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Background:A challenge confronting the United States is delivery of quality specialty healthcare to citizens living in rural areas. Introduction:The Veterans Administration (VA) developed a large national telehealth network to address 5.2 million rural veterans. New Mexico's Albuquerque VA Neurology Service developed a teleneurology program for their rural veterans. This article analyzes our first 1,100 teleneurology patient visits. Materials and Methods:Veterans living in remote areas of New Mexico, southern Colorado, eastern Arizona, and western Texas were offered follow-up teleneurology care at 16 rural VA community-based outpatient clinics (CBOCs) following an initial evaluation at the Albuquerque VA neurology outpatient clinic. Surveys were sent after all teleneurology visits focused on quality of care, ease of communication, satisfaction, and staff's ability to deliver same quality care as in person. Problems encountered, differences between face-to-face clinics and teleneurology, and cost savings were examined. Results:Regarding the 701 (64%) returned surveys, we found 90% perceived they received good care, 91% felt there was good communication, 88% liked the convenience, and 87% reported they desired to continue teleneurology care. Ninety-six percent reported saving time, money, or both through CBOC visits instead of driving to Albuquerque. Discussion:All providers felt that they could deliver excellent care through teleneurology. We found emergency room visits for neurologic problems was similar for both groups. Conclusions:Our rural veteran patients and neurology staff overwhelmingly found high quality patient care can be delivered via teleneurology for a variety of chronic neurologic problems and was comparable to care delivered in neurology face-to-face clinics. [ABSTRACT FROM AUTHOR]

The author discusses the issue of racism in contemporary society. He mentions the growing visibility of racially unjust acts, particularly on social media, the changing demographic profile of the U.S. which will lead to whites as a minority, and the growing challenges to white supremacy.

Background: Delivery of specialty healthcare to rural citizens in the United States remains largely unmet. The Veterans Health Administration is in a unique position to deliver specialty care to rural Veterans because it is mandated to deliver medical care to all eligible Veterans regardless of residence. To accomplish this, the VHA developed large national telehealth networks that provided over 1 million episodes of care in 2012. We investigated whether clinical video telehealth technologies can provide quality efficient neurologic follow-up care to Veterans living in the rural southwest United States. Patients and Methods: Veterans with chronic neurologic conditions living remotely in New Mexico, southern Colorado, eastern Arizona, and western Texas were offered follow-up teleneurology care at 11 rural community-based outpatient clinics following initial evaluation at the Albuquerque, NM, neurology outpatient clinic. Results: Over a 2-year period, 87% of 354 consecutive patients returned a performance improvement satisfaction questionnaire. Ninety percent of the patients were fully satisfied with their visit, and 92% felt teleneurology saved them time and money. We calculated an average time savings of 5 h and 325 miles driven, plus at least $48,000 total cost savings. Ninety-five percent reported they wanted to continue their neurologic care by teleneurology. Conclusions: Our study confirms earlier pilot studies of successful follow-up care through telemedicine. Our patients were highly satisfied with the convenience and quality of their teleneurology visit, and the neurology providers were convinced that neurologic care to both teleneurology and clinic follow-up patients was equivalent. Teleneurology to rural Veterans can provide quality neurologic care and overwhelming patient satisfaction and save considerable time and money. [ABSTRACT FROM AUTHOR]

BACKGROUND Neurocysticercosis (NCC) prevalence is increasing throughout the United States mainly because of immigration from Latin America. Clinicians may fail to recognize the extraparenchymal disease because they do not consider the diagnosis. METHODS To analyze neuroimaging and clinical characteristics of extraparenchymal NCC, we retrospectively reviewed all such cases presenting to a major general medical school hospital in the State of New Mexico. RESULTS Eleven (30%) of our 37 cases of NCC diagnosed using standard criteria from 1998 through 2004 had extraparenchymal disease. On neuroimaging, 36% of the patients lacked parenchymal cysts, 64% had intraventricular cysticerci, 64% had subarachnoid cysticerci, and 64% had hydrocephalus due to either basal arachnoiditis or direct obstruction of intraventricular pathways. Lumbar puncture was performed in 6 patients. All had a cerebrospinal fluid (CSF) pleocytosis, none had CSF or blood eosinophilia, and CSF antibody to NCC could be absent while present in serum. Response to treatment was frequently suboptimal. CONCLUSIONS Extraparenchymal NCC is more frequent than previously thought. Because clinicians outside the Southwest United States are often unfamiliar with NCC as a cause of chronic meningitis, chronic ventriculitis, or hydrocephalus without obvious cysts, the diagnosis of extraparenchymal NCC often depends on the correct interpretation of neuroimaging. [ABSTRACT FROM AUTHOR]

Human neurologic illness following infection with West Nile virus (WNV) may include meningitis, encephalitis, and acute flaccid paralysis (AFP). Most WNV-associated AFP is due to involvement of the spinal motor neurons producing an anterior (polio)myelitis. WNV poliomyelitis is typically characterized by acute and rapidly progressing limb weakness occurring early in the course of illness, which is followed by death or clinical plateauing with subsequent improvement to varying degrees. We describe four cases of WNV poliomyelitis in which the limb weakness was characterized by an atypical temporal pattern, including one case with onset several weeks after illness onset, and three cases developing relapsing or recurrent limb weakness following a period of clinical plateauing or improvement. Delayed onset or recurrent features may be due to persistence of viral infection or delayed neuroinvasion with delayed injury by excitotoxic or other mechanisms, by immune-mediated mechanisms, or a combination thereof. Further clinical and pathogenesis studies are needed to better understand the mechanisms for these phenomena. Clinicians should be aware of these clinical patterns in patients with WNV poliomyelitis. [ABSTRACT FROM AUTHOR]

This article discusses substance abuse and academic performance among African American High School Students. Adolescent developmental research has identified varied factors that affect academic performance, with school based intervention programs focusing on substance abuse prevention to improve academic performance. A case study explored to what extent family financial concerns, individual and parental norms, and substance use correlated to academic performance among a sample of 212 African American students attending an urban high school located in the midwestern United States.

The article provides information on Natural History of Tropical Carbonate Ecosystems, a spring semester course cross-listed in biology, geology and environmental studies, with a prerequisite of two semesters of introductory biology, geology or environmental science. The aim of the course is to provide an introduction to the unique ecology and geology of tropical-marine ecosystems. The components of the course include eight weeks of content development and a ten-day, research-based field study. Students and faculty will use the facilities of the Gerace Research Center (GRC) in San Salvador Island, Bahamas during the field study.

Abstract: Among a small, cross-sectional sample of young Black males transitioning from foster care (), this study explored the relationship of their negative social contextual experiences to two factors relevant to the delivery of mental health services to them: cultural mistrust of mental health professionals and attitudes toward seeking professional help. Three domains of young Black male''s negative social contextual experiences were measured: proximal negative experiences, distal negative experiences, and negative imagery experiences. Results of multivariate analysis of covariance (MANCOVA) controlling for custody status, counselling status and history, and psychiatric history showed that young Black males reporting a high frequency of negative social contextual experiences reported significantly greater cultural mistrust of mental health professionals and significantly less positive attitudes toward seeking professional help for mental health problems than young Black males reporting a low frequency of negative social contextual experiences. Implications and future research directions are discussed. [Copyright &y& Elsevier]

The article presents information on the consequences of overdoses of olanzapine. It reports that typical antipsychotics are a relatively new group of medications for the management of psychosis. Currently approved medications of this category include clozapine, risperidone, quetiapine, and olanzapine. Overdoses can lead to deaths. The American Association of Poison Control Centers Toxic Exposure Surveillance System reported the number of deaths associated with olanzapine to be six in 2000, 10 in 2001, and 10 in 2002. The article presents a case history of a 62-year-old married man who had a long and clear history of bipolar affective disorder with features of obsessive compulsion, and was treated by psychiatrists for more than 10 years.

Social workers have the task of addressing issues that are unique to ethnic minority youth in clinical practice; however, they may be ill equipped to begin practice with these youth due to a lack of specificity within generalist curricula. Using African-American youth as an example, the paper provides evidence that there are critical areas of development and functioning that diverge from the generalist perspective. Social workers are provided with strategies to fill gaps in their knowledge of ethnic-minority youth to enhance their direct practice with this population. [ABSTRACT FROM AUTHOR]

Significant attention has been given to the educational shortcomings of African American students. This study examined predictors of educational success among African American high school sophomores. It explored factors that predict differences in students' academic intention to complete the school year, and how these factors differ by gender. The study was guided conceptually by the theory of planned behavior (TPB). We also assessed perceptions of self. Results indicated that most students had positive predispositions toward school-year completion, with females being more positively oriented toward academic success than males. The TPB's attitude component was the only predictor tested to operate differentially across gender. Having a positive attitude toward school was a significantly greater predictor of intention to complete the school year for males than for females. [ABSTRACT FROM AUTHOR]

Objective: The role of the ipsilateral cortex in proximal muscle control in normal human subjects is still under debate. One clinical finding, rapid recovery of proximal muscle relative to distal muscle use following stroke, has led to the suggestion that the ipsilateral as well as the contralateral motor cortex may be involved in normal proximal muscle control. The primary goal of this project was to identify contralateral and ipsilateral motor cortex activation associated with proximal muscle movement in normal subjects using magnetoencephalography (MEG).Methods: We developed protocols for a self-paced bicep motor task and a deltoid, electrical-stimulation somatosensory task. The MEG data were analyzed using automated multi-dipole spatiotemporal modeling techniques to localize the sources and characterize the associated timing of these sources.Results: Reliable contralateral primary motor and somatosensory sources localized to areas consistent with the homunculus. Ipsilateral M1 activation was only found in 2/12 hemispheres.Conclusions: Robust contralateral motor cortex activation and sparse ipsilateral motor cortex activation suggest that the ipsilateral motor cortex is not involved in normal proximal muscle control.Significance: The results suggest that proximal and distal muscle control is similar in normal subjects in the sense that proximal muscle control is primarily governed by the contralateral motor cortex. [Copyright &y& Elsevier]

A longitudinal study explored high school completion among African Americans. Male and female high school students aged 14 to 17 (N = 166) completed a theory of planned behavior (I. Ajzen, 1991) questionnaire early in their 2nd year. Intentions to complete the year were accurately predicted from attitudes, subjective norms, and perceived behavioral control (R = .71; p < .01). Attitudes were related to beliefs about short- and long-term consequences; subjective norms reflected perceived expectations of family, teachers, and friends; and control considerations included requisite academic abilities, conflict with peers and teachers, and distracting life conditions. Intentions and, to a lesser extent, perceived behavioral control, predicted graduation almost 3 years later (R = .50; p < .01). The findings indicate opportunities for early interventions. [ABSTRACT FROM AUTHOR]

Examines human methanol exposures reported to the American Association of Poison Control Centers Toxic Exposure Surveillance System from 1993 to 1998. Mean number of cases per year; Increase in symptomatic cases for infants and children and for adolescents and adults; Minimum legal dose of methanol for humans; Number of cases of methanol categories by age group and outcome.

The goal of the study was to assess positive factors that contribute to African American students' intentions to stay in school. Two hundred and thirty-one African American students participated in this study. Using the theory of planned behavior (TPB) as a conceptual model, surveys measured student attitudes toward school-year completion, social support for completing the academic year, and their perceptions of personal control over school completion. The contributions of self-esteem and racial self-esteem were also examined for their influence on academic strivings. The TPB was a better predictor of intentions to complete the school year than student grade point averages (GPAs). Self-esteem added only slightly to the variance explained in predicting intentions to complete the school year, but neither self-esteem nor racial self-esteem was a significant predictor of GPAs. [ABSTRACT FROM AUTHOR]

This study examines the relationship between academic performance and a number of contextual factors for African American freshmen in an urban setting. Living arrangements, relatives and friends' religiosity, exposure to academic success, and neighborhood perceptions were analyzed to investigate their impact on intention to complete school, grade point average (GPA), and number of suspensions. Results indicate that gender, church attendance by peers, and percentage of relatives completing high school were significant in predicting positive academic outcomes. Perception of neighborhood deterioration was inversely related to intention for school completion and GPA. School suspensions were positively related to perception of neighborhood deterioration. Implications for interventions are discussed. [ABSTRACT FROM AUTHOR]

Describes a case of recurrent coccidioidal meningitis in which a fungal biofilm on the tip of ventriculo-peritoneal shunt tubing was responsible for a persistence of Coccidioides immitis. Overview of biofilms; Case history of the patient; Features of the case; Presence of leukocytes and red blood cells on the tip of the ventriculo-peritoneal mass.

Presents a case study on epidemic typhus meningitis in New Mexico. Background on the case; Methods and results; Discussion.

The study of unmarried African Americans has received scant attention, although African American single people are proportionately the largest group of single individuals in America. The purpose of this study was to assess factors that affect relationship commitment among a group of single professional African American men and women. The study used as its conceptualization Rusbult's Investment Model of Romantic Commitment, which contends that satisfaction and investment are related positively to partner commitment, whereas available romantic alternatives are related negatively to partner commitment. Although gender differences were observed, considerable support for the investment model was obtained. Gender differences also were noted in perceptions of equity, power, and ideal partner. Implications for social work are discussed. [ABSTRACT FROM AUTHOR]

Relatively little research has been done on the subject of racial balance in grout work. The author reports on a study that relates the racial composition of the grout to such factors as the grout's size, and the nature of its activities and leadership. [ABSTRACT FROM AUTHOR]

The development of knowledge and skills related to ethnic minority groups has become an increasingly visible and important priority for social work education. However, professional consensus regarding the anticipated effects of minority content on students appears to be lacking, with training programs focusing on students' racial attitudes, their beliefs about minority clients, or practice behavior appropriate for interracial situations. This article discusses various objectives for minority content in the curriculum and identifies two training models that are consistent with the professional literature on racial attitudes and beliefs and their implications for practice. [ABSTRACT FROM AUTHOR]

This article examines a study which was conducted to determine the effects of racism on the composition of male and female groups. Race continues to be among the most affect laden and problematic issues in U.S. society. Interactions between black people and white people are often tense and conflictual. Fortunately, over the past 20 years social workers have increasingly acknowledged race as a salient consideration in helping relationships. Although race per se has not always been discussed, group practitioners have long argued that the attributes or characteristics that individuals bring to small groups have the potential to influence the effectiveness of those groups. Moreover, with the increasing racial diversification of this society, race dynamics are likely to remain a major concern for group workers. Unique to group workers has been the concern of small-group interracial dynamics. Despite its clear importance, this question has before the past decade or so begun to receive major attention from group workers. However, guidance in this area is frequently derived from anecdotes, theory and practical experience. Scant empirical data are available to corroborate or enhance existing practice wisdom.

Racial conflict between African Americans and Whites has been observed to occur most frequently at two critical points: when African Americans make up approximately 30% of a given group or when African Americans make up approximately 50% of a given group. These two critical ratios are referred to as the J and (inverted) U patterns of racial conflict, respectively. To date, most of the data supporting either the J or U models have been derived from large demographic studies that do not directly assess individual perceptions. Thus, little is known about the individual reactions of members from either racial group to varying percentages of group racial composition. This small-group experiment examined the responses of African-American and White subjects to their inclusion in four-person groups of varying racial compositions. Three racial configurations were created and included the following percentages of African Americans: 25%, 50%, and 75%. The results support the U model of racial conflict. Moreover, the U model fit the data equally well for African Americans and Whites. [ABSTRACT FROM AUTHOR]

Explores concerns about AIDS and relationship appraisals of African American and White dating couples. Overview; Preliminary analyses; Gender and race comparisons; Partner correspondence in ratings; Canonical correlation analysis.

Discusses Recognize, Anticipate and Problem (RAP), a framework for leadership of multiracial groups. Social workers' concerns on multiracial groups; Racial dynamics; Imperatives for leader action; Influence of race in group work practice; Racial issues and problems; Cultural issues. [ABSTRACT FROM AUTHOR]

Identifies the societal roots of the stresses associated with cross-racial relationships. Factors contributing to the sustainment of race as a salient issue for practice; Key ingredient in professional helping; Client concerns and worker skills; Challenges of racial difference to the helping relationship. [ABSTRACT FROM AUTHOR]

This article sought to determine differences in the cross-racial practice experiences of white and minority social services practitioners. A major assumption of those who have focused on cross-racial practice is that cross-racial practice experience is common for both white and minority social workers. Because the clients seen by this group of counselors were also Vietnam veterans and thus shared a unique experience, it could be expected that both counselors and clients would perceive themselves to better understand one another and could work together more successfully. Yet it is curious that this cross-racial dynamic appears only for white practitioners with minority clients. No similar cross-racial effects were observed for minority counselors working with white clients. Moreover, neither white nor minority counselors reported greater perceptions of success in working with same-race clients as a function of having shared the Vietnam experience. It is also possible that shared Vietnam experience in the white-counselor-minority-client dyad enhanced the credibility of white counselors, whereas shared experience may have been unnecessary or insufficient to enhance the credibility of minority counselors working with white clients.

An understanding of the pathogenesis of congenital cytomegalovirus (CMV) infections is hampered by the fact that the majority of adult infections are subclinical. This prevents documentation of the time of fetal infection. In the instance described, a 17-year-old pregnant female developed cytomegalovirus mononucleosis during her first trimester. CMV was recovered from her convalescent urine at 12 weeks' gestation and from amniotic fluid at 21 weeks' gestation. Following a therapeutic abortion at 22 weeks' gestation, CMV was recovered from multiple fetal organs. Cord serum contained 14 mg/100 ml IgM which is elevated for a 22-week fetus. The IgM fraction of the cord serum contained specific CMV antibodies as demonstrated by indirect hemagglutination and indirect immunofluorescence techniques. This suggests that, under abnormal circumstances such as intra-uterine infections, fetuses may be capable of synthesizing detectable levels of specific IgM antibodies as early as 22 weeks' gestation. [ABSTRACT FROM AUTHOR]

In 2002, the School of Social Work at the University of Pittsburgh established the Center on Race and Social Problems (CRSP). CRSP which is the first race research center to be housed in a school of social work, has six foci: economic disparities; educational disparities; interracial group relations; mental health; youth, families, and elderly; and criminal justice and substance abuse. The main activities are promoting research, mentoring young scholars, and disseminating knowledge. CRSP fosters research by organizing research advisory panels, funding pilot studies, and assisting with applications for outside funding. The center mentors young scholars through post- doctoral fellowships and guidance by senior faculty. The center disseminates knowledge through a lecture series, conferences, summer institutes, courses, and academic publications. [ABSTRACT FROM AUTHOR]

Reviews the motion picture "The Color of Fear," produced and directed by Lee Mon Wah.

Abstract. Trichomonas vaginalis was isolated from the respiratory tracts of two infants with respiratory disease. Bacterial and viral cultures of tracheal aspirates and nasopharyngeal specimens did not detect bacterial pathogens or viruses; however, T vaginalis was found to be present in inoculated cell cultures. Both infants were delivered vaginally by mothers with known previous episodes of T vaginalis infection. The possibility that this organism may, on occasion, cause respiratory tract disease needs further evaluation. [ABSTRACT FROM AUTHOR]

The author shares his views about the advocacy for resiliency. Topics discussed include the tendency of social workers to promote resiliency focus on the poor, definition of resiliency, and the author's use of children being lined up and hit on the head with a bat to discuss his reservations about resiliency.

The article suggests approaches to successfully using presentation software in education-related activities. First, there should be flexibility and variability in the presentation format, one that maximizes the use of visual aids. Second, the presenter should communicate with the audience effectively, even as they are enticed by stimulating text or imagery from the slides. Third, the presenter should keep the presentation simple, concentrate on the contend and annotate the images projected on the screen.

The article focuses on the issues concerning the evaluation process of the performance of the medical students in clinical schools in the U.S. According to the authors, the assessment of a student's mastery of the neurological examination is carried out through direct observation. Furthermore, evaluators interpret the clinical competency in which the student applies his knowledge of neuroanatomy.

Reviews the motion picture "Walking Each Other Home: The Color of Fear 2," produced and directed by Lee Mon Wah.

The incarceration of young people is a growing national problem. Key correlates of incarceration among American youth include mental health problems, substance use, and delinquency. The present study uses a statewide sample of incarcerated youth to examine racial differences in African American and Caucasian juvenile offenders' out- comes related to mental health, substance use, and delinquency. The data indicate that relative to Caucasian offenders, African American offenders report lower levels of mental health problems and substance use but higher levels of delinquent behavior such as violence, weapon carrying, and gang fighting. The data further reveal that African American offenders are more likely than Caucasian offenders to be victims of violence and to experience traumatic events such as witnessing injury and death. Recognition of these patterns may help to improve postrelease services by tailoring or adapting preexisting programs to patterns of risk factors and their relative magnitudes of effect. [ABSTRACT FROM AUTHOR]

Context: Oculopharyngeal muscular dystrophy (OPMD) is a rare myopathy caused by polyalanine triplet repeat expansion in the gene for poly(A) binding protein 2 (PABP2) and is found in isolated cohorts throughout the world. We have observed numerous cases of OPMD in New Mexico.Objective: To characterize the clinical, genetic, and demographic features of the OPMD population in New Mexico.Design, Setting, and Participants: Cohort study with analysis of outpatient clinic medical records from 1965 to 2001 at the University of New Mexico Hospital and the New Mexico VA Health Care System in Albuquerque, which serve the entire state.Main Outcome Measures: Clinical phenotype, supplemented with genetic confirmation (n = 10 patients) and in-depth clinical evaluations (n = 49 patients).Results: We identified 216 cases of OPMD (99 women and 117 men) from 39 kindreds of New Mexicans spanning up to 4 generations. All patients were Hispanic, and the majority of probands came from northern New Mexico. In patients who had both ocular and pharyngeal muscle weakness, ptosis was just as likely to occur before or concurrent with dysphagia. Proximal limb muscle weakness and gait abnormalities were common and occurred later than ocular or pharyngeal weakness. The clinical expression of OPMD caused marked debility, although life-table analysis showed no decrease in life expectancy compared with unaffected family members (P =.81). Ten individuals from different kindreds were found to have an identical polyalanine triplet repeat expansion ([GCG](9)) in the PABP2 gene.Conclusions: Individuals in this cohort had clinical and genetic characteristics of classic OPMD. Longevity was not affected, but patients experienced considerable morbidity. The origin of the PABP2 mutation in New Mexican OPMD patients is unclear, although the geographic and genetic isolation of northern New Mexicans with a long ancestry in this region may have contributed to the development of this cohort. This disease cohort represents a large and previously unrecognized health care issue in the state of New Mexico and should serve to raise the awareness of this disorder among clinicians who treat Hispanics in the Southwest and throughout the United States. [ABSTRACT FROM AUTHOR]

When people of different races come together in treatment, task, and support groups, race is always a salient factor. The extensive literature related to racially, ethnically, and culturally sensitive group practice promotes awareness and offers guidelines, but there has been no systematic evaluation of how effective these guidelines are in preparing students for multiracial practice with groups. This pilot study evaluates the use of the RAP model, a framework for leading multiracial groups, for teaching MSW students. The student subjects in this study reported significant gains on dimensions related to comfort in discussing racial differences between worker and members and among members, skills in talking about differences, knowledge about interventions, and their ability to identify issues and problems. Reports of concerns about issues and problems did not change significantly. Identification of specific concerns about leading multiracial groups and open-ended responses provide useful information about future training needs. [ABSTRACT FROM PUBLISHER]

When people of different races come together in treatment, task, and support groups, race is always a salient factor. The extensive literature related to racially, ethnically, and culturally sensitive group practice promotes awareness and offers guidelines, but there has been no systematic evaluation of how effective these guidelines are in preparing students for multiracial practice with groups. This pilot study evaluates the use of the RAP model, a framework for leading multiracial groups, for teaching MSW students. The student subjects in this study reported significant gains on dimensions related to comfort in discussing racial differences between worker and members and among members, skills in talking about differences, knowledge about interventions, and their ability to identify issues and problems. Reports of concerns about issues and problems did not change significantly. Identification of specific concerns about leading multiracial groups and open-ended responses provide useful information about future training needs. [ABSTRACT FROM AUTHOR]

Background: The herpes zoster vaccine is effective in preventing herpes zoster and postherpetic neuralgia in immunocompetent older adults. However, its safety has not been described in depth. Objective: To describe local adverse effects and short- and longterm safety profiles of herpes zoster vaccine in immunocompetent older adults. Design: Randomized, placebo-controlled trial with enrollment from November 1998 to September 2001 and follow-up through April 2004 (mean, 3.4 years). A Veterans Affairs Coordinating Center generated the permutated block randomization scheme, which was stratified by site and age. Participants and follow-up study personnel were blinded to treatment assignments. (ClinicalTrials.gov registration number: NCT00007501) Setting: 22 U.S. academic centers. Participants: 38 546 immunocompetent adults 60 years or older, including 6616 who participated in an adverse events substudy. Intervention: Single dose of herpes zoster vaccine or placebo. Measurements: Serious adverse events and rashes in all participants and inoculation-site events in substudy participants during the first 42 days after inoculation. Thereafter, vaccination-related serious adverse events and deaths were monitored in all participants, and hospitalizations were monitored in substudy participants. Results: After inoculation, 255 (1.4%) vaccine recipients and 254 (1.4%) placebo recipients reported serious adverse events. Local inoculation-site side effects were reported by 1604 (48%) vaccine recipients and 539 (16%) placebo recipients in the substudy. A total of 977 (56.6%) of the vaccine recipients reporting local side effects were aged 60 to 69 years, and 627 (39.2%) were older than 70 years. After inoculation, herpes zoster occurred in 7 vaccine recipients versus 24 placebo recipients. Long-term follow-up (mean, 3.39 years) showed that rates of hospitalization or death did not differ between vaccine and placebo recipients. Limitations: Participants in the substudy were not randomly selected. Confirmation of reported serious adverse events with medical record data was not always obtained. Conclusion: Herpes zoster vaccine is well tolerated in older, immunocompetent adults. Primary Funding Source: Cooperative Studies Program, Department of Veterans Affairs, Office of Research and Development; grants from Merck to the Veterans Affairs Cooperative Studies Program; and the James R. and Jesse V. Scott Fund for Shingles Research. [ABSTRACT FROM AUTHOR]

We tested the hypothesis that cross-reactivity between the outer surface protein A (OspA) of Borellia burgdorferi and human leukocyte function antigen (LFA) type 1 mediates chronic autoimmune sequelae of Lyme disease. T cell response was studied in subjects with Lyme disease presenting with erythema migrans alone (n = 36), erythema migrans with neurological disease (n = 12), and chronic Lyme disease syndrome (n = 20), as well as healthy control subjects from Lyme-endemic (n = 50) and -nonendemic (n = 18) regions. Antigens included recombinant OspA and OspC (all strain B31) and human LFA-1 peptide (IYVIEGTSKQDLTSF). Proliferation to OspA was detected in 11 (28%) of 39 of subjects presenting with erythema migrans, which increased to 50% at 4 weeks of follow-up. Reactivity to OspA and LFA-1 was significantly correlated (P < .001) and was observed in 18 (78%) of 23 of OspA-responsive subjects. However, there was no correlation between T cell response to human LFA-1 peptide and clinical status. [ABSTRACT FROM AUTHOR]

Discusses ways nurses can prevent multiple body tube mixups. Case histories on trach tube mistake; Foley catheter mistake; Necessity of tracing the tubing from one end to the other; Labeling of each tube with a color-coded, wraparound labels; Encouragement of manufacturers to adopt a uniform color coding system for tubes.

Mental status after acute West Nile virus infection has not been examined objectively. We compared Telephone Interview for Cognitive Status scores of 116 patients with West Nile fever or West Nile neuroinvasive disease. Mental status was poorer and cognitive complaints more frequent with West Nile neuroinvasive disease (p = 0.005). [ABSTRACT FROM AUTHOR]