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The study presented here explores the influences of selected social and social psychological factors that are associated with perceived caregiver burden in a sample of 263 primary caregivers of the elderly in Allahabad City in northern India. The results indicate that although male caregivers' perceived burden depends only on the size of the role overload, female caregivers' perceived burden depends on the interrelationship between the size of the role overload and adherence to Asian cultural norms. Implications of the findings for social work are discussed. Keywords: Asian Indians; cultural norms; elderly persons; feminist perspective; role overload

Electron cryotomography was used to analyze the structure of the Lyme disease spirochete, Borrelia burgdorferi. This methodology offers a new means for studying the native architecture of bacteria by eliminating the chemical fixing, dehydration, and staining steps of conventional electron microscopy. Using electron cryotomography, we noted that membrane blebs formed at the ends of the cells. These blebs may be precursors to vesicles that are released from cells grown in vivo and in vitro. We found that the periplasmic space of B. burgdorferi was quite narrow (16.0 nm) compared to those of Escherichia coli and Pseudomonas aeruginosa. However, in the vicinity of the periplasmic flagella, this space was considerably wider (42.3 nm). In contrast to previous results, the periplasmic flagella did not form a bundle but rather formed a tight-fitting ribbon that wraps around the protoplasmic cell cylinder in a right-handed sense. We show how the ribbon configuration of the assembled periplasmic flagella is more advantageous than a bundle for both swimming and forming the flat-wave morphology. Previous results indicate that B. burgdorferi motility is dependent on the rotation of the periplasmic flagella in generating backward-moving waves along the length of the cell. This swimming requires that the rotation of the flagella exerts force on the cell cylinder. Accordingly, a ribbon is more beneficial than a bundle, as this configuration allows each periplasmic flagellum to have direct contact with the cell cylinder in order to exert that force, and it minimizes interference between the rotating filaments.

This article explores the notion of intimacy within the natural world. The author blends personal quest with scholarship from transpersonal psychology, spirituality, nature writing, and philosophy. It highlights the results of a thematic content analysis of journal entries made during a week of kayaking with the conscious intention of being in better relationship with a specific lake community. A thematic analysis of the journal entries that followed this experience revealed that that certain actions, attitudes, and ways of being increased intimacy and contributed to a greater sense of spirituality. She posits that we can all achieve greater spiritual connection and intimacy with the natural world by cultivating what Maslow refers to as the "plateau experience" and by incorporating the wisdom of nature writers whose craft is dependent on cultivating reciprocity, connection, and love within the natural world. [ABSTRACT FROM AUTHOR]

We present an enhanced version of the FLAMEnGO (Fuzzy Logic Assignment of Methyl Group) software, a structure-based method to assign methyl group resonances in large proteins. FLAMEnGO utilizes a fuzzy logic algorithm coupled with Monte Carlo sampling to obtain a probability-based assignment of the methyl group resonances. As an input, FLAMEnGO requires either the protein X-ray structure or an NMR structural ensemble including data such as methyl--methyl NOESY, paramagnetic relaxation enhancement (PRE), methine--methyl TOCSY data. Version 2.0 of this software (FLAMEnGO 2.0) has a user-friendly graphic interface and presents improved modules that enable the input of partial assignments and additional NMR restraints. We tested the performance of FLAMEnGO 2.0 on maltose binding protein (MBP) as well as the C-subunit of the cAMP-dependent protein kinase A (PKA-C). FLAMEnGO 2.0 can be used as a standalone method or to assist in the completion of partial resonance assignments and can be downloaded at www.chem.umn.edu/groups/veglia/forms/flamengo2-form.html. [ABSTRACT FROM AUTHOR]

Introduction: As telemedicine and telehealth services are experiencing increasing rates of adoption, industry leaders and healthcare service providers are becoming increasingly focused on human resource issues encountered in the delivery of a broad range of telehealth services. To create a forum for the discussion of many interrelated elements of telehealth service industry, a national conference entitled "Telemedicine & Telehealth Service Provider Showcase" (SPS) Conference was established in 2014, and repeated in 2016 and 2017, in Arizona. These SPS Conferences include thought leaders, telehealth service providers, government administrators, and academicians from leading programs addressing service provider workforce issues., Methods: This report summarizes the content of SPS 2017 conference, held in Phoenix, AZ, October 2-3, 2017. The topics covered at SPS 2017 include using telehealth services as a strategic asset; development of appropriate effective partnerships; direct-to-consumer initiatives; important reimbursement, legislative, and regulatory issues (i.e., Centers for Medicare & Medicaid Services [CMS] approaches, financial models, and return on investment [ROI]); marketing; evaluation and applied metrics; remote monitoring and sensors; integration with electronic health records; and overall lessons learned., Results: The content of SPS 2017 is summarized in the body of this report. The SPS 2017 program evaluators included attendees, speakers, and exhibitors. The knowledge attendees gained at SPS 2017 was characterized, by all three groups, as forward-looking and practical., Conclusion: SPS 2017 succeeded in identifying, and focusing on, solutions for issues, challenges, and barriers impacting the rapidly expanding telehealth service segment of the healthcare industry. The growing interest in this annual SPS Conference series apparently reflects, in part, the program committee's successes in identifying practical issues and their potential solutions.

Background: Significant information is available about government-reimbursed telehealth services such as Medicare and Medicaid across the United States. Although currently 20 states mandate reimbursement for telehealth services and some private insurers have voluntarily covered those services in other states, relatively little is known about telehealth provider experiences with reimbursement from private insurance payers., Materials and Methods: To investigate this, the American Telemedicine Association's (ATA's) Telemental Health Special Interest Group (SIG), the Policy Group, and the Business and Finance SIG, with the help of ATA staff, conducted a national private payer reimbursement online survey in 2012 using Survey Monkey™ (Palo Alto, CA) ( www.surveymonkey.com/ )., Results: Survey responses were received from respondents in 46 of the 50 states. The survey found that telehealth services are being reimbursed by private payers but that progress in reimbursement has been relatively slow compared with earlier surveys., Conclusions: Key findings from this study were that government payers as well as several major private payers are highly influential in payment policies for telehealth private payers, that private payers have administrative rules regarding telehealth reimbursement that are barriers to services and reimbursement, and that some providers would benefit from being better informed about billing and coding for telehealth services and how to advocate for telehealth services reimbursement.

This paper reports the results of a satisfaction survey of telepsychiatry patients at a rural community mental health clinic that had been providing psychiatric services solely via telemedicine for 10 years. The survey examined the perceived telepsychiatric session quality over a relatively long period of time with patients who had been utilizing the services for a number of years or over multiple sessions. One-page optional anonymous surveys were distributed from December 1, 2006, through March 30, 2007, covering 230 telepsychiatry patients, approximately 90% of current telepsychiatry patients at the agency. Of these, 76 patients responded, a 33.0% return rate. Among the respondents, satisfaction was generally very high, with telemedicine services provided over a period of up to 10 years perceived to be of similar (no worse) quality than in-person services. Results were further analyzed by gender, age, and number of telemedicine sessions experienced. Female patients appeared more accepting of the quality of medical care via telemedicine than male patients. Patients aged 20-49 had much higher acceptance rates than patients younger than 20 or older than 49. The least positive responses toward telemedicine were from patients in their 50s. Patients who had experienced 5 to 10 telemedicine sessions were more likely than patients who had experienced fewer than 5 to report that their sessions now run more smoothly than their initial sessions. Patients in their 20s and 30s reported the least need to have a clinician in the room with them to make them feel comfortable during their telemedicine sessions. Eight percent of respondents reacted negatively to the presence of a clinician in the room with them during their telemedicine sessions.