At any point in time, 3% to 4% of the 29.1 million diabetic patients in the United States (9.3% of the population) will have a foot ulcer. Diabetes-associated foot ulcers and infection lead to ...>70,000 lower-extremity amputations yearly in the United States. Between one-third and one-half of diabetic patients undergoing a major lower-extremity amputation will die within 2 years after the amputation. Multidisciplinary population health-management strategies have been developed to decrease the rate and magnitude of this important comorbidity in the diabetic population. The goal of the present review is to provide the reader with a framework for the development of a health-care-system strategy for addressing this complex patient population.
Infectious hematopoietic necrosis (IHN) leads to periodic epidemics among certain wild and farmed fish species of the Northeast (NE) Pacific. The source of the IHN virus (IHNV) that initiates these ...outbreaks remains unknown; however, a leading hypothesis involves viral persistence in marine host species such as Pacific herring Clupea pallasii. Under laboratory conditions we exposed specific pathogen-free (SPF) larval and juvenile Pacific herring to 10(3) to 10(4) plaque-forming units (pfu) of IHNV ml(-1) by waterborne immersion. Cumulative mortalities among exposed groups were not significantly different from those of negative control groups. After waterborne exposure, IHNV was transiently recovered from the tissues of larvae but absent in tissues of juveniles. Additionally, no evidence of viral shedding was detected in the tank water containing exposed juveniles. After intraperitoneal (IP) injection of IHNV in juvenile herring with 10(3) pfu, IHNV was recovered from the tissues of sub-sampled individuals for only the first 5 d post-exposure. The lack of susceptibility to overt disease and transient levels of IHNV in the tissues of exposed fish indicate that Pacific herring do not likely serve a major epizootiological role in perpetuation of IHNV among free-ranging sockeye salmon Oncorhynchus nerka and farmed Atlantic salmon Salmo salar in the NE Pacific.
Viral erythrocytic necrosis (VEN) is a condition that affects marine and anadromous fish species, including herrings and salmonids, in the Atlantic and Pacific oceans. Infection is frequently ...associated with severe anemia and causes episodic mortality among wild and hatchery fish when accompanied by additional stressors; VEN can be presumptively diagnosed by (1) light microscopic identification of a single characteristic—a round, magenta-colored, 0.8-μm-diameter inclusion body (IB) within the cytoplasm of erythrocytes and their precursors on Giemsa-stained blood films; or (2) observation (via transmission electron microscopy TEM) of the causative iridovirus, erythrocytic necrosis virus (ENV), within erythrocytes or their precursors. To better understand the kinetics of VEN, specific-pathogen-free Pacific herring Clupea pallasii were infected with ENV by intraperitoneal injection. At 1, 4, 7, 10, 14, 21, and 28 d postexposure, samples of blood, spleen, and kidney were collected and assessed (1) via light microscopy for the number of intracytoplasmic IBs in blood smears and (2) via TEM for the number of virions within erythrocytes. The mean prevalence of intracytoplasmic IBs in the blood cells increased from 0% at 0–4 d postexposure to 94% at 28 d postexposure. Viral load within circulating red blood cells peaked at 7 d postexposure, fell slightly, and then reached a plateau. However, blood cells observed within the kidney and spleen tissues demonstrated high levels of ENV between 14 and 28 d postexposure. The results indicate that the viral load within erythrocytes does not correlate well with IB prevalence and that the virus can persist in infected fish for more than 28 d.
Purpose
Explanatory (i.e. attributional) style has been shown to be related to performance, especially when attributions are pessimistic. This study tested whether this relationship was present for ...residents.
Method
The Attributional Style Questionnaire and the Brief Symptom Inventory were completed by 45 residents. Clinical rotation evaluations and in‐training examination scores were used as performance measures.
Results
Explanatory style and emotional distress were not related to performance, although explanatory style was correlated with emotional distress. Overall, residents displayed an optimistic explanatory style.
Conclusion
The absence of a relationship between explanatory style and performance may be due to the tendency for this resident sample to be optimistic. Also, common indicators of residency performance may not accurately measure clinical and academic performance.
Can Sexual Orientation Change? A Long-Running Saga (By John Bancroft); Understanding the Self-Reports of Reparative Therapy "Successes" (By A. Lee Beckstead); The Malleability of Homosexuality: A ...Debate Long Overdue (By A. Dean Byrd); A Methodological Critique of Spitzer's Research on Reparative Therapy (By Helena M. Carlson); Are Converts to Be Believed? Assessing Sexual Orientation "Conversions" (By Kenneth M. Cohen and Ritch C. Savin-Williams); Reconsidering "Sexual Desire" in the Context of Reparative Therapy (By Lisa M. Diamond); The Spitzer Study and the Culture Wars (By Jack Drescher); Sexual Orientation Change: A Study of Atypical Cases (By Richard C. Friedman); The Politics of Sexual Choices (By John H. Gagnon); Too Flawed: Don't Publish (By Lawrence Hartmann); Evaluating Interventions to Alter Sexual Orientation: Methodological and Ethical Considerations (By Gregory M. Herek); Guttman Scalability Confirms the Effectiveness of Reparative Therapy (By Scott L. Hershberger); Methodological Limitations Do Not Justify the Claim That Same-Sex Attraction Changed Through "Reparative Therapy" (By Craig A. Hill and Jeannie D. DiClementi); Initiating Treatment Evaluations (By Donald F. Klein); A Positive View of Spitzer's Research and an Argument for Further Research (By Richard B. Krueger); Penile Plethysomography and Change in Sexual Orientation (By Nathaniel McConaghy); Finally, Recognition of a Long-Neglected Population (By Joseph Nicolosi); Sexual Orientation Change and Informed Consent in Reparative Therapy (By Bruce Rind); Reparative Science and Social Responsibility: The Concept of a Malleable Core as Theoretical Challenge and Psychological Comfort (By Paula C. Rodríguez Rust); A Candle in the Wind: Spitzer's Study of Reparative Therapy (By Donald S. Strassberg); Spitzer's Oversight: Ethical-Philosophical Underpinnings of "Reparative Therapy" (By Marcus C. Tye); Sexual Diversity and Change Along a Continuum of Bisexual Desire (By Paul L. Vasey and Drew Rendall); Science and the Nuremberg Code: A Question of Ethics and Harm (By Milton L. Wainberg, Donald Bux, Alex Carballo-Dieguez, Gary W. Dowsett, Terry Dugan, Marshall Forstein, Karl Goodkin, Joyce Hunter, Thomas Irwin, Paulo Mattos, Karen McKinnon, Ann O'Leary, Jeffrey Parsons, and Edward Stein); Sexual Reorientation Therapy: Is It Ever Ethical? Can It Ever Change Sexual Orientation? (By Jerome C. Wakefield); Heterosexual Identities, Sexual Reorientation Therapies, and Science (By Roger L. Worthington); How Spitzer's Study Gives a Voice to the Disenfranchised Within a Minority Group (By Mark A. Yarhouse)
The escalating prevalence of chronic health problems related to lifestyle is extremely costly to organizations. It is likely that organizational consultants will have increasing opportunities to plan ...and implement interventions at the individual level for health behavior change. This article describes the importance of such consultation, emphasizing the role of coping in the behavior change process. In addition to identifying relevant research and theoretical literature, specific recommendations for how to conduct lifestyle change consultation are discussed.
Poor performance of medical students, residents, and faculty on a newly developed Inventory of Cognitive Biases in Medicine, suggests that cognitive biases detract from reliance on logical and ...statistical strategies in medical decision making. The test shows promise for use in instructional and research efforts to reduce such bias. (Author/MSE)
Consultant as Confidant Rudisill, John R; Edwards, Jean M; Hershberger, Paul J
Consulting psychology journal,
2004, Letnik:
56, Številka:
3
Journal Article
Recenzirano
This article deals with something that is probably a common experience to every seasoned consultant but is rarely discussed in an academic journal. The authors are unaware of any research studies on ...the topic: the consultant as confidant. They discuss the role of the consultant as confidant through their personal experience and by bringing to bear consulting and other psychological literature. They also discuss why there is a need for consultants as confidants, the experience of being a confidant, violations of the role, and some guidelines for performing the role of confidant.
The three macrolide-resistance-encoding genes, tlrC from Streptomyces fradiae, srmB from Streptomyces ambofaciens, and carA from Streptomyces thermotolerans, encode proteins that possess significant ...sequence similarity to ATP-dependent transport proteins. The N-terminal and C-terminal halves of these proteins are very similar to each other and contain highly conserved regions that resemble ATP-binding domains typically present within the superfamily of ATP-dependent transport proteins. These observations suggest that the mechanism by which these genes confer resistance to macrolides is due to export of the antibiotics, a process that is driven by energy derived from ATP hydrolysis.
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