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The US Information Service Agency (USIA) must reevaluate its role and purposes in the post-Cold War era. In devising a new course, USIA's leadership should be involved in the formulation of US foreign policy, assess its current operations, encourage US relations with Japan, Germany and the Islamic world, promote democracy in Eastern Europe and in the Commonwealth of Independent States and adopt an international perspective. USIA's accomplishments are discussed.

Late-life depression is a major mental health problem that challenges clinicians and will remain so as the population of British Columbians older than 65 continues to grow. Late-life depression contributes to adverse functional, social, and medical outcomes, and can interfere with treatment for medical problems such as stroke. An effective approach to this treatable disorder includes recognition of risk factors, detection, and assessment. The Geriatric Depression Scale and the Cornell Scale for Depression in Dementia can assist in diagnosis, while both psychotherapy and pharmacotherapy are options for management. When psychotherapies are compared, the strongest evidence for effectiveness has been found for cognitive behavioral therapy, problem-solving therapy, and interpersonal therapy. When pharmacotherapies are compared, efficacy is similar for different classes of antidepressants and adjuvant medications but side effect profiles differ and must be taken into account to avoid adverse events. Patients with severe clinical features of late-life depression, including suicidal ideation and psychosis, should be referred to mental health services. [ABSTRACT FROM AUTHOR]

Catheter-related bloodstream infections (CR-BSIs) are bloodstream infections that, through specific laboratory testing, identify the intravascular catheter as the source of the bloodstream infection. By 2015, the rate of elderly patients 80 years of age and older admitted to the intensive care unit (ICU) will represent 1 in 4 admissions. Approximately 80 000 CR-BSIs occur in ICUs annually, potentially resulting in as many as 56 000 CR-BSIs occurring in the geriatric ICU patient, with 20% of these cases resulting in death. To minimize the occurrence of CR-BSIs in these patients, specific knowledge about the geriatric patient will have to be factored into the ICU health care professional's practice, including the development of a vascular access plan, which includes selection of the correct device and proper insertion of that device along with an evidence-based care and maintenance program. Intensive care unit health care professionals may be at a loss when it comes to navigating the vast array of vascular access medical devices available today. The Healthcare and Technology Synergy framework can assist the ICU health care professional to logically review each vascular access device and select those devices that best meet patient needs. [ABSTRACT FROM AUTHOR]

Bovine respiratory disease (BRD) causes severe economic losses to the cattle farming industry worldwide. The major bacterial organisms contributing to the BRD complex are Mannheimia haemolytica, Histophilus somni, Mycoplasma bovis, Pasteurella multocida, and Trueperella pyogenes. The postmortem detection of these organisms in pneumonic lung tissue is generally conducted using standard culture-based techniques where the presence of therapeutic antibiotics in the tissue can inhibit bacterial isolation. In the current study, conventional and real-time polymerase chain reaction (PCR) assays were used to assess the prevalence of these 5 organisms in grossly pneumonic lung samples from 150 animals submitted for postmortem examination, and the results were compared with those obtained using culture techniques. Mannheimia haemolytica was detected in 51 cases (34%) by PCR and in 33 cases (22%) by culture, H. somni was detected in 35 cases (23.3%) by PCR and in 6 cases (4%) by culture, Myc. bovis was detected in 53 cases (35.3%) by PCR and in 29 cases (19.3%) by culture, P. multocida was detected in 50 cases (33.3%) by PCR and in 31 cases (20.7%) by culture, and T. pyogenes was detected in 42 cases (28%) by PCR and in 31 cases (20.7%) by culture, with all differences being statistically significant. The PCR assays indicated positive results for 111 cases (74%) whereas 82 cases (54.6%) were culture positive. The PCR assays have demonstrated a significantly higher rate of detection of all 5 organisms in cases of pneumonia in cattle in Northern Ireland than was detected by current standard procedures. [ABSTRACT FROM PUBLISHER]

We propose a scheme for implementing a single-ion Stochastic Quantum Processor using a single cold trapped ion. The processor implements an arbitrary rotation around the z axis of the Bloch sphere of a data qubit, given two program qubits, that is, the operation realized on the data is determined by using different program qubits and not by varying the gate itself. Unfortunately this cannot be done deterministically, and must be necessarily stochastic. In this proposal the operation is applied successfully with probability p = 3/4. [ABSTRACT FROM AUTHOR]

Examines the usefulness of digital health information provision based on a survey of online users of SurgeryDoor, a consumer health website. Dominant gender and characteristics of online users; How users find the site; Information sources utilized by users when need for health information arises; Health interests and reasons for using the site; Health outcomes of using a health website.

In this article, the author discusses on challenges for clinicians to prevent central line-associated blood stream infections (BSIs) in human body. He informs about easy access of bacteria into the vascular system of body leading to death of patient. He suggests several precautions to be maintained during primary care nursing including handwashing to be done before and after encountering patients, providing emotional care for patient and hub scrubbing before accessing connectors.

The article offers updates in the vascular access practice in the U.S., highlighting a board of directors (BOD) retreat which was attended by the 2013 BOD and committee chairs. A new set of values were determined during the BOD retreat which include patient and public safety, evidence-based practice, and interdisciplinary collaboration and education. It also highlights the vision and mission of the Association for Vascular Access (AVA).

The article offers the author's insights regarding the achievements of their organization from 2012-2013. The author says that the 2012 Association for Vascular Access (AVA) Annual Scientific Meeting with the annual Board of Directors Retreat is designed to bring the Board members, full-time staffs, and committee chairman to plan for the 2013. He mentions the guideline on peripheral intravenous catheter, made by the Clinical Practice Committee which is led by Cathy Perry.

The article presents the author's reflections on the first Association for Vascular Access (AVA) scientific meeting he attended in 1999. He said that he was new to vascular access, notwithstanding the fact that he had 14 years of perioperative nursing experience. He stated that AVA was a refreshing change after having attended several other scientific society meetings in 1999. He added that AVA has always been a multidisciplinary entity.

A letter to the editor is presented in response to the article "Dishing the Dirt on MRSA," by Rita P. Thomas which appeared in the June 2009 issue.

Catheter-related bloodstream infections (CR-BSIs) are bloodstream infections that, through specific laboratory testing, identify the intravascular catheter as the source of the bloodstream infection. By 2015, the rate of elderly patients 80 years of age and older admitted to the intensive care unit (ICU) will represent 1 in 4 admissions. Approximately 80 000 CR-BSIs occur in ICUs annually, potentially resulting in as many as 56 000 CR-BSIs occurring in the geriatric ICU patient, with 20% of these cases resulting in death. To minimize the occurrence of CR-BSIs in these patients, specific knowledge about the geriatric patient will have to be factored into the ICU health care professional's practice, including the development of a vascular access plan, which includes selection of the correct device and proper insertion of that device along with an evidence-based care and maintenance program. Intensive care unit health care professionals may be at a loss when it comes to navigating the vast array of vascular access medical devices available today. The Healthcare and Technology Synergy framework can assist the ICU health care professional to logically review each vascular access device and select those devices that best meet patient needs.

By educating their clients (especially prescribing physicians, nurses, and home healthcare aides) about the advantages of using needle-free devices to administer intravenous medications, compounding pharmacists can help prevent complications associated with vascular access devices and needlestick injuries. Despite state and federal efforts to reduce the incidence of sharps injuries among healthcare workers, percutaneous needle-stick injuries remain a source of emotional stress, morbidity, and possible mortality in those individuals. According to the Centers for Disease Control and Prevention, 50% or more of surveyed healthcare personnel do not report their occupational percutaneous injuries, and an estimated 385,000 sharps-related injuries occur annually among healthcare workers in hospitals alone. Because sharps injuries are associated with the transmission of more than 20 pathogens, including hepatitis B and C viruses and the human immunodeficiency virus, the potential burden of disease is great. For the intgravenous administration of medications, however, devices safer than those requiring the use of needles are available, and pharmacists have a key role in educating caregivers about needle-free equipment and its use. In this article, we explain the types of intravenous needle-free devices of interest to compounding pharmacists and the clients they serve, and we answer frequently asked questions about that equipment. Compounders who understand the design features and capabilities of such products, their clients' intended use of those devices, patients' specific needs can improve treatment outcomes and protect healthcare workers against needlestick injury.

Objectives: To determine the existing patterns of sign-out processes prevalent in emergency departments (EDs) nationwide. In addition, to assess whether training programs provide specific guidance to their trainees regarding sign-outs and attitudes of emergency medicine (EM) residency and pediatric EM fellowship program directors toward the need for the development of standardized guidelines relating to sign-outs., Methods: A Web-based survey of training program directors of each Accreditation Council for Graduate Medical Education (ACGME)-accredited EM residency and pediatric EM fellowship program was conducted in March 2006., Results: Overall, 185 (61.1%) program directors responded to the survey. One hundred thirty-six (73.5%) program directors reported that sign-outs at change of shift occurred in a common area within the ED, and 79 (42.7%) respondents indicated combined sign-outs in the presence of both attending and resident physicians. A majority of the programs, 119 (89.5%), stated that there was no uniform written policy regarding patient sign-out in their ED. Half (50.3%) of all those surveyed reported that physicians sign out patient details "verbally only," and 79 (42.9%) noted that transfer of attending responsibility was "rarely documented." Only 34 (25.6%) programs affirmed that they had formal didactic sessions focused on sign-outs. A majority (71.6%) of program directors surveyed agreed that specific practice parameters regarding transfer of care in the ED would improve patient care; 80 (72.3%) agreed that a standardized sign-out system in the ED would improve communication and reduce medical error., Conclusions: There is wide variation in the sign-out processes followed by different EDs. A majority of those surveyed expressed the need for standardized sign-out systems.