Background: Neuroinvasive West Nile virus infection WNVCNS ; produces severe acute cognitive impairments. However, the frequency and types of long-term neuropsychological deficits produced by WNV-CNS have not been described. Objective: The authors characterize the long-term neuropsychological sequelae of WNV-CNS. Method: Fourteen subjects five women ; , 61.8 SD 6 ; years old with 14 SD 1.8 ; years of education, were evaluated 22.3 SD 4.3 ; months following WNV-CNS. The Mini Mental State Examination MMSE ; , Frontal Assessment Battery FAB ; , and a battery of neuropsychological tests NPB ; were administered. The NPB included: RBANS, WCST, TMT Parts A & B, COWAT, Animal Naming, Stroop CWT, and WAIS-III Similarities. Performance 1 SD below normative data-derived performance expectations on the MMSE, FAB, and on at least 20% of tests on the NPB was considered impaired. Relationships between cognitive performance and age, education, gender, and psychiatric symptoms SCL-90-R ; scores were also investigated. Results: Cognitive impairment was observed in three subjects 21.4% ; on the MMSE, seven subjects 50% ; on the FAB, and five subjects 35.7% ; on the NPB. Cognitive impairment was more common and severe among older subjects. There were no relationships between cognitive performance and either gender or education, and no relationships between cognitive impairment and either depressive or anxious symptoms. Conclusions: WNVCNS produces persistent cognitive impairment of at least mild severity and in a predominantly dysexecutive pattern in a substantial minority of affected persons. Such impairments occur more commonly in older patients and are not solely attributable to psychiatric symptoms. Further study of the neuropsychological sequelae of WNV-CNS is needed.
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The process of developing the CAP guidelines began in 1999 at LRGH. The Infection Control and Epidemiology Committee had established a Respiratory Continuous Quality Improvement CQI ; subcommittee to address the rising rates of hospital-acquired nosocomial ; pneumonia. This multidisciplinary group reviewed all cases of nosocomial pneumonia and recommended improvements that resulted in a reduction of these cases to only 25% of former levels. With the publication of the IDSA guidelines for CAP in 1998, the Respirator y CQI subcommittee decided to apply this This research was funded by LRG Healthcare and by an unrestricted research grant from Bayer Pharmaceuticals Corporation, for example, buy norfloxacin.
Cleanup Procedures - Specific cleanup procedures will include a list of any and all materials to be removed, removal procedures, any proposed cleanup process and appropriate disposal of contaminated materials under the provisions of the Washington State Dangerous Waste Regulations WAC 173-303 ; . Waste Disposal Plan - A waste disposal plan shall be included in the workplan. Materials building structures, clothes, furniture, etc. ; inside the drug lab and the structure housing the lab may have been contaminated by the process of manufacturing drugs. The contractor must determine whether or not the waste generated during the cleanup is dangerous waste under the provisions of WAC.173-303. Knowledge obtained from the pre-cleanup screen and or pre-cleanup site assessment may be used to help designate the waste generated during the cleanup. Under the plan, waste should be segregated into two groups: visibly stained contaminated and visibly clean. A representative sample must be taken from each group. The plan shall include a detailed description of the sampling method. These samples shall be tested and analyzed following the protocols under WAC 173-303. The plan shall identify the permitted "Temporary Storage and Disposal" TSD ; facility that will be used in the event dangerous waste is generated. The dangerous waste must be manifested and transported to the TSD under the provisions of WAC 173-303. If the waste is not designated as dangerous waste, it is solid waste and may be disposed of at a permitted solid waste landfill. The local health department must be contacted prior to disposal of this solid waste to determine if a specific permit is required for disposal at landfills under its jurisdiction. The permitted landfill shall be identified. If the contractor proposes to dispose of the structure by burning, permission must be obtained in writing from the local health department, local air pollution control authority, and local fire department. Post-cleanup Site Assessment Plan - The post-cleanup site assessment plan should include, but not be limited to: air, non-porous surface, soil and water sampling. Sampling and testing should be performed using recognized standards and written procedures designed to ensure accuracy, reproducibility, and relevance to onsite contamination Sections 2.3 and 2.4 ; . Indoor air will be tested for volatile organic compounds VOC's ; , and airborne mercury. Horizontal surfaces will be tested for lead. Other compounds may be tested for, as deemed necessary by the local health department. The testing components of the assessment should include: 1. The exact location within the property where each test sample was or will be collected; 2. The materials, equipment and techniques used or proposed for sampling at each location; 3. The amount of area, and or volume of material collected for each test sample; 4. All control samples taken or to be taken, including the location, materials, techniques and results.
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1398 Guidelines for the Management of Severe Head Injury: Japanese Status Minoru Shigemori, MD Takashi Tokutomi, MD Kazuya Morimoto, MD Fukuoka, Japan ; Key Words: guidelines, management, severe head injury Introduction: Two major sets of management guidelines from the U.S. and Europe had an impact on many Japanese neurosurgeons and critical care physicians. However, these guidelines are not necessarily suitable for actual clinical practice in Japan because of the differences in medical and sociolegal situations in the Western countries. Many controversies still exist regarding not only standard and conventional management but also topics relating to clinical treatment of severely head-injured patients. The issues to be resolved include the trauma care system, prehospital care, initial resuscitation, intensive care units, operative indications and timing, currently optional therapy such as hypothermia, and age-related specificity. Methods and Results: To verify the American and European guidelines, a head injury task force was formed in 1998 with the support of the Japan Society of Neurotraumatology in collaboration of the Japan Neurosurgical Society. The Executive Committee selected key issues relating to the management of severe head injury in adult patients with a Glasgow Coma Scale score of 8 or less. The members started a review of the leading Japanese clinical articles in the last 10 years. After several reviews and critiques, the final version was formed in May 1999. Simultaneously, the authors conducted a nationwide study to elucidate the present status of management at the acute stage of severe head injury in 1998. The questionnaires were delivered to leading neurosurgical institutions and critical care centers and 457 replies were obtained response rate: 42% ; . Conclusions: The collected data showed characteristic and interesting features of the present Japanese status. These results will be presented and
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Reported by: JS Duchin, MD, J Koehler, DVM, Public HealthSeattle & King County, Seattle; JM Kobayashi, MD, State Epidemiologist, Washington State Dept of Health; RM Rakita, MD, K Olson, MD, NB Hampson, MD, Virginia Mason Medical Center, Seattle. DN Gilbert, MD, JM Jackson, Providence Portland Medical Center, Portland; KR Stefonek, MPH, MA Kohn, MD, State Epidemiologist, Oregon Dept of Human Svcs, Health Div. J Rosenberg, MD, D Vugia, MD, Acting State Epidemiologist, California Dept of Health Svcs. M Marchione-Mastroianni, CDC Foundation, Atlanta, Georgia. Respiratory Diseases Br, Div of Bacterial and Mycotic Diseases, National Center for Infectious Diseases; and EIS officers, CDC and
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Mental Health Because values and ideals vary from culture to culture, it is impossible to enumerate all the possible differences. Mainly for purposes of illustration, some commonly cited values of First Nations and Inuit people are given below. It must be emphasized that these values do not necessarily hold true for all First Nations and Inuit, but they do alert the healthcare practitioner to the kinds of differences that can exist and to the possible consequences, for both understanding the client and providing a mental health service, if these differences are not recognized. Non-Interference A high degree of respect for a person's independence leads to the view that giving instructions, coercing or even persuading another person, including a child, is inappropriate. This ethic may be perceived by another culture as apathy, neglect, indifference, lack of social responsibility or evasiveness. Anger Displays of anger could jeopardize the voluntary cooperation essential to survival of a close-knit group. Hostility must be suppressed. It has been suggested that this practice may lead to a particular vulnerability to depression. Time Time is a personal, flexible concept and is not related to the clock so much as to feeling ready to act. Sharing Group survival is more important than personal prosperity. Sharing assures the survival of the group. Cooperation Competition can interfere with group cohesiveness. Cooperation increases the sense of solidarity and pools effort, talent and resources. Excellence Gratitude is rarely shown or verbalized because each individual is expected to behave at a "normal" i.e., excellent ; level. Teaching and Learning Teaching is based on modeling rather than deliberate instruction. Practice and observation occur spontaneously in the learner who is ready to learn and
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The first series of analyses, which examined the efficacy of MPH among the entire cohort of HIV participants, employed a mixed-model analysis of variance with treatment order MPH first vs. placebo first ; as a between-subjects factor and change score prepost MPH vs. prepost placebo ; as the within-subjects factor. Dependent variables included simple RT, choice RT, dualtask RT simple and choice ; , and BDI score. Means are presented in Table 1. Among the entire cohort, for the simple RT, choice RT, and dual-task simple RT conditions, there were no statistically significant at the 0.05 level ; main effects or interactions all P 0.25 ; . For the dual-task choice RT condition, there was a main effect for drug condition change score ; , F 6.05, df 1, 14, P 0.03, with choice RT being 60 ms faster in the placebo condition relative to baseline ; and 23 ms slower in the MPH condition and
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Percentage of resistant isolates 2001 Amoxicillin Amoxiclave Cephalotine Tetracycline Doxycycline Nalidixic acid Nortloxacin Erytromycin Streptomycin Tiamulin Cotrimoxazol Sulfasomidine 12.3 9.6 1.4 0 98.6 78.1 0 4.1 43.8 2002 ance against one or more commonly used antibiotics were found. The results are shown in Table 1. The highest resistance to antibiotics was observed in erytromycin, streptomycin and tiamulin and, on the other hand, resistance to amoxicillin, amoxicillin-clavulanic acid, cephalotine and cotrimoxazol was the least frequent. Resistance to tetracycline, doxycycline, nalidixic acid and norfloxacln sharply increased in the last year although a relative low resistance was observed in 2001. Interestingly, resistance against sulfasomidine decreased almost to one half in 2003 compared with previous years. To our knowledge, this trend was described only in the Czech Republic so far. It is probably caused by decrease in usage of classic sulfonamides in investigated herds for treatment. Differences between the percentages of strains resistant to amoxicillin, amoxicillin-clavulanic acid, cotrimoxazol, erythromycin, streptomycin and tiamulin detected in particular years are small, although the percentages of strains resistant to amoxicillin, streptomycin and cotrimoxazol slightly decreased in 2003 in comparison with the year 2002 Figure 1 ; . Majority of strains were resistant to the group of antibiotics that had been used most frequently in a particular herd for a long time. This is cause of this antibiotics resistance increase, particularly for tetracyclines. They are a broad-spectrum agents, which exhibit their activity against a wide range of bacteria. Therefore, they have been extensively used in the therapy of infections, for prophylactic purposes and for growth promotions in animals and
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INVITED LECTURES BLAND Franois L'amlioration des services tout au long de la vie: Une exprience montralaise, Strengthening the Foundations : Health Services and Policy Research Canadian Health Care, Institute of Health Services and Policy Research, Canadian Institute of Health Research, Montral, 22-24 Novembre 2003 Le dfi de comprendre et de rpondre aux besoins des personnes ges fragiles, Atelier des quipes en vieillissement, Institut canadien de la recherche en sant, Toronto, 30 Octobre 2003. Trajectories of frail elderly people in the health care system, Special Joint CAG CGS CGNA CIHR Symposium, 32nd Annual Scientific and Education Meeting of the Canadian Association on Gerontology, Toronto, 30 Oct-Nov 1st, 2003. Integrating health and social care and care management, Opening conference, 4th Conference of the American Society on Aging, Philadelphie, 26-29 octobre 2003 Longitudinal gender and health research, Institut sur la sant des femmes et des hommes, Institut canadien de la recherche en sant, Edmonton, 21-22 Octobre 2003. Russir l'intgration des soins et services : re-situer la performance. 4ime Sommet qubcois sur la gestion de la performance dans la sant, L'Institut canadien, Montral, 23-25 septembre 2003. Evaluation of a System of Integrated Care SIPA ; in Montreal, Quebec, Canada: A 22-month randomized control trial with 1230 frail older persons. American Geriatrics Society 2003 Annual Scientific Meeting. "Improving Health and Well-Being of Older Adults". Baltimore, Maryland. May 14-18 Un Modelo Integrao de Cuidados para Personas Adultas Mayores, Reunion de Expertos en Salud y Envejecimiento del Adulto Mayor, Organisation pan-amricaine de la sant, Panam, 7-8 avril 2003. Allongement de l'esprance de vie et impact sur la demande de soins et de service, Soins de fin de vie : Enjeux et ambigut, Hpital Ste-Anne, Montral, 4 juin 2004. Projet FRLE : Fragilit, une tude longitudinale de ses expressions, Rseau qubcois de la recherche sur le vieillissement, 3ime Journe de recherche, Qubec, 14 avril 2004. Mobility profile as a predictor of adverse events in frail elderly, Rseau qubcois de la recherche sur le vieillissement, 3ime Journe de recherche, Qubec, 14 avril 2004. tude de la qualit des soins et des servcies griatriques hospitaliers, Rseau qubcois de la recherche sur le vieillissement, 3ime Journe de recherche, Qubec, 14 avril 2004 and nateglinide.
KAREN MAGINNIS, ACCENTHEALTH HOST: THANKS, PAT. EVEN AT A VERY YOUNG AGE, YOUR CHILD SHOULD UNDERSTAND WHAT TO DO IF GETS LOST OR A STRANGER APPROACHES. LEARNING A FEW BASIC RULES IS ONE OF THE FIRST STEPS TOWARDS A SENSE OF SAFETY FOR YOUR CHILD. ALTHOUGH PROGRAMS DESIGNED TO PROTECT CHILDREN, SUCH AS SELF-DEFENSE AND FINGERPRINT IDENTIFICATION, CAN BE HELPFUL, THEY MAY ALSO CAUSE ALARM. THERE ARE SOME MORE PRACTICAL TOOLS THAT CAN HELP YOUR CHILD PROTECT HIMSELF, OR HELP HIM FIND YOU IF HE GETS LOST. AS SOON AS HE IS OLD ENOUGH TO UNDERSTAND, TEACH YOUR CHILD HOW TO GIVE HIS NAME, ADDRESS, AND PHONE NUMBER. ALSO, LET HER KNOW THAT IF SHE GETS SEPARATED FROM YOU IN PUBLIC, SHE SHOULD GO TO THE CHECKOUT COUNTER OR SECURITY OFFICE RATHER THAN WANDERING AROUND LOOKING FOR YOU. TEACH HIM HOW AND WHEN TO CALL THE 911 EMERGENCY NUMBER. AND TEACH HIM TO AVOID CONTACT WITH STRANGERS AND NOT TO OPEN THE DOOR TO A STRANGER. OF COURSE THERE IS NO SUBSTITUTE FOR PARENTAL SUPERVISION, BUT KNOWING WHAT TO DO IN STRANGE SITUATION CAN SHOW YOUR CHILD HOW TO BE SMART WITHOUT BEING SCARED.
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As benomyl, induce paralysis and slow the growth of the nematode Caenorhabditis elegans. We have identified 28 mutations in C elegans that confer resistance to benzimidazoles. All resistant mutations map to a single locus, bend. Virtually all these mutations are genetically dominant. Molecular cloning and DNA sequence analysis established that bend encodes a 3-tubulin. Some resistant mutants are completely.
Providers who do not utilize the Medicaid POS system for claims submission will be at risk for possible claims rejection unless the IVRS is used to verify current Medicaid enrollment information. If additional information regarding the MFCP is needed, providers should contact PHR staff at 803-434-2300. The Palmetto SeniorCare PSC ; is a program that provides an array of services to Medicaid beneficiaries eligible for long term care who reside in Richland and Lexington counties who are age 55 or older. These beneficiaries have voluntarily agreed to receive medical care only through PSC. Thus, they waive the right to choose any providers other than those providers who receive prior approval from PSC. Instead, these individuals accept the PSC as sole provider of all direct or indirect medical care. A capitated payment is made to PSC each month for each enrolled beneficiary. Once an individual is enrolled in the PSC program, neither Medicaid nor Medicare will pay any other providers for services rendered. Pharmacy services providers who do not utilize FIRST HEALTH's POS system for claims submission will be at risk for possible claims rejection unless the IVRS is used to verify current Medicaid enrollment information. Questions regarding the PSC program may be directed to the Division of Community Long Term Care at 803-898-2590.
Carson City--Attorney General Brian Sandoval urges businesses that host cigarette vending machines and vending machine owners to prepare early for compliance with SB315, as the new law will be enforced beginning October 1st 2003. The law provides that cigarette vending machines may be placed in a public area only if persons who are under 21 years of age are prohibited from loitering in that area pursuant to NRS 202.030 OR NRS 463.350. Those statutes restrict access by those under 21 at businesses where alcohol is sold and gaming establishments, respectively. Consequently, the law confines cigarette vending machines to "adults only" establishments or "adults only" areas of casinos. "One of the easiest ways for Nevada's children to obtain cigarettes is from vending machines that are accessible to them, " said Sandoval. "SB315 will reduce that possibility. The efforts of this office since 1995 have reduced underage purchase rates by nearly half, and now we'll do even better. The `We Card' effort is nothing less than businesses conscientiously assisting with the protection of our kids when they are beyond direct parental supervision. This is a commonsense next step." Las Vegas area Station Casinos announced yesterday that they are in compliance with the law at each of their properties: "We've clearly designating certain areas of the casino as `adults only' so that our customers will know where children may go, said Lesley Pittman, spokesperson for Station Casinos. "Cigarette vending machines will only be accessible well within these `adults only' areas.
Godsall, R. & Alderson, A. May 2005 ; . "Psychopharmocology." Georgia Psychological Association Annual Meeting. Atlanta, GA. Hagerman H., Jacobs P., Backus D. Dudley GA. 2006. Exercise responses and adaptations in elite rowers and in complete spinal cord injury individuals. Medicine & Science in Sports & Exercise, 38 5 ; : 958 62. Hartley, C. & Pasch, P. November 2006 ; . "Manual muscle testing of the upper extremity." Brenau University. Gainesville, GA. Hill, J.D. & Koerner, C. July 2006 ; . "Stretch to Sit Protocol following Myocutaneous Flap Repair." ASIA Conference. Boston, MA. Hodges, A., Harris, J. L., Lang, J., & Cohen, D. November 2005 ; . "A team approach for GBS." GBS Society Conference. Atlanta, GA. Jones, M.L. September 2006 ; . Neuroscience advances in treatment of spinal cord injury. Research keynote address. Georgia Spinal Cord Injury Summit. Georgia Brain and Spinal Cord Injury Trust Fund Commission, Atlanta, GA. Jones, M.L. January 2006 ; . "An Introduction to Usability." CARF-CCAC International Conference. Tucson, AZ. Jones, M.L., Clesson, I., Leslie, D.P. December 2005 ; . Managing translational research in a clinical setting: Do you have the "right stuff?" Poster presentation at the 1st International Spinal Cord Injury Treatment and Trials Symposium. Hong Kong. Jones, M.L., Mueller, J.L., & Newell, A. August 2005 ; . Promoting User Sensitive Inclusive Design: Strategies for Communicating Users Needs to Designers. Workshop presented at the Accessible Design in the Digital World Conference. Dundee, Scotland. Koval, J. October 2005 ; . "Emotional adjustment issues concerning the spinal cord injury patient." Institute of Continuing Legal Education in Georgia. Atlanta, GA. Kreutz, D.J., & Johnston-Taylor, S. September 2006 ; . "Manual Wheelchairs 101." Medtrade Conference. Atlanta, GA. Macartney-Filgate, M., Bush, S., Macciocchi, S.N., Johnson-Greene, D. 2005 ; . "Incivility and its discontents: Professional conduct in peer review." American Psychological Association. Washington, D.C. Macciocchi, S.N. 2006 ; . "Brain and spine injuries: A common dual diagnosis in severe trauma." Georgia Institute of Continuing Legal Education. Atlanta, GA. Macciocchi, S.N., Seel, R., Thompson, N. 2006 ; . "Brain Injury and Spinal Cord Injury: Impact on Outcome following Rehabilitation." Federal IntraAgency Conference on Traumatic Brain Injury. Bethesda, MD, for example, what is norfloxacin.
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