [38%]). When compared with patients who never had effusions during their MICU stay, patients with pleural effusions were older (54±2 years, mean±SEM, vs 47±2 years [p=0.04]), had lower serum albumin concentration (2.4±0.1 vs 3.0±0.01 g/dL [p=0.002]), higher acute physiology and chronic health evaluation II scores during the initial 24 h of MICU stay (17.2±1.1 vs 12±1.2 [p=0.010]), longer MICU stays (9.8±1.0 vs 4.6±0.7 days [p=0.0002]), and longer mechanical ventilation (7.0±1.3 vs 1.9±0.7 days [p=0.004]). No patient died as a direct result of his or her pleural effusion. Chest radiograph readings had good correlation with chest sonograms (p<0.0001).
Pleural effusions in MICU patients are common, and most are detected by careful review of chest radiographs taken with the patient in erect or semierect position. When clinical suspicion for infection is low, observation of these effusions is warranted initially, because most are caused by noninfectious processes that should improve with treatment of the underlying disease.
Journal Article