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Aims: This study examined nausea and vomiting (N/V) in hospitalized patients following the use of inhaled peppermint essential oil (aromatherapy) compared to combined aromatherapy/antiemetics or antiemetics alone. Method and Materials: A total of 103 hospitalized patients were offered one of three options to control N/V. Patient choice was considered in the holistic trial design so that patients were not denied either the essential oil or antiemetics. Patients rated nausea 0 to 10 on the Edmonton Symptom Assessment Scale at symptom onset and within 60 minutes of the intervention. Results: Only three subjects enrolled in the antiemetic arm; thus this arm was eliminated from analysis, resulting in 100 evaluable patients. Mean nausea score improved significantly for the entire sample following the aromatherapy or aromatherapy/antiemetic intervention (p <.0001). Patients in the aromatherapy arm had significant improvement in nausea compared to the combined aromatherapy/antiemetic arm (p <.0001). Patient perception that peppermint oil relieves N/V significantly improved for the entire sample. Notable is that 65% of patients used peppermint essential oil alone. Conclusions: Peppermint essential oil is an effective independent or complementary modality for relief of N/V in hospitalized patients. Research designs that incorporate patient decision making should be considered for studies in which placebos do not contribute to holistic care. [ABSTRACT FROM AUTHOR]

Molecular phylogenetic analyses of 18S rDNA ( SSU) gene sequences confirm the placement of Crusticorallina gen. nov. in Corallinoideae, the first nongeniculate genus in an otherwise geniculate subfamily. Crusticorallina is distinguished from all other coralline genera by the following suite of morpho-anatomical characters: (i) sunken, uniporate gametangial and bi/tetrasporangial conceptacles, (ii) cells linked by cell fusions, not secondary pit connections, (iii) an epithallus of 1 or 2 cell layers, (iv) a hypothallus that occupies 50% or more of the total thallus thickness, (v) elongate meristematic cells, and (vi) trichocytes absent. Four species are recognized based on rbcL, psbA and COI-5P sequences, C. painei sp. nov., the generitype, C. adhaerens sp. nov., C. nootkana sp. nov. and C. muricata comb. nov., previously known as Pseudolithophyllum muricatum. Type material of Lithophyllum muricatum, basionym of C. muricata, in TRH comprises at least two taxa, and therefore we accept the previously designated lectotype specimen in UC that we sequenced to confirm its identity. Crusticorallina species are very difficult to distinguish using morpho-anatomical and/or habitat characters, although at specific sites, some species may be distinguished by a combination of morpho-anatomy, habitat and biogeography. The Northeast Pacific now boasts six coralline endemic genera, far more than any other region of the world. [ABSTRACT FROM AUTHOR]

Despite ample best practice recommendations for competency to proceed (CTP) evaluations, direct observation of defendant-attorney interactions is an unstudied methodological technique for assessing defendants' abilities to assist and consult with their attorneys. This mixed-methods study surveyed 57 forensic evaluators regarding their history and opinions of direct observation as a component of CTP evaluations. The majority (70.20%) of forensic evaluators had engaged in direct observation on at least one occasion, with some practicing this approach in up to 85% of their evaluations. A minority endorsed or expressed concerns regarding this practice (e.g., third-party effects, violations of attorney-client privilege). Results of this study provide a preliminary indication of how evaluators perceive the potential utility and hazards of direct observation. In response, we offer a framework for approaching direct observation and highlight the need for additional research examining the impact of this methodological technique for CTP evaluations. [ABSTRACT FROM AUTHOR]