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In the summer of 1998, a large outbreak of Escherichia coli O157:H7 infections occurred in Alpine, Wyoming. We identified 157 ill persons; stool from 71 (45%) yielded E. coli O157:H7. [...]

The Church Missionary Society "Mission of Help" to the Syrian Church of Travancore in the nineteenth century provides much instructive food for thought concerning debates that continue in mission up to the present day. In particular, the episode shows that the links between mission and empire cannot be reduced to seeing mission as a mere handmaiden to imperial concerns, although empire certainly provided a context to missionary endeavor throughout the imperial period. In this specific instance it was the forceful personality of Colonel John Munro who ensured that the Mission of Help became more intertwined with empire than might otherwise have been the case. Another effect of this imperial context for the Mission of Help was that the nature and scope of mission inevitably ended up being broadened to include aspects of societal transformation. It is shown that Benjamin Bailey was not primarily motivated by such concerns, yet was not unconcerned about them. Bailey's thinking through of these tensions perhaps provide a way to think today about the links between the "Great Commission," the "Great Commandment," and cultural transformation. [ABSTRACT FROM AUTHOR]

Benjamin Bailey (1791–1871) was one of the first English-born Church Missionary Society missionaries to go to India. Along with Joseph Fenn and Henry Baker, Sr, he was part of what has been called the Travancore Trio. Their objective was to reform the ancient community of Syrian Christians in Travancore so that they in turn might be a great native missionary force in India. Their mission was known as the ‘Mission of Help’ to the ancient Syrian Church. The mission was distinctive from others in India at that time which sought more directly to call for the conversion of the country's massive Hindu and Muslim populations. This article will show that Bailey seriously underestimated doctrinal differences between the CMS and the Syrians. Moreover, the place of the Syrians in the complex social fabric of Travancore was not adequately understood. Unlike other missions, this one may almost be said to have as its aim the conversion of an existing church. That call for conversion, however, arose from fundamentally divergent understandings of Christian belief and practice. The article concludes by considering further some of the sources of these divergences and engaging with some of the critique that the Mission of Help has received. [ABSTRACT FROM AUTHOR]

Sleep nasendoscopy (SN) is claimed to identify the site of obstruction in habitual snoring and is used to select patients for palatal surgery. The validity of SN is, however, unproven. This is the first prospective blind assessment of the role of SN in the management of habitual snorers. Fifty-five consecutive patients listed for laser-assisted uvulopalatoplasty (LAUP) for simple snoring on clinical criteria underwent SN immediately before surgery. Snoring severity and Epworth Sleepiness Scales were completed before the operation and at least 3 months after the operation. The postoperative scores on the snoring severity scale had significantly improved after LAUP, for each SN grade: grade 1 (palatal obstruction; p = .04) and grade 2 (multisegmental obstruction; grade 2A, p = .003, and grade 2B, p = .01). The Epworth Sleepiness Scale showed significant improvement in the whole group (p = .02). We conclude that SN grading of sites of pharyngeal collapse is an insufficient basis to exclude patients from LAUP. Sleep nasendoscopy is thus not of value in the management of habitual snoring, as the measure is a poor predictor of favorable outcome after palatal surgery. [ABSTRACT FROM AUTHOR]

Identifies cases of acute gastrointestinal illness associated with drinking unchlorinated water among residents of Alpine, Wyoming and visitors from other U.S. states. Cases of diarrhea in Alpine, Wyoming from June to July 1998; Attack rates among persons exposed to municipal water; Environmental investigation of the Alpine municipal water system.

Objectives: Define differences in palatal and uvular dimensions between habitual snorers and healthy nonsnoring control subjects. Document the changes in palatal configuration after different types of palatoplasty. Study Design: A prospective controlled clinical study was performed analyzing video recordings of the soft palate and oropharynx of 251 subjects (121 habitual snorers, 79 patients after laser-assisted uvulopalatoplasty ([LAUP], and 51 healthy volunteers). Methods: The recordings were captured using a rigid endoscope with a reference measure applied to the soft palate and a mark at the junction of the soft and hard palate. Four parameters were studied in the captured pictures after correction for the distortion deformity in fiberoptic endoscopic images: 1) length of soft palate, 2) length of uvula, 3) width of uvula, and 4) distance between posterior pillars. Results: Analysis showed that habitual snorers, compared with healthy volunteers have significantly increased soft palate length ( P = .00001), increased uvula length ( P = .0002) and width ( P = .00001), and narrowed oropharyngeal isthmus (distance between the posterior pillars) ( P = .04). In patients studied after LAUP, the length of the soft palate is significantly shorter ( P = .00001) than in the preoperative cohort, and the oropharyngeal isthmus is significantly narrower ( P = .00001). Moreover, this latter distance is significantly narrower ( P = .00001) when compared with healthy volunteers. Conclusions: Habitual snorers have a long soft palate, a long wide uvula, and a narrowed oropharyngeal isthmus. LAUP shortens and tightens the elongated palate and causes a further reduction in the space between the posterior pillars. [ABSTRACT FROM AUTHOR]