bluuebunny/crossref_metadata_2025 huggingface dataset:
Brexit and the EU Internal Market
Authors: Barnard Catherine
Published: November 2017

The chapter considers Brexit and the EU internal market. Barnard emphasizes the role that the UK played in creating the EU internal market and examines the view that its four freedoms—free movement of goods, services, capital, and people—are indivisible. The decision of the UK to leave the EU has paradoxically contributed to entrench the view that the four freedoms are indivisible. This reduces the possibility for the UK to maintain access to the EU single market after Brexit—a fact acknowledged even by the UK government. However, the EEA model might be the best solution for the UK post-Brexit, reflecting UK citizens’ demands, and also in the interest of the EU. Nevertheless, the withdrawal of the UK may strengthen protectionist trends within the EU. Moreover, Barnard emphasizes that Brexit poses challenges for the UK internal market, which the Great Repeal Bill will need to address.
Royal Responsibility in Anglo-Norman Historical Writing
Authors: Winkler Emily A.
Published: November 2017

It has long been established that the crisis of 1066 generated a florescence of historical writing in the first half of the twelfth century. This book presents a new perspective on previously unqueried matters: it investigates how historians’ individual motivations and assumptions produced changes in the kind of history written across the Conquest. It argues that responses to the Danish Conquest of 1016 and Norman Conquest of 1066 changed dramatically within two generations of the latter conquest. Repeated conquest could signal repeated failures and sin across the orders of society, yet early twelfth-century historians in England not only extract English kings and people from a history of failure, but also establish English kingship as a worthy office on a European scale. The book illuminates the consistent historical agendas of four historians: William of Malmesbury, Henry of Huntingdon, John of Worcester, and Geffrei Gaimar. In their narratives of England’s eleventh-century history, these twelfth-century historians expanded their approach to historical explanation to include individual responsibility and accountability within a framework of providential history, making substantial departures from their sources. These historians share a view of royal responsibility independent both of their sources (primarily the Anglo-Saxon Chronicle) and any political agenda that placed English and Norman allegiances in opposition. Although the accounts diverge widely in the interpretation of character, all four are concerned more with the effectiveness of England’s kings than with the legitimacy of their origins. Their new, shared view of royal responsibility represents a distinct phenomenon in England’s twelfth-century historiography.
Conditional Kingship
Authors: Winkler Emily A.
Published: November 2017

Chapter 6 investigates narratives of becoming an English king, with particular emphasis on stories of royal accessions in the eleventh century in moments of disputed succession. It argues that the four historians created a new idea of English kingship: one in which anyone worthy, including a foreign conqueror, could become a true English king. All four writers diminish the significance of dynasty and being a natural English lord in favour of individual competence and royal responsibility, in different ways. For William of Malmesbury, legitimate succession depended primarily on a prospective king’s character. Henry emphasizes the desire and decision of the English in making a king. John of Worcester writes favourably of the House of Wessex, but king-making occurs in moments of reconciliation between contenders for the throne. For Gaimar, the succession of English kings is not dynastic, but rather a perpetual office wherein the king holds the kingdom of God.
Redeeming the English Past
Authors: Winkler Emily A.
Published: November 2017

The parallels and patterns within each invasion narrative suggest that their shared aim of redeeming England’s history of invasion is the most significant factor in their revised views of eleventh-century England. This goal supersedes conflict between English and Norman loyalties, as well as traditional modes of explanation by Providence and collective sin. This chapter explores the most significant ways in which twelfth-century narratives transformed the English from victims to victors. The four historians redistributed responsibility for conquest and rebellion to emphasize reasons for the English king’s actions, and the gravity of treachery against the king. The historians rewrote the past to give the English proportionally more control over their fate. The changes indicate sympathy for and confidence in the English, and a shared conviction that although the English are not culpable for a king’s unjust actions, they owe loyalty to their rightful king regardless of his origin.
Substantive Opportunity
Authors: Scanlon T. M.
Published: November 2017

Social institutions are not justifiable to those whose life prospects depend on them unless the positions of advantage that they create are open to all. This means not only that the processes through which individuals are selected for these positions should be procedurally fair but that even those born into poorer families should have substantive opportunity to develop their abilities to qualify for these positions. It is often said that such success should depend only on an individual’s talent and effort, rather than on their family’s wealth or income. But, as was argued in Chapter 4, talent in the relevant sense is an institution-dependent notion so it cannot be used to specify the kind of education and other conditions that substantive opportunity requires. Also, to understand effort as a characteristic that it is just to reward is a form of moralism about equality of opportunity that it is important to avoid.
Family Law and Personal Life
Authors: Eekelaar John
Published: November 2017

Developments in the law, scholarship, and research since 2006 form a substantial part of the second edition of this book which sets the governance of personal relationships in the context of the exercise of social and personal power. Its central argument is that this power is counterbalanced by the presence of individual rights. This entails an analysis of the nature and deployment of rights, including human rights and children’s rights. Against that background, the book examines the values of friendship, truth, respect, and responsibility, and how the values of individualism co-exist with those of the community in an open society. It argues that central to these values is respecting the role of intimacy in personal relationships. In doing this, a variety of issues are examined, including the legal regulation of married and unmarried relationships, same-sex marriage, state supervision over the inception and exercise of parenthood (including surrogacy and assisted reproductive technology), the role of fault and responsibility in divorce law, children’s rights and welfare, religion and family rights, the rights of separated partners regarding property and of separated parents regarding their children, and how states should respond to cultural diversity.
Friendship
Authors: Eekelaar John
Published: November 2017

This chapter reflects on the role of friendship in personal relations to see if this illuminates some issues concerning their regulation. It examines various historical perceptions of friendship, drawing lessons from Aristotle’s distinction between utilitarian and full friendship, and Montaigne’s comparison between friendship and marriage. The issue whether unmarried relationships should be regulated is approached by asking how these may be differentiated from friendship, which could be devalued if legally regulated. It is argued that it is justifiable to require friends to restore to one another what each put into their common wealth if the friendship fails. The concept of ‘friendship plus’—which includes marriage and sharing a life plan with another, usually through cohabitation in the same household, but possibly also when ‘living apart together’—is proposed as a justification for imposing a right to compensation in favour of someone disadvantaged by the termination of such a friendship.
Responsibility
Authors: Eekelaar John
Published: November 2017

This chapter analyses the role of relationship responsibility in the law of divorce and parenthood, using a framework that distinguishes historical and prospective responsibility. The former is concerned with attributing blame, the latter with defining roles. For divorce, it argues there are strong reasons why the legal process should not seek to assess blame for marital breakdown. Prospective responsibility is recognized through property and financial allocations after divorce. The grounds for allocating responsibility to specified adults towards children are also examined, including in cases of surrogacy and assisted reproductive technology. It concludes that while people have a responsibility to comply with the law, a fuller sense of responsibility will sometimes demand that people refrain from enforcing their legal rights, or act beyond their legal duties, out of recognition of ‘the other’ and the interests of the community.
The Cyclops
Authors: Alden Maureen
Published: November 2017

Odysseus’ blinding of the Cyclops by a combination of μῆτις‎ and βίη‎ continues the debate on the qualities needed for success initiated in the songs of Demodocus. The uncultivated Cyclopes reflect a reversed image of their relatives, the super-civilized Phaeacians. The mirror of the Cyclopeia simultaneously reflects the suitors (Model A) and Odysseus himself (Model B). In Model A, the suitors parallel the Cyclops as Odysseus’ adversary. No One is the false name by which Odysseus tricks the Cyclops: the suitors fear no one. Their consumption of Odysseus’ flocks and herds corresponds to the Cyclops’ consumption of Odysseus’ companions. Both they and the Cyclops are killed while under the influence of wine. In Model B, Odysseus returns, like the Cyclops, to find intruders consuming his resources. Odysseus confronts the suitors from the doorway of his hall in a near theophany parodied by the blinded Cyclops in his cave doorway.
Making Music in Selznick's Hollywood
Authors: Platte Nathan
Published: November 2017

Making Music in Selznick’s Hollywood explores the network of musicians and filmmakers whose work defined the sound of Hollywood’s golden age (c. 1920s–1950s). The book’s central character is producer David O. Selznick, who immersed himself in the music of his films, serving as manager, critic, and advocate. By demonstrating music’s value in film and encouraging its distribution through sheet music, concerts, radio broadcasts, and soundtrack albums, Selznick cultivated audiences’ relationship to movie music. But he did not do it alone. Selznick’s films depended upon the men and women who brought the music to life. This book shows how a range of specialists, including composers (Max Steiner, Dimitri Tiomkin, Franz Waxman, and others), orchestrators, music directors (Lou Forbes), editors (Audray Granville), writers, instrumentalists, singers, and publicists, helped make the music for Selznick’s films stand apart from competitors’. Drawing upon thousands of archival documents, this book offers a tour of American cinema through its music. By investigating Selznick’s efforts in the late silent era, his work at three major Hollywood studios, and his accomplishments as an independent producer (including his films with Alfred Hitchcock), this book reveals how the music was made for iconic films like King Kong (1933), A Star is Born (1937), The Prisoner of Zenda (1937), Gone with the Wind (1939), Rebecca (1940), Spellbound (1945), The Third Man (1948), and A Farewell to Arms (1957).
Emma Abbott, the “People’s Prima Donna”
Authors: Preston Katherine K.
Published: November 2017

The focus of this chapter is the most successful grand opera company of the decade, the troupe of Emma Abbott. This prima donna was thoroughly trained in the Italian school and performed primarily translated versions of the same continental repertory mounted by companies like James Mapleson’s. A self-made woman who thoroughly understood marketing, Abbott created a new audience of middle-class American opera lovers by providing an entertainment-oriented middlebrow style of opera that was located on the operatic continuum somewhere between comic or light opera and the socially or culturally elite foreign-language styles performed in Italian or German. Her goals, however, were antithetical to some establishment critics who wanted to remove opera from the world of popular entertainment; they dismissed her as a charlatan who enjoyed “popular” rather than “artistic” success. Despite their efforts, Abbott was extremely popular, financially successful, and tremendously influential on American musical culture during the 1880s.
Food, Nutrients, and Health
Authors: Davis George C. , Serrano Elena L.
Published: November 2017

Chapter 1 begins by covering key concepts in nutrition, including the function of nutrients and foods in overall health and the leading causes of death in the US. It then discusses the major nutrition recommendation formats designed to ideally simplify healthy food choices, such as the Nutrition Facts Label, MyPlate, and the Dietary Guidelines for Americans. The chapter closes with a presentation and discussion of some of the most common nutrition indices used in practice and research for measuring overall nutrient and diet quality.
Neuroeconomics
Authors: Davis George C. , Serrano Elena L.
Published: November 2017

Chapter 10 places both the neoclassical and behavioral economic approaches under the broader unifying framework of neuroeconomics. The chapter uses insights from the neuroscience and neuroeconomics literature to consider food and nutrition choices within a dual systems dual objectives framework with limited cognitive resources. This framework allows us to reinterpret and re-evaluate various factors already discussed in the book, ranging from income, to prices, to information campaigns, to behavioral effects. This broader framework sheds new light on why some factors may seem more important than others. This leads naturally to a discussion of the types of nutrition interventions that are most likely to be most effective as well.
Right against Economic Exploitation
Authors: Bajpai Asha
Published: November 2017

The phenomenon of child labour, estimates on its magnitude, available statistics, its causes and consequences, girl child labour and domestic child labour are discussed in this chapter. The link between out-of-school children and child labour has been established and all out-of-school children must be treated as child labourers or potential child labour. The evolution of the Policy on Child Labour in India has been traced. The legal regime and the judicial response relating to Child Labour and Bonded Child Labour are analysed. The Child Labour (Prohibition and Regulation) Amendment Act, 2016 is critically reviewed. This chapter includes a section on international legal interventions, strategies and movements on child labour and bonded children. The chapter includes non-governmental organizations, government initiatives, programmes and schemes relating to child labour and bonded labour. The chapter concludes with recommendations for law reform.
Right to Development
Authors: Bajpai Asha
Published: November 2017

This chapter is in two parts. Part I deals with Right to Education and Part II deals with Right to Play and Recreation. educational policy and planning in India, key developments that guided the development of school education and literacy plans and plans and programmes in India, the number of out of school children and laws relating to child education in India are analysed. Barriers and challenges to right to elementary education including corporal punishment, child labour is pointed out along with their legal provisions. The salient features of the Right to Education Act, 2009, its implementation, important judgements both national and international, and law reform required are discussed. Part II discusses the right to play as a fundamental right. Law reform relating to right to play and recreation and role of some NGOS working to promote right to education and right to play have been included
Perfect Gas
Authors: Rau Jochen
Published: November 2017

The perfect gas is perhaps the most prominent application of statistical mechanics and for this reason merits a chapter of its own. This chapter briefly reviews the quantum theory of many identical particles, in particular the distinction between bosons and fermions, and then develops the general theory of the perfect quantum gas. It considers a number of limits and special cases: the classical limit; the Fermi gas at low temperature; the Bose gas at low temperature which undergoes Bose–Einstein condensation; as well as black-body radiation. For the latter we derive the Stefan–Boltzmann law, the Planck distribution, and Wien’s displacement law. This chapter also discusses the effects of a possible internal dynamics of the constituent molecules on the thermodynamic properties of a gas. Finally, it extends the theory of the perfect gas to dilute solutions.
Phase Transitions
Authors: Rau Jochen
Published: November 2017

At a phase transition two or more different phases may coexist, such as vapour and liquid. Phase transitions can be classified according to their order. A phase transition is of first order if going from one phase to the other involves a discontinuous change in entropy, and, thus, a finite amount of latent heat; higher-order phase transitions do not involve latent heat but exhibit other types of discontinuities. This chapter investigates the necessary conditions for the coexistence of phases, and how phases are represented in a phase diagram. The order of a phase transition is defined with the help of the Ehrenfest classification. The chapter discusses the Clausius–Clapeyron relation which, for a first-order phase transition, relates the discontinuous changes in entropy and volume. Finally, this chapter considers the Ising ferromagnet as a simple model which exhibits a second-order phase transition. It also introduces the notion of an order parameter.
Suspension
Authors: Tyler Amanda L.
Published: November 2017

The crowning of William and Mary and the Glorious Revolution witnessed the restoration of a Protestant monarchy, the continued rise of parliamentary supremacy, and the adoption of the Declaration of Rights. It did not, however, bring a settled peace. Despite their king having fled, James II’s supporters remained eager to engineer his return. It was to defeat the plotting of the Jacobites that Parliament invented suspension for setting aside the very protections for which it had provided in the Habeas Corpus Act of 1679. This chapter details the many suspensions that followed during the Jacobite Wars and war with France, while also detailing how bills of attainder similarly empowered Parliament to work around the constraints of the Habeas Corpus Act. The chapter concludes by highlighting the important legal distinctions drawn in English law during this period between prisoners of war and traitors.
Developing End-of-Training Entrustable Professional Activities for Psychiatry: Results and Methodological Lessons
Authors: Young John Q. , Hasser Caitlin , Hung Erick K. , Kusz Martin , O’Sullivan Patricia S. , Stewart Colin , Weiss Andrea , Williams Nancy
Published: November 2017

Purpose

To develop entrustable professional activities (EPAs) for psychiatry and to demonstrate an innovative, validity-enhancing methodology that may be relevant to other specialties.

Method

A national task force employed a three-stage process from May 2014 to February 2017 to develop EPAs for psychiatry. In stage 1, the task force used an iterative consensus-driven process to construct proposed EPAs. Each included a title, full description, and relevant competencies. In stage 2, the task force interviewed four nonpsychiatric experts in EPAs and further revised the EPAs. In stage 3, the task force performed a Delphi study of national experts in psychiatric education and assessment. All survey participants completed a brief training program on EPAs. Quantitative and qualitative analysis led to further modifications. Essentialness was measured on a five-point scale. EPAs were included if the content validity index was at least 0.8 and the lower end of the asymmetric confidence interval was not lower than 4.0.

Results

Stages 1 and 2 yielded 24 and 14 EPAs, respectively. In stage 3, 31 of the 39 invited experts participated in both rounds of the Delphi study. Round 1 reduced the proposed EPAs to 13. Ten EPAs met the inclusion criteria in Round 2.

Conclusions

The final EPAs provide a strong foundation for competency-based assessment in psychiatry. Methodological features such as critique by nonpsychiatry experts, a national Delphi study with frame-of-reference training, and stringent inclusion criteria strengthen the content validity of the findings and may serve as a model for future efforts in other specialties.
Smoothing the Transition Points in Canadian Medical Education
Authors: Busing Nick , Rosenfield Jay , Rungta Kamal , Raegele Matt , Warren Andrew , Wright Bruce , Walton Mark , Oandasan Ivy , Sanfilippo Anthony , Saxena Anurag
Published: November 2017

In 2010, the Association of Faculties of Medicine of Canada, Collège des médecins du Québec, College of Family Physicians of Canada, and Royal College of Physicians and Surgeons of Canada launched the Future of Medical Education in Canada Postgraduate (FMEC PG) Project to examine postgraduate medical education (PGME) in Canada and make recommendations for improvement. One recommendation that emerged concerns the transitions learners experience across the undergraduate medical education–PGME–practice continuum. The FMEC PG, using a thorough process, developed projects to address these often-tumultuous transitions for the learner, aiming to provide support, tools, and standards for the learner’s educational journey.

With leadership by two senior academics and the Transitions Implementation Committee, three working groups helped implement these transitions projects, which addressed (1) the medical-school-to-residency transition, (2) career planning and the residency matching process, and (3) the residency-to-practice transition. Work products include the development of a learner education handover protocol and the establishment of pan-Canadian entrustable professional activities to be used nationally to help define expectations for new graduates entering residencies. A postmatch boot camp tool and a simulated night on-call tool were developed and are available to all medical schools. National standards are being promoted for career services counseling and best practices in residency selection. A practice management curriculum framework, mentorship resources, resiliency training for graduating residents, and the entry-level disciplines of residency are also being explored.

Ultimately, with system-wide change and better integration of all players, transitions for Canada’s learners will greatly improve.
What Is the Impact of the Underserved Pathway Program on Graduates Entering an Underserved Family Medicine Residency? Five-Year Findings From the University of Washington School of Medicine
Authors: Kost Amanda , Evans David , Dobie Sharon , Sanders Elizabeth
Published: November 2017

Purpose

More primary care physicians are needed in underserved areas of the United States. Prior research indicates that medical student experiences in underserved settings increase the likelihood that they will practice in underserved areas; few studies have controlled for selection bias. This study aimed to estimate the effect of the University of Washington School of Medicine’s (UWSOM’s) longitudinal extracurricular experience, the Underserved Pathway (UP), on graduates’ choice in entering a family medicine residency with underserved training opportunities.

Method

The American Medical College Application Service application that all students submit to apply to UWSOM and a matriculation survey were used to collect demographic information for medical school graduates who subsequently entered family medicine residencies between 2010 and 2015. A given family medicine residency offered underserved training if it had a clinic or rotation at a federally qualified health center or if the admitting hospital was a critical access hospital. Multiple logistic regression was used to estimate the UP program’s effect on graduates entering an underserved family medicine residency, adjusting for 26 covariates.

Results

Participants were 158 UWSOM graduates; 39 (25%) completed the UP program. UP completion was associated with a 3.58 odds ratio increase to matching to an underserved family medicine residency, compared with non-UP graduates.

Conclusions

Completion of the UP was linked to a significant increase in program graduates matching to an underserved family medicine residency. Longitudinal extracurricular programs similar to the UP could be an important component in the pipeline to meeting the primary care needs of underserved populations.
Diagnosis of Cervical Precancers by Endocervical Curettage at Colposcopy of Women With Abnormal Cervical Cytology
Authors: Liu Angela Hui-Chia , Walker Joan , Gage Julia C. , Gold Michael A. , Zuna Rosemary , Dunn S. Terence , Schiffman Mark , Wentzensen Nicolas
Published: November 2017

OBJECTIVE:

To evaluate the performance of routine endocervical curettage (ECC) for diagnosing high-grade cervical intraepithelial neoplasia (CIN) 2 or worse and additional precancers not otherwise detected by ectocervical biopsies.

METHODS:

In a secondary analysis of the Biopsy Study, a cross-sectional study conducted between 2009 and 2012 at the University of Oklahoma Health and Sciences Center that found an incremental increase in detection of cervical precancers by multiple biopsies at colposcopy, ECC was performed in most women aged 30 years or older. Cervical intraepithelial neoplasia 2 or worse yield by ECC alone was evaluated in analyses stratified by cervical cytology (atypical squamous cells of undetermined significance [ASC-US] or low-grade squamous intraepithelial lesions [LSIL] compared with atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesions [ASC-H] or high-grade squamous intraepithelial lesions [HSIL] or worse), colposcopic impression (less than high-grade compared with high-grade), human papillomavirus (HPV)-16 infection status, whether the examination was satisfactory, and by ECC indications per the current guidelines for cervical cancer screening. The diagnostic value of ECC for detecting additional disease was evaluated by the number of lesion-directed ectocervical biopsies.

RESULTS:

Of the 204 women aged 30 years or older, 181 (88.7%) underwent ECC. Overall ECC detected 14.4% CIN 2 or worse (95% CI 10.0–20.2%). Endocervical curettage was more likely to find disease in the endocervix among women with high-grade cytology, positive HPV-16 infection, or high-grade colposcopic impressions (respective P values <.05). Among women with ASC-US or LSIL cytology, those with an unsatisfactory examination had a 13.0% CIN 2 or worse yield on ECC (95% CI 6.1–25.7); when colposcopic examination was normal or satisfactory with visible abnormal lesions, ECC detected less than 5% CIN 2 or worse in the endocervix. An ASC-H or HSIL or worse cytology was associated with a CIN 2 or worse yield of 25.8% by ECC (95% CI 16.6–37.9%). However, ECC found only 3.9% (95% CI 1.9–7.8%) additional CIN 2 or worse beyond the cumulative disease detected by up to four biopsies of visible acetowhite ectocervical lesions. Additional CIN 2 or worse yield by ECC increased when fewer lesion-directed biopsies were taken (P<.05).

CONCLUSION:

The additional yield of CIN 2 or worse by ECC in a colposcopy with up to four ectocervical biopsies was low. Based on our findings, we recommend routine ECC be performed in women aged 45 years old or older with HPV-16 infection and in any woman aged 30 years or older with HSIL or worse or ASC-H cytology, high-grade colposcopic impression, or ASC-US or LSIL cytology and an unsatisfactory examination.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT00339989.
Travel Characteristics and Pretravel Health Care Among Pregnant or Breastfeeding U.S. Women Preparing for International Travel
Authors: Hagmann Stefan H. F. , Rao Sowmya R. , LaRocque Regina C. , Erskine Stefanie , Jentes Emily S. , Walker Allison T. , Barnett Elizabeth D. , Chen Lin H. , Hamer Davidson H. , Ryan Edward T. ,   for the Global TravEpiNet Consortium and the Boston Area Travel Medicine Network
Published: November 2017

OBJECTIVE:

To study characteristics and preventive interventions of adult pregnant and breastfeeding travelers seeking pretravel health care in the United States.

METHODS:

This cross-sectional study analyzed data (2009–2014) of pregnant and breastfeeding travelers seen at U.S. travel clinics participating in Global TravEpiNet. Nonpregnant, nonbreastfeeding adult female travelers of childbearing age were used for comparison. We evaluated the prescription of malaria chemoprophylaxis and antibiotics for this population as well as the administration of three travel-related vaccines: hepatitis A, typhoid, and yellow fever. We also evaluated use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis and influenza vaccines, because these are widely recommended in pregnancy.

RESULTS:

Of 21,138 female travelers of childbearing age in Global TravEpiNet, 170 (0.8%) were pregnant and 139 (0.7%) were breastfeeding. Many traveled to destinations endemic for mosquito-borne illnesses, including malaria (pregnant: 95%; breastfeeding: 94%), dengue (pregnant: 87%; breastfeeding: 81%), or yellow fever (pregnant: 35%; breastfeeding: 50%). Compared with nonpregnant, nonbreastfeeding adult female travelers, eligible pregnant travelers were less likely to be vaccinated against hepatitis A (28% compared with 51%, P<.001) and typhoid (35% compared with 74%, P<.001). More than 20% of eligible pregnant travelers did not receive influenza vaccination. Yellow fever vaccine was occasionally provided to pregnant and breastfeeding travelers traveling to countries entirely endemic for yellow fever (6 [20%] of 30 pregnant travelers and 18 [46%] of 39 breastfeeding travelers). Half of pregnant travelers and two thirds of breastfeeding travelers preparing to travel to malaria-holoendemic countries received a prescription for malaria prophylaxis.

CONCLUSION:

Most pregnant and breastfeeding travelers seen for pretravel health consultations traveled to destinations with high risk for vector-borne or other travel-related diseases. Destination-specific preventive interventions were frequently underused.
Role of Insurance Coverage in Contraceptive Use After Abortion
Authors: Biggs M. Antonia , Taylor Diana , Upadhyay Ushma D.
Published: November 2017

OBJECTIVE:

To assess postaspiration abortion contraceptive use and the role of insurance coverage for abortion in a state that covers abortion and contraception for low-income women.

METHODS:

This is a secondary analysis of a previously published prospective study to assess the safety of abortion provision. From 2007 through 2013, women seeking first-trimester aspiration abortion were recruited at 25 clinical facilities within four Planned Parenthood affiliates and Kaiser Permanente of Northern California. Patients' medical charts were reviewed to assess the contraceptive methods received on the day of the abortion. A 4-week follow-up survey assessed contraceptive use and contraceptive-related incidents. Primary outcomes included leaving with any method on the day of the abortion and use of any method at the 4-week assessment. Secondary outcomes included intrauterine device or implant use on the day of the procedure and at 4 weeks and switching to a less effective method at 4 weeks.

RESULTS:

A total of 19,673 women agreed to participate, and 13,904 (71%) completed the 4-week follow-up survey. Ninety-four percent (18,486/19,673) left their abortion visit with a contraceptive method: 21% (4,111/19,673) with an intrauterine device, implant, or permanent method. By the 4-week survey, 8% (1,135/13,904) switched from a high- or medium-efficacy method to a low-efficacy or no method; 0.4% (60/13,904) experienced a contraceptive incident. In adjusted regression analyses, women who paid for the abortion with Medicaid were significantly more likely to use any method (adjusted odds ratio [OR] 3.70, 95% CI 3.09–4.42) or an intrauterine device or implant (adjusted OR 2.14, 95% CI 1.92–2.38) on the day of the abortion than those who did not pay with insurance. Experiencing a contraceptive-related incident was associated with switching to a low-efficacy or no method by the 4-week survey (adjusted OR 3.98, 95% CI 2.20–7.22).

CONCLUSION:

Insurance coverage for abortion is associated with postabortion contraceptive provision and use, even in settings that cover abortions and contraception for low-income women.
Pica in Pregnancy
Authors: Epler Katharine E. , Pierce Arand , Rappaport Valerie J.
Published: November 2017

BACKGROUND:

Pica is common in pregnancy and is often felt to be benign. The following case of severe pica presenting without anemia is unusual in its presentation, laboratory findings, and treatment.

CASE:

A 31-year-old multiparous woman at 37 0/7 weeks of gestation presented with esophagitis and gastritis secondary to laundry detergent consumption. She had borderline anemia (hemoglobin of 11 g/dL and hematocrit of 37%, mean corpuscular volume 80%) but was severely iron-deficient (serum ferritin 7 micrograms/dL). Parenteral iron infusion was associated with dramatic resolution of her cravings within 36 hours of treatment.

CONCLUSION:

Pica may be related to deficient iron stores in the absence of anemia and can result in serious morbidity. Parenteral iron may be associated with rapid pica resolution in symptomatic pregnant patients.
NOVEL SURGICAL TECHNIQUE FOR INDUCING POSTERIOR VITREOUS DETACHMENT DURING PARS PLANA VITRECTOMY FOR PEDIATRIC PATIENTS USING A FLEXIBLE LOOP
Authors: Cernichiaro-Espinosa Linda A. , Berrocal Audina M.
Published: November 2017

Purpose:

Vitreoretinal surgical diseases in children are challenging because of the complex features of the vitreous, retina, and the interface between them. Posterior vitreous detachment is a crucial step during vitrectomy. To date, pharmacologic vitreolysis that liquefies the vitreous and disrupts the posterior hyaloid attachment to the retina has been studied. However, there are reports of unexplained adverse effects. We describe a case performed with a reproducible, safe and time-saving technique using a commercially available flexible loop for posterior vitreous detachment induction in a pediatric patient.

Methods:

A 10-year-old boy with previously treated retinopathy of prematurity undergoes a 25-gauge pars plana vitrectomy for retina detachment repair. To achieve a posterior vitreous detachment, a flexible loop was used to grasp and pick the vitreoretinal interface around the optic nerve for dissection of the posterior hyaloid, followed by aspiration and cutting with the vitrectomy probe to complete the vitrectomy.

Results:

At 3 months follow-up, total retinal reattachment was observed. The patient's vision improved from 20/400 to 20/150.

Conclusion:

Posterior vitreous detachment induction with a flexible loop instead of pharmacologic vitreolysis seems a promising tool as demonstrated in this clinical case. Further studies to demonstrate long-term safety and anatomical results are needed.
SPONTANEOUS IMPROVEMENT OF SYPHILIS CHORIORETINITIS: CASE REPORT AND REVIEW OF THE LITERATURE
Authors: Sidiqi Ahmad M. , Navajas Eduardo V.
Published: November 2017

Purpose:

To describe a case of spontaneous improvement of syphilis chorioretinitis and review the literature.

Methods:

Case report and literature review of cases with untreated syphilis chorioretinitis.

Results:

A 58-year-old man presented to the emergency department with counting fingers vision, normal fundus, and disruption of the outer retinal layers on optical coherence tomography of the right eye. Examination by a retina specialist 3 weeks later revealed visual acuity of 20/50 and partial restoration of outer retinal layers on optical coherence tomography. Workup showed positive serology for syphilis and human immunodeficiency virus. Treatment with intravenous penicillin resulted in further vision improvement. Literature review showed six cases of spontaneous improvement of syphilis chorioretinitis.

Conclusion:

Spontaneous improvement of syphilis chorioretinitis is possible. Clinicians should keep a high index of suspicion and consider syphilis chorioretinitis in diseases that affect the outer retina even with spontaneous improvement.
The growing epidemic of sexually transmitted infections in adolescents: a neglected population
Authors: Shannon Chelsea L. , Klausner Jeffrey D.
Published: November 2017

Purpose of review

Sexually transmitted infection (STI) incidence is on the rise in the United States. The increase is especially pronounced in adolescents (15–24 years of age). Despite making up only a quarter of the population, adolescents account for approximately half of new STIs in the United States every year. This review summarizes recent developments in the field of STIs, excluding HIV, in adolescents.

Recent findings

In this review, we examine the epidemiology, screening, management, and prevention of STIs in adolescents. STI rates in adolescents have been rising since 2014, with young women and MSM at particularly high risk. Barriers to STI screening for adolescents include confidentiality concerns and lack of access to health services. Prevention through STI vaccines represents a promising way to combat the epidemic.

STIs are a growing concern for adolescents. Routine screening and management are of critical importance. Furthermore, prevention efforts such as human papillomavirus vaccination should be prioritized. Much of the current literature on STIs does not address the unique nature of STIs in adolescents, and additional research into effective prevention and treatment strategies of STIs in adolescents is urgently needed.
What is new in perinatal HIV prevention?
Authors: Fowler Mary G. , Flynn Patricia , Aizire Jim
Published: November 2017

Purpose of review

The purpose of this review is to describe recent clinical trial, laboratory and observational findings that highlight both the progress that can be achieved in elimination of new pediatric infections in international clinical trial settings among HIV-infected breastfeeding women while also describing recent safety concerns related to currently used antiretroviral regimens. The article will also address the ongoing adherence challenges for HIV-infected mothers in taking their antiretroviral drugs. This information is timely and relevant as new regimens are being considered for both prevention of mother-to-child transmission (PMTCT) of HIV and HIV treatment options worldwide.

Recent findings

The main themes described in this article include both efficacy of different antiretroviral therapy (ART) regimens currently being rolled out internationally for PMTCT as well as safety findings from recent research including a large multisite international trial, PROMISE.

The findings from the IMPAACT PROMISE trial as well as other recent trial and observational findings suggest that while progress has been steady in reducing PMTCT worldwide, the goal of virtual elimination of pediatric HIV worldwide will require careful attention to optimizing safety of new regimens which are less dependent on maternal daily ART adherence and safer in preventing certain toxicities.
Measuring quality of life in individuals with Parkinson’s disease attending a self-help club: cross-sectional study in Hungary
Authors: Markó-Kucsera Mária , Kullmann Lajos , Paulik Edit
Published: November 2017

The prevalence of Parkinson’s disease (PD) increases with aging. The aim of our cross-sectional study was to measure the quality of life of PD patients attending a self-help ‘PD club’ and to evaluate the potential positive effect of club life on quality of life. Data collection was carried out using questionnaires (PDQ-39, Hungarian version). Altogether, 101 individuals with clinically diagnosed PD were included, and finally 98 persons’ data were analyzed. Among the eight dimensions, the highest score was found in ‘bodily discomfort’ and the lowest in ‘social support’. The overall tendency of the results was similar to another Hungarian study, but the scores in all dimensions were significantly lower in our participants. These positive results seem to correlate with attending the ‘PD club’, indicating the potential beneficial effect of patients’ organizations on promoting mental health.
Patterns of Sexual Behavior and Sexually Transmitted Infections in Young Men Who Have Sex With Men
Authors: Vasilenko Sara A. , Rice Cara E. , Rosenberger Joshua G.
Published: November 2017

Purpose

Young men who have sex with men (MSM) are at an increased risk for sexually transmitted infections (STIs). Recent research has documented the importance of understanding the multidimensional nature of sexual risk behavior; however, little is known about how multidimensional patterns of sexual behavior among MSM may be associated with STIs.

Method

This study applies latent class analysis to data from a large, HIV− sample of 18- to 25-year-old MSM recruited from social and sexual networking Web sites (N = 5965; 76% white, 11% Latino, 5% black, 4% Asian, 4% other; 74% homosexual, 21% bisexual, 1% heterosexual, 3%, unsure/questioning 1% other) to uncover multidimensional patterns of past-year sexual behaviors, partner factors, and protective behavior and their associations with self-reported STI diagnosis.

Results

We selected a model with 8 classes, with nearly half of participants belonging to a class marked by multiple behaviors with more than 1 partner, and smaller numbers of individuals in classes with a smaller number of behaviors, romantic relationships, and sexual inactivity. Class membership was associated with recent STI diagnosis, with classes marked by no penetrative sex or receptive anal sex with consistent condom use having lower prevalence than those with inconsistent condom use, including those engaging in only insertive anal sex.

Conclusions

Findings suggest heterogeneity of behaviors within MSM and that prevention messages may be more effective if they are tailored to individuals' patterns of sexual behavior, as well as demographic and sociocontextual factors.
Prepectoral Breast Reconstruction in Challenging Patients
Authors: Gabriel Allen , Maxwell G. Patrick
Published: November 2017

Implant-based reconstructions continue to remain on the forefront of breast reconstruction as the prepectoral approach gains popularity. This article reviews the challenging patients that surgeons face when evaluating their candidacy for prepectoral reconstruction. The prepectoral approach for thin, high body mass index and previously radiated patients will be reviewed.
The Economics of Prepectoral Breast Reconstruction
Authors: Glasberg Scot Bradley
Published: November 2017

The world of breast reconstruction over the last several years has seen a dramatic shift in focus to discussion and the application of placing tissue expanders and implants back into the prepectoral space. Although this technique failed during the early advent of breast reconstruction, newer technologies such as advances in fat grafting, improved acellular dermal matrices, better methods of assessing breast flap viability, and enhanced implants appear to have set the stage for the resurgence and positive early results seen with this technique. The main benefits of a switch to prepectoral breast reconstruction clinically appears to be less associated pain, lower incidence of animation deformities, and its associated symptoms as well as presumably better aesthetics. Early data suggest that the results are extremely promising and early adopters have attempted to define the ideal patients for prepectoral breast reconstruction. As with any new operative procedure, an assessment of finances and costs are crucial to its successful implementation. Although current data are minimal, this article attempts to build the fundamentals of an economic model that exhibits and displays potential savings through the use of prepectoral breast reconstruction.
68Ga–Prostate-Specific Membrane Antigen Uptake in Gastrointestinal Stromal Tumor
Authors: Laurens Tom , Witjes Fred , Janssen Marcel , Flucke Uta , Gottardt Martin
Published: November 2017

A 62-year-old man with recently diagnosed prostatic adenocarcinoma was referred for a whole-body 68Ga-prostate-specific membrane antigen (PSMA) PET/CT scan for staging. Although the scan did not reveal metastatic disease, it did reveal a PSMA-avid lesion in the upper abdomen located between the liver and the stomach. Histopathologic examination demonstrated a gastrointestinal stromal tumor. The lesion demonstrated increased uptake in the margins of the tumor with a central photopenic area, which we consider to be the typical pattern on PSMA images of a gastrointestinal stromal tumor, based on theoretical PSMA distribution in such a tumor and other reported cases.
Electroconvulsive Therapy in the Czech Republic
Authors: Kalisova Lucie , Madlova Katerina , Albrecht Jakub , Michalec Jiri , Kubinova Marketa , Raboch Jiri
Published: November 2017

Objectives

Electroconvulsive therapy (ECT) is effective in the treatment of severe psychiatric disorders. Electroconvulsive therapy is applied to almost 1 million patients every year around the world. The aim of this study was to monitor the use of ECT in psychiatric facilities for adults in the Czech Republic (CR) in 2014 and to describe the national practice.

Methods

A 14-item questionnaire was sent to all Czech inpatient psychiatric facilities that provide ECT, with the aim of getting a detailed picture of the use of ECT in the CR. The questionnaire assessed the technical background for using ECT in each center, along with indications for the treatment, the procedure, and the manner of documenting and monitoring adverse effects. The data obtained were supplemented with information about national legal and ethical regulations as well as historical background.

Results

Electroconvulsive therapy is used in 26 centers across the CR. More than 1000 patients were treated with ECT in 2014. All centers use instruments delivering brief pulse stimuli, monitoring electroencephalogram and electrocardiogram. All patients have to be indicated for this treatment, which is a decision the patient's psychiatrist makes. All patients have to sign an informed consent form, excluding a situation where the patient's life is endangered. Somatic state is assessed in all patients. Bitemporal electrode placement is the preferred option in all centers.

Conclusions

This article covers detailed information about the use of ECT in the CR. The results will be used to harmonize national practice and reduce the stigma associated with this method in the CR.