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Arrays of Ni nanowires have been studied by means of first order reversal curves (FORC) diagrams. The dependence of the coercivity of the arrays as a function of the length of the nanowires has been experimentally investigated. We have shown that the FORC diagrams provide detailed information about the distribution of interactions and coercivities and allowed us to observe the reversible component of magnetization. Our results are in good agreement with analytical calculations obtained by means of a simple model. Index Terms--First order reversal curves (FORC), magnetic nanowires.

Several studies are conducted to explain the preparation, as well as the different magnetic properties of the arrays of nanowires of different lengths. A change in the angle of measurements is shown to lead to change of the reversal mode from curling to coherent.

A study of the angular dependence of the remanence and coercivity of Ni nanowire arrays produced inside the pores of anodic alumina membranes is presented. The comparison of analytical calculations with measurements indicated that the magnetization reversal in the Ni nanowire array is determined by means of the nucleation and propagation of a transverse wall.

In this paper, we investigate the use of the contribution to the sample mean plot (CSM plot) as a graphical tool for sensitivity analysis (SA) of computational models. We first provide an exact formula that links, for each uncertain model inputXj, the CSM plotCj(·) with the first-order variance-based sensitivity indexSj. We then build a new estimate forSjusing polynomial regression of the CSM plot. This estimation procedure allows the computation ofSjfromgiven data, without any SA-specific design of experiment. Numerical results show that this newSjestimate is efficient for large sample sizes, but that at small sample sizes it does not compare well with otherSjestimation techniques based on given data, such as the effective algorithm for computing global sensitivity indices method or metamodel-based approaches. [ABSTRACT FROM PUBLISHER]

Background/purpose: The Public Health Crisis Conceptual Model was developed to identify and address healthcare and human services needs related to a disaster. The purpose of this study was to historically apply this model to the counties and populations most affected by the first nuclear test in 1945, with a focus on community and local priorities, and to further describe this model and validate its usefulness. If the model had been applied in 1945, what might have been different with respect to research, epidemiological studies, and reparations?, Methods: A historical, descriptive case study approach was used, with a focus on community and local priorities., Results: While it was deemed necessary to maintain secrecy surrounding the Trinity test during wartime efforts, scientists and the military knew of the potential dangers of radioactive fallout. However, they neglected to inform exposed New Mexicans after the information about the nature of the bombings of Hiroshima and Nagasaki had been made public., Conclusions: Research and epidemiological studies could have been implemented years before they were. Resources were not and have not been distributed equitably to those exposed to fallout from the Trinity test site. Using the Public Health Crisis Conceptual Model will help ensure that community and local priorities are an integral component of future disaster-related research., Competing Interests: Conflicts of Interest: The authors declare no conflicts of interest.

Background: Diagnosis of idiopathic normal pressure hydrocephalus (iNPH) is based on clinical, radiological, and hydrodynamic data of cerebrospinal fluid (CSF) obtained by invasive methods such as lumbar infusion test, which is used to determine the resistance to CSF outflow (Rout). However, Rout has limitations, and its value as predictor of valve response is questioned. Other variables can be obtained by lumbar infusion test, such as the time to reach the plateau (TRP) and the slope until reaching the plateau (SRP). The objectives were to determine if SRP could be a predictor of response to ventriculoperitoneal shunt (VPS) and what variable (Rout versus SRP) would have greater predictive value., Method: Patients with probable iNPH who underwent a lumbar infusion test and were indicated for a VPS were retrospectively studied. Two groups were established, responders and non-responders. Rout, TRP (period between the start of infusion until reaching the plateau measured in seconds) and SRP ((plateau pressure-opening pressure)/TRP) were obtained. For Rout and SRP, the receiver operating curves (ROC) with its areas under the curve (AUC) were calculated., Results: One hundred ten patients were included, being 86 responders (78.20%). Shunt responders had a significantly greater Rout (17.02 (14.45-20.23) versus 13.34 (12.10-16.28) mmHg/ml/min, p = 0.002) and SRP (0.049 (0.043-0.054) versus 0.031 (0.026-0.036) mmHg/sec, p < 0.001) and smaller TRP (641.28 (584.83-697.73) versus 777.65 (654.03-901.27) sec, p = 0.028) than non-responders. The AUC for SRP was greater than the AUC for Rout (0.763 (95 % CI 0.655-0.871, p < 0.001) versus 0.673 (95 % CI 0.595-0.801, p = 0.008), respectively), but the differences were not significant (p = 0.180)., Conclusions: SRP could be considered predictor of response to VPS, and its accuracy tends to be better than Rout. So, this variable may be a useful tool to select shunt candidates among patients with probable iNPH., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

People impacted by disasters may have adverse non-communicable disease health effects associated with the disaster. This research examined the independent and joint impacts of federally declared disasters on the diagnosis of hypertension (HTN), diabetes (DM), anxiety, and medication changes 6 months before and after a disaster. Patients seen in zip codes that received a federal disaster declaration for Hurricanes Gustave or Ike in 2008 and who had electronic health records captured by MarketScan ® were analyzed. The analysis included patients seen 6 months before or after Hurricanes Gustav and Ike in 2008 and who were diagnosed with HTN, DM, or anxiety. There was a statistically significant association between post-disaster and diagnosis of hypertension, X 2 (1, n = 19,328) = 3.985, p = 0.04. There was no association post-disaster and diabetes X 2 (1, n = 19,328) = 0.778, p = 0.378 or anxiety, X 2 (1, n = 19,328) = 0.017, p = 0.898. The research showed that there was a change in the diagnosis of HTN after a disaster. Changes in HTN are an additional important consideration for clinicians in disaster-prone areas. Data about non-communicable diseases help healthcare disaster planners to include primary care needs and providers in the plans to prevent the long-term health impacts of disasters and expedite recovery efforts.

Vision is among the oldest and arguably most important sensory modalities for animals to interact with their external environment. Although many different eye types exist within the animal kingdom, mounting evidence indicates that the genetic networks required for visual system formation and function are relatively well conserved between species. This raises the question as to how common developmental programs are modified in functionally different eye types. Here, we approached this issue through EyeVolve, an open-source PYTHON-based model that recapitulates eye development based on developmental principles originally identified in Drosophila melanogaster . Proof-of-principle experiments showed that this program's animated timeline successfully simulates early eye tissue expansion, neurogenesis, and pigment cell formation, sequentially transitioning from a disorganized pool of progenitor cells to a highly organized lattice of photoreceptor clusters wrapped with support cells. Further, tweaking just five parameters (precursor pool size, founder cell distance and placement from edge, photoreceptor subtype number, and cell death decisions) predicted a multitude of visual system layouts, reminiscent of the varied eye types found in larval and adult arthropods. This suggests that there are universal underlying mechanisms that can explain much of the existing arthropod eye diversity. Thus, EyeVolve sheds light on common principles of eye development and provides a new computational system for generating specific testable predictions about how development gives rise to diverse visual systems from a commonly specified neuroepithelial ground plan., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Lavin, Rathore, Bauer, Disalvo, Mosley, Shearer, Elia, Cook and Buschbeck.)

Leveraging systems biology approaches, we illustrate how metabolically distinct species of Clostridia protect against or worsen Clostridioides difficile infection in mice by modulating the pathogen's colonization, growth, and virulence to impact host survival. Gnotobiotic mice colonized with the amino acid fermenter Paraclostridium bifermentans survive infection with reduced disease severity, while mice colonized with the butyrate-producer, Clostridium sardiniense, succumb more rapidly. Systematic in vivo analyses revealed how each commensal alters the gut-nutrient environment to modulate the pathogen's metabolism, gene regulatory networks, and toxin production. Oral administration of P. bifermentans rescues conventional, clindamycin-treated mice from lethal C. difficile infection in a manner similar to that of monocolonized animals, thereby supporting the therapeutic potential of this commensal species. Our findings lay the foundation for mechanistically informed therapies to counter C. difficile disease using systems biology approaches to define host-commensal-pathogen interactions in vivo., Competing Interests: Declaration of interests L.B. and G.K.G. are co-inventors on patents for C. difficile microbiota therapeutics. L.B., G.K.G., and A.L.S. are SAB members and hold stock in ParetoBio. G.K.G.is an SAB member and holds stock in Kaleido, Inc. A.L.S. is a co-owner of ExArca Pharmaceuticals. The remaining authors declare no competing interests., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: The use of dramatization in health professional education is one method to teach students about implicit bias and cultural difference, yet it has not been widely studied among graduate students of nursing., Objectives: The purpose of this article is to present a qualitative analysis of data regarding doctoral nursing students' responses to a new dramatic exercise as part of a funded project to facilitate cultural learning in a diversity-enhanced nursing curriculum., Design: We employed a cross-sectional posttest design with qualitative data collection and hermeneutic analysis. Setting and., Participants: Subjects were students from two cohorts in a Doctor of Nursing Practice program at a large metropolitan university in the Midwestern United States (n = 136)., Methods: Following a dramatic exercise facilitated by a local theatre group, students debriefed and provided feedback via paper-based surveys collected by their instructor. The research team reviewed and analyzed student feedback with an eye toward new learning or insights around cultural difference., Results: Students rated the dramatic exercise highly. Their written feedback provided for a deeper exploration of how they internalized messages about cultural difference. These experiences were thematized in the following way: (a) Awareness is facilitated through integrating nonverbal (kinesthetic) and verbal encounters, (b) Hesitancy to participate in unfamiliar activities creates tension, and (c) Safety is a foundational aspect of learning sensitive issues., Conclusion: Dramatization of culturally sensitive scenarios for advanced practice nurses can lead to new understanding. Educators who understand the need for thoughtful introduction of dramatization experiences can better prepare nurses for interaction in cross-cultural clinical environments., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: Detecting early type 2 diabetes (T2D) risk factors may reduce or prevent the development of the disease. We conducted a pilot study to generate preliminary data on the perception of T2D and further determined the prevalence of T2D risk factors among college students at an upstate New York campus., Methods: Metabolic profiles were available for 44 college students for cross-sectional analysis. The American Diabetes Association screening guidelines were used to determine risk factors, and perceived susceptibility, perceived seriousness, and self-efficacy were determined with the Health Belief Model's constructs. Sociodemographic and anthropometric data, nutrition knowledge, and metabolic profiles were obtained., Results: The most common T2D risk factors were lack of physical activity (61.4%), decreased high-density lipoprotein cholesterol (HDL-c, 56.8%), high fasting blood glucose (FBG, 45.5%), family history of T2D (43.2%), increased body mass index (BMI, 36.4%), and high blood pressure (15.9%). A high proportion (70%) of participants with detected impaired FBG perceived they were at low risk of developing T2D. Participants with a family history of T2D (mean rank = 24.2) perceived the seriousness of T2D at a similar level as those without family history (mean rank = 21.2), with no significant difference (U = 205, P  = 0.430). Nearly 30% of students did not feel confident they could prevent the development of T2D. Pearson's correlations revealed direct relationships between perceived risk of T2D and BMI ( r  = 0.49, P  = 0.001), fat mass percent ( r  = 0.51, P  < 0.001), and waist circumference ( r  = 0.42, P  = 0.005), and an inverse relationship was found with HDL-c ( r  = - 0.41, P  = 0.005). The association of perceived risk of T2D with a family history of T2D revealed a trend toward significance (Chi-squared = 5.746, P  = 0.057), and the association of perceived risk of T2D with physical activity was not significant (Chi-squared = 1.520, P  = 0.468). The nutrition knowledge score was 74.32 ± 15.97 (recommended is > 75). However, knowledge scores regarding recommended intake of fruits, vegetables, high sodium foods, and whole grains to prevent T2D were only 36.36%, 34.09%, 47.73%, and 63.6%, respectively., Conclusions: The discordance between college students' perceived risk and prevalence of T2D risk factors warrants strategies to address misperceptions of T2D risk and improve lifestyle behaviors among this study sample., Competing Interests: Competing interestsThe authors declare that there are no competing or potential conflicts of interest., (© The Author(s) 2020.)

Objectives: Paranoia is a key symptom in psychosis and associated with a range of poor outcomes. Earlier life experiences increase vulnerability to paranoid thinking, and attachment theory has been proposed as a key model in explaining this causal pathway. Previous reviews highlight evidence of associations between insecure attachment styles and overall severity of psychotic symptoms. Studies report on associations between insecure attachment and paranoia, but to date, this literature has not been adequately synthesized. The aim of the current review was to report the strength and consistency of associations between paranoia and insecure attachment across published studies, and provide systematic appraisal of study quality., Method: We carried out a systematic review of electronic databases using search terms to capture concepts of adult attachment, paranoia, and psychosis. We pre-registered the review protocol and followed PRISMA guidelines., Results: Significant associations were reported in 11 out of 12 studies between an insecure attachment and paranoia, with associations remaining significant in studies that controlled for comorbid symptoms. The strongest, most commonly reported relationship was between an anxious attachment style and paranoia., Conclusions: The findings support the proposed role of attachment insecurity in the development and maintenance of paranoia in psychosis and highlight the need to address insecure attachment representations in the treatment of paranoia., Practitioner Points: There is consistent evidence of associations between insecure attachment style and paranoia. Insecure anxious attachment is more consistently associated with paranoia than an insecure avoidant attachment. Associations between attachment and paranoia remain significant when key confounders are controlled for in the analyses. Interventions that address insecure attachment representations and promote a more secure attachment are likely to help reduce paranoia., (© 2019 The Authors. British Journal of Clinical Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

Background: A significant decrease in back injury claims was observed in a single employer., Objective: The aim of this study was to validate whether back injury claims are decreasing in a multiemployer environment within a non-monopolistic state and quantify the risk of delayed return-to-work and adverse cost of injured workers with back injuries., Methods: Thirty-six thousand four hundred sixty-three claims from 1998 to 2015 were analyzed with descriptive statistics and multivariate logistic and Cox-Proportional Hazards models., Results: Back injury claims decreased three-fold (5.02 to 1.60 per 1000 employees) and were more likely to have claim costs over $100,000 (odds ratio = 2.41) and delayed return-to-work (hazard ratio = 1.16)., Conclusion: Back injury claims are decreasing in a multiemployer environment within a non-monopolistic state.

Genome-wide association studies have identified risk loci associated with the development of inflammatory bowel disease, while epidemiological studies have emphasized that pathogenesis likely involves host interactions with environmental elements whose source and structure need to be defined. Here, we identify a class of compounds derived from dietary, microbial, and industrial sources that are characterized by the presence of a five-membered oxazole ring and induce CD1d-dependent intestinal inflammation. We observe that minimal oxazole structures modulate natural killer T cell-dependent inflammation by regulating lipid antigen presentation by CD1d on intestinal epithelial cells (IECs). CD1d-restricted production of interleukin 10 by IECs is limited through activity of the aryl hydrocarbon receptor (AhR) pathway in response to oxazole induction of tryptophan metabolites. As such, the depletion of the AhR in the intestinal epithelium abrogates oxazole-induced inflammation. In summary, we identify environmentally derived oxazoles as triggers of CD1d-dependent intestinal inflammatory responses that occur via activation of the AhR in the intestinal epithelium., (Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.)

Animal models are essential to dissect host-microbiota interactions that impact health and the development of disease. In addition to providing pre-clinical models for the development of novel therapeutics and diagnostic biomarkers, mouse systems actively support microbiome studies by defining microbial contributions to normal development and homeostasis, and as well as their role in promoting diseases such as inflammatory auto-immune diseases, diabetes, metabolic syndromes, and susceptibilities to infectious agents. Mice provide a genetically tenable host that can be reared under gnotobiotic (germfree) conditions, allowing colonization studies with human or mouse-origin defined or complex microbial communities to define specific in vivo effects. The protocols and background information detail key aspects to consider in designing host-microbiome experiments with mouse models, and to develop robust systems that leverage gnotobiotic mice, microbial consortia, and specific environmental perturbations to identify causal effects in vivo .

The United States needs a national health care and public health workforce with the knowledge, skills, and abilities to respond to any disaster or public health emergency in a timely and appropriate manner. This requires that all of our nation's nurses and health care providers have unrestrained access to high-quality, evidence-based, competency-driven education and training programs. Programs of study for disaster readiness in both the academic and service sectors are limited in number. Those that do exist may be based upon consensus rather than competency and be price prohibitive. They may fail to fully capitalize on existing educational technologies and may not be accessible to all providers. Nurse leaders are ideally positioned to recognize, advocate, and support the need for a broad array of learning options to strengthen the readiness of the health care workforce for disaster response. This article reviews current challenges and opportunities for the expansion of evidence-based education and training opportunities for health care workforce disaster readiness.

Inequalities in society, culture, and finance have resulted in civil unrest, rioting, and intentional violence throughout our history. Nowhere is this currently more apparent than in the cities of Ferguson and Baltimore. It is not the civil unrest itself, but the resulting rioting and intentional violence that can create a disaster situation. This increases the care burden of health care providers during times when the governmental structure may be overwhelmed or functioning in a less than optimal manner. Beginning with the death of Michael Brown, civil unrest over the last 2 years has necessitated a closer examination of the role nurse leaders play in preparing their staff and facilities for potential results of this civil unrest. The similarities between the results of rioting and violence and natural disaster are obvious, but the differences are significant. Without adequate preparation, providers may not offer the appropriate response. Attention to the 10 "musts" for preparedness for civil unrest will facilitate a planning process and provide for a better response and recovery when communities face these issues.

Background and Aim: The use of venous catheters is a widespread practice, especially in oncological and oncohematological units. The objective of this study was to evaluate the complications associated with peripherally inserted central catheters (PICCs) in a cohort of patients., Materials and Methods: In this retrospective cohort study, we included all patient carrying PICCs (n = 603) inserted at our institute between October 2010 and December 2013. The main variables collected were medical diagnosis, catheter care, location, duration of catheterization, reasons for catheter removal, complications, and nursing care. Complications were classified as infection, thrombosis, phlebitis, migration, edema, and/or ecchymosis., Results: All patients were treated according to the same "nursing care" protocol. The incidence rate of complications was two cases per 1000 days of catheter duration. The most relevant complications were infection and thrombosis, both with an incidence of 0.17 cases per 1000 days of the total catheterization period. The total average duration of catheterization was 170 days [SD 6.06]. Additionally to "end of treatment" (48.42%) and "exitus", (22.53%) the most frequent cause of removal was migration (displacement towards the exterior) of the catheter (5.80%)., Conclusions: PICCs are safe devices that allow the administration of long-term treatment and preserve the integrity of the venous system of the patient. Proper care of the catheter is very important to improve the quality life of patients with oncologic and hematologic conditions. Therefore, correct training of professionals and patients as well as following the latest scientific recommendations are particularly relevant., Competing Interests: The authors have declared that no competing interests exist.

The National Health Service Institute for Innovation and Improvement was established to help the NHS to improve healthcare by rapidly developing and disseminating knowledge and evidence about new ways of working. One example is the Emergency and Urgent Care Pathway for Children and Young People which focused on providing high quality and safe healthcare for children and young people requiring urgent or emergency treatment for the most common illnesses and injuries. Monkey's Guide to Healthy Living and NHS Services was developed to increase awareness of acute health services in primary school-aged children. This free resource was posted to every primary school in England. A process and impact evaluation was undertaken to explore how the resource was being utilized during 2013-2014. A small number of in-depth case studies were developed involving classroom-based observations and teacher interviews along with a much larger online survey which was emailed to all primary schools in England. On the whole, the resource was viewed as useful, engaging, and informative; with children, teachers, and other professionals particularly valuing the monkey puppet, video clips, and teacher resources. The National Evaluation highlighted that most respondents integrated the materials into the curriculum, used them as a one-off lesson, or developed their own innovative and strategic approaches to make the best use of the resources; almost two-thirds of schools who responded to the survey felt the resources led to pupils knowing about the available NHS services and healthy lifestyles; over half felt pupils were now more informed about the most appropriate services to use.

This article presents a critical review of the influence of interracial and ethnic variation on pain prevalence, intensity, interference/function/disability, and treatment in older adults. A search of scientific databases published from 1900 to 2011, using key words associated with pain, geriatrics, and race/ethnicity, identified 180 articles, of which 27 empirical studies met the inclusion criteria. Of the retained articles, 17 reported that race/ethnicity was a statistically significant factor at p < .05. Minority older adults reported a higher prevalence of pain and higher pain intensity, and variable responses regarding function/disability compared with responses by non-Hispanic White older adults. Minority older adults were less likely to receive prescription pharmacologic treatments and surgery, and they were more likely to use complementary and alternative medicine treatments. There are interracial/ethnic differences in pain assessment and treatment interventions among older adults.

Aim: This study compared nonpharmacological pain therapies used by ethnically diverse older adults with recommendations of family physicians and identified factors associated with nonpharmacological pain therapies use., Methods: Using a descriptive cross-sectional design, 281 participants in four ethnic groups (European Americans, Hispanics, African-Americans, Afro-Caribbeans) with chronic pain were surveyed. Binary logistic regression analyses were employed to determine associated factors., Results & Conclusion: Nonaquatic exercise and physical therapy were most frequently recommended by physicians, and nonaquatic exercise was most commonly used by participants. Lower pain levels predicted use of nonaquatic exercise, and ethnicity predicted use of prayer to manage chronic pain. Future research should examine barriers to use of psychological treatments and assess the value of combined physical and psychological treatments.

Objective: Quantify temporal changes in opioid use., Methods: Claim and prescription data for Louisiana Workers' Compensation Corporation claims open from 1999 and 2009 were analyzed by claim age and type of opioid., Results: There was a significant cumulative yearly increase in morphine milligram equivalents prescribed for claimants with acute pain (55-mg increase per year), as well as chronic pain (461-mg increase per year). The cost per morphine milligram equivalent was approximately the same ($0.06 to $0.07) for long- and short-acting medications, but the medication cost was 8 times higher in claims where long-acting opioids were prescribed (with or without short-acting opioids) versus only short-acting medications., Conclusions: The annual cumulative dose and cost of opioids per claim increased over the study period related to an increase in prescriptions for long-acting opioids.

Objective: The purpose of the study was to identify factors associated with depressive symptoms in community-dwelling older adults receiving prescription opioids for chronic pain., Design: This was a cross-sectional research design. A survey was used to gather demographic information, pain severity, health status, and factors associated with depressive symptoms., Setting: Eleven outpatient clinics affiliated with the Baltimore Veterans Affairs Medical Center and the University of Maryland Medical System were included., Participants: One hundred sixty-three older adults receiving opioid medications for chronic pain were recruited., Outcome Measures: Depressive symptoms were assessed via the Center for Epidemiologic Studies Depression Scale-10 (CESD-10)., Results: Univariate, bivariate, and ordinary least square (OLS) regression analyses were conducted to identify frequencies and to address the research questions. Nearly 40 percent of the elderly opioid therapy patients had depressive symptoms on the CESD-10. Bivariate analysis revealed that higher levels of pain severity were related to higher levels of depressive symptoms. OLS regression analysis revealed four risk factors significantly associated with higher depressive symptoms: higher pain severity, lower levels of functional status, lower levels of spirituality, and lower levels of social support. Age, gender, living alone, and perception of health status were not significantly associated with depressive symptoms., Conclusions: Depression is an underdiagnosed, treatable pain comorbidity that should be evaluated in older patients receiving opioid therapy. Undertreated depression in chronic pain patients receiving opioid medications may explain suboptimal improvement in pain and functional status despite increasing opioid dosage.

Objectives: This study was to develop a version of the Pain Medication Questionnaire (PMQ) specific to the elderly chronic pain population and to identify relevant subscales and items for that population. Exploratory factor analysis (EFA) was conducted to assess the factor structure of the PMQ, to eliminate items that are not appropriate for this population, and to improve ease of administration in the elderly population., Methods: Data were obtained through a survey administered to older adults with chronic pain who consumed opioid medications in a cross-sectional study at outpatient clinics affiliated with the Baltimore Veterans Affairs Medical Center and the University of Maryland Medical System. EFA was conducted on the PMQ in the geriatric chronic pain population, which was compared with the PMQ studies from the general chronic pain population., Results: A two-factor solution yielded Factor 1 with four items and Factor 2 with three items; 18 items did not load significantly on either factor, and only seven items loaded significantly on either factor. All of the chosen factor loadings ranged from 0.41 to 0.88., Conclusion:   The findings suggest that, although a small number of the items were identified from the overall scale, they adequately explain two relatively unique factors pertaining to pain management among older adults. This preliminary study suggests that the seven-item PMQ may be useful in assessing opioid medication misuse in community-dwelling older adults with chronic pain. Future studies are needed to confirm the reliability, validity, and factor structure of this modified PMQ in the geriatric population., (© 2010 The Authors. Pain Practice © 2010 World Institute of Pain.)

What is present in nearly every U.S. community, performs myriad services from the routine to the life saving on a daily basis, responds to every disaster, and functions 24 hours a day every day of the year? The answer, of course, is the nation's $1.8 trillion public health and healthcare system. Protection of this system's vast infrastructure has assumed increasing urgency since September 11, and there are at least two reasons for this. The first is that this sector must respond to every conceivable event involving risks to human life, including those traditionally within the purview of public health, so its ability to respond to these events must be preserved. The second is that elements of the sector itself face increasing threats to facilities, information systems, and workforces. These reasons alone warrant greater emphasis on protective programs than may have seemed necessary in the past, and the public health and healthcare sector should recognize that it must now understand critical infrastructure protection as well as it does healthcare management.

Solution-phase synthesis of various acylguanidine derivatives and the evaluation of a small library of compounds as potential sodium channel blockers are described.

In 1992, the Johns Hopkins Hospital and University initiated a program aimed at the early diagnosis and treatment of potential upper extremity work related musculoskeletal disorders (UEWMSDs), ergonomic assessment and abatement of work areas where individuals with UEWMSDs are employed, as well as the identification and correction of areas throughout the hospital and university where UEWMSDs could possibly occur. The program resulted in an initial increase in the number and cost for the treatment of UEWMSDs. Subsequently, there was a significant decrease in the number of UEWMSDs reported and virtual elimination of the need to use surgical procedures to correct these conditions. This article suggests that a coordinated program of medical care, ergonomic assessment, and intervention can be efficacious in the primary, secondary, and tertiary prevention of UEWMSD.

Objective: To compare three pillows with regard to pain intensity, pain relief, quality of sleep, disability, and overall satisfaction in subjects with benign cervical pain. The three pillows evaluated were the subjects' usual pillow, a roll pillow, and a water-based pillow., Study Design: Subjects used their usual pillows for the first week of this 5-week randomized crossover design study. They were subsequently randomly assigned to use each of the other two pillows for 2-week periods., Setting: Outpatient neurology and physiatry clinics., Patients: Forty-one subjects with benign cervical pain syndromes and free of cognitive impairments., Main Outcome Measures: Visual analog scale (VAS), Sleep Questionnaire, Sickness Impact Profile (SIP), and a satisfaction scale rating the pillows., Results: The water-based pillow was associated with reduced morning pain intensity, increased pain relief, and improved quality of sleep. The duration of sleep was significantly shorter for the roll pillow. Overall SIP findings showed a significant advantage for the water-based pillow over the roll pillow and standard pillow., Conclusions: Proper selection of a pillow can significantly reduce pain and improve quality of sleep but does not significantly affect disability outcomes measured by the SIP.

The purpose of this study was to compare the effectiveness of the Johnson Anti-Shear Accessory (JASA) and the standard dynamometer accessory (SDA) in controlling tibial translation for isometric knee flexion and extension exercise on the Cybex(R) II. The subject was a 26-year-old male with known anterior cruciate ligament (ACL) deficiency of the left knee. The subject performed maximum isometric muscle contractions for JASA and SDA conditions. Medial-lateral roentgenograms were obtained while the subject maintained isometric knee flexion and extension muscle contractions at three positions of knee flexion. JASA and SDA trials were analyzed for one extension position and one flexion position. The authors compared JASA and SDA conditions for magnitude of contact pad force and for degree of tibial translation evidenced on the roentgenograms. Tibial translation was greater and contact pad force was less for the SDA condition than the JASA condition. The results suggest the JASA is useful in protecting ACL surgical reconstructions, the partially torn ACL, and secondary supporting structures of the knee as patients perform isometric exercise on Cybex instrumentation. J Orthop Sports Phys Ther 1990;11(11):547-553.

The authors reported 3 cases of complete lateral rectus palsy treated with the Carlson-Jampolsky transposition technique with readjustable sutures. A fair balance in the primary position with adduction and abduction around 20 degrees were obtained. The EOG tracings recorded in all the cases prior and after surgery showed interesting aspects of this improvement both in the saccadic velocities, and in the amplitude of the movements. The follow up of these patients, up to two years, did not show any impairment of the results.

When increased pressure limits blood flow to muscles and nerves, prompt action is the key to preventing permanent disability.