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The massive spread of COVID-19 has put people’s standard of living in jeopardy. The mental health status of the students has been a matter of concern throughout the lockdown. The study aims to identify university students’ immediate psychological responses as an index of mental health outcomes during the COVID-19 outbreak lockdown period and to investigate demographic predictors of their mental health outcomes. 167 students responded to a web-based cross-sectional survey that included the IES-R and DASS-21BV in addition to demographic data and relevant COVID-19 questions. 49.2% of the respondents reported stress, 54.6% reported anxiety, 64.2% reported depression ranging from mild to extremely severe, based on DASS-21, and 68.9% of respondents rated having a mild to severe psychological impact from the lockdown on the IES-R. Age was significantly associated with the DASS stress subscale (B = -.159, AR2 =.019, 95% CI: -1.023 to -.021). The study ascertains the commonness of the psychological impact of the lockdown period of the COVID-19 outbreak on university students, necessitating immediate intervention to cope with the unprecedented situation and minimize future mental health problems.

The study aims to gain primary evidences on the mental health condition of Bangladesh. A quantitative survey instrument was applied on 982 respondents from Dhaka, Chittagong, and Rajshahi divisions in Bangladesh. It included adult sample, aged above 18 years from different hospitals, universities and organizations. 51.7% of the respondents were male and rest 48.9% female. The survey focused on knowledge, attitude and behavior related to mental health. This paper presents the behavioral manifestation of mental health condition. From the description of different psychological problems the responders encounter in their life, depression (69.5%) was identified as the highest manifested mental health issue followed by anxiety (66.8%) and study-related issues (64.5%). Notable percentage had experience of trauma (28.0%), and abuse (19.2% physical abuse and 10.1% sexual abuse). Suicidal ideation was found to be present in 19.8% of the respondents. Significant gender differences towards male were found for problem with study, anger, romantic relation, eating, and substance abuse. Females had significantly higher experience of sexual abuse. Similar significant regional difference were noted for several behavioral indicators of mental health; Dhaka being the highest prevailing region. It was found to be true specifically for suicidal thoughts and attempts. This study reestablished the alarming situation of mental health existing among the people in Bangladesh which call forth urgent action to address the most vital aspect of health through psychological assistance. Dhaka Univ. J. Biol. Sci. 30(3 CSI): 405-416, 2022 (June)

Psychological wellbeing, which refers to the overall healthy functioning of a person, is a crucial asset. It is a combination of effective functioning and feeling good of one's surroundings. To achieve and maintain psychological wellbeing is very important for any stages of life, especially for young adults. Young adults go through multiple significant transitions in life. The main aim of the current study was to discover the components and predictors of psychological wellbeing of young adults and develop an effective intervention program to enhance their psychological wellbeing. The study was carried out in three different stages. A mixed-method design was implemented to conduct the study. The 42 items Ryff's Psychological Wellbeing Scale was chosen in the first stage for its optimal usability to measure psychological wellbeing. It needed to be adapted for the Bangladeshi population before conducting the study using this tool. So, in the first stage the adaptation took place. The English and Bangla Psychological Wellbeing Scale had a significant positive correlation. In the second stage Bangla Psychological Wellbeing Scale was administered to a 301-representative sample of young adults. The goal of the second stage was to identify the factors related with psychological wellbeing. In the third stage of the current study aimed to create an effective intervention program to improve the psychological wellbeing of the young adults. This study reinforces the six-factor model of psychological well-being by Ryff (1989) in the design of psychological wellbeing program of young adults.

The long evolutionary battle between humans and pathogens has played an important role in shaping the current network of host-pathogen interactions. Each organ brings new challenges from the perspective of a pathogen to establish a suitable niche for survival while subverting the protective mechanisms of the host. Lungs, the organ for oxygen exchange, have been an easy target for pathogens due to its accessibility. The organ has evolved diverse capabilities to provide the flexibility required for an organism’s health and at the same time maintain protective functionality to prevent and resolve assault by pathogens. The pathogenic invasions are strongly challenged by healthy lung architecture which includes the presence and activity of the epithelium, mucous, antimicrobial proteins, surfactants, and immune cells. Competitively, the pathogens in the form of viruses, bacteria, and fungi have evolved an arsenal of strategies that can over-ride the host’s protective mechanisms. While bacteria such as Mycobacterium tuberculosis (M. tuberculosis) can survive in dormant form for years before getting active in humans, novel pathogens can wreak havoc as they pose a high risk of morbidity and mortality in a very short duration of time. Recently, a coronavirus strain SARS-CoV-2 has caused a pandemic which provides us an opportunity to look at the host manipulative strategies used by respiratory pathogens. Their ability to hide, modify, evade, and exploit cell’s processes are key to their survival. While pathogens like M. tuberculosis have been infecting humans for thousands of years, SARS-CoV-2 has been the cause of the recent pandemic. Molecular understanding of the strategies used by these pathogens could greatly serve in design of predictive, preventive, personalized medicine (PPPM). In this article, we have emphasized on the clinically relevant evasive strategies of the pathogens in the lungs with emphasis on M. tuberculosis and SARS-CoV-2. The molecular basis of these evasive strategies illuminated through advances in genomics, cell, and structural biology can assist in the mapping of vulnerable molecular networks which can be exploited translationally. These evolutionary approaches can further assist in generating screening and therapeutic options for susceptible populations and could be a promising approach for the prediction, prevention of disease, and the development of personalized medicines. Further, tailoring the clinical data of COVID-19 patients with their physiological responses in light of known host-respiratory pathogen interactions can provide opportunities to improve patient profiling and stratification according to identified therapeutic targets.

PURPOSE National Cancer Institute (NCI)–sponsored clinical trial network studies frequently require biopsy specimens for pharmacodynamic and molecular biomarker analyses, including paired pre- and post-treatment samples. The purpose of this meeting of NCI-sponsored investigators was to identify local institutional standard procedures found to ensure quantitative and qualitative specimen adequacy. METHODS NCI convened a conference on best biopsy practices, focusing on the clinical research community. Topics discussed were (1) criteria for specimen adequacy in the personalized medicine era, (2) team-based approaches to ensure specimen adequacy and quality control, and (3) risk considerations relevant to academic and community practitioners and their patients. RESULTS AND RECOMMENDATIONS Key recommendations from the convened consensus panel included (1) establishment of infrastructure for multidisciplinary biopsy teams with a formalized information capture process, (2) maintenance of standard operating procedures with regular team review, (3) optimization of tissue collection and yield methodology, (4) incorporation of needle aspiration and other newer techniques, and (5) commitment of stakeholders to use of guideline documents to increase awareness of best biopsy practices, with the goal of universally improving tumor biopsy practices.

Background The Preschool version of the Dimensions of Mastery Questionnaire (DMQ-18) is a popular instrument to assess children’s ability to master the environment through action or activity to explore, influence, or control the physical atmosphere. Although this instrument was originally developed in English, it has now been translated and validated in five other languages: Hungarian, Turkish, Chinese, Spanish, and Persian. As we notice a growing interest in research on the mastery motivation among Bangladeshi preschoolers, we have taken this effort to translate and validate the DMQ-18 and explore the factor structure of the Bangla version of this questionnaire. Method After translating all 39 items of the questionnaire into Bangla, it was administered on 206 children, aged 3 to 6 years, recruited randomly from ten preschools in Dhaka. The schools were selected randomly from the official list of preschools prepared by the Dhaka City Corporation. Class teachers of the respective children completed the questionnaire with the assistant of research assistants. Results The Bangla version of the questionnaire retained all 39 items, with seven factors as they were in the English version. The Bangla version shows sufficient reliability (Cronbach’s alpha = 0.87; test-retest reliability = 0.89 for whole questionnaire and .79–.89 for sub-scales; inter-rater reliability = 0.88 for whole questionnaire and .79–.88 for sub-scales), and validity (correlated positively with the English version; r = 0.85). Conclusion Due to its robust psychometric properties, the Bangla DMQ-18 is suggested to be used for Bangladeshi preschool children to assess their mastery motivation.

Bronchial Thermoplasty (BT) is indicated in patients suffering from severe and symptomatic bronchial asthma despite maximal medical therapy. However, treatment of the right middle lobe (RML) bronchus is currently not recommended. The aim of this study was to investigate the safety and efficacy of BT if the RML bronchus is included. BT was performed in 17 consecutive patients, quality of life and pulmonary function were characterized before and 90 days after BT completion. Furthermore, we performed a clean-up bronchoscopy following every BT. This study was approved by the IRB of the University of Essen (No. 17-7356 BO) and registered as a retrospective observational study at the German Clinical Trials Registry (No. DRKS 00011550). The median baseline values of FEV1 and Asthma Questionnaire of Life Quality (AQLQ) were 1.33 l (0.91; 1.73) and 3.01 (2.76; 3.61), respectively, and significantly improved 90 days after treatment with FEV 1 at 1.75 l (p-value 0.002) and AQLQ 3.8 (p-value

Several different tracheostomy techniques (percutaneous and surgical) have been studied extensively in previous direct pairwise meta-analyses. However, a network comparative meta-analysis comparing all has not been conducted before. We sought to compare three percutaneous dilatational tracheostomy techniques with open surgical tracheostomy technique (performed in the operating room or in the intensive care unit by bedside) in terms of their association with procedure-related major complications and procedure time. We searched PubMed and Cochrane register of randomized active comparator trials. A network comparative meta-analysis was performed in Stata using frequentist methodology. Major complications were defined as a composite of a priori-selected procedure-related complications. Tracheostomy techniques that did not require any direct bronchoscopic or ultrasonographic visualization of the entire procedure were grouped under the heading—anatomic landmark-based dilatational tracheostomy (ALDT). This along with bronchoscopic-guided dilatational tracheostomy (BDT), ultrasound-guided (UDT), and surgical tracheostomy (SGT) were compared with each other using network meta-analysis in Stata after all major assumptions (similarity, transitivity, and consistency) for performing a network were met. Log odds ratio (and standard errors) of the comparison of major complications between any two tracheostomy techniques (using indirect estimates) was statistically insignificant. Pairwise meta-analysis showed significant differences in procedure times between SGT and ALDT [mean difference: 9.96 min (SE 3.18)] and between SGT and BDT [15.67 min (SE 3.85)]. The indirect network meta-analysis comparing one versus the other also showed a statistically significant time difference between surgical tracheostomy when compared with every other technique. The results of our network meta-analysis show that all tracheostomy techniques are comparable with respect to associated procedure-related complications, but all three percutaneous techniques take far less procedure time compared to the surgical tracheostomy.

The aim of this study is to investigate the impact of psychological counselling on victims with Posttraumatic Stress Disorder (PTSD) from the Rana Plaza tragedy. Data was collected from two different groups using the Impact of Event Scale translated and validated in Bengali. Participants of one group consist of 50 who received life skills training and the other group of 71 who had no such training. PTSD was significantly reduced in both groups of the participants after receiving 6 consecutive sessions of psychological counselling, t(120) = 17.11, p

Interventional pulmonology (IP) is a rapidly evolving subspecialty of pulmonary medicine. In the last 10 years, formal IP fellowships have increased substantially in number from five to now > 30. The vast majority of IP fellowship trainees are selected through the National Resident Matching Program, and validated in-service and certification examinations for IP exist. Practice standards and training guidelines for IP fellowship programs have been published; however, considerable variability in the environment, curriculum, and experience offered by the various fellowship programs remains, and there is currently no formal accreditation process in place to standardize IP fellowship training. Recognizing the need for more uniform training across the various fellowship programs, a multisociety accreditation committee was formed with the intent to establish common accreditation standards for all IP fellowship programs in the United States. This article provides a summary of those standards and can serve as an accreditation template for training programs and their offices of graduate medical education as they move through the accreditation process.

Ultrasonography is a safe, efficient and cost-effective mode of imaging that can assist clinicians with important treatment decisions and provide procedural guidance. Today, point of care ultrasound plays an essential role in the assessment of benign and malignant conditions of chest, both in the outpatient and inpatient setting. Small, ultra-portable, affordable units can now be carried in the coat pocket. Advanced lung cancer, metastatic diseases to the lungs or thoracic malignancies can present with pleural effusion, pulmonary edema, post-obstructive pneumonia, or ascites that can be assessed by the clinician with ultrasound. It can be used to evaluate the extent of thoracic tumors beyond the parenchyma to the parietal pleura or chest wall, assess cervical, supraclavicular lymphadenopathy prior to fine needle aspiration or to determine venous thromboembolism (VTE) associated with malignancy. Thoracic ultrasound is currently being practiced by the pulmonologists, thoracic surgeons and intensivists to provide guidance during placement of pleural catheters, chest tubes or to evaluate the pleural cavity before thoracoscopy. Point of care ultrasound can improve efficiency in procedures by decreasing complications, increasing success and reducing financial strain on the health care system.

The present study examined the effectiveness of nonviolent communication (NVC) workshop on marital adjustment. The hypothesis was receiving nonviolent communication (NVC) workshop has positive impact on marital adjustment. The independent variable was NVC workshop and the dependent variable was marital adjustment score. For conducting this research, repeated measures design was followed and 20 Bangladeshi married people participated in it. The results have shown that there was a statistically significant difference (F = 16.790, p < 0.05) in marital adjustment score of experimental group over the three time periods and pairwise comparisons indicate that there was significant difference between pretest and post-test and also between pretest and follow- up test at the 0.05 level. Results also have shown that, there was statistically significant difference of marital adjustment score between experimental and control group in posttest (t = 4.276, p < 0.05) and follow-up test (t = 4.176, p < 0.05). Thus, after receiving NVC workshop the marital adjustment score of experimental group increased significantly (F = 16.79, p < 0.001) in post-test measure and also remain constant in follow-up, whereas the marital adjustment score of control group had no significant change. This implied a significant positive impact of participation in NVC workshop on marital adjustment. Dhaka Univ. J. Biol. Sci. 26(1): 69-75, 2017 (January)

This study was carried out to explore the level of depression among married women. Additionally, the role of employment status, academic qualification, marital satisfaction and psychological well-being on depression was examined. Depression, marital satisfaction and psychological well-being of 200 married women were assessed. Results showed 15% of the study participants scored above the cut-off point of depression and are at the risk of depression. Employment and academic status, marital satisfaction and psychological wellbeing (GHQ-28) jointly accounted for 56.2% variability in the depression with psychological well-being (β = 0.515, p < 0.001) and marital satisfaction (β = –0.276, p < 0.001) appeared as the most influential predictors. Lower education and unemployment also associated with the higher level of depression. The model indicated if a married woman with poorer psychological well-being, lower marital satisfaction and lower educational qualification is unemployed, she is more likely to be diagnosed as depressed. Implications and future direction are discussed. Dhaka Univ. J. Biol. Sci. 25(2): 113-121, 2016 (July)

Purpose of review Lung cancer is the leading cause of cancer deaths worldwide. Early detection is essential for long-term survival. Screening of high-risk individuals with low-dose computed tomography screening has proven to increase survival. However, current radiological imaging techniques have poor specificity for lung cancer detection and poor sensitivity for detection of mucosal or alveolar preinvasive malignant lesions. Bronchoscopy allows imaging and sampling of early lung cancer, with the highest safety profile and high diagnostic accuracy. Recent findings Available technologies, such as autofluorescence bronchoscopy, narrow band imaging, and radial ultrasound bronchoscopy can significantly increase the yield and diagnostic accuracy of bronchoscopy for early cancer detection in the central airways. Newer technologies such as optical coherence tomography, confocal bronchoscopy, and Raman spectroscopy may significantly increase the diagnostic yield of both central and parenchymal early cancer lesions. Summary Although some of these technologies are still investigational and are not readily available in most centers, they may identify early mucosal and alveolar cancer lesions accurately in the least invasive manner to provide appropriate therapy and prolong patient survival from lung cancer.

Spreading beyond the realm of tertiary academic medical centers, point-of-care ultrasound in the intensive care unit is an important diagnostic tool. The real-time feedback garnered can lead to critical and clinically relevant changes in management and decrease potential complications. Bedside ultrasound evaluation in the intensive care setting with a small, portable equipment is well-suited for placement of central lines, lumbar puncture, thoracentesis or other bedside ICU procedures and in the evaluation of cardiac activity, pleural and abdominal cavity and the overall fluid volume. Formalized curriculums centering on point-of-care ultrasound are emerging that will enhance its applicability and relevance.

For psychologists in less developed countries, psycho-educational assessment is often challenging due to a lack of specialist training and a scarcity of appropriate, psychometrically robust instruments. This article focuses on school psychology and psycho-educational assessment in three countries: Bangladesh, China and Iran. Despite differences in demographic and cultural features, these countries share similar issues that restrict the practice of psycho-educational assessment. We conclude that it is important for psychologists in Western countries to support professional training and testing practices in less developed countries.

Interventional pulmonology (IP) is a maturing field in the subspecialty of pulmonary medicine. Over the last few years, there has been an increased number of listed IP fellowship training programs in the United States and Canada, causing debate about the employment market for IP fellowship graduates.To analyze employment data of IP fellowship graduates.Interventional pulmonary fellows, during their IP in-service examination, were surveyed on employment position after graduation. The survey occurred in May or June in the years 2012, 2013, and 2014. An IP position was defined as a position encompassing more than 60% of effort directly toward IP. Geographic location and practice structure (i.e., academic, private/hybrid, and existing or initiating IP practice) were collected and analyzed.There was an 88.5% response rate, with 53 IP fellows participating in the survey. The majority of IP fellowship graduates (75%; 39/52) had positions in academic IP practices. All seven IP private practice positions were to create an IP program. One IP graduate was in a non-IP academic position, four were in non-IP private practice, one was in a research position, and one had no known employment. Most IP fellowship graduates were men (77.4%). Most IP positions were filled in states east of the Mississippi River; only 8 of 53 (15.1%) positions were filled in states west of the Mississippi river.Despite speculation about the scarcity of academic jobs after fellowship, recently trained IP fellows are more likely to practice in academic settings and join established practices.

Incidence of bullying among school children is very common and well recognized. The present study explored the existing scenario of bullying in high schools in Dhaka city. Phenomenological approach was used to gather and analyze focus group discussion data from 60 parents, teachers and students from both English and Bangla medium school, selected through convenient sampling. The qualitative analysis using software NVivo, revealed seven forms of bullying such as verbal, emotional, exclusion, physical, sexual, cyber, and race, to be prevalent among high school children. Though bullying found to affect large numbers of high school children in both Bangla and English medium, according to teachers’ report, physical and emotional bullying were more common in Bangla medium, while frequency of verbal, sexual, and cyberbullying were high in English medium. Teachers also reported that student of grade 9 and 10 experienced more sexual and cyberbullying than other classes. It was evident that bullying took place at anywhere and everywhere in the school premises, like in classroom, playground, bathroom, around the campus, or even in school bus. Common causes, probable consequences and prevention strategies on bullying were also identified. Seeking attention was found to be an important factor in bully behavior. Opinion of parents, teachers and students about experiences and probable prevention plan were considered to work out a helpful intervention program for bullying in the future.

Tracheostomy is a common procedure. It can be done surgically or percutaneously by dilating the stoma using Seldinger technique. Percutaneous tracheostomy (PT) is now routinely performed by surgeons and non-surgeons such as intensivists and anesthesiologists in the intensive care units (ICU) all over the world. Although obesity, emergent tracheostomy, coagulopathy, inability to extend the neck and high ventilator demand (HVD) were initially thought to be a relative contraindication, recent data suggest safety of PT in these patient population. Ultrasound can be helpful in limited cases to identify the neck structure especially in patients with a difficult anatomy. Bronchoscopy during PT can shorten the duration and avoid complications. PT has favorable complication rate, lower infection rate, shorter procedural duration and is cost-effective. Experience with the technique and careful planning is needed to minimize any avoidable potential complication.

The scribe box under study dates back to the old kingdom. It was excavated by the Italian expedition in Qena (1935-1937). The box consists of the lid and the body. The inner side of the lid is decorated with ancient Egyptian inscriptions written with a black pigment. The box was made by using several panels assembled together by wooden dowels and secured with vegetable ropes. The entire box is covered with a red pigment. This study aims to use analytical techniques to identify and have deep understanding for the box compo-nents. Moreover, the authors were significantly interested in using infrared reflectance transmission imaging (RTI-IR) to improve the hidden inscriptions on the lid. The visual observation and assessment were done to understand the condition of this box. 3D dimensions software was used to illustrate wood joints techniques. Optical microscopy (OM), X-ray diffraction (XRD), X-ray fluorescence portable (XRF) and Fourier Transform Infrared spectroscopy (FTIR) were used in this study in order to identify wood species, remains of insects bodies, red pigment, vegetable fibers and previous conservation adhesives, also RTI-IR technique was effec-tive to improve hidden inscriptions. The results proved that wooden panels and dowels were Acacia (Acacia nilotica), wooden rail is willow (Salix sp). The insects are the cigarette beetle (Lasioderma serricorne) and spider beetle (Gibbium psylloids), the red pigment is Hematite, while the vegetable fibers were linen and previous adhesive was identified as cellulose nitrates. RTI-IR technique was effective to improve hidden inscriptions. The historical study for the inscriptions proved that it is a hieratic writings of a funerary text.

The purpose of this study was to culturally adapt the items of Bayley Scales of Infant Development?II (BSID?II) for administration upon Bangladeshi infants. The adaptation procedure was conducted by following four steps: (i) field survey on normative sample, (ii) national expertise opinion, (iii) international expertise consultancy and (iv) picture sensitivity review. The culture based problems of the original BSID?II were identified from the initial field survey. Major problems identified by the examiners were unfamiliarity of the children with the items (pictures, words and materials). These assessments were evaluated by the national and international consultants. The uncommon items were changed to culturally recognizable ones while Bangla words were replaced to make the test culture?fair. At last, the adapted test was given to 22 healthy children to assess picture sensitivity of the test and found suitable where the infants attentively responded to the items. DOI: http://dx.doi.org/10.3329/dujbs.v23i2.20099 Dhaka Univ. J. Biol. Sci. 23(2): 187-195, 2014

The study focused on birth complication and early medical illness as detrimental developmental factors having adverse impact on children and adolescents’ cognitive abilities and academic attainment. To assess cognitive abilities Wechsler Intelligence Scale for Children - Fourth edition (WISC-IV) was administered on 44 (26 boys, 18 girls) students of primary and secondary level schools of Dhaka city. The performance of last two consecutive school examinations was taken as a measure of academic attainment. The results revealed that higher percentages of students who had serious medical illness during early childhood demonstrated poor academic attainment. It has also revealed significant difference in students’ working memory as well as verbal working memory in terms of academic achievements and serious medical illness during childhood. The results of this study have implications for early screening of children with developmental risk factors for early identification of possible poor cognitive abilities and poor academic attainment. Dhaka Univ. J. Biol. Sci. 22(2): 109-117, 2013 (July)

Glomus tumors are uncommon soft tissue tumors that usually occur in the hands or feet but rarely have been described to appear in the tracheobronchial tree. Tracheal glomus tumors present with symptoms including cough, dyspnea, and wheezing that may be mistaken for other pulmonary disorders. Imaging and pulmonary function testing can detect tracheal obstruction, but pathology is necessary to differentiate glomus tumors from other airway tumors. On pathology, glomus tumors are made up of glomus cells, blood vessels, and smooth muscle and are classified based on the predominant cell type. The differential for this tumor includes carcinoid tumors, paragangliomas, and hemangiomas, and immunohistochemical stains can be used to obtain the correct diagnosis. The most common modality for treatment of these tracheal tumors has been surgical resection. However, there have been reported cases of successful removal with rigid or flexible bronchoscopy. We present a case of a tracheal glomus tumor that was successfully resected using electrocautery snare during flexible bronchoscopy. Our case adds to the evidence that flexible bronchoscopy is a safe, less invasive approach to management of tracheal glomus tumors in select patients.

Objective. To test whether obesity is associated with decreased peak expiratory flow rates (PEFR), increased asthma symptoms, and increased health service use. Design/Methods. Secondary analysis of data from a cross-sectional convenience sample. Setting. Emergency departments (EDs) and primary care clinics in 8 inner-city areas in 7 cities. Participants. One thousand three hundred twenty-two children aged 4 to 9 years with asthma. Measures. Obesity was defined as a body mass index (BMI, weight/height2) >95th percentile. Nonobese children were those with a BMI between the 5th and 95th percentile. Underweight children with a BMI Results. Obese (n = 249) and nonobese (n = 1073) children did not differ in terms of age, gender, family income, passive smoke exposure, caretaker's mental health, and skin test reactivity to indoor allergens. Obese children were more often Latino (28% vs 17%) and, in the 3 months before the baseline interview, were more likely to have used oral steroids (30% vs 24%). There were no differences between groups in terms of baseline PEFR scores. During the 9 months after baseline assessment, the obese group had a higher mean number of days of wheeze per 2-week period (4.0 vs 3.4), and a greater proportion of obese individuals had unscheduled ED visits (39% vs 31%). There were no differences between the groups in terms of frequency of hospitalization, or in nocturnal awakening. Conclusions. In our sample of inner-city children with asthma, obese children used more medicine, wheezed more, and a greater proportion had unscheduled ED visits than the nonobese children.

This investigation examined caregiver and child perceptions of the division of responsibility for asthma management tasks in families. The study sample included 789 children with asthma, aged 6 to 9 years, who lived in the inner city. These children and their primary caregivers completed the Asthma Responsibility Interview. The correlation between the caregiver's and child's ratings of the child's responsibility was low (.19), with children rating themselves as more responsible than their caregivers rated them. Caregiver and child ratings of the child's responsibility increased with the child's age; however, caregivers' ratings of their own responsibility remained constant over the age range studied. Kappa statistics ranged from -.03 to .12, with up to 16% of children reporting less responsibility for self-care than was indicated by the caregiver. More than one third of families reported four or more asthma caregivers. The discrepancy between the caregiver's and child's perceptions and the involvement of multiple caregivers raise the possibility of unintentional nonadherence.

Background: Assault by a patient is a serious problem for patients, staff, and hospitals. There is disagreement in the literature about the relationship between the number of staff on psychiatric units and the assault rate. Objective: The purpose of this study was to determine the relationship between the number of and characteristics of nursing staff and the occurrence of assault on inpatient psychiatric units. Study Design: This was a comparative study of assaults over a 6-month time period. The primary unit of analysis was the unit shift. Results: When comparing shifts with an assault to shifts without an assault, the statistical results for each of the four dependent variables (number of registered nurses, number of staff, patient/staff ratio, and staff gender) were not significant. There was a significant (p < .001) interaction among three factors: assault status, unit, and time. Although the number of registered nurses (RNs) was not significantly related to assault occurrence, examination of individual units by time of day (shift) revealed surprising and important results. Some units had more assaults when there were fewer RNs, and some units had more assaults when there were more RNs. Conclusion: The difference between shifts with an assault and shifts without an assault depended on the particular unit and the particular time of day. The findings cannot be generalized across units and must be examined in detail at the unit level. A most important finding in need of further investigation is the inconsistent pattern of number of RNs related to assault occurrence both among units and within each unit.

BACKGROUND: Assault by a patient is a serious problem for patients, staff, and hospitals. There is disagreement in the literature about the relationship between the number of staff on psychiatric units and the assault rate. OBJECTIVE: The purpose of this study was to determine the relationship between the number of and characteristics of nursing staff and the occurrence of assault on inpatient psychiatric units. STUDY DESIGN: This was a comparative study of assaults over a 6-month time period. The primary unit of analysis was the unit shift. RESULTS: When comparing shifts with an assault to shifts without an assault, the statistical resultsfor each of thefour dependent variables (number of registered nurses, number of staff patient/staff ratio, and staff gender) were not significant. There was a significant (p < .001) interaction among three factors: assault status, unit, and time. Although the number of registered nurses (RNs) was not significantly related to assault occurrence, examination of individual units by time of day (shift) revealed surprising and important results. Some units had more assaults when there were fewer RNs, and some units had more assaults when there were more RNs. CONCLUSION: The difference between shifts with an assault and shifts without an assault depended on the particular unit and the particular time of day. The findings cannot be generalized across units and must be examined in detail at the unit level A most importantfinding in need offurther investigation is the inconsistent pattern of number of RNs related to assault occurrence both among units and within each unit.

Mid-tracheal, postintubation stenosis can be managed with an extended length tracheostomy tube to bypass the stenotic area. However these extra-long tracheostomy tubes are not fenestrated, and when the stenotic tracheal lumen sits against the tracheostomy tube, phonation is not possible as there is no translaryngeal airflow. A 59-year-old man developed distal tracheal stenosis following a prolonged intubation and tracheostomy after a motorcycle accident. He eventually required an extra-long tracheostomy tube to bypass the stenotic region. We modified a silicone tracheostomy tube by creating a fenestration on its posterior wall. This relieved the obstruction while still allowing phonation and speech.

The results of the National Lung Screening Trial strongly support early detection and definitive treatment to reduce lung cancer mortality. Once lung cancer is discovered, accurate staging at baseline is imperative to maximize patient benefit and cost-effective use of health care resources. Although computed tomography (CT) remains a powerful tool for staging of lung cancer, advances in other imaging modalities, specifically positron emission tomography/CT and magnetic resonance imaging, can improve baseline staging over CT alone and can allow a more rapid and accurate assessment of response to treatment. Although noninvasive imaging is extremely useful, tissue diagnosis remains the criterion standard for staging lung cancer and monitoring treatment response. Accordingly, tissue sampling using advanced bronchoscopic imaging guidance, such as ultrasound or electromagnetic navigation, allows precise tissue location and sampling of mediastinal nodes or lung nodules in the least invasive manner. In the future, bronchoscopy may allow real-time microscopic analysis.

The purpose of this 2-year, case control study was to determine whether differentiation between assaultive and nonassaultive patients can be made based on behavioral assessments and/or sociodemographic variables. For each assault incident the chart of the patient who assaulted and a randomly chosen patient who did not assault on that day were reviewed (N = 72 subjects or 26 pairs). Various scales were used to evaluate the subjects retrospectively (the day prior to the assault), and patients who assaulted staff were interviewed when possible. An analysis found no differences between patients who assaulted and controls on sociodemographic variables. Those who assaulted had significantly more prior assaults (p = .04) and more difficulty verbalizing angry feelings appropriately on their units (p < .01). Prior to the assault, assaultive patients were more verbally hostile (p = .037) and showed more increased motor activity (p = .001) than controls.

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is being increasingly used in the sampling of pulmonary masses and mediastinal lymphadenopathy. The blood clot core (BCC) often obtained during EBUS-TBNA may not be a true core and therefore may not be submitted for histological analysis. The frequency in which the blood clot core is positive in patients with negative cytology undergoing EBUS-TBNA is not known. The purpose of this study was to evaluate the diagnostic role of the blood clot core obtained during EBUS-TBNA. An Institutional Review Board-approved retrospective chart review was performed from January through September 2011 for all patients who underwent EBUS-TBNA at The Ohio State University. The data collection included cytology and histology results for each procedure. Blood clot cores obtained from the EBUS-TBNA needle were sent in formalin for histological examination. Seventy patients underwent EBUS-TBNA and 51 (72.8 %) patients had procedures that yielded a BCC for histology and aspirate for cytology. Forty-nine percent of patients with a BCC were diagnosed with malignancy. Of those with a BCC obtained, five (9.8 %) patients diagnosed with malignancy were done so based only on the results of blood clot core alone with negative cytology. Blood clot cores obtained at EBUS-TBNA contain diagnostic material and should be subjected histopathological examination. When blood clot cores are sent for analysis, there is the potential to spare up to 10 % of patients more invasive diagnostic biopsy procedures.

Traditional management of cystic lesions involving the mediastinum or lung parenchyma consists of surgical resection. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been reported to successfully treat bronchogenic cysts. We present 2 cases in which EBUS-TBNA was performed to aid in making the diagnosis. Endobronchial ultrasound imaging and TBNA were successful in both cases. The mediastinal cyst was therapeutically managed with complete aspiration in one case, whereas in the other an intraparenchymal cyst was found to be multiloculated and could only be partially aspirated and required surgical excision. EBUS-guided real-time aspiration of intrathoracic cysts can be both diagnostic and therapeutic in simple mediastinal bronchogenic cysts that can be fully aspirated. However, surgical resection may be required for multiloculated intraparenchymal cysts that cannot be aspirated completely. EBUS guidance helps to identify multiloculation and completeness of the aspiration.

The study explored the attitude and behavior of general people towards suicide with particular focus on role of counseling for suicide prevention in Bangladesh. Seventeen national newspapers were reviewed to look at the extent of suicide in Bangladesh and opinion of 50 people from different age, sex and profession was collected through Focus Group Discussions and an individual questionnaire. The analysis of reported news revealed that women committed suicide 5.68 times higher than men did; married people committed suicide more than unmarried people did. The data also revealed that the number of suicide is highest at age range of 16 to 20 years and family conflict is the number one cause of suicide in Bangladesh. Hanging from the ceiling and poison are the most popular method for committing suicide. Focused group discussions revealed a common belief of suicide as a sin and considered not as a right decision. All the participants undoubtedly believed that counseling is helpful in preventing suicidal behavior. The result of personal questionnaire showed that 20% of the participants thought about ending their life in their lifetime.

Predicting violent behavior is a major concern for nurses as well as other mental health professionals. Two diagnostic assessment systems (Nursing Diagnosis-NANDA and Psychiatric Diagnosis-DSM III-R) were compared in their ability to predict assaultive behavior. The nursing diagnosis potential for violence suggested a difference (p = .07) between the assaultive and control subjects. No differences were found between assaultive and control subjects on psychiatric diagnoses. Nursing diagnosis is based upon measurable behaviors and is time specific. Clinical implications and further research endeavors in this area are suggested.

This paper examines the reliability and validity of several hypothesized indicators of socioeconomic status for use in epidemiologic research, particularly in studies of child health in the less developed world. Population-based surveys of child health and disability were completed in Bangladesh and Pakistan using standard questionnaires designed to measure four domains of household socioeconomic status: wealth, housing, parental education and occupation. Test-retest data indicate moderate to excellent reliability of most of the socioeconomic indicators in both countries. Loadings from factor analyses of the survey data provide further evidence of the reliability of the data, and confirm that the questionnaire measures housing and wealth as distinct domains in both countries. Parental education and occupation are correlated with housing and/or wealth in these data sets. Bivariate logistic regression analyses show that, although 11 of 12 dichotomous indicators of low socioeconomic status constructed from the data are predictive of child death in at least one of the four sub-populations studied (rural and urban Bangladesh, and rural and urban areas of Karachi, Pakistan), no single indicator is predictive of child death in all four sub-populations. These along with multivariate results demonstrate the importance of including multiple measures of distinct domains if the research aims include investigation and/or control of the effects of socioeconomic status on health in diverse populations.