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We examined knowledge and practice of harm reduction strategies among people who use cannabis attending an annual public cannabis advocacy event. We also assessed the sources from which they glean information about cannabis. Participants (n = 472) completed a brief survey assessing cannabis use, sources for information on cannabis, and harm reduction strategies. Participants' knowledge of cannabis was based mostly on their own experiments and experiences rather than on information from health professionals. Participants generally had low accuracy in identifying effective harm reduction techniques and low rates of utilizing effective harm reduction techniques, using them at the same rate overall as techniques without empirical support. Results from this survey will be useful to public health professionals developing and implementing harm reduction educational strategies related to cannabis use. [ABSTRACT FROM AUTHOR]

Objective We sought to describe characteristics of children admitted with pericardial effusion (PCE) and systemic lupus erythematosus (SLE) and determine the association between PCE and outcomes of interest. Methods We performed a retrospective cohort study of the Pediatric Health Information System (PHIS). Patients were included if they were admitted to a PHIS participating hospital from 2004 to 2015 with a diagnosis of SLE and age ≤18 years. Children with congenital heart disease or who had undergone heart surgery were excluded. PCE was the primary predictor variable; multivariable analysis was used to evaluate the effect of PCE on the following outcomes: mortality, length of stay (LOS), and readmission within 30 days. Results There were 5679 admissions, of which 705 (12.4%) had PCE. Median age at admission was 15 years (interquartile range: 13–17). There were no significant differences for age or sex between patients admitted either with or without PCE. A significantly higher percentage of children in the PCE group were black compared with those without PCE (43% vs. 31%, p < 0.001). In multivariable analysis, the odds of a black patient having PCE were 1.7 higher than non-black patients (p < 0.001). In-hospital mortality was 2.5 times higher in children with PCE compared with those without PCE (p = 0.027). Those with PCE also had 1.5 greater odds of readmission within 30 days (p < 0.001). PCE was not associated with increased LOS (0.99, p = 0.753). Conclusion PCE is common in admissions of children with SLE. There are disproportionately more black patients with SLE affected by PCE than non-black. PCE is associated with significantly higher mortality and rates of readmission. [ABSTRACT FROM AUTHOR]

The article offers information on the financial disadvantage faced by the pediatricians and pediatric subspecialists as compared to other physicians. Topics discussed include problems faced by new pediatricians due to lack of financial training, book "The White Coat Investo" written by James Dahle on the same, and retirement accounts for employed pediatricians.

The article comments on the importance of Stephan Fuchs' 'Against Essentialism' for general theory in sociology. Stephan Fuchs's Against Essentialism is the most important work of general theory that has appeared in the last 10 years or more. It is grand theory on the level with Luhmann, Habermas, and Giddens, encompassing society, culture, knowledge, and philosophy, it is general theory both in the sense of giving a framework for all of sociology and in the sense that the word "theory" is now used in humanistic and especially literary fields, the orienting perspective on what cultural knowledge consists in. On issues of culture, Fuchs neatly uncovers essentialist assumptions that vitiate Habermas, Bourdieu, and others. Fuchs marshals the evidence of conversational analysis to show how arguments, business meetings, and casual talk actually take place, and how consensus is constructed as a statement to outsiders rather than an accurate description of what actually happened in the social encounter. Fuchs defends a version of sociological realism against both absolutists and postmodernists. Firm realities are neither impossible nor everywhere; it is a mistake on the postmodernist/deconstructionist side to make the distinction between essences and lack of essences into an absolute contrast, forcing one to make a choice. it is a continuum, and again social networks determine where and when these kinds of realities or relativisms exist. Monopoly and hegemony, too, are not absolutes; these too are historically varying constructions.

This study estimated the 1-year prevalence and location of observing and experiencing threat and aggression among two random samples of young adults. A community sample and a college sample completed a phone survey concerning how often they had observed physical aggression, experienced a verbal altercation, or were the target or the initiator of aggression. About 25% of women and 33% of men had experienced aggression in the preceding year One of the primary locations was in or around a bar For the most severe episode, the most common location was in or around a bar for men and in their own home for women. Experience with threats and aggression is common among young adults. Understanding criminal violence and people's fear of violence necessitates addressing this pandemic level of aggression in our society. [ABSTRACT FROM AUTHOR]

Networking North Queensland (NNQ) was a two-year project to improve access to health services in rural and remote communities. The project involved email and Internet access in 61 communities, in a region almost three times the size of the UK. Videoconferencing equipment was also installed at 21 sites and a total of 197 h of videoconferencing was recorded at 10 of the remote sites over 12 months. As a result of the project, health consumers enjoyed improved access to medical, specialist, allied health and primary health services. In addition, health service providers had better access to reliable, up-to-date health-care information via intranet and Internet services. Consideration of local issues--local needs and existing resources--was vital to the achievements of the project. Community involvement and community access were also important factors in its success. [ABSTRACT FROM AUTHOR]

Fifty consecutive patients with obstructive jaundice treated by operation in Canterbury & Thanet Health District hospitals under the care of one surgeon (RECC) over a 6-year period have been studied. The pathology was found to be common bile duct (CBD) stone in 22 patients (44%); pancreatic carcinoma in 15 (30%), 3 of whom also had CBD stones; chronic pancreatitis in 4 (8%); extrahepatic CBD carcinoma in 4 (8%); ampulla of Vater carcinoma in 3 (6%); primary duodenal carcinoma in 1 (2%); and portahepatis obstruction in 4 (8%). The 8 postoperative deaths (16%) were found to be associated with high preoperative levels of serum bilirubin, but all occurred in patients with malignant disease. Complications occurred in 20 patients (40%) and bile culture state was found to be intimately related to the morbidity rather than operative mortality. The study represents a careful audit of the pathology distribution and the surgical management of obstructive jaundice as seen in district hospitals. [ABSTRACT FROM AUTHOR]

Measurements of the glucose concentration in venous blood and parotid saliva taken from 31 diabetics attending a diabetic clinic showed values ranging respectively from 3.9 to 19.1 mmol/l and 0.06 to 0.83 mmol/l (means 9.6 mmol/l and 0.32 mmol/l respectively). Linear regression of salivary glucose on blood glucose gave a simple correlation coefficient of 0.18 (NS). Since salivary glucose levels did not reflect blood glucose levels, the possibility of diabetics regulating their metabolic control by the noninvasive technique of monitoring salivary glucose concentrations is not possible. [ABSTRACT FROM AUTHOR]

Sulphur dioxide control in the utility sector has come of age with established technologies supplied by companies with international reputations and good track records now taking major contracts on a regular basis. Although not employed as extensively as originally anticipated in the United Kingdom, subject to gaining the necessary consents and authorizations, a major contract may be placed for sulphur control on Orimulsion fired plant. World-wide use of desulphurization technologies continues to expand with many installations now under construction or in operation in areas such as the Pacific Rim and Eastern Europe to meet increasingly stringent environmental regulations aimed at controlling unwanted environmental effects. Previous papers from suppliers and operators have tended to concentrate on the theory of the process or the practical engineering aspects of on-site installation and operation. This paper considers the overall impact and cost of various systems and reviews established and developing systems of flue gas desulphurization processes. It focuses not only on the technology but also on the supply of raw materials, marketing and/or disposal of products, the economics of such systems and some of their potential environmental impacts both on and off site. In this respect the paper reviews all the major areas to be considered in the selection of a process for a particular site. [ABSTRACT FROM AUTHOR]

Background: Upper limb function after stroke can be improved with repetitive, task-specific movement. Achieving high practice intensity necessitates independent activity, outwith routine therapy. Weight support devices (WSDs) can help stroke survivors (SS) perform upper limb exercises by unloading the weight of their arm, providing more opportunity for rehabilitation activities. However, current commercial WSDs are expensive, creating a barrier to adoption by users. The purpose of this work was to interview SS and therapists to obtain the necessary user requirements for an upper limb WSD. Method: Concepts for a WSD were created through brainstorming sessions with engineers and physiotherapists. These concepts were evaluated using a controlled convergence method utilizing the device's performance criteria from a design specification created through research of literature and existing devices. The best concepts were chosen and presented to two focus groups of SS (n = 3) and therapists (n = 6), respectively. Feedback on the designs was recorded focussing on desirable attributes. Results/Findings: Desirable attributes recorded were a device that was portable, comfortable, with supports for both the upper arm and forearm. Incorporation of feedback on movement and completion of functional tasks was also desired. Therapists recommended a design that would help facilitate functional tasks without pain or difficulty. The SS group also highlighted their lack of awareness of WSDs. Conclusion: An upper limb WSD is a desirable tool for rehabilitation. Participant feedback suggests designing a device that is comfortable, has two points of support, and is portable to enable independent home use. A prototype is currently in development. [ABSTRACT FROM AUTHOR]

A case of ruptured common iliac artery aneurysm is reported. The patient presented with a perianal hematoma and had undergone repair of a leaking abdominal aortic aneurysm seven years previously. The presentation and management are discussed. [ABSTRACT FROM AUTHOR]

Purpose: To compare cannabis enthusiasts' knowledge about cannabis risks and effectiveness in treating medical conditions with existing empirical evidence.Design: A brief survey assessed cannabis use, information sources, and knowledge about risks and effectiveness.Setting: A cannabis advocacy event in April 2019 in a state with legal medical and recreational cannabis.Participants: Demographically diverse adults (N = 472) who frequently used cannabis; 85% used cannabis for health or medical purposes.Measures: Participants reported the sources of their cannabis information, health conditions they thought cannabis was effective in treating (n = 10), and health risks increased by cannabis (n = 6). Conditions and risks were based on ratings of evidence (ie, from substantial to insufficient) for therapeutic effects and risks identified in a review by The National Academies of Sciences, Engineering, and Medicine (NASEM, 2017).Analyses: Chi-square tests examined the correspondence between participants' knowledge and NASEM conclusions.Results: Most participants' (95% confidence interval [CI]: 74%-81%) knowledge of cannabis was from their own experiences; 18% (95% CI: 14%-21%) received information from primary care providers. On average, participants' beliefs matched NASEM conclusions for half of effectiveness (95% CI: 50%-53%) and risk items (95% CI: 55%-57%). Many (95% CI: 38%-42%) thought that cannabis use did not increase any risk. Contrary to NASEM conclusions, many thought cannabis was effective in treating cancer (76%), depressive symptoms (72%), and epilepsy (68%). Those who received cannabis information from their primary care providers had better knowledge of medical effectiveness. Medicinal cannabis use frequency inversely predicted knowledge of medical effectiveness and increased risks of adverse events.Conclusion: There were considerable discrepancies between cannabis users' knowledge and available evidence, highlighting the need for more research and education (by physicians, caregivers, and dispensaries) on effectiveness and health risks, especially for users with specific health issues such as pregnant women and people with depression. [ABSTRACT FROM AUTHOR]

Some people are adept at using discrete emotion categories (anxious, angry, sad) to capture their felt experience; other people merely communicate how good or bad they feel. We theorized that people who are better at describing their emotions might be less likely to self-medicate with alcohol. During a 3-week period, 106 underage social drinkers used handheld computers to self-monitor alcohol intake. From participants’ reported experiences during random prompts, we created an individual difference measure of emotion differentiation. Results from a 30-day timeline follow-back revealed that people with intense negative emotions consumed less alcohol if they were better at describing emotions and less reliant on global descriptions. Results from ecological momentary assessment procedures revealed that people with intense negative emotions prior to drinking episodes consumed less alcohol if they were better at describing emotions. These findings provide support for a novel methodology and dimension for understanding the influence of emotions on substance-use patterns. [ABSTRACT FROM PUBLISHER]