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Background Oxygen (O2) is a mainstay of treatment in acute severe asthma but how it is administered varies widely. The objectives were to examine whether a trial comparing humidified O2 to standard O2 in children is feasible, and specifically to obtain data on recruitment, tolerability and outcome measure stability. Methods Heated humidified, cold humidified and standard O2 treatments were compared for children (2–16 years) with acute severe asthma in a multi-centre, open, parallel, pilot randomised controlled trial (RCT). Multiple outcomes were assessed. Results Of 258 children screened, 66 were randomised (heated humidified O2 n = 25; cold humidified O2 n = 21; standard O2 n = 20). Median (IQR) length of stay (hours) in hospital was 37.9 (29.1), 52 (35.4) and 49.1 (29.7) for standard, heated humidified and cold humidified respectively and time (hours) on O2 was 15.9 (9.4), 13.6 (14.9) and 13.1 (14.9) for the three groups respectively. The mean (standard deviation) time (hours) taken to step down nebulised to inhaled treatment was 5.6 (14.3), 35.1 (28.2) and 32.7 (20.1). Asthma Severity Score decreased in all three groups similarly, although missing data prevented complete analysis. Humidified O2 was least well tolerated with eight participants discontinuing their randomised treatment early. An important barrier to recruitment was research nurse availability. Conclusion Although, the results of this pilot study should not be extrapolated beyond the study sample and inferential conclusions should not be drawn from the results, this is the first RCT to compare humidified and standard O2 therapy in acute severe asthmatics of any age. These findings and accompanying screening data show that a large RCT of O2 therapy is feasible. However, challenges associated with randomisation and data collection should be addressed in any future trial design.

ObjectivesThe study sought to explore the knowledge, attitudes and perceptions of healthcare providers and health programme managers regarding the benefits, challenges and impact of international medical volunteers’ clinical placements. Views on how to better improve the work of international medical volunteers and the volunteer organisation Voluntary Service Overseas (VSO) for the benefit of local communities were also explored.SettingsPublic healthcare facilities, VSO offices in Gulu and VSO offices in Kampala, Uganda.ParticipantsUgandan healthcare providers (n=11) and health programme managers (n=6) who had worked with or managed international medical volunteers.InterventionsData collection was conducted using key informant interviews. Transcribed interviews were coded by topic and grouped into categories. Thematic framework analysis using NVivo identified emerging themes.ResultsBoth healthcare providers and managers reported a beneficial impact of volunteers and working with the volunteer organisation (clinical service provision, multidisciplinary teamwork, patient-centred care, implementation of audits, improved quality of care, clinical teaching and mentoring for local healthcare providers); identified challenges of working with volunteers (language barriers and unrealistic expectations) and the organisation (lack of clear communication and feedback processes); and provided recommendations to improve volunteer placements and working partnership with the organisation (more local stakeholder input and longer placements). Most healthcare providers were positive and recommended that volunteers are enabled to continue to work in such settings if resources are available to do so.ConclusionsHealthcare providers based in a low-resource setting report positive experiences and impacts of working with international medical volunteers. Currently, there is lack of local feedback processes, and the establishment of such processes that consider local stakeholder reflections requires further strengthening. These would help gain a better understanding of what is needed to ensure optimal effectiveness and sustainable impact of international medical volunteer placements.

This chapter discusses that the rise of the so-called gender gap in the 1980s represented such a "broken contract" for women in America, since the growth of a distinctive women's perspective on political issues arose, essentially, because the polity failed to respond to several basic needs facing different types of women in modern society. Several sets of social forces are generally credited with producing the gender gap in ideology and partisanship. Once again, the enduring nature of the gender gap indicates that it taps some basic value and role differences between men and women in American society. The contention that feminism and/or self-interest explain at least part of the widening gender gap is based on the assumption that social change led to a shift in the attitudes of certain types of women. The gender gap in voting and partisan affiliation seemingly reflected important changes in the way men and women viewed the central issues in American politics.

Background: Oxygen (O2) is a mainstay of treatment in acute severe asthma. While there are physiological reasons why O2 should be warmed and humidified, how O2 is administered in the UK and Europe varies widely. Aim: To examine whether a trial comparing different humidified O2 to standard O2 is feasible, and specifically obtain data on accrual, adherence and outcome measure stability. Methods: Children 2-16yrs attending AE 23, 6-16yrs) recruited at 4 sites. See Table for results; all data are mean (95%CI). ASS decreased in all three groups similarly following randomisation. Conclusions: This is the first RCT to compare humidified and standard O2 therapy in acute severe asthma in children. With the caveat that these are pilot data, children treated with heated humidified O2 received more nebulised treatment and were more likely to have their treatment escalated. These findings and accompanying screening data will inform a future definitive clinical trial.

Social work students have few guidelines to help them evaluate the implication of their posted information on Internet-based social networking sites (SNSs). There is a national trend among employer...

Mouse cerebellar development occurs at late embryonic stages and through the first few weeks of postnatal life. Hormones such as 17-beta-estradiol (E2) have been implicated in cerebellar development, through the expression of E2 receptors (ER). However, the role of E2 in the development and function of cerebellar neurons has yet to be fully elucidated. To gain insight into E2's actions on the developing cerebellum, we characterized a cloned neuronal cell line, E(t)C.1, derived from late embryonic cerebellum for its neural properties and responsiveness to E2. Our results revealed that E(t)C.1 cells express markers characteristic of neural progenitor cells such as Nestin, Musashi, and Doublecortin (DCX), and of the granule cell lineage such as Math1 and Zipro1. The ER alpha and beta (ERalpha and ERbeta) were also identified in this cell line. Functionality of ERs was verified using an Estrogen Response Element (ERE)-Luciferase reporter plasmid. E2 modulated ERalpha, FMRP, and IL-6, which were expressed in these cells. However, E2 did not induce changes in neural proteins nor induce maturation of E(t)C.1 cells. CREB and ERK(1/2) protein kinases were not modulated by E2 either. Interestingly, E(t)C.1 expressed active p450 Aromatase (P450arom), which was confirmed by the aromatization of androstenedione (AD) to E2 and other estrogen metabolites. Collectively, our results show that the E(t)C.1 cell line may serve as a model to study early development of cerebellar progenitor granule cells, and their responsiveness to E2.

T h e E a r ly Ye a r s o f t h e a h s s To u r s ( J a n e t C l a r k ) Fifty years of the ahss? The weekend Tours have been running for at least half of these years. My first one as Organiser was in 1984, and before that they had been operated by Evelyn Macaulay jointly with eafas. My last was to North West Ulster in 1996, so for 13 years they were pretty prominent in my life. In 1984 the tour to ‘Strathmore and the Mearns’ was for the Forth & Borders Group of the Scottish Georgian Society. By 1985 we were the ‘Architectural Heritage Society of Scotland’ but the Tour was still ‘Forth & Borders Group’. After 1990, it became the ahss National Tour. But all this was academic; the process of planning and organising remained much the same. Over the years I’ve forgotten much of the detail, but looking at the old notes brings back very vividly many of the best and worst moments. On the coach on the return journey, we’d start by asking people where they’d like to go next year. Some suggestions were more realistic than others, but over the years we covered the country pretty well. Having settled on the location, we’d have a recovery period over the summer and then start brainstorming. List every conceivable building – the RCAHMS was, and continues to be, the prime source of information; identify the owners – this was easier in the days of the Valuation Roll; write and sound them out. Offer to come and visit them in the autumn, playing down the fact that a coach-load of 45 people would follow in the spring. Most owners were very welcoming at this stage, and the ‘Recce Tours’ were great fun. I’m sure they still are. A huge amount can be packed into three days by a few people in a car, coffee and tea flow freely even if real meals are a bit scarce, hundreds of miles are covered, often late into the night, ideas and plans are bounced around, and the fun of meeting all these new people, explaining our mission and being so warmly welcomed is tremendous. You get to see many buildings never open to the public; this curiosity is one of the main attractions for people booking the Tours. At the same time you have to note mileages, estimate times for a coach, watch out for tight corners and narrow bridges. ‘How wide is a coach? We’ll measure the gateway with my belt.’ The travel can be hair-raising – coaxing the car back to life in a snowstorm on Drumochter – or truly magical – the perfect calm and luminous light on the ferry to Shapinsay. Back to reality and formulate an itinerary. Rule out the ridiculously impractical – ‘It’s definitely not worth going all that way just to see two pieces of pottery’; if possible establish a linking thread; be realistic about how long it takes to get 45 people on and off a coach; know the

Objectives To determine the prevalence, diagnostic patterns, and management of prostatitis, interstitial cystitis, and epididymitis (PIE) in Canadian urology outpatient practice. Methods Representative urologists were randomly selected from the Canadian and Quebec Urological Associations. Each patient identified with a PIE diagnosis during a typical 2-consecutive-week period during April 2004 to July 2004 was requested to complete a corresponding Chronic Prostatitis Symptom Index (CPSI), O’Leary-Sant Symptom Index (OSSI), or a Chronic Epididymitis Symptom Index (CESI). Each day the participant urologist completed an outpatient log and a detailed programmed chart review to transcribe demographics, investigations, and treatments associated with each PIE patient. Results Sixty-five urologists were invited to participate. Fifty-seven (88%) agreed, and 48 (74%) completed the audit. Of the 8712 patients seen in outpatient practice (average 182 per urologist), 2675 were female and 6037 male. Prostatitis was identified in 2.7% of the men (n = 166; mean age 50 years; mean duration 3.1 years; mean CPSI score 19.7), interstitial cystitis in 2.8% of patients (n = 242; 211 women [7.9%], 26 men [0.4%]; mean age 50.2 years, mean duration 4.5 years, mean OSSI score 11.8), and epididymitis in 0.9% of men (n = 57; mean age 41.1 years, mean duration 2.5 years, mean CESI score 15.5). There was wide variance in investigations and treatments. Conclusions This prospective audit indicates that prostatitis might not be as common as frequently believed and that interstitial cystitis is more common, and it represents the first estimate of the prevalence of epididymitis in urologic practice. The wide variance in investigations and treatments confirms the need for practice management guidelines.

Purpose:: We determined the effect of a best evidence based monotherapeutic strategy for patients diagnosed with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) referred to a specialized prostatitis clinic.Materials and Methods:: Patients with CP/CPPS referred by urologists after failure of prescribed therapy for evaluation and treatment at Queen’s University prostatitis research clinic were extensively evaluated, aggressively treated following a standardized treatment algorithm and followed for 1 year using a validated prostatitis specific symptom and quality of life instrument, the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). All patients underwent a standardized protocol for CP/CPPS including a history, physical examination, standard 4-glass test, plus urethral swab and semen for microscopy and culture, uroflowmetry and residual urine determination. Treatment followed a best evidence based strategy with a standardized monotherapy based algorithm.Results...

This paper applies aggregate data analysis to explore the relationships among the economic development level, the status of women, and the quality of life in developing societies. In particular, it tests the hypothesis that the status of women is positively related to the quality of life even after the effects of economic growth and development are statistically controlled. Our analysis strongly confirms this hypothesis since the status of women in a society appears to rival the economic development level for explaining how good or ill is the quality of life enjoyed by its citizens. We undertook this study from the theoretical perspective that questions conceptualizing and measuring development simply in terms of the level and growth of GNP per capita. Rather, the social needs and quality of life in a society, the presumed consequences of development, are important as well.

A review of a book written by Clive Chitty (2002 with a useful focus on issues of equity and social justice, including prejudice, discrimination and bullying in secondary schools. Education policy makers need to explore the extent to which it is important to produce interested, motivated and socially balanced young adults. It is well researched and documented.

Objectives To re-survey (after 1 year) men identified in 1999 as having perineal and/or ejaculatory pain/discomfort severe enough to suggest a clinical diagnosis of chronic prostatitis (using the National Institutes of Health-Chronic Prostatitis Symptom Index, NIH-CPSI), and to compare them with an age-matched population of men who had no prostatitis-like symptoms in the initial survey, to determine the effect of time on specific symptoms associated with the diagnosis of chronic prostatitis. Subjects and methods A comprehensive questionnaire incorporating the pain and voiding domains of the NIH-CPSI, and data on demographics, medical history, socio-economic status, health-seeking behaviour and a quality of life assessment, was sent to 67 men who had reported prostatitis-like symptoms in the 1999 survey, and to 202 age-matched controls (1 : 3) who reported no prostatitis-like symptoms in the same survey. Results Forty men (60%) with previous prostatitis-like symptoms, i.e. a mean (sd) 1999 NIH-CPSI pain score of 8.8 (0.4), and 119 (59%) of the control population completed and returned the survey. There was no difference in the 1999 demographics (P = 0.82) or NIH-CPSI pain score (P = 0.49) between patients who returned the recent questionnaire and those who could not be located or declined to complete the survey. Fifteen men (38%) identified with prostatitis in 1999 did not report similar symptoms in 2000. The initial mean NIH-CPSI pain score (0–21) for the men who had resolution of their prostatitis-like symptoms was 7.5 (0.6); 1 year later it was 0.73 (0.3). Their mean age was 51.1 (3.9) years and mean duration of symptoms 1.1 (0.3) years. Those with persistent symptoms had an initial NIH-CPSI pain score of 9.6 (0.5); 1 year later it was 8.68 (0.4), at mean age of 51.4 (2.5) years and duration of symptoms 2.2 (0.3) years. Four men (3%) in the control group who had no symptoms in 1999 reported prostatitis-like symptoms in 2000; these men had a mean age of 52.5 (5.9) and NIH-CPSI pain score of 7.0 (0.9). Conclusion About a third of men reporting prostatitis-like symptoms in the general population had resolution of their symptoms (usually those with a shorter duration and less severe symptoms) 1 year later. The severity of symptoms of men with persistent chronic prostatitis remained relatively unchanged over the year.

To our knowledge antibiotics are the most popular choice of therapy for all categories of the chronic prostatitis/chronic pelvic pain syndrome. We determine if culture, leukocyte and/or antibody status of prostate specific specimens predicts patient response to antibiotic therapy.Patients clinically diagnosed with the chronic prostatitis/chronic pelvic pain syndrome according to the National Institutes of Health (NIH) definition had a lower urinary tract evaluation that included standard microscopy and culture of prostate specific specimens, and determination of the ratio of voided bladder 3 and voided bladder 2 antibody levels against a panel of identified prostate pathogens (enzyme linked immunosorbent assay methodology). Symptom evaluation consisted of the NIH chronic prostatitis symptom index (derived) pain scale 0 to 21, symptom severity index scale 0 to 100, symptom frequency questionnaire scale 0 to 50 and quality of life scale 0 to 6. Patients were stratified according to microscopy, culture and immune status, were treated with 12 weeks of ofloxacin, and were assessed at 4, 12 and 24 weeks with symptom scores as well as global assessments.Based on leukocyte and culture results, 102 evaluable patients were stratified into categories II (14%), IIIA (48%) and IIIB (38%) of the chronic prostatitis/chronic pelvic pain syndrome. Of the cases 23% were categorized as antibody positive and 77% as antibody negative. Average age was 42 +/- 10 years and 92% of patients were white. Of the patients 57% believed that they had moderate to marked improvement. All categories of the chronic prostatitis/chronic pelvic pain syndrome and patients in whom antibody was positive or negative had significant improvement in the NIH chronic prostatitis symptom index, symptom severity index, symptom frequency questionnaire and quality of life scores compared with baseline (p0.001). There was no significant difference in patient response to the stratification based on culture, leukocyte, that is categories II, IIIA and IIIB had same beneficial response, or antibody status.Culture, leukocyte and antibody status of prostate specific specimens does not predict antibiotic response in patients with the chronic prostatitis/chronic pelvic pain syndrome. The perceived beneficial effect of antibiotics needs to be evaluated in a randomized placebo controlled trial.

We have developed and tested a fractionated, purified and deproteinized emulsion of a mycobacterial cell wall (MCW) and report on a controlled study of this compound in the treatment of the experimental R3327-H adenocarcinoma of the prostate. The intraperitoneal route of administration was found ineffective at the weekly dose of 500 micrograms. The intratumoral administration of 1000 micrograms of MCW exhibited significant antitumor activity. Tumors larger than 2.2 cm.3 in volume showed evidence of temporary regression, but no cures were recorded in these animals. Complete tumor regression was found in 50% of the rats with tumor volumes less than 2.2 cm.3 at the onset of treatment. The animals in this group not responding initially were treated with a second 3-week course of MCW which resulted in complete tumor regression in one-half of the animals, for a total cure rate, in the smaller tumor cohort, of 75%. Mycobacterial cell wall is an effective biological response modifier in the Dunning R3327-H adenocarcinoma of the prostate in Copenhagen rats. Additional studies to elucidate the effect of the compound in relation to dose and tumor volume are underway.

Estrogen acts through two molecularly distinct receptors termed estrogen receptor alpha (ERα) and estrogen receptor beta (ERβ) which bind estradiol with similar affinities and mediate the effects of estrogen throughout the body. ERα plays a major role in reproductive physiology and behavior, and mediates classic estrogen signaling in such tissues as the uterus, mammary gland, and skeleton. ERβ, however, modulates estrogen signaling in the ovary, the immune system, prostate, gastrointestinal tract, and hypothalamus, and there is some evidence that ERβ can regulate ERα activity. Moreover, ERβ knockout studies and receptor distribution analyses in the CNS suggest that this receptor may play a role in the modulation of mood and cognition. In recent years several ERβ-specific compounds (selective estrogen receptor beta modulators; SERM-beta) have become available, and research suggests potential utility of these compounds in menopausal symptom relief, breast cancer prevention, diseases that have an inflammatory component, osteoporosis, cardiovascular disease, and inflammatory bowel disease, as well as modulation of mood, and anxiety. Here we demonstrate an antidepressant-like effect obtained using two SERM-beta compounds, SERM-beta1 and SERM-beta2. These compounds exhibit full agonist activity at ERβ in a cell based estrogen response element (ERE) transactivation assay. SERM-beta1 and 2 are non-proliferative with respect to breast as determined using the MCF-7 breast cancer cell-based assay and non-proliferative in the uterus as determined by assessing the effects of SERM-beta compounds on immature rat uterine weight and murine uterine weight. In vivo SERM-beta1 and 2 are brain penetrant and display dose dependent efficacy in the murine dorsal raphe assays for induction of tryptophan hydroxylase mRNA and progesterone receptor protein. These compounds show activity in the murine forced swim test and promote hippocampal neurogenesis acutely in rats. Taken together these data suggest that ERβ may play an important role in modulating mood and the ERβ specific compounds described herein will be useful tools for probing the utility of an ERβ agonist for treating neuroendocrine-related mood disturbance and menopausal symptoms.

This paper presents a case study of county spending in Wyoming during the 1970s and 1980s to test the applicability of several competing perspectives upon budget policy derived from higher level and more visible governments in the United States. Our findings about the consequences of Wyoming's boom and bust cycle during the 1970s and 1980s for county finances possess several implications for the competing theories of budget policy. Concerning how budgets are made, they confirm the growing consensus that models of “budgetary incrementalism” are inadequate, as well as providing some evidence consistent with the “garbage can” model of decision-making. However, they also suggest that “the baby should not be thrown out with the bath water,” since temporal consistency and incrementalism are evident in several areas. Turning to the factors affecting budget substance, resource base turned out to be the most important factor influencing Wyoming county budgets. Several instances of special social needs and politica...

Reflex sympathetic dystrophy (RSD) or complex regional pain syndrome type 1, is characterized by spontaneous pain or allodynia and hyperalgesia disproportionate to the inciting event, multiperipheral nerve involvement, edema, vasomotor or sudomotor change, and possible loss of function. It has been described in relation to various insults, including a number of infectious and inflammatory conditions. We report a case of a patient who developed RSD 1 week after an exacerbation of hidradenitis suppurativa, a rare chronic inflammatory disease of apocrine sweat glands. The patient responded well to a combination of range-of-motion exercises, thermal modalities, and oral steroids. Hidradenitis suppurativa should be considered when searching for an etiology of new onset RSD.

T-type calcium channels are important in burst firing and expressed in brain regions implicated in schizophrenia. Therefore, we examined the effects of novel selective T-type calcium channel antagonists in preclinical assays predictive of antipsychotic-like activity. TTA-A2 blocked the psychostimulant effects of amphetamine and MK-801 and decreased conditioned avoidance responding. These effects appeared mechanism based, rather than compound specific, as two structurally dissimilar T-type antagonists also reduced amphetamine-induced psychomotor activity. Importantly, the ability to reduce amphetamine's effects was maintained following 20 days pre-treatment with TTA-A2. To explore the neural substrates mediating the observed behavioral effects, we examined the influence of TTA-A2 on amphetamine-induced c-fos expression as well as basal and stimulant-evoked dopamine and glutamate release in the nucleus accumbens. TTA-A2 decreased amphetamine-induced c-fos expression as well as MK-801-induced, but not basal, glutamate levels in the nucleus accumbens. Basal, amphetamine- and MK-801-induced dopamine efflux was altered. These findings suggest that T-type calcium channel antagonism could represent a novel mechanism for treating schizophrenia.

Despite the fact that the Reagan election was viewed as a power shift toward the West, the decade of the 1980s produced cruel disappointment. The region was generally left out of the economic recmery of the nation because of the bust in the agricultural and mineral industries. These state and local gmernments which sufferfrom high costs and low resources were particularly dependent on the national gmernment at the very time when the Reagan Administration was cutting federal aid and transferring power to the states. Unlike Nixon's New Federalism which helped the state and local governments of the West, Reagan's policies caused their relative position in federal aid flows to deteriorate. Although the Reagan revolution in cutting domestic programs was viewed as the embodiment of western rugged individualism, the region lost in terms of federal aid to small rural local governments.

Chronic infections in the urinary environment include medical device related infections, chronic cystitis, chronic prostatitis, and infected struvite stones. Many different uropathogens are associated with these infections, but their common feature is adhesion, followed by growth as microcolonies and biofilms. In acute infections, the disease runs its course before being cleared by antibiotics or host defence mechanisms present at the tissue surface (e.g. the mucous layer and the immune response) and within the urine itself (e.g. low iron levels and high osmolality due to urea) and micturition. Chronic urinary tract infections (UTI) arise when the natural host defences are defective or obstructed by the presence of a foreign object such as a catheter or calculus. In these cases, adherent pathogens are not cleared or eradicated. Rather they coat themselves with an extracellular polysaccharide matrix, and upon growth form encapsulated microcolonies and biofilms. This mode of growth enables the biofilm to be notoriously resistant to both the immune response of the host and to antibiotics. In order to accurately mimic the chronic human UTIs in animals, it is essential that the uropathogens are encouraged to grow in their natural state as biofilms. In this report, several models used to examine chronic biofilm-associated infections are described.

1. Pneumococcus polysaccharides Types I, II and III adsorbed on collodion particles, and Types I and III adsorbed on carbon (norit) are antigenic in mice. 2. Unadsorbed pneumococcus polysaccharide of Type I is antigenic in mice in proper dilution. One preparation of Type II polysaccharide was not antigenic, while another one immunized against Types I and II. Type III polysaccharide was only slightly antigenic against Type III but immunized against Type I. 3. The antigenicity of pneumococcus polysaccharide in optimal dosage is tentatively explained by an adsorption phenomenon taking place in the body in instances in which the polysaccharides had not been adsorbed before injection. 4. The aggressin-like action of large doses of pneumococcus polysaccharides Types I, II and III is further established.

Premature ejaculation (PE) is a common sexual dysfunction. Treatment ranges from behavior modification to systemic and topical pharmacological treatments. Results to date have been generally inconsistent and of limited effectiveness. New avenues of therapy are needed.To investigate the effect of extracorporeal functional magnetic stimulation (FMS) as a noninvasive treatment for men with PE.The NeoControl System for FMS was used in the study. Baseline assessment included: history and physical, medications, hormonal assessment and intravaginal ejaculatory latency time (IVELT) by stopwatch determination. Treatment involved a first phase of five biweekly sessions (primary outcome). Men who reported an improvement in IVELT and desired to continue were given a second identical course (secondary outcome). Outcome measures included: IVELT and a global assessment questionnaire (GAQ). The responses incorporated both the patient's perception of response together with the more objective IVELT timing and were rated as: 1. Worse: no improvement in GAQ or mean IVELT for the total number of attempts; 2. Unchanged: improvement in IVELT but the patient reported no improvement; 3. Slightly improved: increase in IVELT100% and a reported mild improvement and 4. Better: IVELT increase ofor = 100% with GAQ indicating "moderate" to "marked" improvement.Two primary outcome measures were considered in both treatment phases, the IVELT and the GAQ.Fourteen men were treated. Their mean age was 43.7 years. Fifty-seven percent reported primary PE and 63% were circumcised. Hormone levels were normal in all. Baseline IVELT for the group was 60.6 seconds. All patients completed phase I. Of these, 50% reported no change in the GAQ although they recorded an increase in IVELT; 29% were categorized as slightly better and 14% as better. Eight men entered phase II. Of these, 3 (37.5%) were unchanged; 2 (25%) were slightly better and 3 (37.5%) were classified as better. The response in these last three has persisted for over 6 months post treatment. Both phases of the study showed a trend towards IVELT improvement, more evident at the end of phase II. However the differences did not reach statistical significance on either phase. Side effects were mild and non-treatment related.The use of FMS is claimed to alter the spinal centers without altering cerebral neurotransmitters. Although there were some remarkable responses, our results, are not better than the purported responses to behavioral or pharmacological methodologies. There was a clear trend in IVELT improvement; however, this didn't translate into an equivalent subjective estimation by most of the subjects. This outcome dissonance might be diminished by longer/more intense regimens of treatment. The pilot nature of the study does not permit to draw solid conclusions but stimulate the search for a new therapeutic option in PE.

Since the passage of the Nineteenth Amendment, women's representation in public offices has grown slowly, and women are still greatly underrepresented in most states and in the national government. Since 1975, the women's movement has provided impetus for the steady growth in the numbers of women in office. The number of women in Congress, 31, is the highest ever. Women constitute 18 percent of the state legislatures, 17 percent of state executives, 9 percent of county governing boards, and 14 percent of mayors and city councils. The proportion of women in America's Congress is about half the average for national legislative bodies throughout the world. Many theories have been developed to explain the under-representation of women in politics. Political culture, socialization, and role conflict have all had an impact on women's representation. Discrimination against women by political elites and voters has also existed. Finally, the political structure itself forms barriers to the election of women. Current trends, however, are favorable to the continued gradual increase in the number of women in public office.

One of the complications of thermal injury is the development of scars and contractures during the healing process. This scarring can be devastating, especially when it involves the mouth. The purpose of this report is to describe the construction of an alternative vertical mouth stretching orthosis for vertical microstomia. By using thermoplastic splinting material and a long thread screw, a vertical mouth-stretching orthosis can be custom-fit to any patient's mouth. The device can be fabricated for a pediatric or adult patient for the rehabilitation of a circumferential mouth burn, especially targeting the vertical diameter. When using this device, patients gave positive feedback for comfort and ease of use, with increased mouth mobility and range of motion. This vertical orthotic device provides an economical and comfortable alternative for vertical mouth diameter enlargement to the current five devices available in the literature.

Background Recently a novel tryptophan hydroxylase isoform (TPH2) was identified and shown to be highly expressed in the central nervous system (CNS). Hormonal effects on TPH2 mRNA expression in the rodent dorsal raphe nucleus (DRN) are unknown. Methods In situ hybridization histochemistry and real-time reverse transcriptase-polymerase chain reaction (RT-PCR) were used to assess the effects of dexamethasone or estradiol on TPH2 mRNA levels in the DRN of C57/Bl6 mice. Results Dexamethasone reduced TPH2 mRNA levels in the DRN of both ovx female and intact male mice. Reduction of TPH2 mRNA in the DRN was blocked by co-administration of mifepristone. Estradiol had no detectable effect on TPH2 mRNA levels in the DRN. Conclusions TPH2 mRNA is regulated by glucocorticoids but not estradiol in the mouse DRN. Glucocorticoid-mediated reduction of TPH2 message may have relevance to the etiology of major depression, psychotic major depression in particular, where elevated glucocorticoids are one hallmark of the disease.

Background Distinct expression patterns of estrogen receptor (ER)-α and ER-β are displayed in the murine central nervous system. ER-β is the predominant form of the receptor expressed in the murine midbrain dorsal raphe nucleus (DRN). Tryptophan hydroxylase (TPH) is abundantly expressed in the serotonergic neurons of the DRN and is regulated by estrogen in both the monkey and the guinea pig. Methods In this study we used immunocytochemistry to show that ER-β and TPH are colocalized in the serotonergic cells of the murine DRN. We utilized the ER-α and ER-β gene deletion mouse models and in situ hybridization to demonstrate that ER-β is responsible for regulating TPH1 mRNA expression. Results Estrogen increased TPH1 mRNA expression in the DRN of wild type and ER-α knockout mice (α-ERKO) but not ER-β knockouts (β-ERKO). Conclusions These data indicate that ER-β is responsible for mediating estrogen regulated TPH1 expression in the murine DRN.

Objectives To perform a Canadian multicenter randomized placebo-controlled trial to evaluate the safety and efficacy of 6 weeks of levofloxacin therapy compared with placebo in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Uncontrolled studies have supported the use of antibiotics in CP/CPPS. Methods Men with a National Institutes of Health (NIH) diagnosis of CP/CPPS (specifically, no infection localized to the prostate) were randomized to levofloxacin (500 mg/day) or placebo for 6 weeks in 11 Canadian centers. Patients were assessed at baseline and at 3, 6, and 12 weeks with the NIH Chronic Prostatitis Symptom Index (NIH-CPSI) and global patient assessments (subjective global assessment and patient assessment questionnaire). Results Eighty men (average age 56.0 years, range 36 to 78; duration of symptoms 6.5 years, range 0.6 to 32) were randomized to receive levofloxacin (n = 45) or placebo (n = 35). All were evaluated in an intent-to-treat analysis. Both groups experienced progressive improvement in symptoms as measured by the NIH-CPSI. However, the difference in response was not statistically or clinically significant at end of treatment (6 weeks) or at the end of the follow-up visits (12 weeks). No patients withdrew because of adverse events. One patient withdrew before the 6-week assessment. Adverse events (all mild) were reported in 20% of the levofloxacin group and 17% of the placebo group. Conclusions This pilot placebo-controlled study showed that 6 weeks of levofloxacin therapy in men diagnosed with CP/CPPS resulted in symptom improvement that was not significantly different from that with placebo at end of treatment or follow-up. The clinical ramifications of these findings need to be addressed.

The National Institutes of Health (NIH) chronic prostatitis symptom index was used to determine the prevalence of prostatitis-like symptoms among men (age 20 to 74 years) at risk in a community based study.The study was a cross-sectional postal survey of men age 20 to 74 years in Lennox and Addington counties, which included a large rural area, 1 major town and a suburban area with a stable population of men representative of Canadian demographics. The questionnaire collected information on 2 domains of chronic prostatitis identified in the NIH chronic prostatitis symptom index, including pain (location, severity and frequency), voiding function (irritative, obstructive), demographics, quality of life, general health and health seeking behavior. The self-reported pain score was used to identify prostatitis-like symptoms in the most discriminating domain. Based on analysis of the index final validation study comparing patients with prostatitis to normal controls and those with benign prostatic hyperplasia, the 2 questions most specific for prostatitis, including perineal and/or ejaculatory pain/discomfort, and a total pain score (0 to 21) 4 or greater were used to identify men with significant prostatitis-like symptoms.A total of 2,987 eligible men received the survey, and it was completed by 868 (29%). Of the men 84 (9.7%) were identified as having chronic prostatitis-like symptoms (mean NIH chronic prostatitis symptom index pain score 9.1 +/- 0.3). The average age of the prostatitis population was 50 years compared with 52 years for men without prostatitis-like symptoms. Prevalence was 11.5% in men younger than 50 years and 8.5% in men 50 years or older. Of the sampled population 57 (6.6%) men had prostatitis-like symptoms and an index pain score 8 or greater (moderate to severe). The index voiding score (0 to 10) was 4.1 +/- 0.5 in men younger than 50 years compared with 1.5 +/- 0.1 for normal controls, and 4.7 +/- 0.4 in those 50 years or older compared with 1.9 +/- 0.1 for normal controls. Of the prostatitis group 60% sought medical help for their symptoms.In our opinion this community based study using the new prostatitis symptom index confirms that chronic prostatitis-like symptoms are common.

To investigate the relative efficacy of heparin (H), pentosanpolysulfate (PPS) and hyaluronic acid (HA) in preventing the absorption of 14C labeled urea in protamine pretreated bladders compared with saline pretreated control bladders.Control Group - Rabbit bladders were pretreated with phosphate buffered saline (PBS) followed by instillation of 14C-urea. Radioactivity was determined in blood, bladder and fluid drained from the bladder. Protamine Group - Bladders were pretreated with of PBS followed by protamine sulfate. The bladders were then treated with 14C-urea and radioactivity determined as above. GAG Groups - Bladders were pretreated with saline and protamine as described above followed by instillation of: Group 3A - HA, Group 3B - H and Group 3C - PPS. The bladders were then treated with 14C-urea and radioactivity determined as described above.Protamine treated bladders demonstrated significantly more radioligand uptake in bladder tissue compared with control bladders. There was no significant difference in radioligand uptake in bladders treated with PPS and H compared with control. While not significantly different, there was considerably more radioligand concentration in the blood of rabbits with bladders treated with protamine and protamine-HA compared with those of control rabbits and those treated with protamine-PPS and protamine-H.Exogenous GAG's are effective in providing an epithelial permeability barrier in protamine pretreated bladders. There is a difference in the relative efficacy of the various GAG's in producing this effect.

Epilepsy is the UK's most common serious neurological condition affecting 1 in 131 adults in the UK. Around 75 people are newly diagnosed with the condition every day. Epilepsy can affect anyone, of any age at any time in their life. A diagnosis of epilepsy can have a devastating effect on the individual, his/her lifestyle and his/her family. Antiepileptic drugs (AEDs) are used to stop seizures happening—they do not cure epilepsy.

Confucian societies have a well-deserved reputation for possessing patriarchal cultures which confine women to subordinate roles and almost entirely exclude them from the public sphere. In Taiwan, however, women have done quite well by international standards in winning legislative elections. This paper applies "countersocialization" theory to explain women's growing role in Taiwan's electoral politics. It finds that the careers of women politicians in Taiwan are strongly conditioned by their exposure to countersocialization, primarily in terms of their adult family environments. These findings are quite consistent with the arguments based on socialization theory that women's entrance into public life depends upon an individual psychological reorientation in which "political women" reject traditional cultural norms that limit them to subservient and privatized roles. Such a reorientation can be stimulated by a variety offactors to which an individual woman might be exposed-a mother's role model proving that women can have broader horizons, social and generational change legitimating more active roles, and (most importantly in our data) an adult family and spouse encouraging and supporting her "empowerment" in public affairs.