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Editor's Note: The National Environmental Health Association strives to provide up-to-date and relevant information on environmental health and to build partnerships in the profession. In pursuit of these goals, we [...]

Children with autism spectrum disorder (ASD) are frequently included in regular music classrooms, yet little is known about teachers' and students' classroom experiences. We sent a 35-question survey to all members of the National Association for Music Education who had identified themselves as elementary music teachers. We received a total of 569 responses; we analyzed the results from 441 who taught in the United States and who completed the entire survey. Most teachers were positive about including students with ASD and confident in teaching them. Teachers who expressed greater confidence in teaching students with ASD had more instruction related to special education during their undergraduate preparation and collaborated with more professionals in their school settings. Teachers reported that students with ASD were included in most of the regular music curriculum, and interactions with classmates were reported to be positive. Implications for teacher preparation, collaboration, and students' music learning are discussed.

BackgroundThe appearance of bite cells associated with methemoglobinemia can be caused by oxidizing drugs such as dapsone in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency or high drug serum levels. Bite cells are often pathognomonic for oxidant injury in patients with G6PD deficiency and suggest active hemolysis.Case presentationWe report a case of a woman with no prior history of G6PD deficiency who presented with anemia, methemoglobinemia and bite cells on peripheral blood smear after dapsone therapy for new onset idiopathic urticaria. Laboratory tests for G6PD, blood count and liver function were within normal limits prior to initiation of therapy. During the patient's hospital course, moderate methemoglobinemia and anemia were identified despite mildly increased serum G6PD level. These pathologies were reversed upon stopping dapsone therapy.ConclusionThis case highlights the potential for therapeutic levels of dapsone to induce side effects in patients without G6PD deficiency and highlights the importance of routine blood monitoring for anemia and hemolysis during the course of drug therapy.

Rare cases of human herpesvirus 8 (HHV8)-negative effusion-based large B-cell lymphoma (EB-LBCL) occur in body cavities without antecedent or concurrent solid mass formation. In contrast to HHV8 + primary effusion lymphoma (PEL), EB-LBCL has no known association with HIV or HHV8 infection. However, the small sample sizes of case reports and series worldwide, especially from non-Japanese regions, have precluded diagnostic uniformity. Therefore, we conducted a retrospective, multi-institutional study of 55 cases of EB-LBCL and performed a comprehensive review of an additional 147 cases from the literature to identify distinct clinicopathologic characteristics. In our study, EB-LBCL primarily affected elderly (median age 80 years), immunocompetent patients and manifested as lymphomatous effusion without a solid component. The lymphomatous effusions mostly occurred in the pleural cavity (40/55, 73%), followed by the pericardial cavity (17/55, 31%). EB-LBCL expressed CD20 (53/54, 98%) and PAX5 (23/23, 100%). Most cases (30/36, 83%) were of non-germinal center B-cell subtype per the Hans algorithm. HHV8 infection was absent (0/55, 0%), while Epstein-Barr virus was detected in 6% (3/47). Clinically, some patients were managed with drainage alone (15/34, 44%), while others received rituximab alone (4/34, 12%) or chemotherapy (15/34, 44%). Eventually, 56% (22/39) died with a median overall survival (OS) of 14.9 months. Our findings were similar to those from the literature; however, compared to the non-Japanese cases, the Japanese cases had a significantly higher incidence of pericardial involvement, a higher rate of chemotherapy administration, and longer median OS. Particularly, we have found that Japanese residence, presence of pericardial effusion, and absence of MYC rearrangement are all favorable prognostic factors. Our data suggest that EB-LBCL portends a worse prognosis than previously reported, although select patients may be managed conservatively. Overall, EB-LBCL has distinct clinicopathologic characteristics, necessitating the establishment of separate diagnostic criteria and consensus nomenclature.

Pharmacists are increasingly expected to communicate skillfully, yet few Doctor of Pharmacy (PharmD) curricula include theoretically-derived or evidence-based communication training. The 12 Fundamentals of Highly Effective Communicators is a pedagogical tool that we developed to teach principles of communication to two consecutive cohorts of PharmD students in their second year (P2). Students were asked to reflect on which of the 12 Fundamentals they found most helpful in their pharmacy training and practice. The most frequently selected Fundamental was "There is no 'one size fits all' message that will work in EVERY situation." Students provided specific examples of how they perceived that these Fundamentals could help them have effective and appropriate interactions with patients and colleagues.

This study compares two methods of teaching a dance technique class to determine which yields a greater increase in high school students' technical skills. The historic, widely accepted method of teaching a dance technique class is through direct, teacher-centered instruction. However, current research, largely on undergraduate college students, suggests that student-centered instruction may be more effective. In this experimental study a group of high school students (n = 23) received standard, direct instruction, while the intervention group (n = 24) received student-centered instruction. All students took pre- and post-performance assessments and were scored on a skill rubric. Analysis of these assessment scores indicated a statistically significant increase in students' technical abilities in both the direct instruction group and the intervention group, however, the experimental group was not found to be more successful than the control group. The results of this study found that future research on this topic should include teaching students how to give and receive feedback before entering a student-centered curriculum structure.