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The purposes of this review are to describe differences between palliative care for adult patients and palliative care for pediatric patients, both generally and in the intensive care unit; to highlight ethical considerations for pediatric intensive care unit patients by using illustrative cases; and to examine the impact of these ethical considerations on decision-making for children and their families. [ABSTRACT FROM AUTHOR]

This study used critical interpretive phenomenological analysis to explore the lived experiences and phenomena of motherhood of five young Black women in Pennsylvania as they transition into motherhood. The core themes that emerged were systemic inequities, kinship, survival, and apprehension around the transition to motherhood. Additional analysis suggested that racism, structural oppression, childhood trauma, healthcare coercion, perinatal mental health distress, family chaos, poverty and economic insecurity, and birthing trauma were also relevant. These findings suggest that experiences from throughout the life course, including early trauma, may influence the journey to motherhood and may be intimately connected to mental health before, during, and after pregnancy. If clinicians and policy makers can better understand the lived experiences of Black women transitioning into motherhood, they can better engage in authentic, collaborative, patient-centered care. [ABSTRACT FROM AUTHOR]

The early detection of relapse following primary surgery for non-small-cell lung cancer and the characterization of emerging subclones, which seed metastatic sites, might offer new therapeutic approaches for limiting tumour recurrence. The ability to track the evolutionary dynamics of early-stage lung cancer non-invasively in circulating tumour DNA (ctDNA) has not yet been demonstrated. Here we use a tumour-specific phylogenetic approach to profile the ctDNA of the first 100 TRACERx (Tracking Non-Small-Cell Lung Cancer Evolution Through Therapy (Rx)) study participants, including one patient who was also recruited to the PEACE (Posthumous Evaluation of Advanced Cancer Environment) post-mortem study. We identify independent predictors of ctDNA release and analyse the tumour-volume detection limit. Through blinded profiling of postoperative plasma, we observe evidence of adjuvant chemotherapy resistance and identify patients who are very likely to experience recurrence of their lung cancer. Finally, we show that phylogenetic ctDNA profiling tracks the subclonal nature of lung cancer relapse and metastasis, providing a new approach for ctDNA-driven therapeutic studies., Author(s): Christopher Abbosh [1]; Nicolai J. Birkbak [1, 2]; Gareth A. Wilson [1, 2]; Mariam Jamal-Hanjani [1]; Tudor Constantin [3]; Raheleh Salari [3]; John Le Quesne [4]; David A. Moore [...]

One of the major roles of a school psychologist is psychoeducational testing and the preparation of psychoeducational reports. Unfortunately, parents often have difficulty understanding psychoeducational reports. This difficulty might be ameliorated by supplementing psychoeducational reports with graphs. This hypothesis was tested with 144 parents who were asked to read a psychoeducational report either with or without supplemental bar graphs and then to complete recall and satisfaction measures. Parents who read a report with graphs recalled significantly more information correctly than did parents who read a report without graphs. Parents who read a report with graphs also expressed greater satisfaction than parents who read a report without graphs. Regardless of the type of report, parents with a college degree performed better on the recall measure than parents without a college degree. (Contains 1 note, 4 tables, and 1 figure.)

The transboundary expansion of highly pathogenic avian influenza virus (AIV) (H5N1) in 2005 increased the interest in global AIV spread by wild birds (1,2). Although the degree to which wild [...]

In sociology, studies of social change in the non-Western world have not assigned a prominent role to missionary organizations. This relative neglect is the product of two assumptions: first, that missions abroad were ineffective as agents of fundamental social change; and, second, that their activities were shaped more by powerful secular agendas over which they had little control than by autonomous religious interests. Contrary to the first assumption, there is ample evidence that some missions were impressive agents of social transformation; contrary to the second, some of them took a stand in direct opposition to the secular political and economic interests to which they are often considered subordinate. Together these observations reinforce the concept of the relative autonomy of religion. I argue here that one key to understanding mission resistance to powerful nonreligious forces can be found in religious conceptions of the proper relationships among land, labor, and community stability. When these are threatened, the symbiosis between religious and secular interests can give way to open and effective defiance.

The article discusses effectiveness of a wearable blanket versus water bottle to increase safe sleep practices among parents or caregivers. It mentions that caregivers who received wearable blankets were more likely to report being reminded about safe sleep practices for their infants. It also mentions need of strategies to help educate caregivers on the safe sleep guidelines.

When avian influenza viruses (AIVs) are transmitted from their reservoir hosts (wild waterfowl and shorebirds) to domestic bird species, they undergo genetic changes that have been linked to higher virulence and broader host range. Common genetic AIV modifications in viral proteins of poultry isolates are deletions in the stalk region of the neuraminidase (NA) and additions of glycosylation sites on the hemagglutinin (HA). Even though these NA deletion mutations occur in several AIV subtypes, they have not been analyzed comprehensively. In this study, 4,920 NA nucleotide sequences, 5,596 HA nucleotide and 4,702 HA amino acid sequences were analyzed to elucidate the widespread emergence of NA stalk deletions in gallinaceous hosts, the genetic polymorphism of the deletion patterns and association between the stalk deletions in NA and amino acid variants in HA. Forty-seven different NA stalk deletion patterns were identified in six NA subtypes, N1-N3 and N5-N7. An analysis that controlled for phylogenetic dependence due to shared ancestry showed that NA stalk deletions are statistically correlated with gallinaceous hosts and certain amino acid features on the HA protein. Those HA features included five glycosylation sites, one insertion and one deletion. The correlations between NA stalk deletions and HA features are HA-NA-subtype-specific. Our results demonstrate that stalk deletions in the NA proteins of AIV are relatively common. Understanding the NA stalk deletion and related HA features may be important for vaccine and drug development and could be useful in establishing effective early detection and warning systems for the poultry industry. [ABSTRACT FROM AUTHOR]

Summary: Background: COPD patients have varying degrees of airways disease and emphysema. CT scanning can differentiate these pathological subtypes. We evaluated airway dimensions and emphysema severity with low dose CT scanning in COPD patients to determine relationships with clinical features of the disease. Methods: Fifty six patients with COPD had a low dose thoracic CT scan. Airways were analysed using novel software as either proximal (1st and 2nd generation) or distal (3rd to 6th generation); the extent of emphysema was assessed as the percentage of pixels less than −950 Hounsfield units. CT measures were related to clinical features of COPD. Results: Thicker walls in the proximal airways were associated with clinical features that may represent a bronchitic phenotype (MRC Bronchitis Score; β = 0.20, p = 0.003, Frequent Exacerbations; β = 0.14, p = 0.017, Total St George’s Score; β = 0.50, p = 0.001 and body mass index [BMI]; β = 0.26, p = 0.049); these associations were independent of emphysema. BMI was negatively correlated with the degree of emphysema (β = −0.41, p = 0.001). Airway wall thickness was negatively correlated with CT measured emphysema for both proximal and more distal airways (r = −0.30, p = 0.025 and r = −0.32, p = 0.015). Conclusions: CT measured airway dimensions are associated with several clinical measures of COPD; these are related to a bronchitic phenotype and the effect is independent of emphysema. [ABSTRACT FROM AUTHOR]

A model is formulated that describes the spatial propagation of a disease that can be transmitted between multiple species. The spatial component consists, for each species, of a certain number of patches that make up the vertices of a digraph, the arcs of which represent the movement of the various species between the patches. In each of the patches and for each species, a susceptible-exposed-infectious-recovered (SEIR) epidemic model describes the evolution of the disease status of individuals. Also in each patch, there is transmission of the disease from species to species. An analysis of the system is given, beginning with results on the mobility component. A formula is derived for the computation of the basic reproduction number R0 for sspecies and npatches, which then determines the global stability properties of the disease free equilibrium. Simulations for the spread of a disease in one species and two patches are presented. [ABSTRACT FROM AUTHOR]

We conducted a survey among nine geographically dispersed, large metropolitan refugee health programs to estimate the number of U.S. refugee arrivals during 1997 and 1998, the number receiving health assessments, and the percentage of sites offering health services. The nine sites received an estimated 40% of all U.S. refugee arrivals during the study period. Of these refugees, 76% received a health assessment. The completeness of health assessments, including services offered, varied by site; some services were provided by the private sector. Most sites offered services for infectious diseases and vaccinations. While 78% of the sites offered mental health care, but only 33% actually performed mental status examinations. These statistics show that such health services need to be provided on a broader basis and possibly reflect a need to address cultural and language barriers that might be preventing their delivery to this diverse population. [ABSTRACT FROM AUTHOR]

Deals with a study which analyzed the medical records of passengers with acute respiratory illnesses during their North American cruise vacations in 1997. Nationality of passengers at risk for complications of influenza virus infection; Epidemiological investigation conducted on the outbreak; Description of the outbreak.

The present study compared the type (oral or liquid) and schedule of feeding on plasma corticosterone levels, adrenal weight, GI segment weight and protein content, and liver weight and protein content. [ABSTRACT FROM AUTHOR]

El artículo examina la política de Uganda para los desplazados internos, un grupo que constituye más de 6% de la población. Como consecuencia del conflicto armado entre el gobierno y el Ejército de Resistencia del Señor, 90% de la población ha huido del norte donde viven en campos destartalados. Con la ayuda de Walter Kälin, representante del Secretario General de Naciones Unidas, el gobierno ha establecido una política racional para los desplazados.

The article presents information on the Brookings-Bern Project on Internal Displacement in Uganda. In an effort to address issues concerning internally displaced, the Brookings-Bern Project on Internal Displacement convened a two-day workshop in Kampala to identify the challenges to the implementation of Uganda's IDP policy and work towards practical solutions.

Abstract: Public gene sequence databases have become important research tools to understand viruses and other organisms. Evidence suggests that the identifying information for some of the sequences in these databases might not belong to the sequences they are associated with. We developed two tests to conduct a comprehensive analysis of all published sequences of the hemaglutinin and neuramidase genes of avian influenza viruses (AIVs) to identify sequences that may have been misclassified. One test identified sequence pairs with highly similar nucleotide sequences despite a difference of several years between their sampling dates. Another test, which was applied to samples sequenced and deposited more than once, detected sequences with more nucleotide differences to their own than to their closest relatives. All sequences identified as misclassified were further traced to relevant publications to assess the likelihood of contamination and determine if any conclusions were associated with the use of these sequences. Our results suggested that among 4040 published gene sequences examined, approximately 0.8% might be misclassified and that publications using these sequences may include inaccurate statements. Findings from this report suggest that using laboratory-adapted strains and handling multiple samples simultaneously increases the risk of contamination. The tests reported here may be useful for screening new submissions to public sequence databases. [Copyright &y& Elsevier]