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In the front-end community, there is a lot of attention related to documenting JavaScript. That's not so much the case with CSS. Often times I feel like lost when I join a project with minimal or no CSS documentation.

Even though CSS is relatively easy to write, it can be quite hard to maintain. The specificity , the global scope of everything, and the lack of guidance can easily lead to inconsistency, code duplication, and over-complication.

I've long been curious what a really well-documented CSS codebase looks like. Here, I'll share my experience, along with the expectations I have towards my vision of well-documented stylesheets.

It surprises me where I hear people say that commenting CSS is not that important. I imagine none of them have had to deal with 10,000+ line stylesheets! Often I've struggled with what HTML results in what specific style. Without having a solid context about the development decisions taken, debugging efforts increase. Easy Street Maxwell Knee High Boot Womens R6Rg28
increase exponentially too.

Many times I've spent hours to figure out what the developer intended, why she didn't do it the another way, why is this layout seemingly so complex. There is much pain buried in these "why" questions.

So, here we go! Let's examine the 4 big signs of a well-documented CSS codebase.

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1) CSS Tech Stack Toolchain

There are likely things as part of our CSS code base like third-party libraries, mixins, or other tools. Looking in the package manager's dependencies list doesn't give a lot of context why the decisions were made to add these things, what they do exactly, and how we're using them.

It would be good for everyone to know why a certain library or tool was introduced. Imagine, for example, that a third-party library was introduced only to solve what has become an obsolete CSS issue. If we had context like that, we could make more informed decisions.

There sometimes can be quite a few third-party libraries in a project. Have you ever spent a bunch of time on web searching each one figuring out what it even is? It can be quite a challenge to know or to keep track of what each exactly does.

A well-documented codebase would include a description for each dependency. Perhaps you could include a tweet-length (140 characters) code comment explaining why it is there. That would give anyone else in the code base a head start on why something is there.

I like adding these descriptions right in the place where I @import them.

Good coding conventions result in consistent, readable, and unambiguous source code. They standardize the structure and coding style of an application so that you and others can easily read and understand the code.

Fig. 1. sequencing results identifying a unique hemizygous/homozygous mutation: 1240 C>T (p.Arg414Cys, known as Arg386Cys) in exon 2.

Although the anesthesia community is aware that some individuals will have BChE variants with reduced catalytic activity, BChE and DN testing is infrequently performed, most likely because of the relatively low incidence of BChE variants within the general population. Testing is frequently prompted when an individual experiences prolonged paralysis after exposure to succinylcholine, as occurred in this case. In this scenario, however, the timing of sample collection is important, and samples should be obtained only after all succinylcholine has completely cleared. Failure to do so can produce misleading results or uninterpretable biochemical data that could lead to an error, for example, in which the phenotype obtained implies no or only a slight risk of prolonged paralysis in an individual who is actually at high risk. In one study ( Tidewater Sandals Cape Cod Thong Sandal Womens RvXd9M
), 3 patients were assigned a BChE phenotype of UF (slight risk), but 1 of the patients was determined to have an AA BCHE genotype (high risk) ( 12 ).

Because the half-life of succinylcholine is prolonged beyond the expected 0.7 min in patients with qualitative BChE variants due to impaired catalytic activity, we recommend waiting a minimum of 48 h after succinylcholine exposure before collecting a sample for BChE phenotyping.

For our patient, similar BChE and DN results were obtained with 2 different samples, one of which was collected when succinylcholine was likely still present in the patient's blood. The effect of succinylcholine on the BChE and DN results was less apparent because the patient had a rare SS BCHE genotype, which produced a BChE variant with very low catalytic activity.

POINTS TO REMEMBER

Succinylcholine is a paralytic drug used to induce muscle relaxation and short-term paralysis.

BChE has no known physiological function but is capable of hydrolyzing exogenous choline esters found in certain drugs of abuse, aspirin, antidepressants, anticonvulsants, and paralytics.

Extended paralysis by succinylcholine occurs in individuals with reduced BChE activity due to genetically determined enzyme variants.

Dibucaine is a competitive inhibitor of BChE and is used to determine an individual's DN, which is the percentage of BChE inhibited by dibucaine.

The BChE activity and DN can be used to infer an individual's biochemical BChE phenotype.

Acknowledgments

We are grateful to Dr. Christopher Reif at the Community University Health Care Center, University of Minnesota, Minneapolis, Minnesota, and his help in obtaining patient samples and clinical information.

Footnotes

4 Nonstandard abbreviations:

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In particular, recent evidence has found that supplementing with omega-3s may reduce some inflammation caused by fat accumulation in Non-Alcoholic Fatty Liver Disease (NAFLD). (, )

4. Linked to Preventing and Managing Autoimmune Diseases

Autoimmune disease is a sometimes frustrating branch of medicine— on average, it takes 6–10 visits to a doctor for autoimmune disease to be suspected as the root cause of the plethora of symptoms these conditions cause.

Autoimmune disease

Characterized by the immune system attacking healthy cells, mistaking them for foreign intruders, autoimmune conditions include diseases such as type 1 diabetes , lupus, rheumatoid arthritis, ulcerative colitis, multiple sclerosis, leaky gut syndrome and many more.

leaky gut syndrome

Multiple studies have found links between high omega-3 intake and a decreased risk for autoimmune diseases or an improvement in symptoms. Some of these suggest the best protective effect comes when omega-3 fatty acids are consumed in high amounts in the first year of life. (, , , , , , )

5. Associated with Lowered Cancer Risks

Through several epidemiological studies, in which researchers observe trends in large population samples over time, it seems possible that high levels of omega-3 fats may be associated with a lowered risk of certain cancers.

People who consume more long-chain omega-3s (DHA and EPA) seem to have a reduced risk of colorectal cancer, according to observations in Scotland and China. (, )

After a large number of lab studies found that omega-3 fatty acids may be effective in slowing or reversing the growth of hormonal cancers, namely prostate and adidasAdilette Cloudfoam Mono 6Z2NfY8Wzk
cells, animal and human epidemiological studies have been conducted to see whether this effect occurred in real-life scenarios. The evidence is somewhat conflicting in some reports, but there is some evidence to suggest breast and prostate cancers may be potentially slowed (or the risk reduced) in people who eat a lot of oily fish and possibly those who supplement with omega-3. (, , )

breast cancer

A lab study in 2014 found that the pancreatic cancer-fighting impact of circumin, the active ingredient in turmeric , may be enhanced when combined with omega-3 fatty acids, encouraging further studies in animal and human models to investigate the potential of this combination. ()

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This article has Open Peer Review reports available.

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BMC Health Services Research 2012 12 :117

https://doi.org/10.1186/1472-6963-12-117

© Riggs et al.; licensee BioMed Central Ltd.2012

Received: 26October2011

Accepted: 15May2012

Published: 15May2012

Open Peer Review reports

Abstract

Background

Often new arrivals from refugee backgrounds have experienced poor health and limited access to healthcare services. The maternal and child health (MCH) service in Victoria, Australia, is a joint local and state government operated, cost-free service available to all mothers of children aged 0–6 years. Although well-child healthcare visits are useful in identifying health issues early, there has been limited investigation in the use of these services for families from refugee backgrounds. This study aims to explore experiences of using MCH services, from the perspective of families from refugee backgrounds and service providers.

Methods

We used a qualitative study design informed by the socioecological model of health and a cultural competence approach. Two geographical areas of Melbourne were selected to invite participants. Seven focus groups were conducted with 87 mothers from Karen, Iraqi, Assyrian Chaldean, Lebanese, South Sudanese and Bhutanese backgrounds, who had lived an average of 4.7 years in Australia (range one month-18 years). Participants had a total of 249 children, of these 150 were born in Australia. Four focus groups and five interviews were conducted with MCH nurses, other healthcare providers and bicultural workers.

Results

Four themes were identified: facilitating access to MCH services; promoting continued engagement with the MCH service; language challenges; and what is working well and could be done better. Several processes were identified that facilitated initial access to the MCH service but there were implications for continued use of the service. The MCH service was not formally notified of new parents arriving with young children. Pre-arranged group appointments by MCH nurses for parents who attended playgroups worked well to increase ongoing service engagement. Barriers for parents in using MCH services included access to transportation, lack of confidence in speaking English and making phone bookings. Service users and providers reported that continuity of nurse and interpreter is preferred for increasing client-provider trust and ongoing engagement.

Conclusions

Although participants who had children born in Melbourne had good initial access to, and experience of, using MCH services, significant barriers remain. A systems-oriented, culturally competent approach to service provision would improve the service utilisation experience for parents and providers, including formalising links and notifications between settlement services and MCH services.

Refugee Maternal and child health Access to health services Cultural competence

Australia currently accepts approximately 13,750 refugees per year with approximately 4,000 settling in the state of Victoria [ 1 ]. Many new arrivals from refugee backgrounds have experienced poor health and limited access to healthcare services [ 2 ]. Families from refugee backgrounds face a range of challenges that can affect child rearing practices, due to the experience of torture and trauma, changes in family roles, separation of family members and poor access to primary healthcare [ 3 , 4 ]. Traditional support networks are often missing due to loss and separation of family and community. Families from refugee backgrounds may have faced extreme circumstances which reduce their capacity to adapt to their new environment. Settlement difficulties may be exacerbated by unemployment, financial instability and financial responsibility and concern for family members who remain overseas or in refugee camps [ 3 , 5 ]. Access to health services can be difficult for families with children of refugee backgrounds because of a lack of culturally appropriate information, cultural differences in practices such as child rearing, as well as a limited understanding of Australia’s health system [ 6 ], which could be addressed by a culturally competent healthcare system that is responsive to these issues. Gender, education, occupation, income and ethnicity and place of residence are all closely linked to people’s access to, experiences of, and benefits from health care [ 7 ]. In addition, because refugee children and families may present with a range of health issues which are unfamiliar to Australian healthcare professionals [ 6 ], their complex needs may go undetected.

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