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Presents information on a study which examined the pathophysiology of epidemic Saint Louis encephalitis in Dallas, Texas. Control measurements of pituitary-adrenal function; Cerebral blood flow and metabolism of patients; Syndrome of inappropriate secretion of antidiuretic hormone.

Background: The Cardiovascular Disease Outcomes Strategy (department of health (DoH), 2013) recommends the use of existing cardiac rehabilitation (CR) programmes for people after transient ischaemic attack (TIA) and mild disability stroke. However, there is no research exploring the attitudes of CR or stroke staff who might feasibly be delivering this service. Method: Using a qualitative interpretive approach with five researchers, seven focus groups with CR and stroke teams were conducted prior to stroke patients taking part in CR and four focus groups after CR. Group discussions were audiotaped and transcribed verbatim. Themes were identified to explain attitudes. Results/Findings: Main themes were as follows: Confidence - CR team lack of confidence to deliver the service and the stroke team having lack of confidence in the CR team, change in confidence in CR team post CR. Lack of Knowledge - CR team -stroke knowledge, Stroke team - CR knowledge, cardiovascular (CV) training, and healthy lifestyles, Stroke and Exercise - barriers - stroke team more aware of personal barriers, both teams aware of environmental barriers, social barriers, and cultural barriers, both teams - identified most patients motivated early after stroke. CR adaptations needed - education programme to include stroke information and class structure. Discussion: Importance of communication, education, and support between stroke and CR teams to provide effective CR for people with stroke. Conclusion: Stroke and CR teams feel that small numbers of people with mild stroke can be included in existing CR programmes where CR staff have increased stroke knowledge and confidence and the programme is adapted and supported by specialist stroke staff. [ABSTRACT FROM AUTHOR]

Objective: To explore the attitudes and beliefs of cardiac rehabilitation and stroke teams towards adapted cardiac rehabilitation, and the broader topics of exercise, healthy lifestyles and health behaviour change, for people with mild-to-moderate severity stroke in the sub-acute phase of recovery., Design: Qualitative focus group-based study., Setting: Acute and community national health service trusts., Participants: Stroke and cardiac rehabilitation team members., Intervention: Adapted cardiac rehabilitation., Main Measures: Focus groups. Thematic analysis was applied to the transcribed data., Results: Overall, 57 health professionals participated in 12 focus groups. Positive impacts for teams and stroke survivors were identified particularly confidence. However, there were negatives, barriers and adaptations identified. In addition, there was a lack of knowledge for cardiac rehabilitation teams in relation to stroke survivors and stroke teams in relation to cardiac rehabilitation, exercise and healthy lifestyles., Conclusions: Cardiac rehabilitation and stroke staff attitudes to cardiac rehabilitation for stroke survivors showed a range of benefits, negatives, barriers and adaptations needed. Confidence and knowledge of the cardiac rehabilitation and stroke teams needs to be addressed., Registration: ISRCTN65957980., Competing Interests: Declaration of Conflicting InterestsThe authors declared the following potential conflicts of interest with respect to the research, authorship and/or publication of this article: Professor Robinson is an NIHR Senior Investigator. Professor Singh is an NIHR Senior Investigator.

In the summer of 2020, SARS-CoV-2 infection rates among the U.S. population aged 20-39 years exceeded other age groups, with the largest increases occurring in the southern US. As many colleges reopened for in-person instruction in August and September, these trends continued among campuses across the country. Our study aimed to identify risk factors (demographic and behavioral) associated with SARS-CoV-2 infection among college students. We used data from a survey administered to students at a southern university in the US. The survey had a total of 765 respondents and this study included the 679 (88.8%) who responded about their SARS-CoV-2 infection status. We examined associations between population characteristics and reported SARS-CoV-2 infection and calculated prevalence ratios along with 95% confidence intervals. SARS-CoV-2 infection was 2.5 times more likely among current users of electronic nicotine delivery systems (ENDS) compared to those who do not use ENDS (95% confidence interval [CI]: (1.76-3.4)) and 2.8 times more likely among those who reported a high frequency of binge drinking compared to those who did not report binge drinking (95% CI: (1.81-4.36)). Current high frequency ENDS users were 2.76 (1.79-4.25) more likely to report SARS-CoV-2 infection than non-users. Current low frequency users of ENDS were 2.27 (1.53-3.37) times more likely to report SARS-CoV-2 infection than nonusers. A trend analysis among ENDS use frequency and SARS-CoV-2 infection was statistically significant, showing a significant dose response with increasing ENDS use. The results of this analysis may assist in providing guidance on policies as well as may serve as a steppingstone for future research concerning SAR-CoV-2 infection among university populations.

Objectives: Does adapted cardiac rehabilitation (CR) improve the physical behaviours of people with mild-to-moderate stroke in the sub-acute recovery phase using a compositional data analysis (CoDA) approach?, Design: Before-after., Setting: University Hospitals of Leicester, Glenfield Hospital, UK., Participants: 24 individuals completed CR and provided valid physical activity (PA) data (mean (SD) 63.1 (14.6) years, 58% male (14/24))., Intervention: 6-week adapted CR program within 6-months of stroke., Main Outcome Measures: Physical behaviours were assessed using waist-worn accelerometry. Step count, stationary time (ST), light PA (LPA), and moderate-to-vigorous PA (MVPA) were compared pre post CR using conventional analyses and CoDA. Analysed compositions were: Waking day (ST, LPA, MVPA); ST (1-9-minutes, 10-29-minutes, ≥30-minutes bouts); and MVPA (1-4-minutes, 5-9-minutes, ≥10-minutes bouts)., Results: Following CR, patients took significantly more steps (mean (SD) 3255 (2864) vs 3908 (3399) steps/day, P=0.004) and engaged in more bouts of MVPA lasting ≥5 and ≥10-minutes (≥5-minutes: mean (SD) 0.7 (1.4) vs 1.2 (1.8) bouts/day, P=0.008). Using CoDA, no changes in waking day or ST compositions occurred. For waking day, 42% (10/24) increased their LPA and MVPA at the expense of ST. For ST, 33% (8/24) increased their short bouts at the expense of medium and long bouts. For MVPA, 13% (3/24) increased their medium and long bouts at the expense of short bouts., Conclusion: People with stroke in the sub-acute stage of recovery exhibited low levels of PA. CR appears to be an effective intervention to increase step count but did not alter the overall proportion of time individuals spent being sedentary, or engaging in LPA or in MVPA., Registration: ISRCTN65957980., (Copyright © 2019 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.)

Objective: To determine the construct validity and test re-test reliability of the Six-minute Walk Test (6MWT) and Incremental Shuttle Walk Test (ISWT) in the sub-acute recovery phase following mild-to-moderate severity stroke., Participants: 40 stroke patients (mean age: 68.27 years, SD: 13.48) of median National Institutes of Health Stroke Scale (NIHSS) score 1.2 (range: 0 to 8) within six months of stroke., Method: Each participant completed one Incremental Cycle Test (ICT) followed by two ISWT and two 6MWT in a randomised order. Pearson's Correlation Coefficients were used to determine the validity and Bland Altman plots were used to determine the test re-test reliability., Results: The Incremental Cycle Test (ICT) was positively correlated with the ISWT (r=0.59, 95% confidence intervals 0.35 to 0.76, P=0.001) and the 6MWT (0.55, 0.35 to 0.71, P<0.001). The correlation of the ICT with the ISWT and 6MWT was higher for the 17 patients with no residual (ISWT: r=0.79, P<0.001; 6MWT: 0.826, P<0.001) compared to mild-to-moderate neurological impairment (ISWT: r=0.45, P=0.03; 6MWT: r=0.38, P=0.08). Test-retest reliability for both the ISWT and the 6MWT showed that there was some variability between the first and second tests with a better performance on the second test., Conclusion: The ISWT and 6MWT have a significant, modest correlation with the ICT for stroke patients in the sub-acute recovery phase. The ISWT and 6MWT are not strongly correlated with ICT (VO 2 peak) in a stroke population that is disabled. The test-retest reliability of the ISWT and 6MWT indicated that two tests may be needed to accurately assess an individual's capabilities., (Copyright © 2018 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.)

The national health burden created by AIDS/HIV disease has had a significant impact on the insurance industry. In an analysis of the MetLife health and life insurance claims from 1986 through 1989, it was found that a total of $323,900,000 has been paid for AIDS/HIV disease. This figure and related information from those years were based on the Company's underwriting and claims files, with personal and group operations reported separately. Personal life insurance claims rose from 344 in 1986 to 874 in 1989 with the dollar amounts increasing from $3.2 million to $8.9 million. In 1989 there were 689 group life claims with a face amount of $31.5 million and 6,450 people who received group medical claim payments for a total of $111.2 million. In 1989 AIDS claims comprised 1.61 percent of MetLife claims--up from 0.4 percent in 1986.

Light-chain glomerulopathy occurred in a middle-aged woman with adult-onset diabetes mellitus and IgG-kappa light-chain multiple myeloma. Unusual features of the glomerulopathy included the presence of numerous epithelial crescents and rapid progression to chronic renal failure. The aggressiveness of her disease may be related to her underlying diabetes mellitus and associated abnormalities in glomerular clearance of macromolecules, including immunoglobulin light chains.

Given the rigorous demands of regulatory agencies and the funding cutbacks prevalent in current educational institutions, educators must find new ways to incorporate modern advances in their respective fields into already overcrowded curricula. This article describes a major problem facing educators today, outlines various methods that have been used (for the most part, unsatisfactorily) to solve the dilemma, and posits a systematic approach to modern curriculum planning that has been field tested at the Kettering Medical Center School of Medical Technology. By way of illustration of this process, the authors include data gathered during development of the cost-effective curriculum planning approach. While the method described in this article has been expressly designed for the allied health professions, its theory and recommendations may be generalized to virtually any field.

In recent years, self-instructional teaching methods have come under criticism from educators, much of it warranted. But when self-instructional materials are written by experienced educators who teach the topic and are developed within a versatile process using a proven format, they are extremely valuable teaching aids. We discuss here the results of a grant project funded by W. K. Kellogg Foundation and describe the process used at Kettering Medical Center's School of Medical Technology to develop and produce over 100 self-instructional units. We also discuss potential uses of self-instructional units in professional continuing education programs and suggest ways self-instructional units might be used to promote interdisciplinary health care and expansion of professional knowledge banks. This project confirmed that professions can create their own educational materials through the independent efforts of their members.