bluuebunny/crossref_metadata_2025 huggingface dataset:
Meckel's Diverticula in an Adult Surgical Unit Eleven Years Experience
Authors: Pickard M. A. , Simpson C. J.
Published: January 2017

A retrospective review of Meckel's diverticula over an 11-year period in a surgical unit, to which children were seldom admitted, revealed 28 diverticula, seven of which were symptomatic from inflammatory disease or obstruction. There was no morbidity nor mortality in this group. Twenty-one diverticula were removed as incidental findings, four patients dying from the cause of their symptoms. The complications of Meckel's diverticulum can be satisfactorily managed and are uncommon in the adult. Prophylactic diverticulectomy is difficult to justify.
Outcome Indicators: Who Benefits?
Authors: Russell E.M. , Cole S.K.
Published: January 2017

Most of the recent work on performance indicators has concentrated on the provision or activities of health services rather than on their impact on the patients and populations who use them. Although the precise relationship between treatment and outcome is often unclear, simple examination of routinely available data can show whether mortality and morbidity are changing in desired directions. This pinpoints topics for more detailed professional review. It is incumbent on doctors to match the concern over the efficient use of health services with information about their effects on people's health.
Thoraco-Abdominal Birth Injury — Presentation, Diagnosis and Management in an Unusual Case
Authors: Wilson-Storey D. , MacKinlay G.A.
Published: January 2017

As a result of a traumatic delivery a newborn male child developed thoracic and intra-abdominal problems. Haemoperitoneum and chylous ascites were diagnosed; from a scrotal enlargement secondary to bilateral patent processus vaginalis and a chylothorax became apparent during investigation of the scrotal swellings. We discuss the presentation, diagnosis and management of the case and review the literature.
Fungal Peritonitis in Children on Continuous Ambulatory Peritoneal Dialysis
Authors: Mocan H. , Murphy A.V. , Beattie T.J. , McAllister T.A.
Published: January 2017

Between 1979 and 1985, six of 26 patients undergoing continuous ambulatory peritoneal dialysis developed fungal peritonitis. All had received antibacterial therapy with cefamandole and/or netilmicin prior to the diagnosis. The causal organisms were Candida albicans (three), Candida glabrata (one), Cryptococcus laurentii (one) and Saccharomyces cerevisiae (one). Treatment comprised catheter removal preceded by antifungal drugs (flucytosine and/or amphotericin B) in four patients and catheter removal alone in two. All patients were transferred to haemodialysis and five of the six developed extensive intra-abdominal adhesions. The most prudent management of fungal peritonitis in children would seem to be early cannula removal.
Peptic Ulcer Perforation: A Complication of Double Contrast Barium Meal Examination
Authors: Shimi S. M.
Published: January 2017

This is a case report of peptic ulcer perforation as a complication of double contrast Barium meal examination in the presence of gastric outlet obstruction.
Malignancy in Nonagenarians
Authors: Sclare G.
Published: January 2017

In a series of 143 necropsies on aged subjects, age range 90 to 100, 20 patients were found to have died of malignant disease and a further 16 patients had a total of 20 non-fatal malignant tumours. The rate of clinical recognition was lower than would be expected in other age groups. Adenocarcinomas of the digestive system predominated in the fatal group. This study confirms previous reports of a high incidence of non-fatal tumours and a diminished tendency to metastasis in both fatal and non-fatal cases. These features are not thought to imply diminished aggressiveness of malignant tumours in extreme old age, since analysis of individual cases provided other explanations such as death from unrecognised local complications of the tumour or the intervention of an unrelated cause of death. There was, however, an unexpectedly high number of cases of long survival after excision of a malignant tumour, including a case of spontaneous regression.
A Possible New Approach to the Problem of Refractory Peptic Ulceration. a Role for Free Radical Scavengers?
Authors: Salim A.S.
Published: January 2017

Refractory peptic ulceration refers to those gastric and duodenal ulcers that are slow to heal despite active treatment. Oxygen-derived free radicals are cytotoxic and promote tissue injury. This report shows that radical scavengers stimulate the healing of refractory peptic ulceration, thus, providing a valuable method for the treatment of such ulceration.
Co-Ordinating Geriatric and General Medical Services; Experience of a Geriatric Assessment Ward in the Royal Infirmary of Edinburgh
Authors: MacLennan W.J. , Chapman B.J. , Smith M. , Prescott R.J. , Wang J.X.
Published: January 2017

The paper describes the work of an assessment unit setup to provide a service for frail elderly patients admitted to general medical units at the Royal Infirmary of Edinburgh during the period of April 1989 to March 1990. Patients were selected on the basis of diagnosis, mental and physical function, age and social background and transferred to the assessment ward within 24 hours of admission to a medical ward.

Most of the 376 patients admitted to the ward had a high level of multiple pathology and physical incapacity and a third had an acute confusional state. The mean length of stay was 19.4 days. There was a 13% mortality with 71% of survivors returning to their own homes. Review of mobility and self care capacity of the group revealed a striking increase in function during their stay in the ward. Factors increasing the likelihood of discharge included having a spouse, receiving support at home, having a low initial dependence rating. Adverse factors included having cerebrovascular disease, having dementia and initial maintenance of urine and faeces.
A Patient with Neurosyphilis Presenting as Chorea
Authors: Jones A.L. , Bouchier I.A.D.
Published: January 2017

Despite the marked decline in frequency of neurosyphilis over the past three decades in the United Kingdom, new cases continue to appear both sporadically and as a complication of HIV infection. There is clinical evidence that neurosyphilis is becoming less typical. We describe a case of neurosyphilis presenting predominantly with choreoathetosis and associated hemiparesis in an otherwise healthy, immunocompetent patient. Only six cases of neurosyphilis presenting with features of basal ganglia damage have been reported in the recent literature, five of whom had HIV infection.
Systemic Hypersensitivity Reaction to Intravescial BCG
Authors: Lyons D. , Miller I. , Jeffers A.
Published: January 2017

BCGosis is a recognised complication of intravesical BCG immunotherapy for superficial bladder carcinoma. We present here a case of granulomatous hepatitis, pneumonitis and probable pericarditis resulting from an hypersensitivity reaction to intravesical BCG.
High Reported Prevalence of Congenital Anomalies in a Scottish City
Authors: Stone D. H. , Dolk H
Published: January 2017

The Glasgow Register of Congenital Anomalies reports the highest birth prevalence of congenital anomalies of all 18 participating centres in the EUROCAT project for the years 1980 to 1988. A high prevalence is found in most defect categories, with Glasgow in the top three places in the EUROCAT “league” in 7 of the 10 categories studied. While the high rate could reflect a high level of ascertainment, we have concluded that there is enough reason to be seriously concerned that the high Glasgow rate is a reflection of risk rather than methodology.
Is There a Case for a Virus Aetiology in Multiple Sclerosis?
Authors: Souberbielle Bernard E. , Szawlowski Paul W.S. , Russell William C.
Published: January 2017

Multiple Sclerosis (MS) is a devastating demyelinating disease with a very high prevalence in North-East Scotland and in the Orkney and Shetland Islands. MS appears to be a multifactorial disorder with environmental and genetic elements and it has been proposed that these, in tandem, provoke an autoimmune response giving rise to the disease. Although there is no direct evidence of a specific virus being involved in MS, there are nevertheless grounds for suspecting a viral association. This review discusses these aspects of MS and suggests that a more aggressive approach to unravelling the role of viruses is needed.
Changes in Skeletal and Cardiac Muscle Enzymes during the Scottish Coast to Coast Triathlon
Authors: Denvir M.A. , Galloway P.J. , Meighan A.S. , Blyth M. , Alexander C. , Fleming C. , Frame F
Published: January 2017

While skeletal muscle injury is common after prolonged exercise, evidence in the literature supporting cardiac muscle injury is conflicting. Creatine kinase and cardiac troponin-I were measured, in 31 amateur athletes (25 male) before, and 12–24 hours after, a 300km cycling/running/canoe triathlon event. A short questionnaire was used to assess level of fitness, training and previous experience. Creatine kinase levels were greater after the 45km cross-country run compared with after a 155km road cycle (60.5±62.8iu/L/kg vs 19.3±9.6iu/ /kg, P=0.03). Individuals performing running and cycling events consecutively had creatine kinase similar to those observed after running alone (50.2±53.8 iu/L/kg vs 60.5±62.8iu/L/kg, P=0.55). Cardiac troponin-I was elevated above the normal range (0.1 ng/L) in six athletes (four in running and cycling events, one in the running and one in the cycling event). We conclude that running produces significantly more skeletal muscle injury than cycling and that strenuous endurance exercise involving running and cycling in amateur trained athletes is associated with release of cardiac specific enzymes. The functional and longer term consequences of this require further study.
Audit of the Effect of Introducing Local Guidelines for Referral for Carotid Duplex Scanning
Authors: Holdsworth R.J. , Bryce J.S. , McCollum P.T.
Published: January 2017

Guidelines for referral of patients for carotid duplex scanning were introduced stating that scans were only indicated for patients with hemispheric localising symptoms or asymptomatic bruits. A 19% reduction in referral rate was seen for new scans in a one year period. The number of “inappropriate” requests fell from 2 7.6% in 1994 to 12.8% in 1995. There was no reduction in the numbers of patients identified with effectively occult asymptomatic disease who may have been suitable for surgery in the same period. Guideline introduction had the effect of reducing unnecessary scans without any effect on the overall pick-up, rate for carotid disease.
A Crystallinity Study of Cellulosic Fibers Employing Deuteration and Infrared Spectroscopy
Authors: Knight J. A. , Hicks H. Lamar , Stephens Kenneth W.
Published: January 2017

The crystallinities of the cellulosic materials, cotton, ramie, and viscose rayon, were studied utilizing deuteration exchange and a recently developed method for obtaining the ir spectra of natural or synthetic short staple fibers. The crystallinities from this work are in the range of values reported by other investigators utilizing other methods. This work extends the deuteration-ir method to the determination of the crystallinities of short, staple cellulosic fibers in which the only change, other than deuterium exchange, is the physical pressing of the fibers so that ir spectra can be obtained.
Changes in Cotton and Nylon Fabrics Caused by Increments of Accelerotor, Schiefer, and Stoll Abrasion
Authors: Galbraith Ruth , Boyle Margaret , Cormany Esther , Davison Suzanne , Ginter Adella , Ericson June , Lapitsky Mary , Lund Lillian , Cooper Margaret
Published: January 2017

Two fabrics, 100% cotton and 100% nylon, were abraded with Stoll (inflated diaphragm), Schiefer, and Accelerotor instruments. Fabrics were given nine levels of abrasion, ranging from slight distortion of the fabric surface to fabric rupture, with each type of instrument. After abrasion, selected physical properties of the fabrics were measured and microscopic studies were made to determine the types of fabric, yarn, and fiber damage caused by the three abraders.

The Stoll abrader caused severe fabric damage at very low levels of abrasion because the abradant pressure was highly localized in the center of the abraded area. The Schiefer and Accelerotor instruments caused uniform abrasion over the entire areas and abrasive damage to the fabric structure built up more slowly than with the Stoll. Both the Accelerotor and the Schiefer were more sensitive to differences in fiber toughness than was the Stoll. An imbalance between warp and filling yarn crimps had a much greater effect on the rate of damage and point of attack for the two flat abrasion testers than it had on Accelerotor abrasion. The tumbling action of the Accelerotor caused the greatest increases in fabric thickness by shaking fiber ends loose from the yarn structure and then cutting or breaking them off more slowly than did the Stoll abrader.
Set/Supercontraction Characteristics and Longitudinal Swelling of Keratin Fibers
Authors: Gandhi R. S.
Published: January 2017

The longitudinal swelling of three different sorts of wools, when permanently set, has been studied. It has been observed that, when progressively set, Mohair fibers, which acquire a set much more readily, show retarded swelling, compared to Blackface wool fibers. The effect of setting time reveals that the structure of Mohair fiber opens up at a much faster rate, but the swelling is high in the case of Blackface wool fiber which exhibits poor settability. Moreover, in each case, fibers, on acquiring a certain set, show a decrease in longitudinal swelling due to bond re-formation. It appears that the increase in longitudinal swelling, which is due to changes in the cortical regions, is influenced not only by the setting strain or the setting time; the number of strained bonds initially present and the ease of bond re-formation also determine the extent of swelling.
Phosphorus-Nitrogen Flame Retardant via Copper Complex
Authors: Donaldson D. J. , Daigle D. J.
Published: January 2017

Copper salts were found to stabilize tetrakis (hydroxymethyl) phosphonium hydroxide (THPOH)-ammonium hydroxide solutions by formation of a complex thereby making it possible to apply THPOH to cotton fabric from a single bath without the use of gaseous ammonia.

The effect of the concentration of copper salts, THPOH, and NH4OH on the stability of the solution was studied. Cotton fabric with good flame retardancy, strength retention, and hand was obtained by the use of conventional pad-cure techniques for applying the solutions. Cotton fabrics with approximately 17% add-ons retained their flame retardancy after 25 home launderings.
New Econometric Techniques for Textile Market Research
Authors: Burley S. P.
Published: January 2017

The work presented here is part of a detailed study on the nature and origin of fluctuations in international wool prices. Special attention is drawn to the usefulness of recent developments in statistical time-series analysis for market studies of this type. These make it possible to show that the “textile cycle” evident in wool (and other textile) prices for more than a century is fundamentally a strongly amplified version of a similar broadband fluctuation in general business conditions in the major manufacturing countries. However, it is seen that more recently this simple pattern has been disrupted somewhat, probably by the impact of a sequence of capacity expansions in the synthetic fiber industry
Community leadership and engagement after the mix: The transformation of Toronto’s Regent Park
Authors: Brail Shauna , Kumar Nishi
Published: January 2017

The CAD$1 billion transformation of Toronto’s Regent Park neighbourhood from Canada’s largest public housing site to a mixed income community is likely to inform the next several decades of public housing redevelopment policy both nationally and internationally. This paper focuses on the process and impacts of large-scale redevelopment, in the context of attempts to build a physically and socially inclusive neighbourhood incorporating non-market and market housing in downtown Toronto. Drawing from in-depth interviews with 32 Regent Park community leaders and other key decision makers, the paper explores how resident engagement and leadership development opportunities impact redevelopment processes in mixed income initiatives. Results focus on three key emerging areas of both strength and concern: (1) efforts to build community alongside the redevelopment as an integral, evolving and place-specific strategy; (2) the impacts and challenges of both a strong institutional environment in Regent Park and a sense of weak institutional memory; and (3) formal and informal leadership and mentorship opportunities and their contribution towards the development of engagement and cohesion in Regent Park. The opportunity for low-income housing initiatives to support knowledge building and learning, preservation of institutional memory and local leadership development is significant in the context of examining physical and social redevelopment.
Revisiting the Tourism-Led Economic Growth Hypothesis: The Case of China
Authors: Zuo Bing , Huang Songshan (Sam)
Published: January 2017

This article examines the relationship between the level of tourism specialization (TS) and economic growth using a panel dataset covering 31 provinces in mainland China from 1995 to 2013. A quadratic function was introduced following the basic economic law of returns to overcome the weaknesses of constant returns to scale associated with the tourism-led economic growth hypothesis (TLGH). Using tourist arrivals as a percentage of host population (TA) and tourism receipts as a share of real GDP (TR) as the indicators of TS which represent respectively the level/size and the quality/structure dimension of TS, the system generalized method of moments (SYSGMM) regression results suggest that a meaningful inverted-U- or an N-shaped relationship exists between tourism specialization and economic growth. Based on the portfolio of TA and TR in destinations, the effects and characters of tourism on economic growth are discussed regarding the future direction of regional development.
Practical Hospital Pharmacy Management: Management Strategies and Methods
Authors: Cranmer Alan
Published: January 2017

This review deals with the practical management of hospital pharmacies based on experience in Indian Christian hospitals with capacities ranging from about 30 to 500 beds. However the standards of pharmacy management should not depend on size; they should be kept under review and improved as staff and financial considerations allow.
Retinopathy in Gambian Children Admitted to Hospital with Malaria
Authors: Burton Matthew , Nyong'o Omondi , Burton Kathryn , John Wilhelmina , Inkoom Ebenezer , Pinder Margaret , Corrah Tumani , Johnson Gordon , Bailey Robin
Published: January 2017

A characteristic retinopathy associated with a poor prognosis has previously been described in African children with established cerebral malaria. However, relatively little is known about retinal abnormalities in children with severe non-cerebral malaria, the group most at risk of developing the cerebral complications of this disease. In this study the prevalence, pattern, clinical significance and accessibility to clinical examination of this characteristic retinopathy are described in 106 Gambian children admitted consecutively to hospital with severe malaria, including six with established cerebral malaria.
A Review of Non-Operative Treatment of Splenic Trauma
Authors: Alidria-Ezati Isaac
Published: January 2017

From January 1984 to June 1992, a period of 8.5 years, 60 patients with splenic trauma were treated in Lacor Hospital. The spleen trauma was managed conservatively in 47 (78%) of the patients. Of these, 36 of the patients (60%) were not operated upon. Eleven (18%) were operated upon but nine (15%) patients had exploratory laparotomy only without spleen manipulation and in two (3%) splenic repair was performed. Thirteen (22%) patients had splenectomy. In the non-operative group, recurrent or rebleeding was detected in one patient (2%) and delayed bleeding occurred in five patients (8%). Overall mortality rate was five (8%); two (3%) occurring in splenic salvage and three (5%) in splenectomized patients. It is concluded that with availability of facilities and personnel, in selected cases of blunt splenic trauma, splenic conservation is safe but requires close monitoring.
The Management of Tetanus 1996
Authors: Sanders R K M
Published: January 2017

The three main basic concepts in the understanding and management of tetanus:

Tetanus is polysystemic in terms of pathology and management. Most body organs, as well as the nervous system, are severely affected by tetanus toxins Prevention is not only by immunization, but also by specific treatment. Since the toxin cannot be therapeutically eradicated from the body, therapy is directed towards preventing continued spread of the toxins and the consequences of intoxication Variability in terms of prevalence and prognosis. The natural incidence and severity of tetanus varies greatly with social environment, season, climate and soil. Prognosis is influenced by age, source of infection and delay in treatment.
Simplified Care of Women with Prolonged or Persistent Retention of the Placenta: The Use of Paracervical Block
Authors: Mola Glen , Sapuri Mathias , Bergström Staffan
Published: January 2017

Thirty patients with prolonged or persistent retention of the placenta were randomized to either paracervical block or intravenous cocktail of pethidine and diazepam. When paracervical block worked, the analgesia produced was better than that usually achieved with intravenous cocktail of pethidine and diazepam. From a cost-benefit point of view paracervical block is preferable to intravenous cocktail. No significant side-effects occurred during the trial.
Treatment of Tibial Defects due to Osteomyelitis by Postero-Lateral Cortico-Cancellous Bone Grafting
Authors: Beaso J
Published: January 2017

Four cases of children with tibial defects due to osteomyelitis are presented. Tibialization of the fibula using postero-lateral cortico-cancellous bone grafting achieved a stable weight bearing limb in all four patients. The surgical technique employed should be within the skills of any tropical surgeon able to take a bone graft and expose the tibiofibular joints.
Histopathology Services in a Rural African Hospital: How Audit Can Improve Service
Authors: Kettle H , Wilkinson D
Published: January 2017

Audit is about doing things right. We undertook a detailed audit of the histopathological service at a rural district hospital in Africa because delays in obtaining biopsy results had been noted by clinicians. A wide range of serious pathology was found in the 100 consecutive biopsies reviewed. It took 26 days on average from the time a biopsy was taken to the time the result was returned to the clinician, and most of this delay was administrative in nature, occurring after the pathologist had reviewed the specimen at the regional laboratory. Because of these delays, only 22% of patients biopsied were ever informed of their results. By performing this audit, reporting the results, and acting against the problems discovered, the service rapidly improved. This study illustrates the importance of simple, routine audit in district hospitals in developing countries.
Flaws in the Out-Patient Flow at a Semi-Rural Hospital in Northern Namibia
Authors: Meguid Tarek , Amaambo Filemon , Mhata Petrus
Published: January 2017

The aim of this study was to determine the quantity and quality of our service in the out-patient department (OPD). During 2 weeks in November and December 1996 all out-patients were followed throughout their stay. Service times, waiting times, time on arrival, time on departure and completeness of the service were recorded. All in all, 4999 patients, who had 17436 contacts with healthcare providers were recorded. Approximately 500 out-patients were seen daily with 48.43% follow-ups and 15.24% referrals. Two-thirds (74.79%) of all patients arrived before 1100 h. Between 200 and 300 patients were present in the OPD at any time between 0900 h and 1600 h. Twelve per cent (621 patients) left the hospital with an incomplete service. Of the 1511 patients screened by the nurses only 20 (1.32%) were treated by them. The way the work was organized was inefficient and client unfriendly. Inefficient, because available expertise was not utilized. Client unfriendly, because this leads to situations where patients were denied the service to which they were entitled.
What Potent Blood: Non-Invasive Prenatal Genetic Diagnosis and the Transformation of Modern Prenatal Care
Authors: Chachkin Carolyn Jacobs
Published: January 2017

What potent blood hath modest May,

What fiery force the earth renews,

The wealth of forms, the flush of hues ….

—Ralph Waldo Emerson

Someday soon, virtually any pregnant woman will be able to learn — with 98-99% accuracy — whether her fetus has contracted a serious genetic disorder by undergoing nothing more than an inexpensive, non-invasive blood test. For years, scientists have sought a method of prenatal testing that could boast both high levels of accuracy and low levels of risk. The most promising solution lies in an exciting recent discovery: tiny quantities of fetal cells and DNA cross over into the mother's bloodstream during pregnancy. If the fetal genetic material can be successfully isolated from the maternal blood, it can be used to diagnose a number of genetic disorders, such as Down Syndrome, cystic fibrosis, Tay-Sachs disease, and sickle cell anemia. Indeed, researchers have spent the last decade developing ways to accomplish this.
Imaging Body Structure and Mapping Brain Function: A Historical Approach
Authors: Tovino Stacey A.
Published: January 2017

Now in its second decade, functional magnetic resonance imaging (fMRI) localizes changes in blood oxygenation that occur in the brain when an individual performs a mental task. Physicians and scientists use fMRI not only to map sensory, motor, and cognitive functions, but also to study the neural correlates of a range of sensitive and potentially stigmatizing conditions, behaviors, and characteristics. Poised to move outside the traditional clinical and research contexts, fMRI raises a number of ethical, legal, and social issues that are being explored within a burgeoning neuroethics literature.

In this Article, I place these issues in their proper historical context. The ethical, legal, and social issues raised by advances in functional neuroimaging are challenging and somewhat distinctive, but they are not entirely new. Earlier methods of body imaging and brain mapping, including phrenology, x-ray, positron emission tomography, and single-photon emission computed tomography, raised similar issues, and perhaps we can use our experiences with these sciences and technologies to help guide current functional neuroimaging policy.
Is a Picture Worth a Thousand Words? Neuroimaging in the Courtroom
Authors: Baskin Joseph H. , Edersheim Judith G. , Price Bruce H.
Published: January 2017

Neuroimaging has advanced our understanding of how the living brain operates, providing structural and functional images of both healthy and diseased brains. This technology pervades today's society, particularly affecting the legal arena. Some judges argue that scientific evidence, which offers insight into the offender's mental state, is crucial because it is the only means of determining whether an offender's punishment is proportional to his crime. Other judges argue that “objective” evidence does not “wholly determine the controversy,” and focus instead on their duty as gatekeepers to independently evaluate scientific evidence. If courts use brain images to make their culpability determinations more objective and sound, these images must meet pertinent legal standards and shed light on medical conditions. For neuroimaging to meet these legal and medical standards with scientific integrity, scientists must convincingly correlate the dynamic images in a person's brain with the way the person is thinking or acting at that moment.
A Double-Edged Sword: The Role of Neuroimaging in Federal Capital Sentencing
Authors: Barth Abram S.
Published: January 2017

H.L.A. Hart has stated that certain mental conditions have an “excusing” effect on punishment, whereby “[t]he individual is not liable to punishment if at the time of his doing what would otherwise be a punishable act he is … the victim of certain types of mental disease.” The Supreme Court, however, upheld a state statute allowing for increased “punishment,” in the form of civil commitment, for sexually violent predators who suffer from a “mental abnormality.” Thus, American jurisprudence is faced with a paradoxical role of mental conditions: serving to both aggravate and mitigate sentences. This dual purpose of mental conditions becomes a pressing legal issue as mental conditions associated with brain structure or function become more detectable with the emergence of neuroimaging.

In federal capital sentencing, judges are obligated to consider aggravating and mitigating factors before imposing a death sentence. There are aggravating and mitigating factors that could be implicated by mental conditions, including future dangerousness, and impaired capacity, respectively.
Rights to Healthcare in the United States: Inherently Unstable
Authors: Orentlicher David
Published: January 2017

Although international covenants have long recognized a fundamental right to healthcare, and other countries provide healthcare coverage for all of their citizens, rights to healthcare in the United States have been adopted only grudgingly, and in a manner that is inherently unstable. While a solid right to healthcare would provide much benefit to individuals and society, the political and judicial branches of the U.S. government have granted rights that are incomplete and vulnerable to erosion over time.

Unfortunately, enactment of the Patient Protection and Affordable Care Act (ACA) does not change these fundamental weaknesses in the regime of U.S. healthcare rights. Millions of Americans will remain uninsured after ACA takes full effect, and rather than creating a more stable right to healthcare, ACA gives unstable rights to more people. As a result, even if ACA survives its constitutional challenges, access to healthcare still will be threatened by the potential for attrition of the rights that ACA provides.
Litigating the ACA: Securing the Right to Health within a Framework of Negative Rights
Authors: Record Katherine L.
Published: January 2017

President Obama entered the White House with a clearly defined goal: expanding healthcare coverage to all Americans. He marketed this goal to the public and Congress as a “moral imperative,” as well as a necessary means to achieving a “more effective and efficient health care system.” Yet as reform proceeded, it became clear that the latter was the preeminent, if not only, goal of most legislators. While the President's rhetoric was essential in drumming up support for historic reform, it reflects an appreciation for human rights that many Americans do not share. As Congress focused on the failings of the most expensive healthcare system in the world, it became evident that the right to health (a fundamental and nonderogable human right under international law) would not be a factor in the new legislation.

This defining characteristic of reform may, paradoxically, prove invaluable in preserving the law. In challenging the Patient Protection and Affordable Care Act (ACA), litigators, politicians, and judges have focused on principles of federalism, asserting that Congress has overstepped its authority in enacting such landmark legislation. As opponents hone in on the insurance mandate and Medicaid expansion, they condemn the unprecedented expansion of coverage that moves America closer to realizing a universal right to health. The government has an extremely strong argument that these provisions are properly grounded within Congress’s authority to regulate commerce or within its taxing and spending power, although legal scholars differ on the Supreme Court’s projected interpretation of the matter. Still, the law’s basis in economic regulation, and not rights, will, if anything, prove to be its saving element.
Variable Symptomatology in Idiopathic Retroperitoneal Fibrosis
Authors: Fletcher C D M , Jarrett P E M
Published: January 2017

Idiopathic retroperitoneal fibrosis is uncommon enough to be placed low down on a list of differential diagnoses of any problem facing a general surgeon in a district hospital. In this paper, 4 cases of retroperitoneal fibrosis are described, all of whom presented within a 5-year period to the same surgeon; each described a different symptomatology. This paper serves to reiterate the diversity of presenting features in retroperitoneal fibrosis and to demonstrate that this condition may not be as rare as is widely believed.
Massive Gastrointestinal Bleeding in Crohn's Disease
Authors: Dent M T , Freeman A H , Dickinson R J
Published: January 2017

Massive gastrointestinal bleeding is rare in Crohn's disease. Three young adult patients are reported in whom the diagnosis of Crohn's disease was made following investigation for life-threatening gastrointestinal bleeding.
Familial ‘Hashitoxic’ Periodic Paralysis
Authors: Leung Alexander K C
Published: January 2017

Four members of a Chinese family who had thyrotoxicosis and periodic paralysis are described. Two of these patients had ‘hashitoxicosis’ (Graves' disease and Hashimoto's thyroiditis) as evidenced by the presence of thyroid antibodies in addition to elevated thyroxine (T4) levels. The other two patients were not available for testing. The association of the familial occurrence of ‘hashitoxicosis’ and periodic paralysis does not appear to have been reported previously.
Geographical Variations in Use of Surgery for Glue Ear
Authors: Black Nick
Published: January 2017

Study of geographical variations in the rate of surgery for glue ear reveals striking differences both between English health regions and between health districts. There are two-fold differences between regions and up to seven-fold differences between districts. Analysis of these differences at different levels of population aggregation reveals that professional uncertainty about the indications and value of surgery for this condition is the major factor responsible. In addition, the availability of otolaryngologists influences the surgical rate at district though not at regional level. The method used in this study is unable to determine the part played by geographical variation in patient expectation and morbidity rate. In contrast to the lack of consensus among otolaryngologists regarding the use of surgery for glue ear, there appears to be a high degree of agreement as regards tonsillectomy. The latter has coincided with the end of the decline in the tonsillectomy rate in the late 1970s.
Simple Lateral Release in Treatment of Tennis Elbow
Authors: Calvert P T , Macpherson I S , Allum R L , Bentley G
Published: January 2017

The records of 340 patients with a clinical diagnosis of tennis elbow were surveyed and the results of conservative treatment assessed. Of 157 patients successfully treated by local steroid injections, 92% achieved their good result after one or two injections. Repeated injections were not helpful. Simple lateral release of the common extensor origin was carried out on 42 elbows in 37 patients. Thirty-seven elbows in 32 patients were personally reviewed. Satisfactory pain relief was achieved in 33 elbows (89%). There were no significant complications.
Personal Constructs in School Psychology
Authors: Reynolds Michael , Janzen Henry L.
Published: January 2017

George Kelly's personal construct theory and Rep Grid technique was followed to analyse perceptions of some aspects of the role of psychologist in the schools. Differences in role subsystems for ‘trainees’ and ‘experts’ were examined in the light of personal construct corollaries. Subjects were 23 ‘trainees’ and 15 ‘experts’. Investigation of the results indicated tentative support for the existence of a specific subsystem for the role of psychologist in the schools. Subjects who had previous work experience were able to make more extreme and consistent characterizations than their inexperienced counterparts. More agreement was evident for both groups when role descriptions contained a positive aspect.
Self-Esteem in the Classroom
Authors: Gurney Peter W.
Published: January 2017

This paper reviews well-controlled experimental studies which have sought to enhance children's self-esteem in classroom settings. Different approaches are examined in six sections, namely, (1) curriculum packages directly aimed at self-esteem enhancement, (2) interventions aimed primarily at improving academic performance, (3) counselling interventions, (4) other forms of direct curriculum intervention, (5) changing teacher behaviour, (6) changing pupil behaviour. The paper concludes with a discussion of related issues and of the implications for classroom strategies to enhance children's self-esteem.
Towards a New Model in Political Psychology for School Psychologists
Authors: Zaki Moshe
Published: January 2017

This paper rests on the assumption that it is less the quality and level of service delivery than the status of a professional organization which is in direct relationship to the power which it accumulates through affiliation with central political systems. In Israel, the status of school psychology within the organizational structure of the Ministry of Education is relatively weak, and school psychologists have little hope of gaining central political power; thus they are exposed to a present plight which includes curtailing of resources and a constant threat of closing down psychoeducational services. The steps taken by school psychologists to counter these measures by raising professional standards, adopting new advanced techniques of intervention in schools and creating political lobbies seem to be inefficient. Since school psychologists have no political patron to protect their professional interests and resources, it is assumed that the most efficient way they can pursue their profession is to strengthen their local power within the community they serve, and thus to broaden and enhance their sphere of influence from a limited clientele of patients to the larger social structures. The prerequisite for the implementation of this model will be delineated and the implications for political educational psychology will be discussed.
Original Thinking in Israeli Preschool Children
Authors: Milgram Roberta M. , Moran James D. , Sawyers Janet K. , Fu Victoria R.
Published: January 2017

Original thinking, as measured by the Wallach and Kogan Creativity Battery, was examined in 41 Israeli preschool children. A larger proportion of original responses was generated by these preschoolers than by older children or adolescents. Original thinking was unrelated to Wechsler preschool intelligence scores. Quantity and originality of ideational output were strongly related. A more marked order effect — popular responses occurring earlier and original responses later in the response sequence — was found in high original subjects than in low. These findings duplicate those found with preschool children in the United States and indicate that the Guilford-Mednick conceptualization of original thinking has validity beyond a given Western society.
Societal Conditions and the Gender Difference in Well-Being
Authors: Zuckerman Miron , Li Chen , Diener Edward F.
Published: January 2017

Findings from a meta-analysis on gender differences in self-esteem (Zuckerman et al., 2016) suggest that the relation between the degree to which societal conditions are favorable to women and gender difference in self-esteem might be quadratic; when conditions improve, women’s self-esteem (relative to that of men) trends downward but when conditions continue to improve, women’s self-esteem begins to trend upward. Testing whether these relations generalize to subjective well-being, the present study found a quadratic relation between improving societal conditions and the gender difference in life satisfaction and positive affect (women are lower than men when societal conditions are moderately favorable compared to when they are at their worst and at their best); the relation was linear for negative emotion (women report more negative emotions than men when societal conditions are better). Directions for future research that will address potential explanations for these results are proposed.
Enhancing Gifted Education for Underrepresented Students
Authors: Ecker-Lyster Meghan , Niileksela Christopher
Published: January 2017

For decades, our educational system has been criticized for the limited recruitment and retention of minority students in gifted education programs. Unfortunately, relatively little progress has been made to alleviate these concerns. An examination of the literature on gifted education for underrepresented students reveals a dearth of information regarding effective programming practices. This article seeks to fill this void by exploring promising best practices for recruitment and retention of underrepresented students in gifted education. Multicultural education, mentoring, and noncognitive skill development are three promising areas that gifted educators can use to enhance programming.
Migration and Community Resilience in Nicaraguan Afro-Caribbean Coastal Communities
Authors: Sausner Erica B. , Webster Nicole
Published: January 2017

Bluefields, Nicaragua, is a diverse and complex city that has a panoply of cultures and languages. Youth face complex issues due to geographic, cultural, and linguistic differences from the broader Nicaraguan society. This theoretical analysis and literature review considers the marginalization of youth as a threat that encourages migration away from the community, further exposing youth to a future of isolation. Migration theories are reviewed and linked to the role that education can play in reducing these dangers and reinforcing cultural assets of the Bluefields community.
Unilateral Congenital Foot Lymphoedema with Hypoplastic Toes
Authors: Fassiadis N. , Law N.
Published: January 2017

Congenital lymphoedema causes limb swelling from impaired lymph drainage and it can predispose patients to infection and rarely to cancer. We report a case of unilateral primary congenital lymphoedema of the foot associated with hypoplastic toes, which has not been documented in the literature before.
The Role of Ambulatory Surgery of Thrombosed Varicose Veins
Authors: Zelikovski A. , Haddad M. , Sahar G. , Reiss R.
Published: January 2017

Superificial thrombosis is among the most frequent complications of varicose veins. Miscellaneous treatments have been attempted for relief of patients' symptoms, most of them unsatisfactory. We advocate simple evacuation of the thrombosed varix followed by elastic bandaging and walking exercises, a regimen which gives relief in a short period. Treatment of varicose veins should follow; no drug therapy is necessary.
Socio-Economic Benefits of Ambulatory Surgery and Compression Sclerotherapy for Varicose Veins
Authors: Neglén P. , Jönsson B. , Einarsson E. , Eklöf B.
Published: January 2017

During the last two decades the treatment of varicose veins has undergone radical changes including shorter hospitalization, and the introduction of ambulatory (out-patient) surgery and modern compression sclerotherapy (CST).

This article attempts to describe the changing pattern of care and its socio-economic consequences. It concludes that given optimal conditions possibly 60% of all patients suffering from varicose veins can have out-patient surgery performed, 20% need admission for surgery and the remaining 20% benefit from CST rather than surgery.

Applied generally this policy would result in 30% lower costs when compared with in-patient surgery alone. The socio-economic gain is probably doubtful since productivity usually increases whereas the total health care cost does not decrease. However, in general the introduction of less costly medical methods of treatment might make it possible to use available resources in new medical fields within a given economic frame-work, preserving the same level of service.
The Bacteriology of Leg Ulcers
Authors: Schraibman I.G.
Published: January 2017

An unusually high incidence of beta haemolytic streptococci — 30% of 114 pathogenic bacteria — in 73 limbs with leg ulcers has been ascribed to special bacteriological methods used to grow this organism in culture. This organism is responsible for the production of giant ulcers, case histories of which are presented. In view of the invasive propensities of this organism and its ability to destroy native or grafted skin, special search should be routinely made for its existence and appropriate antibiotic therapy instituted if clinically indicated.
The Varicose Saphenous Vein, Functional and Ultrastructural Studies, with Special Reference to Smooth Muscle
Authors: Thulesius O. , Ugaily-Thulesius L. , Gjores J.E. , Neglen P.
Published: January 2017

Specimens from the proximal and distal parts of saphenous vein of 16 patients undergoing stripping operations for varicose veins were investigated with pharmacological technique and electron microscopy. The ultrastructural investigation showed a venous wall with increased connective tissue elements such as collagen fibres. In parts endothelial damage could be observed. These changes were about equally frequent in specimens from the proximal and distal great saphenous vein. The pharmacological study showed reduced maximal contraction of varicose veins compared to controls. Moreover there was a slightly higher maximal tension (contraction per unit trans-sectional area) in specimens from the lower leg, compared to the thigh. This means that there is functional disturbance of the smooth muscle function in varicose veins, and other structural elements show significant alterations such as connective tissue and endothelial cells.
Plethysmographic Measurement of Venous Flow Resistance and Venous Capacity in Humans with Deep Venous Thrombosis
Authors: Rouweler B. J. F. Klein , Kuiper J. P. , Brakkee A. J. M.
Published: January 2017

Venous flow resistance ( Rv) and venous capacity ( C10)2 was studied in humans with deep vein thrombosis (DVT) using strain-gauge plethysmography. Rv was found to be significantly higher than normal while C10 was significantly lower, notably in measurements at the calf-level. In a follow-up study it was demonstrated that Rv usually decreased sharply within the first few months after the acute event while C10 increased. Rv usually returned to (high-level) non-thrombotic values, while C10 returned to (low-level) normal values. The sensitivity of Rv when used as a diagnostic criterion for recent proximal DVT was assessed retrospectively. For proximal DVT, the sensitivity of Rv-prox (measured with strain-gauges around the calf) was 95% (95% confidence limits 83–99%) and for distal DVT, the sensitivity of Rv-dist (measured with strain-gauges around the foot) was 36% (95% confidence limits 13–65%). The specificity for Rv was 100% (95% confidence limits Rv-prox: 90–100%; Rv-dist: 59–100%). Influencing factors for sensitivity and specifity are discussed.
Injection Sclerotherapy for Varicose Veins: History and Effectiveness
Authors: Goren Gabriel
Published: January 2017

Others preceded Tournay in practicing ‘modern’ methods of injection sclerotherapy. Extensive evidence indicates that injection sclerotherapy gives poor long-term results in the treatment of varicose veins related to saphenous incompetence and that high saphenous ligation is necessary to prevent reflux and recurrent varices.
Venous Ulceration in Drug Abusers: An Important Physical Sign
Authors: Allen S.
Published: January 2017

A young male presented with venous ulceration accompanied by linear scarring. The latter is diagnostic of previous septic thrombophlebitis resulting from the intravenous injection of drugs. Particular care should be taken in the management of such patients, in view of the risk of HIV infection.