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In this interview, Dr. Thomas discusses the relationship between race and copyright. This conversation with Tucker Taylor of the Journal of Copyright in Education and Librarianship covers Dr. Thomas’s path to copyright education as well as her work at Connecting Communities Digital Initiative (CCDI) at the Library of Congress. Dr. Thomas details the interaction of race and copyright, and how it relates to librarianship and education. She also details ideas for librarians and educators to help improve our current situation.

This study investigated the relationship between spiritual development and cultural reentry adjustment in a group of missionaries. One hundred and two missionaries completed a questionnaire that correlated the Spiritual Assessment [...]

The Five Smooth Stones: Essential Principles for Biblical Ministry. By Robertson McQuilkin. Nashville: B & H, 2007, 223 pp., $14.99. paper. One of the greatest challenges facing every minister is [...]

This article presents an evidence‐based approach to the patient with newly diagnosed Parkinson disease (PD). It includes a discussion of the current understanding of the aetio‐pathogenesis of PD and of clinical features, both motor and non‐motor, that assist the clinician in making this diagnosis. An approach to the management of early stage PD is discussed, including emerging evidence of the benefits of physical exercise in this condition, and issues to consider in the selection of dopaminergic medication. The newly diagnosed patient with PD is often keen to know what the future holds for them, as they face this progressive neurodegenerative condition. While currently available medical therapies are symptomatic, rather than disease‐modifying, in nature, it is hoped that improved understanding of the aetio‐pathogenesis of PD will pave the way for future disease‐modifying therapies. [ABSTRACT FROM AUTHOR]

Parkinson disease (PD) is a complex neurodegenerative disorder that can present heterogeneously with a combination of motor and non-motor symptoms. α-synuclein, a neuronal protein, can undergo aberrant conformational change resulting in the intra-neuronal accumulation of toxic oligomers that form Lewy bodies, the pathological hallmark of PD. There is evidence that pathological α-synuclein exhibits prion-like behaviour in its mode of transmission through the nervous system. The choice of initial dopaminergic treatments should be individually tailored but long term outcomes appear to be equivalent. There is level A evidence supporting the benefit of three different device-assisted therapies in treating troublesome motor fluctuations and dyskinesias. Stem cell transplantation as currently being trialled is predominantly a symptomatic therapy targeting only limited regions of the brain affected by PD, and will need to be proven to be not only as effective but as safe as currently available device-assisted therapies. New modes of treatment including active immunisation against oligomeric α-synuclein and drugs that alter cellular metabolism show some promise. The inability to effectively treat a range of non-motor, non-dopaminergic symptoms remains a major therapeutic challenge. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 66-year-old man who presented to his general practitioner with a half-year history of tremor in his left hand. Tremor is a clinical problem in middle-aged and older patients. It was mentioned that several features of his condition are typical of parkinsonian tremor, which diminishes during limb movement. The man's wife stated that his posture had become more stooped over the past two years.

Parkinson disease (PD) is a multisystem neurodegenerative disorder that affects about 1% of the population over the age of 55 years and has mean age of onset of about 60 years. The Braak hypothesis proposes that the earliest pathological evidence of PD is found in the enteric nervous system, medulla and olfactory bulb, and only subsequently progresses (over years) to the substantia nigra and cortex. Non-motor symptoms, such as constipation, hyposmia and sleep disorders, may precede typical motor features of PD by several years. No treatment has been convincingly shown to slow PD progression (ie, a neuroprotective drug remains elusive). Symptomatic benefit from dopaminergic therapy is usually maintained throughout the course of the disease. The decision as to whether to commence treatment with either levodopa or a dopamine agonist needs to be individually tailored, but long-term outcomes appear to be equivalent. Advanced PD is complicated by the loss of non-dopaminergic neurones, resulting in symptoms that are largely unresponsive to dopaminergic therapy. Treatment with apomorphine, Duodopa or deep-brain stimulation surgery may be beneficial for selected patients with advanced PD. Non-motor symptoms, such as mood disorders, cognitive impairment, autonomic dysfunction and sleep disorders, are responsible for significant morbidity. Management often requires a multidisciplinary approach. [ABSTRACT FROM AUTHOR]

The article examines the case of a patient with dystonia-parkinsonism due to pallidal and nigral necrosis following heroin overdose. The patient has a history of marijuana use, post-traumatic stress disorder, depression and amphetamine-induced psychosis. Examination of the patient revealed right hemichorea and impairment of left-sided fractioned finger movements. It revealed that the evolution from hemichorea to dystonia was owing to acute and subacute effect of pallidal anoxia, respectively.

The article discusses a study which identified and quantified current deficiencies in primary and secondary stroke prevention and possible gains from optimal employment of thrombolysis. The study involved 259 consecutive patients admitted to a tertiary hospital stroke unit from January 24 2006 to January 10 2007 in Adelaide, South Australia. The researchers found that 183 patients had a disabling or fatal stroke, while 135 patients had at least one suboptimally managed risk factor.

The article presents a case study of a 42-year-old man with segmental dystonia from long-term dextromethorphan abuse. The susceptibility of the patient to drug-induced dystonia is investigated. Explored is the association of the spectrum of movement disorders with N-methyl-D-aspartate (NMDA) receptor blockade.

Background Patients with Parkinson disease ( PD) commonly experience motor fluctuations and dyskinesias in response to oral dopaminergic medications. Affected patients may benefit from device-assisted therapy, such as medication infusion or deep brain stimulation surgery. This is the first Australian study of the long-term adherence to apomorphine infusion ( AI) in patients with PD. Aims To assess the adherence to AI in patients with PD in a single centre over a 10-year period and to find the reasons for discontinuation in patients who discontinued AI. Methods This is an observational study of patients with PD treated with AI between 2004 and 2014. Outcome measures included changes in motor function and quality of life following AI, change in dose of other dopaminergic medications following AI, duration of infusion, adverse effects, reasons for cessation of AI and subsequent treatment after cessation. Results Mean duration of AI was 21.65 months. No patient achieved apomorphine monotherapy, and the mean reduction in the levodopa-equivalent dose of other dopaminergic medications after AI was 22.7%. The benefit of AI on motor function and quality of life was rated as 'much improved' or 'better' in 83% of patients. The most common reasons for discontinuation of AI were adverse effects and inadequate motor benefit. Most patients who discontinued AI were subsequently treated with another device-assisted therapy. Conclusion AI is an effective therapy for severe motor response complications in PD, especially in the short and medium term. However, many patients cannot be maintained on AI in the longer term. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 63 years old woman with cerebellar syndrome with seizures, hypomagnesaemia, and pantoprazole. It discusses the symptoms including dizziness, lethargy, and anorexia. It also presents information on the use of proton pump inhibitors, electrocardiogram results, and computed tomography scan results of the chest.

The article discusses the case of a female patient diagnosed with rhabdomyolysis and bilateral peroneal and tibial neuropathies caused by wearing and squatting in tight jeans. Topics discussed include the clinical presentation of the patient which include severe weakness of both ankles and impaired sensation, results of nerve conduction studies and the treatment of the patient intravenous hydration.

A 35 year old woman presented with bilateral foot drop and numbness following repetitive squatting while wearing “skinny” jeans. Her examination demonstrated bilateral, severe, global weakness of ankle and toe movements, somewhat more marked on the right, absent ankle jerks and impaired sensation over the lateral aspects of both lower legs and the dorsum and soles of both feet. Her lower limbs were markedly oedematous and the jeans had to be cut off for removal. Investigations showed a creatine kinase level of 73215 IU/L with normal renal function. CT scan of the lower limbs demonstrated myonecrosis in the posterior calf muscles. Nerve conduction studies showed bilateral conduction block between the popliteal fossa and fibular head of the common peroneal nerves. Compound muscle action potential amplitudes of the tibial nerves were also diminished with stimulation in the popliteal fossa, compared with the ankle. The sural and superficial peroneal sensory responses were normal but the right medial plantar SAP was absent and the left medial plantar SAP was markedly reduced in amplitude. With conservative therapy, the patient’s oedema and neurological function improved and she was discharged after regaining independence with her mobility four days later. We postulate that the patient’s peroneal neuropathies were the result of compression between the biceps femoris tendon and fibular head as a result of squatting while the tibial neuropathies were likely caused by compression of the nerves in the posterior compartment of the calf by oedematous muscles which had undergone ischaemic myonecrosis as a result of squatting. The wearing of “skinny” jeans had likely potentiated the tibial neuropathies by causing a compartment syndrome as the lower legs swelled. [ABSTRACT FROM AUTHOR]

Background: Whether intravenous tissue plasminogen activator (alteplase) is effective beyond 3 h after onset of acute ischaemic stroke is unclear. We aimed to test whether alteplase given 3-6 h after stroke onset promotes reperfusion and attenuates infarct growth in patients who have a mismatch in perfusion-weighted MRI (PWI) and diffusion-weighted MRI (DWI).Methods: We prospectively and randomly assigned 101 patients to receive alteplase or placebo 3-6 h after onset of ischaemic stroke. PWI and DWI were done before and 3-5 days after therapy, with T2-weighted MRI at around day 90. The primary endpoint was infarct growth between baseline DWI and the day 90 T2 lesion in mismatch patients. Major secondary endpoints were reperfusion, good neurological outcome, and good functional outcome. Patients, caregivers, and investigators were unaware of treatment allocations. Primary analysis was per protocol. This study is registered with ClinicalTrials.gov, number NCT00238537.Findings: We randomly assigned 52 patients to alteplase and 49 patients to placebo. Mean age was 71.6 years, and median score on the National Institutes of Health stroke scale was 13. 85 of 99 (86%) patients had mismatch of PWI and DWI. The geometric mean infarct growth (exponential of the mean log of relative growth) was 1.24 with alteplase and 1.78 with placebo (ratio 0.69, 95% CI 0.38-1.28; Student's t test p=0.239); the median relative infarct growth was 1.18 with alteplase and 1.79 with placebo (ratio 0.66, 0.36-0.92; Wilcoxon's test p=0.054). Reperfusion was more common with alteplase than with placebo and was associated with less infarct growth (p=0.001), better neurological outcome (p<0.0001), and better functional outcome (p=0.010) than was no reperfusion.Interpretation: Alteplase was non-significantly associated with lower infarct growth and significantly associated with increased reperfusion in patients who had mismatch. Because reperfusion was associated with improved clinical outcomes, phase III trials beyond 3 h after treatment are warranted. [ABSTRACT FROM AUTHOR]