bluuebunny/crossref_metadata_2025 huggingface dataset:
The Induction of Fos-Like Proteins in the Suprachiasmatic Nuclei and Intergeniculate Leaflet by Light Pulses in Degus (Octodon degus) and Rats
Authors: Krajnak Kristine , Dickenson Lia , Lee Theresa M.
Published: January 2017

In nocturnal rodents, exposure to light results in an increase in Fos expression in two regions that receive direct retinal input: the suprachiasmatic nuclei (SCN) of the hypothalamus and the intergeniculate leaflet (IGL) of the thalamus. The induction of Fos within the SCN of nocturnal rodents is phase dependent, with light presented during the subjective night increasing Fos expression and light presented during the subjective day having little effect. By contrast, Fos expression increases in the IGL when light is presented during the subjective day or night. It is unclear whether Fos is part of the pathway mediating light-induced phase shifts in diurnal rodents. In the present study, the ability of light to induce immunostaining for Fos in the SCN and IGL was compared in diurnal rodents, Octodon degus (degus), and nocturnal rats. Degus and rats were either maintained in constant darkness or exposed to a 1-h light pulse at circadian time (CT) 4 or 16. Degus exhibit robust phase shifts at each of those circadian hours, whereas rats demonstrate phase shifts only at CT 16. In degus, exposure to a 1-h light pulse at CT 16 resulted in an increase in the number of Fos-immunopositive (Fos+) cells in the ventrolateral SCN. By contrast, a 1-h light pulse at CT 4 resulted in a decrease in the number of Fos+ cells in the dorsomedial portion of the SCN. In rats, a light pulse presented at CT 16 resulted in an increase in Fos+ cells throughout the SCN, and a pulse at CT 4 had no effect on Fos staining. Both degus and rats showed increases in Fos expression in the IGL after light exposure at CTs 4 and 16. The authors conclude that light pulses presented at times that produce phase shifts in activity rhythms also alter Fos expression in the SCN and IGL of degus. Although these effects of light exposure on Fos expression are not identical in diurnal and nocturnal rodents, it is likely that Fos and other immediate early genes are part of the pathway mediating the effects of light in both diurnal and nocturnal rodents.
A Direct Comparison of Photoperiodic Time Measurement and the Circadian System in European Starlings and Japanese Quail
Authors: King Verdun M. , Bentley George E. , Follett Brian K.
Published: January 2017

The extent to which circadian rhythms are involved in photoperiodic time measurement in quail is enigmatic, and earlier investigations have produced results consistent with an hourglass clock or one involving damped circadian oscillators. To address the problem further, the present authors carried out a direct comparison between the clocks in quail and those in starlings. Starlings possess strongly self-sustaining circadian oscillators. In Experiment 1, comparisons of testicular growth were made between the two species when birds were exposed to light:dark (LD) 6:30, LD 6:18, and LD 18:6. Starlings grew their testes rapidly under both LD 6:30 and LD 18:6, and they became photorefractory (under LD 6:18, the testes remained undeveloped). Quail grew their testes rapidly under LD 18:6 but did not do so under LD 6:30 or LD 6:18. In Experiment 2, entrainment of the activity rhythm under cycles of LD 6:30 was investigated by measuring the phase of the rhythm after release into constant darkness (DD). Birds were exposed to either 10 cycles or 11 cycles of LD 6:30 prior to DD. Starlings maintained their 24-h rhythmicity under LD 6:30 and always free ran from the phase of the subjective day By contrast, quail showed circadian activity approximately 24 h after every light pulse and free ran from the phase of the last light pulse received. In Experiment 3, phase response curves (PRCs) were generated to 6-h light pulses. The species were strikingly different; starlings produced a Type 1 PRC, whereas quail produced a Type 0 PRC. More important, in quail the 6-h light pulse had the same effect regardless of circadian time and in almost every case activity free ran from the position of the 6-h light pulse. The results in quail are consistent with the photoperiodic time measurement system being based on a weakly self-sustaining (rapidly damping) circadian system that is invariably reset by 6 h of light, whereas in starlings the pacemakers are strongly self-sustaining. The results support the notion that hourglass pacemakers can be highly damped circadian pacemakers.
Explaining Racial Differences in Ferguson’s Impact on Local Residents’ Trust and Perceived Legitimacy: Policy Implications for Police
Authors: Kochel Tammy Rinehart
Published: January 2017

Public support and trust are critical to effective democratic policing, but scholars have suggested police in the United States may be experiencing a legitimacy crisis. High-profile police-involved shootings like those which have happened over the last 2 years can have negative consequences. This study assesses the consequences of the Ferguson, Missouri unrest and police response on local residents’ views. A panel survey of St Louis County, Missouri residents conducted before and after the police shooting of Michael Brown examines the effects on procedural justice and trust, police legitimacy, and willingness to cooperate with police. Results reveal a significantly different effect on African American versus non-Black residents. African Americans’ views significantly declined while non-Black residents’ perceptions were stable. Qualitative data are used to apply the conflict/group position and accumulated experience theories to explain racial disparities and are used as a basis to offer strategies to improve confidence and trust in police.
Management of Tuberculosis in Home Health Care
Authors: Magruder Cathryn Cook , Hamilton Grace
Published: January 2017

Tuberculosis (TB) continues to be a major public health concern within the United States. In 1993, the World Health Organization (WHO) declared TB a global emergency. An increase in the number of cases, coupled with fewer admissions to hospitals, and shorter lengths of stay have resulted in the majority of people with TB being managed in the home setting. The challenge for health care workers is to promptly identify and treat all cases of TB, identify and screen close contacts, and develop screening programs for high-risk individuals. Home health care providers are often the critical link in the successful management of this clientele.
Infectious Diseases: Education, Prevention, and Nursing Diagnoses
Authors: Gingerich Barbara Stover
Published: January 2017

The infectious disease process has been studied since the times of Louis Pasteur and Jonas Salk. Three key components comprise any infection: the agent, the spread, and the incubator (host). When considering these three components, it is recognized that the causative agents have remained relatively consistent through the years and include bacterium, spirochetes, virus, fungi, chlamydiae, parasite, ricketsettia, protozoans, and helminths, to name the more common. These agents can be located in both animate and inanimate environments and are spread by being released from their usual environment. The invasion and multiplication of these agents, microorganisms, throughout the host leads to the signs and symptoms and responses exhibited by the patient. Home health care nurses are well aware of the transmission of organisms from the more common body systems, such as respiratory gastrointestinal (GI), genitourinary, integumentary, and cardiovascular. Home care nurses also need to become increasingly aware o the spread of infectious diseases through nonhuman channels, such as through flies, mosquitoes, ticks, parrots, and contaminated food sources, as well as transmission through water, ventilation systems, the soil, and contaminated infusion products, such as drugs and blood products.
Developing Nutritional Services in a Large Home Health Care Agency
Authors: Anderson Nancy B. , Kennedy Lynn L. , Lesley Beverly B.
Published: January 2017

Nutritional assessment for home health care patients has commonly been perceived as an unnecessary and unbillable service. However, just as hospitals have implemented nutrition screening programs, home care agencies can use similar screening methods to identify and treat those patients at potential nutritional risk. Addressing nutritional deficiencies and making appropriate treatment recommendations can improve overall patient outcomes. This article describes the process that one home care agency took in developing and implementing nutritional services. The discussion will include successes and pitfalls experienced along the way as well as some valuable recommendations for other agencies to use in implementing their own nutrition service.
Meditation as a Health Patterning Modality in Nursing Practice
Authors: Malinski Violet M.
Published: January 2017

Abstract: Meditation has been practiced throughout the centuries. This article explores meditation as a health patterning modality for nurses to employ for themselves and to facilitate clients' knowing participation in their change process. The theoretical framework for this interpretation is Rogers' Science of Unitary Human Beings. Meditation has the potential to promote awareness of the experience of flow in the human/environment patterning process. Out of this evolves an expanded awareness of creative potentials for change. Two clinical vignettes are offered to illustrate this process.

Summary: Meditation is a health patterning modality that can facilitate knowing participation in change. It broadens awareness of potentials that can be actualized as nurses and clients seek to promote their own health and well-being. Meditation can assist both in experiencing the rhythm of their human/environment mutual process and open them to an expanded field image. According to Rogers, this experiencing is pandimensional, transcending traditionally perceived limitations of space and time. Meditation opens the door onto new and creative potentialities in the process of becoming.
Cost Analysis of Dialysis Modalities in Italy
Authors: Tediosi F. , Bertolini G. , Parazzini F. , Mecca G. , Garattini L.
Published: January 2017

This study analyses management and costs of dialysis in the Italian National Health Service (NHS). Information on efficacy and health-related quality of life (HRQOL) based on the existing literature also is presented. The clinical differences between the dialysis modalities seem to be related to their appropriateness to specific patient groups. Efficacy rates are similar and the only differences are in complications and HRQOL. Traditional haemodialysis (THD) can be done by Italian patients in dialysis centres or in hospital. High-flux haemodialysis (HFHD) is generally only done in hospital. Peritoneal dialysis (PD) is usually done at home. The cost analysis was performed on a sample of Italian dialysis centres and hospitals, according to the full cost method. As expected, HFHD was more expensive than THD and PD, but no marked differences emerged among the different HFHD modalities. THD modalities in dialysis centres were less costly than in hospitals. Automated PD (APD) was much more expensive (almost twice) than continuous ambulatory PD (CAPD), the cheapest method in absolute terms. This study confirms that dialysis is costly and that it is very difficult to assess the cost-effectiveness of the different approaches. Although this study has limits, it should provide sufficient analytical information to local healthcare managers for more rational allocation of financial resources to dialysis services.
Cost of Nosocomial Infection in Turkey: An Estimate Based on the University Hospital Data
Authors: Khan M. Mahmud , Celik Y.
Published: January 2017

Nosocomial infections significantly affect the resource needs of hospitalized patients. They increase the mortality and morbidity of affected individuals and expose hospital staff to increased risk of infection. To estimate the additional resources needed in the hospital sector to deal with such infections, a sample of infection cases was selected from the Hacettepe University Hospital in Ankara, Turkey. Each case of nosocomial infection was matched with a noninfected case after controlling for age, sex, clinical diagnosis etc. of the patients. The empirical results indicate that hospital infection increases the average hospital stay by about four days. Total cost of an infected case, on average, was found to be $442 higher than that for a matched noninfected case. Using this incremental cost estimate, projections for Turkey implies that the hospital sector had to spend an additional $48 million in 1995 for medical management of nosocomial infections. The benefit: cost ratio for a hospital-based infection control programme is found to be about 4.6. Clearly, a programme for preventing nosocomial infections will not only pay for itself but also will generate other direct and indirect benefits to patients and society as a whole.
HIV/AIDS Challenges the Normative Model of Healthcare Delivery in Canada
Authors: Tsasis P.
Published: January 2017

With advances in therapeutics, effective therapy for human immunodeficiency virus (HIV) has shifted the focus of HIV care from an acute illness to a chronic disease requiring the services of several disciplines in a primary care setting. This article describes a collaborative model in the delivery of HIV care for HIV-infected individuals who remain fragile, both physically and psychosocially.
The Impact of the Changing Healthcare Environment on the Attitudes of Nursing Staff: A Longitudinal Case Study
Authors: Heckert D. Alex , Fottler Myron D. , Swartz Bruce W. , Mercer Alice A.
Published: January 2017

Attitude surveys of registered nurses were conducted in 1984 (just prior to implementation of prospective payment) and in 1989 (after implementation of changes responsive to prospective payment and increased competition) in an academic medical center. Results indicate more negative attitudes toward hospital administration, pay and promotional opportunities in 1989. However, overall job satisfaction, job variety, job market alternatives, participation in decision making, and intention to leave were unchanged while job variety and perceptions of job market alternatives were more positive in 1989. Implications for health-care management and future research are discussed.
The Financial Awareness of Managers in the Reformed NHS
Authors: Marriott Neil , Mellet Howard
Published: January 2017

Managers in the NHS are facing financial reforms which will impact greatly on their role. In general terms, service managers tend to be functionally trained and their financial awareness has not been a pre-requisite for their selection. Their ability to respond to their new role requirements is therefore untested, but it represents a crucial factor in the success of the reforms. This article examines the financial awareness of a group of managers who need financial skills, drawn from a range of work categories. The results indicate that there is room for the managers in the sample to improve their financial awareness, and reports that significant differences between work categories may be expected. However, the managers expressed satisfaction with the financial information they received although this information could be better presented. Given the increased complexities of financial information produced in the reformed NHS, these managers will require further training if they are to fulfil their new role to their true potential.
Integrity, Ambiguity or Duplicity? NHS Consultation with the Public
Authors: Peck Edward
Published: January 2017

Recent guidance from the Department of Health and National Health Services (NHS) Executive has stressed the importance of public involvement in the NHS. This paper places this guidance in the historical context of public consultation in the NHS and explores, through a detailed case study, the traditional approach to consultation that the guidance is seeking to change. The paper concludes with some reflections on the challenges that will need to be addressed in order for the guidance to be put into practice.
Cross-National Comparison of Capitation Funding: The American, British and Dutch Experience
Authors: Persaud D. , Narine L.
Published: January 2017

In this paper we review the performance of the capitation payment systems of three countries—he Adjusted Average Per Capita Cost (AAPCC) system used in the United States to reimburse Health Maintenance Organizations (HMOs) for insuring Medicare recipients, a somewhat similar system in the Netherlands which reimburses third-party payers for insuring the entire population and a weighted system utilized in Britain for regional funding.

Our review revealed significant problems with the current version of the AAPCC formula as there is evidence of the biased selection of beneficiaries and actual losses to Medicare through its use. Furthermore, several studies show that the demographic adjusters utilized in the AAPCC formula are extremely poor predictors of future healthcare utilization relative to the potential of direct and indirect health status measures. The Dutch experience with capitated funding has been similar to that of the United States. While Dutch researchers have built on the work of their American counterparts they acknowledge that further work is needed before a fully functional system is implemented. Britain's weighted system has fulfilled its original mandate to redistribute healthcare resources based on population need but recent changes giving increased influence to age weighting could reverse some of these gains.

A number of proposed improvements to these risk adjustment problems were reviewed including the development of diagnostic cost groups, the coexisting hierarchical conditions model and the use of community-rated high-risk pooling. The findings from this study can help others narrow the alternatives they need to consider when thinking of introducing capitation funding or refining already existing systems.
Half-Life of Cotton-Wool Spots in the Acquired Immunodeficiency Syndrome
Authors: Mansour Ahmad M , Rodenko George , Dutt Rinku
Published: January 2017

Cotton-wool spots are a hallmark of human immunodeficiency virus (HIV) retinopathy in the acquired immunodeficiency syndrome (AIDS). We analysed the half-life of cotton-wool spots in AIDS in a prospective study, and found the average time to disappearance to be 6.9 weeks. HIV retinopathy differs from diabetic retinopathy in having a smaller size cotton-wool spot and a much shorter half-life, suggesting a patchy involvement of the retinal capillaries in AIDS and a widespread capillary disease in preproliferative and proliferative diabetic retinopathy.
Sir George Newman (1870–1948)
Authors: Storey Geoffrey O , Smith Heather
Published: January 2017

George Newman (1870–1948) was a major figure in the development of public health and school medicine in the years between World Wars I and II. From a Quaker background, he became first Chief Medical Officer to the Board of Education and then Chief Medical Officer to the Ministry of Health. In these posts he wrote many reports to the minister concerned and stimulated others. He educated the public in health matters with notable literary skill. He remained an active Quaker all his life.
Joseph Strnad (1889–1962): Handmaker of Surgical Tools
Authors: Mastoraki Aikaterini , Papadopoulou Martha , Geroulanos Stefanos
Published: January 2017

Joseph Strnad was a charismatic person who lived in Vienna and Zurich in the first half of the 20th century. He created surgical instruments that are still famous for their functionality and quality. His life story and his contribution to surgery were told by his daughter on the occasion of the donation of her father's tools to the Museum of History of Medicine at the University of Ioannina, as well as in thank you letters to Strnad from famous surgeons.
Suggested Screening Guidelines for Familial Colorectal Cancer
Authors: Hodgson S V , Bishop D T , Dunlop M G , Evans D G R , Northover J M A
Published: January 2017

Guidelines for screening for colorectal cancer in subjects with a positive family history of the disease, without the use of DNA based screening, are outlined. These suggestions are derived from (a) the experience of screening 644 subjects at an estimated lifetime risk of dying from colorectal cancer of 10% or more, in the StMark's Family Cancer Clinic, over six years, and (b) a review of published studies, particularly incorporating the experience of the International Collaboration Group on Hereditary Non-polyposis Colorectal Cancer (HNPCC). Selection of subjects for surveillance depends upon the empirical evaluation of their risk of colorectal cancer, based upon family history details, with the exclusion of a diagnosis of familial adenomatous polyposis in the family.

When DNA predictive tests for genes predisposing to HNPCC are available, surveillance can be directed at subjects with a germline mutation known to confer an increased genetic risk of colorectal cancer and discontinued in those at lower (or average) risk. In many subjects, however, DNA testing may still not be possible because of the failure to identify a predisposing mutation in an affected subject in their family. Any surveillance protocol can only be evaluated by long term follow up of those subjects in multiple centres.
The Human Element in Medical Screening
Authors: Laming Donald
Published: January 2017

An explanation is offered for the reasons why an experienced pathologist engaged in the screening of cervical smears should have issued a large number of false negative diagnoses. The explanation centres on the interactions which occur between successive judgments when a long sequence of similar stimuli are inspected. Briefly, those interactions have the character of an assimilation of each judgment to its predecessor, and the resultant process is capable of “running away”. A procedure is suggested, in which the provision of immediate knowledge of results for a small proportion of the smears inspected would prevent such systematic misdiagnoses from recurring in the future. The implications of this natural experiment for medical screening in general are spelt out.
Short Stature: Does it Matter? A Review of the Evidence
Authors: Voss Linda D
Published: January 2017

Short stature is widely regarded to be a liability, but despite the importance commonly ascribed to the psychological impact of physique, there is a paucity of methodologically sound research on the topic. The question of growth hormone therapy for a short, but otherwise normal child is still controversial. The justification for such treatment will depend not only on whether a marked improvement in height can be achieved but also on whether short stature can be shown to be an appreciable handicap, either in childhood or later in life.

There is some evidence, though much is anecdotal, to suggest that the short statured adult is disadvantaged both socially and economically. There are no conclusive data as yet, however, to suggest that short statured children, either before or during early adolescence have significantly lower scores on conventional psychometric testing than children of average stature. Possibly, the problems associated with short stature will only emerge in the older adolescent, but for the present, alternative, less expensive forms of treatment should be considered for those children apparently unable to cope.
Screening for Colorectal Cancer by Once Only Sigmoidoscopy: A Feasibility Study in Turin, Italy
Authors: Senore Carlo , Segnan Nereo , Rossini Francesco P , Ferraris Roberto , Cavallero Mariella , Coppola Franco , Pennazio Marco , Atkin Wendy S
Published: January 2017

Objectives

–To assess the impact on compliance of three invitation methods, as well as the acceptability and efficacy of two bowel preparation regimens, for endoscopic screening in the general population.

Methods

–1170 subjects (men and women aged 55 to 59, in the rosters of a sample of general practitioners (GPs) in Turin), were randomly allocated to one of three invitation groups (A: personal letter, signed by GP, with a pre-fixed appointment; B: same as for A + letter supporting the study by a well known scientist; C: letter signed by the study coordinator, NS) and two preparation regimens (i: one enema, self administered at home two hours before the test; ii: two enemas, administered the night before and two hours before the test). A postal reminder was mailed to non-attenders. A sample of non-responders was contacted for a telephone interview by a trained nurse. Written consent was obtained from all subjects undergoing the test.

Results

–A total of 278 subjects attended for sigmoidoscope screening. An invitation from the GP alone produced the highest response rate (compliance: A = 29.3%; B = 24.9%; C = 26.8%). A single enema was as effective as two enemas in achieving satisfactory preparation for the test: the proportion of subjects invited to repeat the test was 8.1% in the single enema group, and 9.6% in the group receiving two enemas.

Conclusions

–Compliance with this screening procedure tends to be low. One enema, self administered two hours before sigmoidoscopy, can ensure a satisfactory bowel preparation.
Screening for Toxoplasmosis in Pregnancy: What is the Evidence of Reducing a Health Problem?
Authors: Eskild Anne , Oxman Andy , Magnus Per , Bjorndal Arild , Bakketeig Leiv S
Published: January 2017

Objectives—

Toxoplasma gondii is a parasite which may give rise to congenital infection. Screening pregnant women for antibodies against toxoplasmosis is being debated in many countries. The preventive impact of toxoplasmosis screening of pregnant women depends on the magnitude of disease caused by congenital toxoplasmosis (incidence x transmission rate to fetus x diseased proportion of infected children), on the one hand, and the preventable proportion of disease (sensitivity of the screening test x efficacy of the treatment x compliance), on the other. In this study the preventive impact of screening pregnant women for toxoplasmosis antibodies is assessed by letting the value for these variables change within reasonable limits.

Methods—

To obtain information on these variables, relevant publications were reviewed in the Medline database from 1983 to February 1996 and the Cochrane Pregnancy and Childbirth Database. References in review articles on congenital toxoplasmosis were also studied.

Results—

The literature review showed that no population based prospective studies of the natural history of toxoplasmosis infection during pregnancy, nor any randomised controlled trials of the efficacy of antiparasitic treatment, had been carried out. In the empirical studies which have been performed the values of most variables show considerable differences. According to these values, the estimates in this study of the impact of toxoplasmosis screening in pregnancy may range from 0 to 40 children in whom disease is preventable per 100 000 pregnant women susceptible to toxoplasmosis infection.

Conclusion—

Sufficient scientific evidence is not yet available to propose screening for toxoplasmosis in pregnant women, and efforts should be made to provide such knowledge. Also, the magnitude of the negative impact of screening, such as induced abortion of healthy fetuses, anxiety in women with false positive screening tests, and side effects of treatment, has not been sufficiently examined.
A Comparison of Two View and One View Mammography in the Detection of Small Invasive Cancers : Results from the National Health Service Breast Screening Programme
Authors: Blanks R G , Moss S M , Wallis M G
Published: January 2017

Objective—

To examine the effect of using two view mammography in comparison with one view mammography in the detection of small (<15 mm) invasive cancers.

Setting—

Screening programme data from National Health Service breast screening programme (NHSBSP).

Methods—

Data were collated from all screening programmes in the United Kingdom on standard “Korner” returns (KC62 forms) for the screening year 1 April 1994 to 31 March 1995. The comparison of invasive cancer detection rates by programmes using one and two view mammography with indirectly age standardised invasive cancer detection rates.

Results—

Programmes using two views for women attending their prevalent screen (first screen) in the NHSBSP detected 3% more non-invasive/microinvasive cancers, 7% more large invasive cancers (⩽15 mm), and 42% more small invasive cancers (<15 mm) than programmes using one view mammography.

Conclusions—

The success of the screening programme depends largely on the ability of individual programmes to detect small invasive cancers. The results suggest that the benefit of using two view mammography is largely in the increased detection of these cancers.
Business Systems and Global Commodity Chains: Competing or Complementary Forms of Economic Organisation?
Authors: Whitley Richard
Published: January 2017

Capitalist economies are organised in a variety of different ways and, increasingly, have become more interdependent in the late twentieth century. Two recently developed frameworks for comparing systems of economic organisations and their interconnections are the business systems and global commodity chains approaches. The former focuses on particular configurations of firms and markets that have become established in distinctive institutional contexts, while the latter deals with the co-ordination of economic activities across national boundaries. These approaches differ in the specific phenomena being explained, the dimensions on which they vary, explanatory factors, major lacunae and key intellectual affinities. They are both, though, concerned with systems of economic organisation and so could be integrated into a common framework capable of explaining variations in both national and international economic co-ordination systems.
Key differences in treatment-seeking stimulant users attending a specialised treatment service: a means of early intervention?
Authors: Arunogiri Shalini , Petrie Margret , Sharkey Michelle , Lubman Dan I
Published: January 2017

Objectives:

Few people who use stimulants seek clinical treatment. This study sought to describe a cohort of stimulant users who attended a stimulant-specific treatment service, Access Point, in Melbourne, Australia between 2008 and 2014.

Methods:

A retrospective audit of the records of adults ( n = 175) who sought treatment for stimulant use at a stimulant-specific outpatient treatment service was conducted.

Results:

Service users had a median age of 32 (range = 19–54). Most stimulant users were in part- or full-time employment (53.6%) and had stable accommodation (85%). There was a high rate of mental health comorbidity, with over half (52%) reporting a previous history of mental health problems, while one-third (33%) reported previous suicide attempts. There was a high rate (48%) of previous methamphetamine-associated psychosis, which was significantly correlated with frequency of use ( x2 = 13.698, p = 0.008).

Conclusions:

This study supports the potential of a targeted and specialised treatment service as a means of early intervention for stimulant users. The high prevalence of methamphetamine-associated psychosis history in this group suggests that frequent use of stimulants increases the risk of psychosis, even among high-functioning individuals.
EU-approved rapid tests might underestimate bovine spongiform encephalopathy infection in goats
Authors: Meloni Daniela , Bozzetta Elena , Langeveld Jan P. M. , Groschup Martin H. , Goldmann Wilfred , Andrèoletti Olivier , Lantier Isabelle , Van Keulen Lucien , Bossers Alex , Pitardi Danilo , Nonno Romolo , Sklaviadis Theodoros , Ingravalle Francesco , Peletto Simone , Colussi Silvia , Acutis Pier Luigi
Published: January 2017

We report the diagnostic sensitivity of 3 EU-approved rapid tests (ELISAs; 1 from IDEXX and 2 from Bio-Rad) for the detection of transmissible spongiform encephalopathy diseases in goats. Ninety-eight goat brainstem samples were tested. All the rapid tests had 100% specificity and ≥80% sensitivity, with the IDEXX test significantly more sensitive than the 2 Bio-Rad tests. All tests detected 100% of samples from goats with clinical scrapie, but missed 8% (IDEXX) to 33% (Bio-Rad SG) of samples from preclinical goats. Importantly, only IDEXX picked up all samples from clinical bovine spongiform encephalopathy (BSE)-infected goats, whereas the other 2 rapid tests missed 15% (Bio-Rad SG) to 25% (Bio-Rad SAP). These results show that a fraction of preclinical scrapie infections are likely missed by EU surveillance, with sensitivity of detection strongly dependent on the choice of the rapid test. Moreover, a significant proportion of clinical BSE infections are underestimated by using either Bio-Rad test. Assuming that the same sensitivity on preclinical goats would also occur in BSE-infected goats, our data suggest that IDEXX is likely the most sensitive test for detecting preclinical field cases of BSE infection in goats, although with an 8% failure rate. These results raise some concerns about the reliability of current EU surveillance figures on BSE infection in goats.
Anaphylactoid Reaction to Intravenous Acetylcysteine Associated with Electrocardiographic Abnormalities
Authors: Bonfiglio Mark F. , Traeger Sheldon M. , Hulisz Darrell T. , Martin Bradley R.
Published: January 2017

OBJECTIVE:

To review the potential for anaphylactoid reactions to intravenously administered acetylcysteine when used in the treatment of acetaminophen overdose. This case is unique in that electrocardiographic changes, including ST segment depression and T-wave inversion were associated with the episode and complicated the diagnosis.

DATA SOURCES:

Reference articles and letters are identified in the text.

DATA SYNTHESIS:

Intravenous administration of acetylcysteine has been used in the treatment of acetaminophen overdose. This route may be considered in some clinical situations where oral therapy is complicated. Anaphylactoid reactions, including cutaneous eruptions, flushing, chest pain, tachycardia, and fever have been reported in up to three percent of patients receiving intravenous acetylcysteine. The nature of these reactions and evidence concerning their etiology suggest a histamine-release phenomenon. Response to intervention with antihistamines and the safety of further acetylcysteine administration are discussed.

CONCLUSIONS:

This case illustrates a variant anaphylactoid reaction to intravenously administered acetylcysteine and emphasizes the need for practitioners to consider the potential for these reactions prior to initiation of therapy and indicates appropriate treatment of these reactions.
Involvement in Medical Informatics May Enable Pharmacists to Expand Their Consultation Potential and Improve the Quality of Healthcare
Authors: Woodruff Alise E. , Hunt C. Anthony
Published: January 2017

The outlook for pharmacy-related services foretells more involvement of both computers and information systems. Expert therapeutic systems and databases will enable pharmacists to expand their consultation potential through networks and improve the quality of healthcare that they provide. Therapeutic information management could be the largest pharmacy speciality of the future. As knowledge-based systems and networks become commonplace, there will be an increasing need for new components, system monitoring, and quality assurance. This is an opportunity for pharmacy to bring medical computing, as it relates to therapeutics, into the mainstream of the profession as a new discipline.
A Study of Adverse Effects of High-Dose Intravenous (Pulse) Methylprednisolone Therapy in Patients with Rheumatic Disease
Authors: Baethge Bruce A. , Lidsky Martin D. , Goldberg Jerry W.
Published: January 2017

OBJECTIVE:

To determine the frequency of significant adverse effects associated with high-dose intravenous methylprednisolone therapy (HIVMP) given as methylprednisolone 1 g/d for three consecutive days.

DESIGN:

Retrospective study of consecutive patients.

SETTING:

Department of Veterans Affairs Medical Center (VAMC), university teaching hospital, and private outpatient clinic.

PATIENTS:

Eighty-four patients given HIVMP for systemic rheumatic disease.

MEASUREMENTS:

Subjective complaints were elicited via a standardized questionnaire that identified adverse effects through organ system review. Medical records were reviewed for adverse effects occurring within two weeks of HIVMP therapy.

RESULTS:

Two hundred seventy-five HIVMP treatments were examined by either patient questionnaire (76 patients) and/or chart review (78 patients). Sixty-five patients described symptoms after HIVMP treatment. Most symptoms were transient in duration, mild in severity, and required no medical treatment. Chart review found 42 possible complications occurring within two weeks of HIVMP therapy. In 18 instances medical intervention was required for problems that included hypertension, seizures, gastric erosions, sepsis, and other infections. It is impossible to attribute all of the complications to HIVMP alone because of underlying disease, use of other medications at the time of therapy, or both.

CONCLUSIONS:

HIVMP has an acceptably low risk of significant adverse effects.
New Financing for Sustainable Development
Authors: Yamaguchi Rintaro , Managi Shunsuke
Published: January 2017

We propose that national governments could issue bonds whose interest payments are linked to green net national product (gNNP) or, almost equivalently, to inclusive wealth. The main intention of this new financial instrument is to entice investors and the national government to invest in human and natural capital for which the corresponding financial assets currently do not exist. As the concept of wealth expands to include human and natural capital, so should the corresponding assets side in the balance sheet of nations. While the argument for gross national product (GNP)–linked bonds focuses on trimming public debt toward fiscal sustainability, the proposed bonds aim to ensure long-term sustainability. The theoretical link associated with welfare economics is also more plausible. Moreover, it could lead to the virtuous cycle of increased government expenditure directed toward inclusive wealth, expanding tax revenue, increased coupon payment to investors, and increased social well-being.
Measurement of the First/Second Intermetatarsal Angle Following Proximal Oblique Metatarsal Osteotomy
Authors: Allen Diane M. , Nunley James A.
Published: January 2017

The radiographs of 21 consecutive patients who had undergone proximal oblique metatarsal osteotomy were reviewed. The first/second intermetatarsal and MP angles were measured before and after surgery using two different well-described methods. Values for each patient using the Hardy and Clapham and center-of-head methods were compared using a paired t-test. The degrees of angular correction obtained for the first/second intermetatarsal angle and MP joint were significantly different on the same foot as measured by the two different methods. Although we cannot choose between these two methods on the basis of this study, we hope to call attention to the discrepancy and urge readers to be cautious in comparing the results of studies until consensus may be reached regarding standard measurement of radiographic results.
Outcomes After Interpositional Arthroplasty of the First Metatarsophalangeal Joint
Authors: Aynardi Michael C. , Atwater Lara , Dein Eric J. , Zahoor Talal , Schon Lew C. , Miller Stuart D.
Published: January 2017

Background:

For patients with hallux rigidus seeking a motion-sparing procedure, interposition arthroplasty is an alternative to fusion. The purpose of this study was to report patient outcomes after interpositional arthroplasty for hallux rigidus.

Methods:

All patients undergoing interpositional arthroplasty at our institution from 2001 to 2014 were identified and a retrospective chart review was performed. Follow-up was conducted through a telephone survey to obtain survivorship, satisfaction, and functional scores. Survivorship of the interpositional arthroplasty procedure was defined as no subsequent surgery on the hallux after the index procedure. Patients were excluded for incomplete records. Complications were recorded. From 2001 to 2014, 183 patients were identified. Of these, 14 were excluded for incomplete data, leaving 169 patients. Of these, 133 had an average follow-up of 62.2 months (range, 24.3 months to 151.2 months).

Results:

The overall failure rate was 3.8% (5/133). Patient-reported outcome was rated as excellent in 65.4% (87/133) or good in 24.1% (32/133) of patients and fair or poor in 10.5% (14/133) of patients. Of 133 patients, 101 (76%) were able to return to fashionable or regular footwear. The infection rate was 1.5% (2/133). Patient-reported cock-up deformity of the first metatarsophalangeal joint (MTPJ) occurred in 4.5% (6/133) of patients. In addition, 17.3% (23/133) of patients reported metatarsalgia of the second or third MTPJ at the time of final follow-up, and there was no significant difference between interposition types ( P = .441).

Conclusion:

Interpositional arthroplasty for hallux rigidus was found to have excellent or good results in most patients at a mean follow-up of 62.2 months.

Level of Evidence:

Level IV, retrospective case series.
Gifted & Green
Authors: Schroth Stephen T. , Helfer Jason A.
Published: January 2017

Environmental studies provide an ideal opportunity for gifted children of any age to build critical and creative-thinking skills while also building skills in science, technology, engineering, and mathematics (STEM) areas. Exploring issues related to sustainability and environmental concerns permits gifted learners to identify problems, develop research questions, gather and analyze data, develop possible solutions, and disseminate this information to others. Green issues are especially appealing to gifted learners as they are sensitive to the world around them and often long to engage in projects that touch on issues facing their communities. Although the relevance to STEM subjects is clear, green investigations can also build skills across the content areas, in diverse subjects such as English/language arts, social studies, music, and art. A variety of resources, including national and Common Core State Standards, exist that can help parents and teachers create investigations for gifted children that permit them to be both gifted and green.
Dynamic characteristics of infinite-length and finite-length rods with high-wave-number periodic parameters
Authors: Ying Zu-Guang , Ni Yi-Qing
Published: January 2017

The dynamic characteristics of the infinite-length and finite-length rods with periodic distribution parameters are studied. The differential equation of longitudinal motion of the period-parametric rod is given. The algebraic matrix equation for the wave motion characteristics of the infinite-length periodic rod is derived based on the Bloch theorem and Fourier series. The characteristic frequencies are determined by the matrix eigenvalues which depend on the characteristic wave number and parametric wave number. Then the algebraic matrix equation for the dynamic characteristics of the finite-length periodic rod is derived based on the Galerkin method. The natural frequencies are determined by the matrix eigenvalues which depend on only the parametric wave number. An improving approach algorithm for solving the eigenvalue problem of high degree-of-freedom systems is developed based on the Rayleigh quotient. Finally, the circular cross-section rod with period-varying diameter is considered and numerical results on the dynamic characteristics are given. Large characteristic wave number and parametric wave number are considered for the infinite-length and finite-length periodic rods. The characteristic frequencies varying with the characteristic wave number and parametric wave number are shown, and the band gaps vanishing are revealed for increasing characteristic wave number. The finite-length periodic rod has the dynamic characteristics different from the infinite-length periodic rod. The effect of the term number of the displacement expansion on the natural frequencies and the natural frequencies varying with the parametric wave number and wave amplitude are shown for the finite-length periodic rod. The local resonance and periodical short descent of the natural frequencies with the increase of the parametric wave number and the different changes of the natural frequencies with the parametric wave amplitude are revealed. The above new dynamic characteristics of the infinite-length and finite-length rods with periodic distribution parameters have a potential application to period-structural design and optimization.
From Academe, to the Theatre, to the Streets: My Autocritography of Aesthetic Cleansing and Canonical Exception in the Wake of Ferguson
Authors: Johnson Amber Lauren
Published: January 2017

Using autocritography, this essay acts as a critical performance of interracial communication, civil and academic unrest, and theatre during the Grand Jury Hearing for Darren Wilson a year after he murdered Michael Brown in the streets of Ferguson. On the second day of my interview for the intercultural communication professor position at Saint Louis University, the grand jury decided not to indict Darren Wilson. Protests erupted around the city. Later that week, after Thanksgiving and as protests began to wane, my family and I went to the Fabulous Fox Theatre to view Motown: The Musical. Drawing from canonical prejudice, this essay adds canonical exception to the discussion in an attempt to illuminate the repulsive practice of respectability politics in policed spaces like the academy, theatre, and music.
Coming Unhinged: A Twice-Told Multivoiced Autoethnography
Authors: Ellis Carolyn , Bochner Arthur P. , Rambo Carol , Berry Keith , Shakespeare Hannah , Gingrich-Philbrook Craig , Adams Tony E. , Rinehart Robert E. , Bolen Derek M.
Published: January 2017

This story tells about an accident that occurred at the 2016 International Congress of Qualitative Inquiry. The first author presents her autoethnography of her partner’s fall and her subsequent reaction. Then to complicate and deepen her telling, she crafts a second multivoiced account from the responses of eight people who were part of the event. The participants’ stories are juxtaposed to tell a multivoiced tale and to theorize what happened in an experience-near mode. Twice-told multivoiced autoethnography brings other voices, subjectivities, and interpretations into our autoethnographic accounts, providing a collective consciousness and offering the possibility of initiating conversations about the values of care and empathy connected with the project of autoethnography.
Intersectional Identity Negotiation
Authors: Compton-Lilly Catherine , Papoi Kristin , Venegas Patricia , Hamman Laura , Schwabenbauer Briana
Published: January 2017

We cast our lens on intersectional networks of identity negotiated by young children in immigrant families. Although some scholars discuss identity construction, we reference identity negotiation to capture the active, strategic, and agential work that we witnessed in our study. We begin by synthesizing relevant research on children’s identity negotiation. We then explore theoretical frames that form the basis for our claims related to intersectional identity negotiation. These 3-year longitudinal collective case studies of Carlos and Liz involved observations, spoken data, and student-created artifacts (e.g., writing samples, maps, photographs, drawings). Data sources were designed to highlight literacy practices and identity construction across time. The cases of Carlos and Liz reveal intersectional networks of identity negotiation that entail positionings relative to various dimensions of self including language, gender, technological practices, nationality, and race. We maintain that attending to the identity negotiations of children in immigrant families reveals sophisticated, agential, and strategic negotiations on the part of children.