Sunday, March 29, 2015

Feeding lettuce to the birds, and an Egyptian goose

Tried today to feed Hillsborough Park's geese, ducks and coots with lettuce, and some grass.  They were underwhelmed, it has to be said.   One Canada goose came up to us, hissed at the coots that were near it, and when they went away, ignored the lettuce we had put on the path.   Some of the coots did peck at it a bit, but did not look as keen as they do when you have bread.

What was happening?   Was it the rain?   Are they so used to bread that they only want bread?  Were they already full?  Was there something about the lettuce?

More research needed, I think.  

Meanwhile, here is one of the recently arrived Egyptian geese:  

Just under a fortnight ago, I was walking through the park when a pair of these circled two or three times, and then landed, one on the water, and one on the shore.  Then, one of them flew across the lake to the shore where I was standing.

They have been there each day I have looked since, sometimes two, sometimes, like today, one.  

According to the RSPB, the Egyptian goose, revered in Ancient Egypt, is more often seen in Norfolk, although it is known elsewhere.   The excellent ARKive has more worldwide information.   The GB Non Native Species Secretariat website has a document that explains how this goose was introduced into England in the 17th century and became a popular choice for private estates in the 19th, in the south and east of England, from where it has been spreading.  A very attractive bird, but it is an offence to introduce it (this does not stop it introducing itself, I imagine!).   The Sheffield Bird Study Group has been recording sightings of 1 or 2 in Hillsborough Park, including one there today.

Sunday, March 22, 2015

Drinking after an accident, not drinking causing an accident.

Having fallen from my bike in September and sustained a head injury, and being keen on exploring the output of small Sheffield breweries (in moderation), I had a personal reason for looking into this, but it turns out to be quite an interesting exercise in literature searching.

I am talking about Medline.  First of all, "alcohol" as a search term leads you to the MeSH term Alcohols/, which is the chemical.  There is no mention in the scope note of any alternatives, but the definition does make you think it is the chemical.  "Drinking" leads you to Alcohol Drinking/, which looks better.  The scope note tells you this is an old term (first used in 1969) and previously material was put under Alcoholic Beverages/.  This term still exists, with narrower terms Absinthe/, Beer/ and Wine/ available.

If you use PubMed and type in alcohol, then you'll be mapped to Alcohols/ and not Alcohol Drinking/ or Alcoholic Beverages/.

The MeSH term Craniocerebral Trauma/, if exploded, covers skull fracture, head injuries (closed or penetrating) and brain injury.  The search term "head injury" will map to it.

So, exp Craniocerebral Trauma/ and (Alcohol Drinking/ or exp Alcoholic Beverages/) looks promising.  Note that if you explode Alcohol Drinking, you include Binge Drinking/, which you might not want, as it might lead to literature about excessive drinking as a contributory factor in head injury.

But even so, a lot of the results are about role of alcohol in causing brain injury.  Some, like this (the link sends me to ScienceDirect and a paywall, but many older issues are available for free on the journal's own site), seem to indicate that giving up drinking after a head injury is a good idea, as it aids recovery of the brain, but the article starts by mentioning that two thirds of people with  "TBI" (traumatic brain injury) have a history of heavy drinking, and half of people with TBI were injured while drunk.

Back to the personal side.   I was advised at the head injury rehabilitation clinic not to drink, but I do not have a history of heavy drinking, and I had not been drinking at the time of my incident.  The article quoted above (1) mentions that the brain is more sensitive to the effects of alcohol after injury. 

So, what evidence is there that not drinking after a head injury, regardless of your drinking patterns beforehand, is a good idea?   And is it possible to disentangle this evidence from material about changing drinking habits of people who perhaps drank too much before their injury, or material about drinking causing the injury?

I have no answer yet - perhaps reviewing all the results and excluding those you do not want is the only way - but I have been experimenting with:

Subheadings - Craniocerebral trauma/rh or de, or brain/de;

((alcohol or drink*) adj2 after adj2 (head or brain))

Or adj3.

Using and instead of the adjfinds thousands, but limiting to title only (for all terms) finds tens.  Some of those are about rats, others about excessive alcohol use, but some look potentially useful.  At least one seems to suggest (from a reading of the abstract) that the reverse is true - higher blood alcohol concentration is linked with improved survival (2)!


(1) Bombardier CH. Alcohol use after traumatic brain injury. Arch Phys Med Rehab 2013; 94: 2040-1.
(2) Berry C, Ley EJ, Margulies DR, Mirocha J, Bukur M, Malinoski D, Salim A. Correlating the blood alcohol concentration the outcome after traumatic brain injury: too much is not a bad thing.   Am Surg 2011;77(10):1416-9.

Tuesday, March 17, 2015

Avian botulism, or feeding the ducks

On a recent visit to Hillsborough Park to feed the geese, ducks and coots, we spotted some peas on the ground by the side of the lake.   We were surprised that birds ate such things, but the Canal and River Trust are recommending that people do indeed feed water birds frozen peas, or lettuce, or grain.  This story was picked up extensively in the UK media yesterday and today.

But not bread.  The video in this piece from the Daily Telegraph has figures for the amount of bread that is fed to water birds.   A lot of it is not eaten by the birds, but ends up as a culture medium for microorganisms, making the birds ill and encouraging rats.  See also this piece from the Canal and River Trust.

A web search for avian botulism bread finds news stories from last summer and autumn, so the finger of suspicion has been pointing at bread for some time.

A quick web search and search of PubMed suggests the fingers of suspicion in the academic and government literature are pointing at a link between avian botulism and algae, although there seems to be no study directly relating bread and the disease in water birds.  

There is a page from the US National Wildlife Health Center about avian botulism, discussing the conditions that the bacterium needs to grow (a protein source, warm temperatures, and no oxygen) and pointing out that there are regular outbreaks in the USA and Canada (my PubMed search turned up more than one item discussing the problem in the Great Lakes).

This What's New in Health and Safety from the Canal and River Trust (scroll down when you have loaded it) discusses what to do if a bird suspected of dying from avian botulism is discovered.  DEFRA need to be informed.

Thanks to Emma Kimberley for sharing the Daily Telegraph piece via Facebook.

Scarlet fever

BBC's "Look North" programme today is reporting a higher than expected number of cases of scarlet fever, focusing on a case in Harrogate.  A quick search of news through Google suggests it is a problem not confined to Yorkshire, and finds this BBC piece relating to England. Looking at September 2014 - March 2015, and comparing with the same period in 2013-2014, there have been twice as many cases.

Places to look for more information:

Public Health England information (on

NHS Choices information - good place to start if you are worried that someone you know has scarlet fever, covering symptoms, how to stop it spreading, and when to seek medical advice.

Clinical Knowledge Summaries, a summary for primary care practitioners.

For epidemiological information, try ProMED-mail - click search and search for the subject scarlet fever.

Wednesday, March 11, 2015

Vasovagal syncope, and hypertrophic obstructive cardiomyopathy

The Swansea City footballer Bafetimbi Gomis collapsed during their recent game against Tottenham Hotspur, and was taken off the pitch on a stretcher, on oxygen.  After spending some time in the dressing room he was taken to hospital for tests and later released.

For those watching, and especially those on the pitch, it brought back memories of the collapse a few years ago at the same ground of Fabrice Muamba, who recovered but had to retire from the game.  Muamba's collapse was due to hypertrophic obstructive cardiomyopathy.  The wall of the heart thickens, and the heart cannot pump blood efficiently. has information.

Gomis' was due to a vasovagal condition - fainting - which has caused him problems before. has information about syncope and describes vasovagal syncope as "common faint", with several possible causes.

NICE Clinical Guideline 109 covers "transient loss of consciousness" in adults and young people.  NICE have produced an evidence update to that guideline.

Plain packaging

The trouble with writing a draft while you think about it is that you then forget about it.  So here we are, several weeks after the debate in the UK press about selling cigarettes in plain packaging.  Indeed, here we are, with a vote in the House of Commons in favour of plain packaging, from May 2016.

The Netherlands is about to do the same,  although the packaging will not be "plain", but have unsavoury pictures of the disorders due to smoking.  Actually, neither perhaps will be the English packets (the vote applied to England only), as the Guardian reports that the packaging will have "graphic health warning images".

Australia already has introduced such packaging, and there is some discussion in the first Guardian piece linked to above about how effective it has been.  And in this piece, which also references the Chantler report prepared for the UK government, but now archived.  The illustrations in that piece indeed suggest the "plain" packaging is like that proposed in the Netherlands, so with pictures of the effects.

So, is there any evidence in the medical literature that "plain" packaging reduces the number of smokers or cigarettes smoked?

This rough strategy, then limited to Clinical Trials, All, finds 13 references in Medline (search done 11th March 2015).  And 5 systematic reviews or meta analyses.

Smoking cessation/mt
Product packaging/ or packaging
(1 or 2) and 3

Saturday, March 07, 2015

International Women's Day

International Women's Day is tomorrow, 8th March.  

So it is a good time to mention Athena Swan, an Equality Challenge Unit scheme to recognise commitment to advancing women's careers in science, technology, engineering, maths and medicine ("STEMM") subjects in higher education and research.  The ECU works to promote equality and diversity in higher education.

There is the Athena Swan Charter, and awards.   The University of Leicester has an institutional bronze award, nine departments have a departmental bronze award (including one that I work with, the Department of Infection Immunity and Inflammation) , and one (the Department of Health Sciences, which is also one of "mine") has silver.

Details of what needs to be demonstrated to be awarded bronze or silver are in the handbook.  To be awarded bronze, the department must belong to an institution that has been awarded bronze, and then demonstrate that it has identified challenges (where the department is in regard to gender equality, for example).  To be awarded silver, the department must demonstrate that it has taken action in regard to those challenges and can demonstrate impact.  To get gold, the department must be a "beacon of achievement" and an example of good practice to the community.

I have compiled a resource list of material held in the library (print or digital) relating to women in STEMM.   I notice that it only includes one "M", and have made a note to address that...