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Food insecurity and loneliness are shockingly large and growing problems in the older population in the U.S. and globally. Thus, the study's primary aim was to investigate the prevalence as well as the association between these two social determinants of health in the marginalised and often underserved population of older residents of urban subsidised housing (also referred to as social housing or affordable housing). Of particular interest was whether a greater sense of loneliness increases the risk of older residents being food insecure. The study uses survey data gathered through in-person interviews conducted onsite in English or Spanish with 216 of the 300 older adults (72% response rate) living in a subsidised housing community in a central neighbourhood of a U.S. northeastern city. Amongst the 216 participants, 50% identified as Black and 45% identified as Latino. In addition to food insecurity and loneliness, the survey assessed participants' health, food access challenges, and sociodemographic characteristics. Results revealed a 34% food insecurity prevalence rate amongst the participants which is higher than the estimate of slightly less than 10% of the U.S. older population being food insecure. The participants' 34% loneliness rate was also higher than the 19%-29% prevalence range in U.S. older population studies. Bivariate analyses highlighted the interrelatedness or intertwining of food insecurity, loneliness, poor health and food access challenges whilst a series of logistic regressions further explored the significant association of loneliness with food insecurity. Loneliness increased the odds ratio of food insecurity in the binary (unadjusted) regression (p 0.001, OR = 3.1) and the multivariate (adjusted) regression that included all covariates (p 0.05, OR = 2.4). Overall, the findings underscore the need for greater awareness of loneliness as a public health threat as well as future research exploring how loneliness may intensify the health consequences of food insecurity in later life.

Findings indicate that an in-service educational program can help an agency achieve two ends: determine the types of persons to hire and plan future training. This analysis of a program for juvenile court personnel points out how this might be done. (Author)

In spite of the controversies surrounding the environmental deterioration of Mono Lake, and the significant amount of research being done on this remarkably productive body of water, nobody has ever attempted to survey the protists that live beneath its surface. Beginning in July of 2003, we have been trying to remedy this situation and we spent 2 months there studying the protistan species that reside in its waters and since then have been receiving regular sample collections for analysis. Based on the metazoan eukaryotes that live in this lake, which include only Artemia monica, Ephydra hians, rare rotifers and a nematode, we were warned to expect the lake to be depauperate of protists as well. However, we are happy to report that, while not as rich in species as most freshwater lakes, Mono Lake does support a robust population of phagotrophic and heterotrophic protozoa in addition to its many species of unicellular algae, including diatoms. It contains ciliate species representing at least the genera Cyclidium, Frontonia, Lacrymaria, Litonotus, Euplotes and Aspidisca, and the stalked suctorian Tokophrya. Additionally, there are species representing the heliozoa, helioflagellates, choanoflagellates, Pseudobodo, Cercomonas and Chilomastix, among other flagellates. The gymnamoebae are represented by Vanella, Nuclearia, Mayorella and Hartmanella, and, from the Heterolobosea, probable Vahlkampfia and Gruberella species. Micrographs of many of these species will be presented. Work on these species is still very much in its preliminary stages and a more detailed analysis and identification of the protists found in this extreme environment is advancing. This work was partially supported by an NSF grant (MCB 99-77901) to Robert Jellison.

Osteoarthritis and Cartilage

A 6-year-old boy presented with 4 areas of ulceration on the right side of his face and scalp. Medical history was significant for a right-sided exophytic juvenile pilocystic astrocytoma that was diagnosed at 5 years of age after he developedapersistenthead tilt to the left.Postoperative scans disclosed minimal residual tumor in the lateral brainstem. Within a year, the patient noticed the absence of sensation on his right cheek and lip and no taste on the right side of his tongue. He began drooling from the right side of his mouth, and his parents noticed that his smile was uneven as well. A residual tumor had grown to impinge on cranial nerves V and VII, and the patient underwent a second craniotomy in an attempt to restore function. The entire tumor was removed with this second surgery, but 3 months later, the patient’s right eye became edematous and an absence of tear production was discovered. Ocular lubricant was prescribed, and the eye was patched daily for 2 weeks. Within a short time, the skin on his right forehead began to break down owing to the adhesive bandage used for his eye protection. He then developed a similar ulceration on his right nasal ala and at other locations that were not occluded with tape or dressings (Figure1).

e19000 Background: The 5-year survival of Stage III melanoma ranges from 30-70%. High dose interferon alfa-2b (IFN) is an adjuvant immunotherapy approved in 1995 for stage III melanoma, however, its use has been limited by its significant toxicity and modest benefit. We hypothesized the utilization of adjuvant immunotherapy is less in older age group compared to younger patients. Methods: Using the National Cancer Data Base (NCDB) aggregate data, demographic, socioeconomic, insurance information, and treatment data were analyzed. Proportions were compared using Pearson Chi squared tests. Results: From 2000-2008, 27,365 cases of stage III melanoma were reported to NCDB. Most patients were male (63%) and Caucasian (94.2%). Twenty-nine percent were over the age of 70. Educational and socioeconomic factors across all age groups were not significantly different. The primary insurer for patients younger than 60 was a managed care plan (54.3%) as compared to Medicare with supplemental insurance for patients older than 60 (47.4%). In terms of systemic therapy, 23% received immunotherapy alone, 6% received chemotherapy alone, 2% received both, and 66% received no therapy. When compared to patients under age 39, older age groups were significantly less likely to receive adjuvant immunotherapy as shown in the table below. Conclusions: There is an inverse relationship between age and the use of adjuvant immunotherapy. Further study is planned to adjust for comorbidity, socioeconomic status using patient-level data. [Table: see text]

SummaryFactor XIII (FSF or fibrinoligase), an enzyme required for normal blood coagulation, can be measured by its catalysis of the incorporation of a fluorescent amine, monodansylcadaverine (N-(5-aminopentyl)-5-dimethylamino-l-naphthalene-sulfon-amide) into casein. The amine incorporation test was applied to fourteen patients who had major operations. Levels of factor XIII were measured before surgery and at intervals of two, four, and six days after operation. Plasma factor XIII showed a significant, linear decrease for each day after surgery. Patients having orthopedic surgery showed less pronounced changes than the remaining patients. Factor XIII also decreased after operation in patients with neoplastic disease, but the change was not different from that after general surgical procedures done in the absence of neoplasia. Platelet factor XIII levels were increased on the second day after operation, diminished on day four, and increased above pre-operative levels on the sixth day after surgery. Possible explanations of the observations are presented.

At this moment in history, social workers are viewed by many publics as little more than implementers, unable to think in new ways about old, unresolved problems. Prac titioners and educators are becoming acute ly aware of a shortage of creative idea pro duction as virtually a trained incapacity of the profession. Certainly the need for ere ativity in solving problems is shared by each method in the social work profession, but the pressure of current events on the do mestic scene has made its lack appear par ticularly blatant in the area of community organization. In a profession, the place and develop ment of creative processes in problem solving cannot be separated from recogni tion by the profession that there is indeed a vital importance to such functions as . . 1. Problem perception. 2. Incubation. 3. Insight. 4. Elaboration, test, and evalua tion. 5. Application."2 Up to the 1960's, 1 At the time this article was written Mr. Melzer was Assistant Professor at the School of Applied Social Sciences and Director, Improvement of Community Probation Ser vices Program, at Cleveland College, Case Western Reserve University. 2 Tom Cornelia, "Understanding Creativity for Use in Managerial Planning," Automation, (April, 1966), pp. 72-76.

Siemens Corporation defines the source of the Mevatron 20 linear accelerator as a line source approximately 2 m in length. Calculations for secondary barriers for leakage radiation are generally based on 0.1% of the useful beam 1 m from the target. The difference in source terms can lead to calculating thinner barriers than are required. The placement of a 30 X 10 X 10-cm block of lead behind the head was required to achieve acceptable radiation levels.

A patient undergoing treatment with cytotoxic chemotherapy for Hodgkin's disease developed graft versus host disease (GVHD) following a transfusion of packed red cells. This is the 28th reported patient with a malignancy who did not have a bone marrow transplant and developed GVHD after transfusion of normal blood or blood products. All patients had received cytotoxic chemotherapy prior to acquiring GVHD. The underlying malignancies included lymphoma, acute leukemia, neuroblastoma, rhabdomyosarcoma, and glioblastoma. Twenty-three of the 28 patients died of GVHD. The incidence of transfusion-related GVHD in this patient population is low but the illness is often fatal as treatment is largely ineffective. Transfusion-related GVHD can be prevented by irradiating all blood products with 1500 rad prior to administration.

Arden E. Melzer, DSW, is Associate Professor of Social Welfare and Research, School of Social Work, University of Pittsburgh, Pittsburgh, Pennsylvania, and Marie Haug, Ph.D., is Asso ciate Professor of Sociology, Sociology Depart ment, Case Western Reserve University, Cleve land, Ohio. The program described was part of the Improvement of Community Probation Services Program, Cleveland College, carried out by Case Western Reserve University and a metropolitan juvenile court.

Treatment of the helix of the ear with a lead shield placed behind the ear during electron beam therapy significantly increases the radiation close to the skin above the block. With film densitometry, the increased radiation dose is 10 % higher than the dose at the dose maximum. It is believed that the increase is a result of bremssrrahlung and scattered electrons originating in the lead. The increased dose should be taken into account when calculating the dose to those structures.