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There is a paucity of literature on the use of dalbavancin, a long-acting lipoglycopeptide, in infective endocarditis. Existing case reports have investigated dalbavancin in endocarditis as a sequential treatment after clearance of bacteria from the bloodstream with conventional therapy.A 27-year-old female who injects drugs presented with fever and pleuritic chest pain and was found to have methicillin-sensitive Staphylococcus aureus tricuspid-valve endocarditis with septic pulmonary emboli. Given non-adherence with conventional therapy, she was successfully treated off-label with once-weekly dalbavancin infusions in an outpatient setting. We summarize the patient’s clinical course and review published reports of endocarditis treated with dalbavancin in the peer-reviewed literature.Our case supports further investigation of outpatient dalbavancin infusions as a reasonable therapeutic alternative to standard treatment with daily intravenous therapy for serious staphylococcal infections among patients who have difficulty engaging with conventional therapy. Keywords: Infective endocarditis, Bacteremia, Long-acting lipoglycopeptide, Dalbavancin, Primary treatment, Outpatient therapy

Background: Fish consumption has been shown to have beneficial effects on biological and subjective measures of health and well-being. However, little is known about the effects of fish consumption at the behavioral level. Objective: The primary aim of this study was to investigate the influence of diet on behavior such as physical activity during winter in forensic inpatients. The secondary aim was to investigate the relationship between vitamin D status and physical activity. Design: Eighty-one male forensic inpatients participated in this study. Participants were randomized into two different diet groups: a Fish group receiving fatty fish three times per week and a Control group receiving an alternative meal (e.g. chicken, pork, and beef); while the Fish group received their fish, the Control group received an alternate meal, but with the same nutritional value as their habitual diet. The duration of the food intervention was 6 months. Results: The results revealed that the Fish group had a regular pattern of physical activity throughout the intervention period. The participants in the Control group showed a more irregular pattern of physical activity in addition to a significant reduction in physical activity over time. Conclusion: Behavior such as physical activity during winter seemed to be influenced by the diet.

Risk Matrix 2000’s ability to assess relative risk for sexual and violent recidivism has been well established through meta-analysis. However, the instrument was originally designed for use in the United Kingdom and has not been widely tested in other parts of Europe, raising questions about how generalizable the results are. This paper assessed the instrument’s ability to assess relative risk for these outcomes in a sample of over 300 Austrian adult males serving a prison sentence for a sexual offense for whom 5-year rates of sexual and violent recidivism were available. Results indicated an ability to assess relative risk that was comparable to that observed in the United Kingdom. In the context of previous results from Germany, the findings of the present study indicate that Risk Matrix 2000 may be appropriately applied in Europe. Analyses explored the added value of using the Sexual and Violence risk scales in conjunction to identify the kinds of criminogenic need that should be addressed in treatment and supervision.

Abstract There is growing recognition that mucus and mucin biology have a considerable impact on respiratory health, and subsequent global morbidity and mortality. Mucins play a critical role in chronic lung disease, not only by providing a physical barrier and clearing pathogens, but also in immune homeostasis. The aim of this review is to familiarise the reader with the role of mucins in both lung health and disease, with particular focus on function in immunity, infection and inflammation. We will also discuss their receptors, termed glycan‐binding proteins, and how they provide an attractive prospect for therapeutic intervention.

Stuttering is associated with compromised sensorimotor control (i.e., internal modeling) across the dorsal stream and oscillations of EEG mu (μ) rhythms have been proposed as reliable indices of anterior dorsal stream processing. The purpose of this study was to compare μ rhythm oscillatory activity between (PWS) and matched typically fluent speakers (TFS) during spontaneously fluent overt and covert speech production tasks. Independent component analysis identified bilateral μ components from 24/27 PWS and matched TFS that localized over premotor cortex. Time-frequency analysis of the left hemisphere μ clusters demonstrated significantly reduced μ-α and μ-β ERD (pCLUSTER

The Wilson Sex Fantasy Questionnaire (WSFQ) assesses the use of 40 specific sexual fantasies, which are grouped into four overarching themes (Intimate, Exploratory, Impersonal, and Sadomasochistic). It also includes two items that reflect characteristics associated with children. Since sexual fantasies are a key factor in sex offender treatment, the present study tested the validity of the WSFQ for use with men who have sexually offended against children (SOC). Differential validity was assessed by comparing 54 SOC, 22 community males with a sexual interest in children (C-SI), and 79 community males with no sexual interest in children (C-NSI) on each WSFQ subscale and child-related item. Results showed that SOCs scored lower on each subscale than both community groups. On the two child-related items, the SOCs and C-SIs scored higher than C-NSIs. For the “Sex with someone much younger than yourself” item, younger SOCs had greater scores than younger C-NSIs, while older C-NSIs had greater scores than older SOCs. Construct validity was assessed using the SOC sample by examining relationships between WSFQ variables and 1) the self-reported use of deviant sexual fantasies assessed via the Thoughts and Fantasies Questionnaire and 2) offending behavior derived from crime scene data. The WSFQ Intimacy subscale was unrelated to any deviant sexual fantasies, while the other subscales were most strongly associated with sadistic fantasies. The child-related WSFQ items were most strongly associated with sexual fantasies about prepubescent children. Very few relationships were observed between the WSFQ variables and crime scene behaviors. The implications of the results are discussed, along with the study’s limitations and suggestions for future research.

Objective: To determine whether changes in sensorimotor control resulting from speaking conditions that induce fluency in people who stutter (PWS) can be measured using electroencephalographic (EEG) mu rhythms in neurotypical speakers.Methods: Non-stuttering (NS) adults spoke in one control condition (solo speaking) and four experimental conditions (choral speech, delayed auditory feedback (DAF), prolonged speech and pseudostuttering). Independent component analysis (ICA) was used to identify sensorimotor μ components from EEG recordings. Time-frequency analyses measured μ-alpha (8–13 Hz) and μ-beta (15–25 Hz) event-related synchronization (ERS) and desynchronization (ERD) during each speech condition.Results: 19/24 participants contributed μ components. Relative to the control condition, the choral and DAF conditions elicited increases in μ-alpha ERD in the right hemisphere. In the pseudostuttering condition, increases in μ-beta ERD were observed in the left hemisphere. No differences were present between the prolonged speech and control conditions.Conclusions: Differences observed in the experimental conditions are thought to reflect sensorimotor control changes. Increases in right hemisphere μ-alpha ERD likely reflect increased reliance on auditory information, including auditory feedback, during the choral and DAF conditions. In the left hemisphere, increases in μ-beta ERD during pseudostuttering may have resulted from the different movement characteristics of this task compared with the solo speaking task. Relationships to findings in stuttering are discussed.Significance: Changes in sensorimotor control related feedforward and feedback control in fluency-enhancing speech manipulations can be measured using time-frequency decompositions of EEG μ rhythms in neurotypical speakers. This quiet, non-invasive, and temporally sensitive technique may be applied to learn more about normal sensorimotor control and fluency enhancement in PWS.

Introduction We created a standardized workshop to engage residents in quality improvement (QI) using the root cause analysis model. The workshop allows for a robust learning experience while providing solutions derived from clinicians to address important local problems. No prerequisite knowledge or experience is required. Methods The workshop is facilitated by one or more moderators, ideally with experience in QI. An interdisciplinary group of residents, medical students, nurses, and other attendees comprise an audience which actively engages in workshop activities. Facilitators follow a scripted model to teach important patient safety concepts with frequent break-outs for hands-on application of QI tools. During the workshop, participants create a process map and fishbone diagram, as well as develop and critically evaluate novel interventions. Results Over the course of one academic year, the workshop has been implemented 17 times with roughly 25 internal medicine residents in attendance at each workshop. In addition, the workshop was run online for 126 participants with varied exposure to QI techniques. Forty percent of these participants completed a survey indicating that over 89% learned something new, 87% felt they could apply the material to their work, and 95% would recommend the workshop to a colleague. Discussion This 60-minute workshop can provide hands-on QI experience in a standardized format to achieve the dual objectives of teaching QI to clinicians and allowing them to generate innovations. The module can be used for internal case development and trainee participation, but prepared cases are provided for facilitators without the resources for local case development.

Biodiesel from waste cooking oil (WCO) requires antioxidants to meet oxidation stability specifications set forth in ASTM D6751 or EN 14214. In contrast, unrefined cottonseed oil (CSO), containing tocopherols and gossypol, produces biodiesel of higher oxidation stability. However, only a portion of these CSO endogenous antioxidants are suspected to be retained in biodiesel. Because the economics of biodiesel manufacturing rely upon inexpensive sources of triglycerides, emphasis was placed on developing improved alternative processing methods where WCO was the main source of methyl esters (WCOME) and CSO was used as a supplemental source of triglycerides and antioxidants in a 4:1 ratio. This study compared four processing methods for their ability to produce biodiesel of increased oxidative stability prepared from a 4:1 ratio of WCO:CSO. Two novel processing methods developed for this study utilise solvent properties of fatty acid methyl esters and glycerol to avoid additional chemical inventory for biodiesel processors. This study concludes that the two new processing methods resulted in biodiesel that had statistically significant improved oxidation stability when compared to two common industrial processing methods. Another significant finding is that high-shear homogenisation during transesterification reduced reaction time from the published one hour to 16 minutes.

Programs falling under the general rubric of "experiential education" take a number of forms, varying on several dimensions; what is offered here is a schematic overview. In general, they all involve students in activities that look rather different from more traditional classroom-based methods: (1) the formal lecture and discussion; (2) the reading assignment; and (3) the sit-down examination. Although these experiential activities go by different names in different program formats, they share the core characteristic of students' direct engagement in productive work outside the classroom. In some way, the activity is thought to bring the student-intern in contact with the phenomena, concepts, and problems addressed in classes, curricula, and disciplines. This article introduces some of the forms and practices of experiential education and raises some challenging questions about the role that pedagogy plays in institutions of higher learning.

Experience in the workplace represents a significant domain for the analysis of learning. Based on many years of research on high-school and college interns, the article proposes a set of interdisciplinary ideas and strategies for conducting such an analysis. The core argument is that learning is the construction, enhancement or reorganization of knowledge and knowledge-use in an activity system, and that it happens through an interactional process involving participants, their joint actions and their material and informational resources. Understanding learning as a situated process requires an investigation of the way activities are established, accomplished, and processed, and of the social, cultural, political, and technological factors that shape them. The analyst must examine the ways knowledge is defined, distributed and used in the setting; learning, or the ways that knowledge-use changes over time; and pedagogy, or the social organization of the process by which learning is made possible.

Experiential learning research and service learning research are both fairly rudimentary. Researchers in both fields should collaborate to make greater progress toward answering various shared questions (e.g., how field-based experience shapes and is shaped by classroom learning, what pedagogical strategies best foster learning, and how both forms of experience build skills and help students think about careers). (SM)

A framework for analyzing the social organization of education in nonclassroom environments is developed, based on observations of students in an experiential learning program. The argument is made that the process of education must be understood by the effect of the broader social context in which it occurs. (Author/SK)

Its controversial past notwithstanding, psychopathy has emerged as one of the most important clinical constructs in the criminal justice and mental health systems. One reason for the surge in theoretical and applied interest in the disorder is the development and widespread adoption of reliable and valid methods for its measurement. The Hare PCL-R provides researchers and clinicians with a common metric for the assessment of psychopathy, and has led to a surge in replicable and meaningful findings relevant to the issue of risk for recidivism and violence, among other things. Most of the research thus far has been based on North American samples of offenders and forensic psychiatric patients. We summarize this research and compare it with findings from several other countries, including England and Sweden. We conclude that the ability of the PCL-R to predict recidivism, violence, and treatment outcome has considerable cross-cultural generalizability, and that the PCL-R and its derivatives play a major role in the understanding and prediction of crime and violence. Copyright © 2000 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Viceroy Francisco de Toledo’s 16th century population re–concentrations of the indigenous peoples of Charcas (modern day Bolivia) have been widely recognized as the most definitive attempt to transform indigenous Andean society along Iberian lines of settlement and government. While the previously dispersed indigenous populations were resettled into a limited number of urban towns, native tribute obligations elevated, and Castilian forms of municipal government imposed, modern historiography is still debating the precise details of what Toledo’s reforms meant for the indigenous populations of this district. A review of decisions made by the Audiencia of Charcas and the contemporary correspondence of this court’s judges are examined to illustrate how the relationship between the high court and indigenous leaders ―caciques― changed through the period of Toledo’s reforms. This investigation reveals an explicit and previously underappreciated transformation in the political model from one where caciques frequently sought out and received legitimization from the Audiencia ―similar to the model used in the Inca system― to a situation where the caciques understood and utilized the Audiencia less as a partner in power and instead as a forum to be opportunistically used to obtain economic goods and privileges. Using the figure of the cacique as a proxy, this province–wide perspective on the changes engendered to native society by Toledo’s reforms is distinct from but complementary to the several more localized studies on the subject undertaken by other historians. The changes elucidated by these court records and official correspondence suggest the origins of the emergence of indigenous leaders whose skillful use of the colonial legal system would represent a hallmark of indigenous–Spanish relations throughout the remaining two centuries of the Spanish presence in the Viceroyalty of Peru.Las re–concentraciones de las poblaciones indígenas del siglo XVI en Charcas (actual Bolivia) llevadas a cabo por el Virrey Francisco de Toledo han sido ampliamente reconocidas como la tentativa definitiva de transformar la sociedad andina indígena de acuerdo a esquemas ibéricos de gobierno. Si bien es indiscutible que bajo estas medidas las previamente dispersas poblaciones indígenas fueron reorganizadas en torno a centros urbanos, elevado el tributo nativo e impuestas formas castellanas de gobierno municipal, la historiografía moderna todavía discute las repercusiones que las reformas de Toledo tuvieron para las poblaciones indígenas de este districto. Este trabajo plantea una revisión de las decisiones tomadas por la Audiencia de Charcas y la correspondencia de los jueces de esta corte con el propósito de mostrar hasta qué punto las relaciones entre el tribunal superior y los líderes indígenas ―caciques― cambiaron durante el período de las reformas de Toledo. En su desarrollo, la investigación revela una transformación explícita ―y previamente no valorada― del modelo político virreinal, que de una situación en la que los caciques frecuentemente buscaban y recibían legitimación de la Audiencia ―como en el sistema Inca― cambia a una en la que los caciques utilizaban a la Audiencia como un foro que podía ser usado oportunísticamente para obtener privilegios y beneficios económicos. Usando la figura del cacique como apoderado, esta investigación en torno a los cambios generados en la sociedad andina a raíz de las reformas de Toledo es distinta pero complementaria a estudios emprendido por otros historiadores en torno al mismo tema. Los cambios elucidados por registros judiciales y correspondencias oficiales sugieren los orígenes de la aparición de líderes indígenas cuyo hábil manejo del sistema legal colonial será representativo de las relaciones indígeno–españolas a través de los dos siglos de presencia española en el virreinato del Perú.