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UNLABELLED: Brain death (BD) is determined after a patient has sustained some form of a catastrophic neurologic injury that results in an irreversible loss of cerebral and brain steam function. Variability is caused by the small number of patients who progress to BD annually causing a lack of opportunity for physicians and healthcare staff to stay competent in performing the examination. BACKGROUND: The current University of Cincinnati Medical Center policy on BD had not been updated since publication of the 2010 American Academy of Neurology guidelines on this subject. The diagnosis of BD in the medical community is an acceptable medical diagnosis, but the examination is difficult to perform, and explaining this diagnosis to a family can be challenging related to the emotions involved with discussing end of life. The goal of updating the current policy was to decrease variability in testing through consistency of practice among clinicians performing the examination. METHODS: An integrative review of the evidence-based literature was conducted to identify articles discussing both BD confirmation and secondary confirmatory testing. Using this integrative review, results from hospital-based chart reviews, and targeted provider surveys, a policy update was completed. The bedside medical clinicians were provided this policy with evidence-based guidelines regarding performance of the clinical examination and confirmatory testing needed to diagnose BD and then communicate this diagnosis to the family. RESULTS: The current hospital policy lacked two important components of any BD policy: (a) the apnea test techniques and (b) guidance regarding secondary confirmatory testing. Both components were added during revision of the policy. Implementation of the new policy occurred through computer-based training that incorporated both didactic education of the updates and a video demonstration of a BD examination. DISCUSSION: A better defined policy for determining BD is essential. In addition, the implementation and quality assurance elements of the policy are necessary for efficiency and clinical decision making. By updating the policy within the University of Cincinnati Medical Center, the clinicians have been equipped with the latest evidence to perform the clinical examination for diagnosis of BD and then appropriately communicate this diagnosis to the family. Language: en

Consultation of the views of the public and interested groups on the intentions and outcomes of government and public sector institutions is now an integral feature of the policy making process. What, however, is less certain is the value and effectiveness of these consultations both from the perspective of the policy-maker and those who are ‘consulted’. This paper therefore seeks to examine the issues surrounding the consultation process through a project the Community Operational Research Unit (CORU) undertook, which reviewed the effectiveness of consultation between Access/disability groups and the public sector at a local and national level. The paper will equally reflect on the project's community research path beginning in very localised ‘roots’ in one participants experiences of consultation, leading to local and national surveys and finally to presentation of the findings to the All Party Disability Group (APDG) at Westminster.

The extent of angiogenesis and/or vascular endothelial growth factor (VEGF) expression in neuroblastoma tumors correlates with metastases, N-myc amplification, and poor clinical outcome. Recently, we have shown that insulin-like growth factor-I and serum-derived growth factors stimulate VEGF expression in neuroblastoma cells via induction of hypoxia-inducible factor-1α (HIF-1α). Because another marker of poor prognosis in neuroblastoma tumors is high expression of brain-derived neurotrophic factor (BDNF) and its tyrosine kinase receptor, TrkB, we sought to evaluate the involvement of BDNF and TrkB in the regulation of VEGF expression. VEGF mRNA levels in neuroblastoma cells cultured in serum-free media increased after 8 to 16 hours in BDNF. BDNF induced increases in VEGF and HIF-1α protein, whereas HIF-1β levels were unaffected. BDNF induced a 2- to 4-fold increase in VEGF promoter activity, which could be abrogated if the hypoxia response element in the VEGF promoter was mutated. Transfection of HIF-1α small interfering RNA blocked BDNF-stimulated increases in VEGF promoter activity and VEGF protein expression. The BDNF-stimulated increases in HIF-1α and VEGF expression required TrkB tyrosine kinase activity and were completely blocked by inhibitors of phosphatidylinositol 3-kinase (PI3K) and mammalian target of rapamycin (mTOR) pathways. These data indicate that BDNF plays a role in regulating VEGF levels in neuroblastoma cells and that targeted therapies to BDNF/TrkB, PI3K, mTOR signal transduction pathways, and/or HIF-1α have the potential to inhibit VEGF expression and limit neuroblastoma tumor growth. (Cancer Res 2006; 66(8): 4249-55)

Health inequalities and offending are issues that have raised considerable interest fmm policy makers, practitioners and the research communi~ as they seek to understand the causes and the potential solutions to their redress. A research 'gap' nevertheless exists in that whilst successive reports have identified vulnerable groups who are most likely to offend and have 'poor' health outcomes, there is limited 'field' research amongst these groups traditionally considered 'hard to reach'. As.this paper explores in 2003 the Community Operational Research Unit (CORUj was invited to evaluate a Healthy Living Centre (HLC) within Lincolnshire Probation and this provided an exceptional opportunity to examine the problems through a sustained 'engaged' research project. What became evident as the HLC and the research emerged were the challenges and rewards of community operational research as much as the issues rhat were intensively explored.

This paper argues for a change of thinking about the ‘ideal body’ in relation to ballet as a dance form and how it is studied. It distinguishes between spectator and practitioner perspectives on ballet, and draws on the practice of established dance artists and that of the author to write about the first‐person experience—from the inside out. Using a balletic concept, en dehors/en dedans, as a metaphor, the discussion moves from looking at the outside product of the ballet inwards to look at the inside processes or practice. The impact of the spectator perspective on the characterization of practice is considered, raising questions about the construction of binaries such as free/rule bound and the perception of the body and form as fixed. A case is made for ballet study as a somatic practice, and how engaging the first‐person experience and perspective on the body allows the individual dancer to develop as both artist and technician.

Past research had found that one-half or more of all women who have had an experience that might meet the definition of rape do not label themselves rape victims. The present study examined the actual rape experiences of 33 women who labeled their assault experience as rape and 56 women who did not label their assault experience as rape through questionnaires and open-ended descriptions of what happened during their assault. Quantitative findings replicated past research, finding that acknowledged victims, compared to unacknowledged victims, were older, knew their assailant less well, experienced more forceful assaults, and had stronger negative emotional reactions to the experience. Qualitative analysis revealed that women were mostly likely to acknowledge their experience as rape when the assailant was not their boyfriend and they woke up with a man penetrating them or the assailant used force and dominated them to obtain intercourse. Women assaulted as children also acknowledged their experience as rape. However, when the assault involved a boyfriend, or if the woman was severely impaired by alcohol or drugs, or if the act involved oral or digital sex, the women were unlikely to label their situations as constituting rape.

Active immunization against the beta-amyloid peptide (Alphabeta) with vaccines or passive immunization with systemic monoclonal anti-Abeta antibodies reduces amyloid deposition and improves cognition in APP transgenic mice. In this report, intracranial administration of anti-Alphabeta antibodies into frontal cortex and hippocampus of Tg2576 transgenic APP mice is described. The antibody injection resulted initially in a broad distribution of staining for the antibody, which diminished over 7 d. Although no loss of immunostaining for deposited Abeta was apparent at 4 hr, a dramatic reduction in the Alphabeta load was discernible at 24 hr and was maintained at 3 and 7 d. A reduction in the thioflavine-S-positive compact plaque load was delayed until 3 d, at which time microglial activation also became apparent. At 1 week after the injection, microglial activation returned to control levels, whereas Alphabeta and thioflavine-S staining remained reduced. The results from this study suggest a two-phase mechanism of anti-Alphabeta antibody action. The first phase occurs between 4 and 24 hr, clears primarily diffuse Alphabeta deposits, and is not associated with observable microglial activation. The second phase occurs between 1 and 3 d, is responsible for clearance of compact amyloid deposits, and is associated with microglial activation. The results are discussed in the context of other studies identifying coincident microglial activation and amyloid removal in APP transgenic animals.

Human C1q when injected directly into hippocampus and cortex of doubly transgenic APP+PS1 mice results in the increase of Congo red-positive fibrillar deposits. Although there was no significant change in overall area stained for Aβ total, qualitatively it appeared that there was less diffuse Aβ in C1q-treated mice versus vehicle. There was no apparent change in astroglial or microglial activation caused by injection of C1q with respect to vehicle injections. These effects of C1q were only found in 50% BUB/BnJ mice, a strain with higher serum complement activity than other mouse lines. These in vivo data were consistent with the effects of C1q to increase fibrillogenesis of Aβ in vitro. In conclusion, complement protein C1q, believed to be involved in the pathogenesis of Alzheimer's disease in humans, can cause increased fibrillogenesis in the APP+PS1 mouse model of amyloid deposition.

BACKGROUND: Recent studies have shown that tumor-specific DNA from multiple types of tumors can be detected circulating in plasma and this has raised the possibility of “liquid biopsies” using mutated tumor DNA as a potential diagnostic and prognostic biomarker. Detection of mutations with allele frequencies below 0.1% remains challenging however given that circulating cell-free DNA is highly degraded and in low abundance. Detection of multiple different mutations in the same sample presents an additional challenge particularly when the mutation panel may change from patient to patient. We have developed a novel approach, called SimSen-Seq, to introduce molecular barcodes into sequencing libraries with DNA inputs as low as 5ng. Barcodes enable differentiation of true mutants from background noise introduced by Taq polymerase errors and permits detection of variant alleles with frequencies below 0.1%. The barcodes are protected from mis-priming using a hairpin structure which permits a high degree of multiplexing and flexibility for detection of multiple mutations from one plasma sample. We are using this technology to test the utility of liquid biopsy as a biomarker for esophageal adenocarcinoma (EAC) diagnosis and disease monitoring. METHODS: Blood samples were obtained at a single time point from patients with various stages of EAC and longitudinal blood samples were also collected from patients undergoing neoadjuvant therapy followed by surgery. Tumor samples were obtained from biopsy or resection specimens. Tumor DNA was sequenced using a targeted EAC panel to identify mutations in each tumor. SimSen-Seq assays were designed to identify these mutations in plasma, and hairpin barcodes were attached. Sequencing libraries were generated from circulating DNA, sequenced and analyzed using the barcodes to reduce background noise. RESULTS: Mutations were identified in tumor samples from 37 patients. To date, 29 patients have had plasma analyzed; 5 stage I, 6 stage II, 13 stage III, and 5 stage IV. Of these 29, the same mutations have been identified in 15 plasma DNA samples (20% stage I, 50% stage II, 54% stage III, 80% stage IV. Six patients demonstrated multiple mutant alleles in plasma DNA. One patient with detectable pre-treatment ctDNA underwent serial blood draws during their treatment course, and post-operative detection of tumor-specific markers preceded physical evidence of disease recurrence. DISCUSSION: SimSen-Seq shows promise as a novel ultra-sensitive, highly multiplexed sequencing method for identifying rare circulating mutations. Possible applications include prognostication in early stage patients and rapid monitoring of therapeutic response and recurrence. Further work is to evaluate this is ongoing. Citation Format: Matthew Egyud, Jennifer Jackson, Emiko Yamada, Anders Ståhlberg, Paul Krzyzanowski, Virginia Litle, Lincoln Stein, Tony Godfrey. Detection of tumor-specific mutations in plasma DNA: A potential esophageal adenocarcinoma biomarker [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 2746. doi:10.1158/1538-7445.AM2017-2746

1. Introduction Jennifer Jackson and Lina Molokotos-Liederman Part I: Theoretical framework and methodological considerations 2. A new model of boundary complexity Richard Jenkins 3. 'Boundary', 'Border', 'Limit' in the Human Sciences: Towards a Conceptual History Jean Terrier 4. Modernity, globalization and nationalism: The age of frenzied boundary-building Daniele Conversi 5. Ethnic boundaries: A critical rationalist perspective Michael Banton Part II: Case Studies 6. Boundaries and Belonging: Dominant Ethnicity and the Place of the Nation in a Global Era Michael Skey 7. A' the Bairns o' Adam? The Ethnic Boundaries of Scottish National Identity Michael Rosie 8. Ethnicity and Boundaries in Jewish Nationalism Yitzhak Conforti Part III: Comparative Perspectives 9. The migration of frontiers. Ethno-national conflicts and contested cities Wendy Pullan 10. Nationalizing States and Ethno-national Boundaries: A Comparative Perspective on Soviet Successor States Rogers Brubaker 11.Conflict Management in Divided Societies: The Many Uses of Territorial Self-Governance Stefan Wolff 12. Concluding Remarks Jennifer Jackson and Lina Molokotos-Liederman

Background. Prescription opioids are the most frequently misused class of prescription drug among young adults aged 18–25, yet trajectories of opioid misuse and escalation are understudied. We sought to model opioid misuse patterns and relationships between opioid misuse, sociodemographic factors, and other substance uses.Methods. Participants were 575 young adults age 16–25 who had misused opioids in the last 90 days. Latent class analysis was performed with models based on years of misuse, recency of misuse, and alternate modes of administration within the past 12 months, 3 months, and 30 days.Results. Four latent classes emerged that were differentially associated with heroin, cocaine, and methamphetamine use, tranquilizer misuse, daily opioid misuse, and opioid withdrawal. Alternate modes of administering opioids were associated with increased risk for these outcomes. Sociodemographic factors, homelessness, prescription history, and history of parental drug use were significantly associated with riskier opioid misuse trajectories.Conclusion. Young adults who reported more debilitating experiences as children and adolescents misused opioids longer and engaged in higher risk alternate modes of administering opioids. Data on decisions both to use and to alter a drug’s form can be combined to describe patterns of misuse over time and predict important risk behaviors.

The social determinants of health (SDH) are recognized as a prominent influence on health outcomes across the lifespan. Racism is identified as a key SDH. In this article, the authors describe the concept of racism as an SDH, its impact in discriminatory actions and inactions, and the implications for cardiovascular nurses. Although research in Canada on the links among racism, stress, and cardiovascular disease is limited, there is growing evidence about the stress of racism and its long-term impact on cardiovascular health. The authors discuss how cardiovascular nursing could be enhanced through an understanding of racism-related stress, and race-based differences in cardiovascular care. The authors conclude with strategies for action to address this nursing concern.

A qualitative intervention was used to explore how older adults living in a long-term care environment (nursing home) understand hope and experience being participants in a group in which a hope intervention was carried out. A group project in which each session focused intentionally on a hope strategy was carried out with a convenience sample of 10 women (ages 75–99) who were members of an existing group. Data were analyzed using thematic analysis of the interviews (conducted before the group intervention was carried out and again at the end), field notes, and collaborative conversations regarding emerging themes. Findings from this study suggest that hope is not static and that it can change over time in response to one’s situations and circumstances. Also evident in this study is the potential for using a group process in long-term care to foster hope in an intentional way to make it more visible in the lives of the residents and their environment suggesting that one is “never too old for hope.”

Trees of newly acquired Ulmus species originating from the temperate regions of China and growing at The Morton Arboretum, Lisle, IL, were evaluated in no-choice and multiple-choice laboratory bioassays and cage-studies for feeding preference for adults of the Japanese beetle, Popillia japonica Newman. Ulmus lanceaefolia, U. prunifolia, U. pseudopropinqua, and U. taihangshanensis were less preferred for feeding by adult Japanese beetles. No-choice, multiple-choice, and cage feeding studies revealed that Ulmus wallichiana was moderately preferred, and U. procera and U. americana were highly preferred for feeding. Dry fecal pellet weights were strongly correlated with the percent of leaf tissue removed. Feeding preference in the multiple-choice study was strongly correlated with feeding preference in the cage study and in the no-choice study. Likewise, adult feeding preference in the cage study was strongly correlated with preference in the multiple-choice and no-choice studies. The less preferred species of U. lanceafolia, U. prunifolia, U. pseudopropinqua, and U. taihangshanensis show promise for future elm breeding programs.

To examine how descriptions of the performance of female athletes are likely to reflect dominant beliefs about gender in society, 769 passages from the print media describing gold medal winning contests for four U.S. women’s teams in the 1996 Olympics (basketball, gymnastics, soccer, and softball) and the U.S. women’s hockey team in the 1998 Olympics were subjected to content analysis. The sports analyzed fall under the categories of Matteo’s study classifying the gender appropriateness of sport (masculine, feminine, and neutral). Two dimensions were examined for each passage: task relevance and use of gender stereotypes. Consistent with our expectations, female athletes in male sports were described by the print media using frequent male-to-female comparisons and comments that had little to do with sports or the athlete’s performance. Print media coverage of female athletes in female sports focused on performance while reinforcing female stereotypes. Implications of the images of female athletes portrayed by the print media are discussed.

National minorities are collectivities who possess that trait which is the current normative underpinning of states, namely nationhood, and yet for practical purposes cannot enjoy outright political independence. Because national minorities bear these normatively significant characteristics they may be deemed to have legitimate international claims to certain special rights even if these fall short of statehood. Yet although this rationale may be logically sound and morally justified, pursuing it nevertheless raises serious problems with regard to state sovereignty.

It could not have been predicted when the first Sub-Commission [on the Prevention of Discrimination and Protection of Minorities] resolution on population transfer [or ethnic cleansing] was adopted in 1990 that this form of human rights abuse would become so central to conflicts and pressing political issues of which the international community is now seized. A.S. AI-Khasawneh and R. Hatano UN Special Rapporteurs, 19932

The 1990s debate on minority rights clearly indicates that minority issues are among the most controversial subjects of international relations. Questions concerning national minorities gained new prominence in international relations, especially in East Central Europe, following the end of the Cold War. Between 1990 and 1995 the formulation of international standards regulating state conduct towards national minorities was a priority for European organisations. This standard setting episode raises several important questions. Why did national minorities reappear on the international agenda after 1989? How were they responded to? Why did state sovereignty continue to take precedence over minority rights?

Sovereign insiders and minority outsidersThe ‘problem of minorities’, with its numerous implications for both international theory and practice, has been a significant issue in international society for centuries. It has constituted an ongoing friction between states, a pretext for separatism, irredentism and intervention, and a direct and indirect cause of local and general wars.Among the best works which examine various aspects of the ‘problem of minorities’ are the following: I. Bagley, General Principles and Problems in the International Protection of Minorities (Geneva, 1950); I. Claude, National Minorities: An International Problem (Cambridge, MA, 1955); G. Gotlieb, Nation Against State (New York, 1993); W. Kymlicka, Multicultural Citizenship (Oxford, 1995); J. Laponce, The Protection of Minorities (Berkeley, CA, 1960); C. Macartney, Nation States and National Minorities (London, 1934); J. Mayall, Nationalism and International Society (Cambridge, 1990); H. Miall (ed.), Minority Rights in Europe (London, 1994); D. Moynihan, Pandaemonium; Ethnicity in International Politics (Oxford, 1993); and P. Thornberry, International Law and the Rights of Minorities (Oxford, 1991). Why?

We are particularly interested in looking at how people change their own communities – i.e. the processes by which people recognise and respond to local needs (and opportunities) and the structural forms that help shape and influence these processes in rural communities. We present illustrations of recent change and development activities within two UK rural communities that highlight some aspects we have found particularly interesting in these processes.

Overdose prevention programs (OPPs) train people who inject drugs and other community members to prevent, recognise and respond to opioid overdose. However, little is known about the experience of taking up the role of an "overdose responder" for the participants.We present findings from qualitative interviews with 30 participants from two OPPs in Los Angeles, CA, USA from 2010 to 2011 who had responded to at least one overdose since being trained in overdose prevention and response.Being trained by an OPP and responding to overdoses had both positive and negative effects for trained "responders". Positive effects include an increased sense of control and confidence, feelings of heroism and pride, and a recognition and appreciation of one's expertise. Negative effects include a sense of burden, regret, fear, and anger, which sometimes led to cutting social ties, but might also be mitigated by the increased empowerment associated with the positive effects.Findings suggest that becoming an overdose responder can involve taking up a new social role that has positive effects, but also confers some stress that may require additional support. OPPs should provide flexible opportunities for social support to individuals making the transition to this new and critical social role. Equipping individuals with the skills, technology, and support they need to respond to drug overdose has the potential to confer both individual and community-wide benefits.

Young female injection drug users (IDUs) are at risk for HIV/HCV, and initiating the use of a new drug may confer additional and unexpected risks. While gender differences in the social context of injection drug use have been identified, it is unknown whether those differences persist during the initiation of a new drug. This mixed-methods study examined the accounts of 30 young female IDUs in Los Angeles, CA, USA from 2004 to 2006, who described the social context of initiating injection drug use and initiating ketamine injection. The analysis aimed to understand how the social context of young women’s injection events contributes to HIV/HCV risk. Women’s initiation into ketamine injection occurred approximately 2 years after their first injection of any drug. Over that time, women experienced changes in some aspects of the social context of drug injection, including the size and composition of the using group. A significant proportion of women described injection events characterized by a lack of control over the acquisition, preparation, and injection of drugs, as well as reliance on friends and sexual partners. Findings suggest that lack of control over drug acquisition, preparation, and injection may elevate women’s risk; these phenomena should be considered as a behavioral risk factor when designing interventions.

Deficits in the ability to organize, integrate, and modulate emotions, thoughts, and behaviors when dealing with stress have been found to be related to the onset and escalation of substance use among adolescents and young adults. However, limited research has focused on understanding how coping and emotion regulation tendencies might be associated with different patterns of prescription and illicit drug use, particularly among high-risk young adults who may already face additional challenges relative to lower-risk populations.Young adults aged 16-25 years who had misused prescription drugs within the past 90 days were interviewed in Los Angeles and New York. The current study utilized latent profile analysis to empirically derive coping and emotion regulation typologies/profiles that are then used to predict different patterns of substance use (N=560).Four latent classes/groups were identified: (1) suppressors, (2) others-reliant copers, (3) self-reliant copers and (4) active copers. Distinct patterns of prescription and illicit drug misuse were found among different coping/emotion regulation profiles, including differences in age of initiation of opiates, tranquilizers, and illicit drugs, recent injection drug use, substance use-related problems, and past 90-day use of tranquilizers, heroin, and cocaine. Specifically, suppressors and others-reliant copers evidenced more problematic patterns of substance use compared to active copers.This is among the first studies to show how coping and emotion regulation profiles predict distinct patterns of substance use. Results provide the groundwork for additional investigations that could have significant prevention and clinical implications for substance-using high-risk young adults.

Carpal Tunnel Syndrome (CTS) is an increasingly common nerve entrapment disorder which is a direct result of humans subjecting their hands to hours of repetitive motion. This case's subject was a 21-year-old female intercollegiate volleyball setter diagnosed with CTS. The study's purpose was to monitor the progression of her symptoms' severity over the observation period and to demonstrate that surgery may not always be the answer. Analysis revealed that only task abstention and not conservative medical treatments is effective in symptom retardation.

We investigated social network factors associated with participation in overdose prevention training among injection drug users (IDUs). From 2008 to 2010, 106 IDUs who had witnessed an overdose in the past year from two syringe exchange programs in Los Angeles provided data on overdose prevention training status (trained vs. untrained), social networks, history of overdose, and demographics. In multivariate logistic regression, naming at least one network member who had been trained in overdose prevention was significantly associated with being trained (Adjusted Odds Ratio 3.25, 95% Confidence Interval 1.09, 9.68). Using social network approaches may help increase training participation. Limitations are noted.

Background Prescription drug misuse among young adults is increasingly viewed as a public health concern, yet most research has focused on student populations and excluded high-risk groups. Furthermore, research on populations who report recent prescription drug misuse is limited. This study examined patterns of prescription drug misuse among high-risk young adults in Los Angeles (LA) and New York (NY), which represent different local markets for illicit and prescription drugs. Design and Methods Between 2009 and 2011, 596 young adults (16 to 25 years old) who had misused prescription drugs within the past 90 days were interviewed in Los Angeles and New York. Sampling was stratified to enroll three groups of high-risk young adults: injection drug users (IDUs); homeless persons; and polydrug users. Results In both sites, lifetime history of receiving a prescription for an opioid, tranquilizer, or stimulant was high and commonly preceded misuse. Moreover, initiation of opioids occurred before heroin and initiation of prescription stimulants happened prior to illicit stimulants. NY participants more frequently misused oxycodone, heroin, and cocaine, and LA participants more frequently misused codeine, marijuana, and methamphetamine. Combining prescription and illicit drugs during drug using events was commonly reported in both sites. Opioids and tranquilizers were used as substitutes for other drugs, e.g., heroin, when these drugs were not available. Conclusion Patterns of drug use among high-risk young adults in Los Angeles and New York appear to be linked to differences in local markets in each city for illicit drugs and diverted prescription drugs.

Gang youth are at an increased likelihood of participating in unsafe sexual behaviors and at an elevated risk of exposure to sexually transmitted infection (STIs), including HIV. This manuscript presents quantitative and qualitative data on sexual behaviors among a sample of predominately heterosexual, male gang youth aged 16 to 25 years interviewed in Los Angeles between 2006 and 2007 (n = 60). In particular, sexual identity, initiation and frequency of sex, and number of sexual partners; use of condoms, children, and other pregnancies; group sex; and STIs and sex with drug users. We argue that gang youth are a particular public health concern, due to their heightened risky sexual activity, and that behavioral interventions targeting gang youth need to include a component on reducing sexual risks and promoting safe sexual health.

Purpose: To determine current Canadian physical therapy practice for adult patients requiring routine care following cardiac surgery. Methods: A telephone survey was conducted of a selected sample (n=18) of Canadian hospitals performing cardiac surgery to determine cardiorespiratory care, mobility, exercises, and education provided to patients undergoing cardiac surgery. Results: An average of 21 cardiac surgeries per week (range: 6–42) were performed, with an average length of stay of 6.4 days (range: 4.0–10.6). Patients were seen preoperatively at 7 of 18 sites and on postoperative day 1 (POD-1) at 16 of 18 sites. On POD-1, 16 sites performed deep breathing and coughing, 7 used incentive spirometers, 13 did upper-extremity exercises, and 12 did lower-extremity exercises. Nine sites provided cardiorespiratory treatment on POD-3. On POD-1, patients were dangled at 17 sites and mobilized out of bed at 13. By POD-3, patients ambulated 50–120 m per session 2–5 times per day. Sternal precautions were variable, but the lifting limit was reported as ranging between 5 lb and 10 lb. Conclusions: Canadian physical therapists reported the provision of cardiorespiratory treatment after POD-1. According to current available evidence, this level of care may be unnecessary for uncomplicated patients following cardiac surgery. In addition, some sites provide cardiorespiratory treatment techniques that are not supported by evidence in the literature. Further research is required.

This chapter sheds light on the relationship between minorities, states and international security, and assesses the Bolzano/Bozen Recommendations on National Minorities in Inter-State Relations from the perspective of the complex nature of the minority problematique . First, it discusses the "minority problem": namely the perception of minorities as problematic entities in the context of the international system composed of nation-states. Then, it examines the international dimension of the "minority problem" because the processes of nation-building and state-formation have resulted in ethnically heterogeneous populations within nation-states that, in the vast majority of cases. The chapter concludes with a schematic presentation of the various interests and relationships that exist in the international society, between different types of actors, because of the existence of minorities. Keywords:Bolzano Recommendations; Bozen Recommendations; inter-State relations; international security; minority problem

The expression of anger is considered to be abnormal in depression, yet its role is only poorly understood. In the present study we sought to clarify this role by examining the moderating influence of the family environment on overall levels of anger expression and anger reactivity in depressed and non-depressed adolescents during conflictual interactions with their parents. One hundred and forty one depressed and non-depressed adolescent participants engaged in a problem-solving task with their parents during which their behavioral expression of anger and heart rate were recorded. The results demonstrate that general levels of parental anger in the family environment (as indicated by the overall level of expressed anger by the parents during the interactions) strongly moderates how depressed differ from non-depressed adolescents in terms of their anger, heart rate and reactivity. Overall, the findings suggest that in depressed adolescents anger is much less adaptively attuned to the environment, consistent with models that predict dysfunction in the regulation of anger that prevents depressed individuals responding adaptively to their social environment.

Liver samples from 33 wild American alligators (Alligator mississippiensis) livers from the Charleston, South Carolina, area were analyzed for arsenic (As), cadmium (Cd), cobalt (Co), chromium (Cr), mercury (Hg), nickel (Ni), lead (Pb), and selenium (Se) concentrations. Alligators are top predators and are considered a good biomonitoring species for various toxins, including heavy metals. Alligators from other areas in the US have shown high concentrations of mercury and other heavy metals, but the Charleston area, which is highly industrialized, has not been investigated. We found wide variation in hepatic heavy metal and selenium concentrations among alligators. Length and sex did not show a strong relationship with any metal based on statistical analysis. However, cluster analysis revealed three groupings of alligators based on liver metal concentrations. Alligators with low Se:Hg ratios also had high concentrations of Hg. Due to the wide variation in metal concentrations among individual alligators, we postulate that individual diet and microhabitat usage could be the cause for this variation.